Good Luck Cat

by Lissa Warren

  —L. M. Montgomery

  As the day of Ting’s surgery approaches, Mom and I are wracked with guilt over what we’re about to put her through. Ting has never spent a night away from us, and we’re afraid she’ll think we’ve abandoned her forever. We’re afraid she’ll be terrified by all the strange people who’ll be touching her—all the strange sights, sounds, and smells. We ask each other again and again whether we’re doing the right thing. Our research has shown us it’s not a surgery that always goes smoothly, and even when it does, there can be huge complications later. The lead can slip off the heart. Scar tissue can form around it, blocking the current, rendering it useless. And, of course, any surgery involving anesthesia has its risks.

  Given how small Ting is, we can’t imagine how someone—even someone as skilled as Dr. Laste, who is kind of a tiny person herself—will be nimble enough to do what needs to be done to her walnut-size heart. I try to calm myself by researching surgery performed on babies in utero, calculating that if heart surgery can be performed on an unborn child, it can surely be performed on a cat of similar size, especially when there’s a lot more space to maneuver. Meanwhile, Mom has located information on a ferret who had a successful pacemaker implantation by a doctor at Tufts University’s Cummings School of Veterinary Medicine. Ting is much bigger than a ferret, we rationalize.

  Still, we keep second-guessing ourselves. The only thing we don’t hesitate over is the cost, steep though it is. We believe animals have as much right to good health care as people do. And it’s a good thing we feel that way, because between the surgery itself, the anesthesia, the pacemaker, the X-rays to make sure it’s positioned properly, the pain medication and antibiotics after, and the stay in the hospital, we’re looking at around $10,000. We’re grateful we have savings, and think of the families who couldn’t afford this for their child, much less their cat.

  The night before the surgery, we don’t sleep. I think back to the night before Dad’s bypass surgery more than a dozen years ago—to the special soap he had to shower with, the sleeping pill they prescribed for him. I think back to Dad’s cardiothoracic surgeon, the aptly named Dr. Payne. I don’t ask Mom if she’s thinking of these things, too, but I’m pretty sure she is. Except for my four years in college—when, truth be told, I called her every day—we’ve lived pretty much the exact same life ever since I was born. We can usually guess what the other is thinking. We can start and finish each other’s sentences. It used to drive Dad nuts.

  On the morning of the surgery, before the sun is even up, Mom and I cajole Ting into her cat carrier and drive the hour to Angell, arriving at 7:30 a.m. The place is already bustling—businesspeople taking their dogs and cats for routine appointments before heading to work; nervous pet parents who brought their dog or cat, rabbit or parakeet, to Angell first thing, after a long, dark night of worry. I’ve taken the day off, but I’m wearing business clothes in the hope that, if I don’t like how Ting is being treated and have to speak up, I’ll at least be taken seriously. It’s silly, really—the doctors at Angell are always respectful, and they treat their patients with so much care. But ever since losing Dad, I always dress for battle.

  We’re ushered into an exam room—a different one than the last time—where we take Ting out of her carrier and take turns kissing her on the forehead before handing her over to one of the nurses, telling her to be brave and that we’ll be right there when she gets out. She’s shaking. She knows where she is and that something bad is about to happen. I’m tempted to wrap her in my sweater and run, but the best thing I can do for her is relinquish.

  We wait dutifully in the “cats” area, drinking too-strong tea from the vending machine, and alternating our trips to the ladies’ room so that one of us is always there should a nurse or doctor come looking for us. We don’t engage in conversation with any of the other cat people, because we don’t want to have to explain that our cat is our entire world, and that, somewhere down the hall, someone is attaching an electrode to her heart—that normally we’d be sympathetic, but today their kitten’s fleas, or infected paw, or runny nose are irrelevant to us. We don’t engage in conversation with each other because at times like these, we can’t be civil—we’re just too tightly wound.

  I have read that this surgery takes sixty to ninety minutes. Almost two hours have gone by. Every time the door to the surgery wing opens, I expect someone to come through it and give us devastating news, like they did with Dad. Finally, Dr. Laste comes out, and as she walks briskly across the lobby she flashes us a double thumbs-up and gives us a giant smile. I bite the inside of my bottom lip in an effort to keep from crying. When she gets to us, I hug her first, then Mom does.

  She tells us all is well, but that it was touch and go for a while—that as she was trying to sew on the lead, Ting’s heart rate dropped precipitously. However, Dr. Laste had anticipated this before the surgery even started, and had placed an external pacing wire through an artery in Ting’s neck just in case a jump was needed before the permanent pacemaker was safely in place. We are thankful for Ting’s cautious doctor. We’re thankful, too, that she feels good about where she placed the pacemaker—just under the skin on Ting’s left side (her “left flank,” as they call it), far enough back so that it won’t affect the use of her front legs, and far enough forward that she’ll still be able to use her hind legs to jump. What’s more, even though she’s fourteen years old, her skin is thick enough that Dr. Laste didn’t have to implant the pacemaker under muscle, which can lead to involuntary spasms, or, worse, in her stomach, which is sometimes the only option, and which, of course, can lead to all kinds of digestive issues.

  Dr. Laste’s description of the surgery is, by necessity, simplified for us. But here’s what actually happened, according to Ting’s medical records:

  Left lateral thoracotomy performed at 6th intercostal space. Pericardium opened and four stay sutures of 4-0 nylon placed to create pericardial sling. Region of left ventricle located that did not have obvious coronary arteries present selected for pacemaker placement. Two interrupted sutures of 4-0 silk placed parallel to one another and used to secure pacemaker electrode in place. Electrode checked for function. Pericardium closed over electrode with 3-0 PDS in simple continuous pattern with 1 cm opening at ventral aspect. 3 cm incision in left dorsal flank. Blunt dissection ventral to incision to create pocket. Pacemaker wire passed through ventral 7th intercostal space and through subcutaneous tissue to left flank incision. Pacemaker attached to lead and secured in subcutaneous pocket with 2-0 nylon dermal interrupted suture. Lavage of thorax. Placement of 8 Fr chest tube. Thorax closed with circumcostal sutures of 0 Surgipro in interrupted pattern. Muscular layers (serratus ventralis, latissimus dorsi) closed in simple continuous pattern of 3-0 PDS. Subcutaneous closure with 3-0 PDS, simple continuous pattern. Skin closed with 3-0 nylon in Ford interlocking pattern. Incision over pacemaker closed with subcutaneous 3-0 PDS simple continuous. Skin closed with 3-0 nylon in Ford interlocking pattern. Chest tube secured with purse string and finger-trap of 2-0 nylon.

  And all of this takes place in about eight pounds’ worth of space.

  Dr. Laste walks us back to the recovery room. Ting is laid out on a table on top of several blankets, a critical care nurse standing beside her. Her eyes are completely open, but she’s still pretty out of it due to the anesthesia. Occasionally she tries to lift her head, but it’s clear the effort depletes her. The fur has been shaved off one side of her neck, her chest, and her abdomen, and above her left front paw. A row of sloppy stitches pokes out from the gauze.

  “I’m sorry they’re not neater,” says Dr. Laste. “We rushed to close so we could bring her out of sedation.” Ting has a drainage tube in her chest, an IV in her front leg, and an oxygen mask on her face. I can’t help but think of Dad—how he looked in his last hours.

  We’re shown back out to the waiting area and told we can see Ting again in a few hours, after the anesthesia has worn off and they’ve gotten her settled in her
cage. We’re not hungry, but we want to keep our strength up because we know these next few days will be tough. We’re afraid to leave the hospital in case Ting takes a turn for the worse, so Mom goes to the front desk and asks the receptionist if they know of a place that delivers. They do, of course—even furnish us with a menu. Forty-five minutes later we’re eating Caesar salad wraps and drinking fresh-squeezed lemonade.

  I feel guilty enjoying a meal while Ting is all alone, and probably scared, and possibly in pain, even though they have a pain management specialist on staff who’ll be monitoring her closely. I feel guilty about a lot of things lately—almost everything, really. It seems wrong to eat a sandwich when Dad doesn’t get to. It seems wrong to take a Saturday-afternoon nap, wrong to drink hot chocolate (even just the instant kind), wrong to spend an hour reading the Boston Sunday Globe, wrong to play a game of Scrabble. In short, it seems wrong to do anything he’d have liked doing.

  I know Mom feels it too, because there are things we just don’t do anymore—and we don’t discuss not doing them. Most noticeably, we avoid going to the Chinese restaurant where Dad took us every Friday night—the one in the nearby strip mall with the all-you-can-eat buffet; the one Dad used to call the Panda Palace, even though that wasn’t its name; the one where the waitresses just waved us in because they knew which booth we’d sit at, and that we didn’t need menus. I missed being a regular. I missed hanging out with my dad. I missed the predictable path his meal would take—hot and sour soup; chicken and broccoli over rice; a crab rangoon or egg roll if Mom wasn’t looking (a pan-seared pot sticker if she was); a sparerib or two if he was in the mood to withstand a lecture from me on the intellectual similarities between pigs and canines.

  I had started to process the fact that half my safety net had disappeared when Dad died, but I was still struggling with the small, subtle ways a death in the family changes things—how it alters daily routines and makes everything good fair game for guilt. My one comfort was that Dad didn’t have to go through all of this drama with Ting. I’m not sure he could have hacked it; I wouldn’t have wanted him to have to.

  As the start of visiting hours approaches, the lobby begins to get full. Finally, a woman with a clipboard comes out and begins to read off names: Smokey, Peanut, Samson, Chloé. After what seems like ages she calls Ting-Pei, and we’re escorted back to see her, our heels clicking on the floor. They’ve situated her at the end of a row in an oxygen chamber—not because she needs constant oxygen, but because it’s quieter and more out of the way. Thoughtful of them.

  Still, Ting seems miserable. She’s hiding under a thin white towel they’ve left with her for just that purpose (her pale-yellow one remains with us so that it doesn’t get lost), because we’ve told them she’s a burrower. When we unlatch the door the white towel starts to shake. I inch it back from her face so she can see it’s just us, and when she does, she lets out a volume-ten yowl that makes the other families look up from their own pets.

  The fur around Ting’s eyes is slightly matted from the ointment they put in to keep them moist during surgery. It’s all too familiar. Mom takes a tissue from her purse and starts to clean Ting’s face, while I stroke the top of her head—the only part of her I’m certain won’t be sore. After a couple of minutes Ting tries to stand up, but the IV in her front leg and the gauze that’s wrapped around it makes it impossible to balance, and she rolls back onto her side, which is also thoroughly wrapped in gauze and thankfully doesn’t look to be seeping.

  According to her chart she’s getting three different kinds of pain medication: Hydromorphone (a form of morphine) through her IV, 15 milligrams of Gabapentin (used to relieve nerve pain) by mouth three times a day, and constant Fentanyl from a patch. We’re confident she’s as comfortable as she can possibly be, but we’re pretty sure that’s not too comfortable.

  She tolerates us petting her for a while, but there’s no purring, and we can tell she’s exhausted. Mom tucks the towel around her and, as quietly as possible, I close the door and latch it. Soon she settles down and falls asleep. We stand there watching her until visiting hours end.

  Chapter Sixteen

  Homecoming Again

  The cat does not offer services. The cat offers itself. Of course he wants care and shelter. You don’t buy love for nothing.

  —William S. Burroughs

  There’s a lot more love in a house when there’s a cat. Ting has to stay at Angell for almost a week, and the place is quiet and strange without her. And Dad is deader, somehow, when Ting’s not around.

  Mom and I go to visiting hours each day—me leaving work early to get there, Mom driving down from home. We come to know some of the other animals at Angell and what they’re there for. There’s a Great Dane around the corner from Ting who is undergoing chemo for lung cancer. The nurses have put a soft mat down on the floor of his closet-size cage, and when his people visit, they lie right down and curl up next to him. They only get up when the oncologist stops by to give them a progress report. The cancer sounds formidable, but they seem hopeful.

  We become friends with an impeccably dressed woman named Pilar whose Cavalier King Charles Spaniel, Penelope, had spinal surgery around the same time Ting had her pacemaker implanted. Penelope’s cage is below and just to the right of Ting’s. Like us, Pilar never misses visiting hours. And, like us, her pet’s recovery is going more slowly than expected. Penelope still can’t use her back legs. Pilar is sturdy, like Hemingway’s boat—for which she was or wasn’t named (I never get the chance to ask)—and we know that, when she finally gets to take Penny home, she’ll carry her upstairs if Penny can’t get there under her own power. Still, we hope it doesn’t come to that. For Penny’s sake, and for Pilar’s, we want to see Penny walk.

  As the week goes on, we become increasingly concerned. Ting’s not eating. She’s not drinking. With little going in, nothing’s coming out. We bring her her own food from home, but she shows absolutely no interest. The nurses try everything from tuna to Meow Mix, which they tell us is pretty much crack for cats. Ting turns her nose up at it. Though they haven’t even mentioned it yet, we’re afraid they’re going to have to resort to a feeding tube. We don’t know if it’d mean a tube down her nose or a tube in her side, and we’re too afraid to ask. Either way, we want to avoid it. Our cat has been through enough.

  Ting is losing weight by the day, and Mom and I agree that what she needs is to come home—to get back to familiar surroundings and her usual routine. To get back to her people. We talk with Dr. Laste, who says it’s worth a try, and lets us sign her out. A usually silent passenger, Ting gives us an earful the entire ride back to New Hampshire—all along Storrow Drive, straight up 93, and onto bumpy Pond Street, where, just briefly, she’s jostled into silence.

  Her first days at home are a blur. Normally we pick her up without thinking—left hand under her chest, right hand supporting her back legs—and, in one smooth motion, tuck her body against ours. It was as natural for us as breathing. But now we’re oddly tentative, afraid we’re going to jostle the pacemaker somehow and hurt her. She senses our hesitance, and tenses when we approach.

  Wanting to sleep next to her but afraid she might fall off the bed, we take turns sleeping on the floor beside her—positioned so that, if she tries to get up, one of us will know it. Each morning, she steps into her litter box and sits there, confused. After a few minutes, she paws at nothing—dainty habit—and stumbles out. She’s not grooming herself at all, and grooming is the sign of a happy, healthy cat. Her fur is starting to get matted in places, so Mom and I tear up one of my old T-shirts, wet the strips slightly with lukewarm tap water, and take turns bathing her in long, languid strokes, just like her cat mother would have done, in the hope it’ll somehow seem familiar.

  When we hold a glass of water up to her, Ting laps a little bit, but she’s still not eating. We keep dry food in her bowl at all times, just in case, but each morning we end up dumping it in the toilet and replacing it with fresh. I set Ting on ou
r bathroom scale to try to gauge her weight, but she won’t stay on it—won’t stand still. I pick her up in my arms, step on the scale, and subtract a hundred pounds. It leaves me with just over six. She’s lost almost two pounds.

  Desperate, we call Dr. Belden for advice. She recommends we swaddle Ting in a towel and force-feed her canned cat food using a syringe—squirt it right down her throat, around the clock, every two hours. Mom goes to Bulger to get the syringe and some special high-nutrient cat food. When she gets home, we take turns trying to feed Ting, but it doesn’t work any better than it sounds like it’ll work. Even though she’s weak, Ting fights us tooth and nail. The cat food gets in my hair and underneath my fingernails. Mom ends up wearing more of it than Ting ingests. But we keep trying. We set every alarm we have so that every two hours, something goes off.

  Back when Ting first started wearing the heart monitor, we moved her kitty bed from its usual spot on top of Dad’s armoire to the top of Mom’s dresser, which was quite a bit lower. Because she’s not yet strong enough to hop up and sleep in it, we decide to construct an elaborate tepee for her to rest in. I drag the clothes rack from the basement and splay it open beside the orange chair in Mom’s room, draping it with a couple of towels. Mom tests each of the pillows on her bed, then sets the softest one on the floor of the tent. Gingerly I set Ting in. She stays and, minutes later, we hear her snoring. We check her more often than we should, to make sure she’s still alive.

  Ting-Pei has become a team effort, more than ever before. If Mom and I feel like squabbling in that very special way that mothers and daughters do, we have no choice but to bury the hatchet. We have a cat who needs us. If we want to take our grief out on each other, we can’t; we need each other too much, and Ting needs us to work together.

  We’re desperate to help Ting get better, so we take to the Internet for ideas. We come across a Scientific American article by a professor at the UC Davis School of Veterinary Medicine who explains that cats purr at a frequency between 25 and 150 hertz, and that frequencies in this range have been shown to increase bone density and encourage healing—in the animal as well as the human. It sounds a little woo-woo to us, but we figure, what the hell, and make a chart on which we can track the ten five-minute “purring sessions” per day that we’ve assigned ourselves. We use a combination of kisses, brushes, scratches, and rubs to elicit the desired sound, and Ting is more than compliant. I catch myself wondering if this will help Mom’s osteoporosis, too.