No way to say goodbye

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A few years ago I wrote a short piece about how I think resilience works to add positive dimensions to my life. A couple of years later, I then chose it as my mot de l’année (fancy for ‘word of the year’!), blithely enthusing that I felt that it provided me with a framework that encapsulated both mental and physical robustness and, with that, the tools to bounce back from whatever came my way.

Such naïveté only works until the universe provides a reminder that all things are relative. As it turns out, resilience, like so many things, is subjective. Circumstances change, curved balls come one’s way and, sometimes, there simply isn’t enough fuel in the tank (aka strength or fortitude stockpiled) to manage the particular realities of the here-and-now. Who knew?

In our case, just as things were ramping up for the jollifications of the festive season, an uber-grinch leapt out of the woodwork at us. One evening in early December we noticed that our otherwise seemingly perfectly healthy MissMolly had a very swollen belly. She’d inhaled her dinner at her usual speedy rate, so our first panicked thought was, as ever: bloat – that background horror-concern for anyone with a deep-chested dog.

We bundled her into the car and off to the veterinary emergency service, where she was seen very promptly – jumping the queue due to the possibility of bloat. After and examination, an abdominal scan and blood tests, the duty-vet confirmed it was NOT the dreaded bloat. Yay. However, as MM did have a large volume of what was referred as ‘free fluid’ in her abdomen, she was to stay overnight stay for observation and to wait on some remaining test results.

The what and why of the abdominal fluid remained a mystery the next day when we went to pick her up. The duty-vets said they weren’t keen to do anything about the fluid build up as it really required further investigation by a specialist vet. They said we should keep MM calm and quiet (!) and see our own vet for a specialist referral after that weekend. Less yay. More worry.

In due course we secured both a referral and the first available appointment at the only specialist vet service prepared to take on an outpatient case for comprehensive chest and abdominal scans at short notice. After a long and worrying wait at Animalius, a somber-faced vet came through to give us a diagnosis. She told us that MM had a classic case of end stage liver failure, that her liver was not able to function properly and that we had to prepare ourselves for the reality that our girl had weeks left, perhaps a bit longer. There was no point in more tests, she said, as they would only distress Molls; there was nothing to be done other than see our own vet about a palliative care treatment plan.

What? How could we – and Dr Kelly – have missed this? It was incomprehensible.

In the days that followed, Kelly reviewed all Molly’s records – even calling on a colleague to double check, and found no clinical signs of compromised liver function. MM endured our desperate scramble to try to prove it to be not true. We tried everything and anything: diuretics, pain relief, anti-inflammatories, a special diet, reduced activity. She’d seem to rally for a few days, trying to play, snuggling and being close, and our hopes would climb – only to be dashed. As the month progressed, we could see her gradually fading away in front of us – frightened and confused by the pain in her gut as her wretched liver failed her – but trying so hard to play and just be herself.

We said our final goodbyes to MissMolly just before New Year, sitting with her as she faded out of life. To say that we’ve missed our crazy, excitable, noisy, loving, talkative, space-invading girl every single day since then is putting it mildly. She was the most people-oriented and joy-filled hound ever, having absolutely no concept of personal space, curling up next to us everywhere and anywhere. Her endless enthusiasm and energy was infectious – and its absence is hard to bear.

Rudyard Kipling, a favourite of my father’s, wrote any number of poems, many of which were read to us as children. Whilst most have held little appeal or relevance in my life, some – oh, some – really can hit home at times. And losing a beloved friend is definitely one of those times.

I have done mostly what most men do and pushed it out of my mind;
But I can’t forget, if I wanted to, Four-Feet trotting behind.
Day after day, the whole day through , wherever my road inclined —
Four-feet said, “I am coming with you!” and trotted along behind.
Now I must go by some other round, which I shall never find —
Somewhere that does not carry the sound
Of Four-Feet trotting behind.

Goodbye, MissMolly – we love you and will always remember you and your four great big feet – they have left indelible paw prints on our hearts.

Our Molly

Forgetting to remember

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What is it that makes us who we are?

It’s often argued that the self is socially constructed, developed through the interconnectedness of the various aspects of the society in which we function. More specifically, the self could be seen as a complicated jigsaw puzzle of how we’re parented, our schooling, our social interaction with family and friends, and all our other life experiences.

But what happens if pieces of the puzzle that’s been created start to disappear? Are we still ourselves if we forget some of the bits that make us who we are?

What’s brought this to mind is my dear friend Mil. For a while she’s been getting more and more forgetful. But until fairly recently she just found it an inconvenience, something that could be considered an inevitable consequence of ageing. It was mostly variations on a theme of oh-dear-where-have-I put-xxx and not a cause for undue concern, she thought, considering that we all do that sort of thing sometimes.

Then suddenly great big gaps in her memory started to appear, seemingly overnight. The gaps seem random – her birthday party a couple of months ago, visitors from overseas last year, a tragic death in the family a few years before that, her youngest son and his family coming to stay last Xmas and a number of short-term gaps as well. Most worrying is that, despite visits to the hospital, consulting a neurologist and all manner of tests and scans, there appears to be no specific or discernible reason for it.  So there’s no clear diagnosis, just a great deal of confusion and worry.

Talking to her, I’ve realised that Mil feels as though she could wake up on any given morning and another little chunk of what makes her herself might be gone. Another memory – big or small – could have disappeared and, until told otherwise by family or friends, it will be as though the event never happened.

More frightening than the actual memory loss, she says, is the randomness of it all. For someone accustomed to being in control of her life, to planning events and taking an active interest in the world around her, who values logic very highly, this is a very scary place for Mil to find herself.

No matter how much I think about the situation or read up on memory loss, I find that I end up with more questions than answers. What does one do when events, days and years start to fizzle and disappear?

Standard advice seems to be to plan ahead once a diagnosis is obtained. This includes legal, financial and health planning. But the path to diagnosis, to discovering choices and to possible treatment seems to take so very long.

Starting to keep a journal seems to have helped. Mil’s found that simply making a note of things as they happen or writing down how she’s feeling on any given day provides her with reference points. When she pages back, even if she’s forgotten the events, she feels she can trust the words on the pages. She can see that she’s written them, even if she can’t remember having done so, and that distinction makes a big difference to her.

I find that this puts my years of intermittent journaling into a new perspective for me. Perhaps I’ve always been writing for a future me, providing myself with trustworthy breadcrumbs back to a past I’ll very possibly forget one day.

Perhaps it’s something we could all consider doing. That, and making sure that every year we have is as good a year as we can make it.

Loss and guilt

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The harsh reality of having a pet in one’s life is that they will almost certainly die before you do. I am told that dogs – my preferred household pet – sometimes live up to 19 or 20 years and can be hale and hearty for most of their lifespan. My experience, however, has been that 10 years is the best that one can realistically hope for. This indicates a clear need for acceptance and understanding of this outcome from the start in order to minimise emotional upsets further down the track.

Advice of that sort sounds sensible and is easy enough to give, although implementation can be a tad more problematic. What seems to happen in my case is that pets come into my life, become part of my family and that I give little thought to their possible or probable demise. I/we feed them, walk them, take them with us to the beach and on holidays, make sure they have regular checkups at the vet and that they get their inoculations on time. In short, we simply live our lives and enjoy the companionship they provide.

In due course, however, some or other event catches up with us and brings home the stark reality of their relatively short lifespan. In every case this has left me saddened and – in some cases – quite bereft. Looking back across my life, I remember each of my furry buddies – and the gap they left when they died. Time eases the ache and new furry friends come into our lives, but I’ve found that it’s impossible to simply replace a friend with another friend.
nuschka2_3nov14
Most recently Nuschka came to us. She was two years old, seemed fit and healthy and was in need of a secure home. We all thought she’d be with us for a long time to come and incorporated her into the family post haste.  In the yearn that followed we had a lot of fun together, but there was also a good deal of dog stress – low levels at first, but mounting over time to quite significant proportions. After months of her suffering chronic diarrhoea, numerous vet visits and all manner of investigations, we agreed to a procedure called a fecal microbiota transplantation (FMT) for her in mid-December. Essentially this involved surgical intervention to empty her intestine and bowel and to then repopulate them with healthy bacteria. At the same time biopsies of her gut and intestine could be done in order to eliminate cancers as a possible reason for her ill health and to establish whether there were any other issues.

We brought her home after her surgery and, although she was clearly happy to be at home and pleased to see us, after a week she had lost weight, was vomiting and dehydrated. Despite  calming words from the vet, we rushed her back to the surgery at 3am on Christmas Eve. The week that followed was spent waiting. We waited to hear from the vet each day – and each day brought no new plan, no improvement and no clear idea of any resolution. The biopsies had shown that she had both inflammatory bowel disease, as suspected, as well as lymphangiectasia – a chronic and pathologic dilation of the lymph vessels.

We finally ran out of options just before New Year.  The surgery was very busy when I got there to see her and we ended up sitting together in a back room, my Nuschka and I, until our turn came. She was so happy to see me, her great plume of a tail swishing back and forth as she sniffed me and licked my hands and face. We sat there for four hours, cuddled up on the floor, my hand compulsively stroking her as I talked to her. I think I even dozed off with her at one point.

In due course the vet came back to give the lethal injection via Nuschka’s intravenous drip, after which we just sat with her as her life slowly ebbed away – and then for a while longer, chatting quietly about dogs and loss and life. This was the final thing I could do for my girl – to be there and take responsibility for my decision to end her life. Even though the decision was certainly in her best interests, I could not leave the implementation completely in the hands of others. She was my responsibility, not theirs.

It’s hard to sit by and watch a beloved family member fade away – but it is much harder to watch them suffer, particularly when there is an alternative. By the time I got home I thought I was all cried out – but I was wrong, apparently. Dear Nuschk – what a damn shame it ended up this way.

Finding the right words

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I must admit that I’ve never actually thought ‘there must be a German word for that’ – but that changed when I came across a copy of a highly entertaining book by Ben Schott this weekend. Courtesy of Schottenfreude I suddenly have words for a range of weird and unusual situations – and feel almost sure that there’s a word for being happy about that too. Amongst my favourites in the book is entlistungsfreude (the satisfaction achieved by crossing things off lists). Although this does bring strange little Miss Hawkins in A Five Year Sentence (Bernice Rubens) to mind and make me feel mildly anxious about the times that I write things onto lists just in order cross them off… But we’ve all done that, right?

Last Friday I really needed a word to encapsulate that moment when the world slips out from under you – and now I have leertretung (pronounced lair-treh-toong). Schott’s definition of this is to step down heavily on a step that isn’t there or, even more appropriately, void-stepping – which fits the bill perfectly.

It turned out to be quite a void-stepping sort of day, starting with the moment I clambered down my little kitchen ladder onto a step that wasn’t there. Technically it was actually there, I just managed to navigate right past it and indulge in a quick leertretung to get my heart rate up. Schott probably has a word for the sound I made as I hurtled to the ground – and for the one I made when I landed with a thud loud enough to bring the dog running, but I haven’t found them yet. I do know the Anglo-Saxon equivalents, though, and that’s probably good enough for all practical purposes.

Having fended off the worried dog and rejected her friendly are-you-okay face-licks, I pulled myself together in time to field a call from my mother-in-law. The news was that her lovely daughter was finally about to lose her battle against stage IV melanoma. She told me that Aj was fading fast and it would very probably be her last day with us. I don’t recall putting the phone down or walking to my study or dropping onto my desk chair to gaze vacantly and tearfully out the window, but that’s where I found myself a little while later.

We all provided what support we could throughout the day/evening, but there was really nothing anyone could do and Aj passed away at home on Friday night with her family nearby.

Is there a German word for coping with a sudden unexpected surge of sadness? Would knowing it make me feel any better about the loss of this vibrant, quirky young woman who has fought the melanoma monster so valiantly for the past two years? I think not. But knowing it might distract me for a brief moment. Perhaps void-stepping is descriptive enough, encompassing that feeling of disorientation and unexpected panic when the thing one expects to be there (a step, a family member) simply isn’t.

My heart aches for the loss this family is enduring. Aj was a wife, a mother, a daughter, a sister, a friend. As a mother myself, I can only begin to imagine the complex layers of sadness, pain and regret at the loss of a child. They remain our kids even when they’re all grown up and have families of their own – and it defies logic for them to die before we do. I don’t have the right words – or enough words – to express this kind of sadness.