 My friend Dawn was the caregiver for her mother. Dawn’s Mom had cancer and was slowly dying, and it worried Dawn to no end how and when her Mom would pass. Each morning she would tread towards her Mom’s bedroom and check her pulse to see if she was still alive. Dawn’s Mom was a playful person who would open her eyes and shout, “I’m still alive, honey! You’ll know when I am ready to leave. I will send you a sign.” Several months into this morning exchange, Dawn left the house to go to the pharmacy. She never left her Mom alone, but needed to pick up pain medication that her Mom desperately required. While driving back home, Dawn turned on the radio in her car and heard Tom Jones sing the “Green Green Grass of Home”. It was then that her fear disappeared, for this was her mother’s favorite song. Dawn was filled with deep calm as she placed her key in the front door, opened it up and saw her Mom on the sofa, eyes closed with a smile upon her face. “I never realized that death could be so peaceful,” Dawn remarked. “My Mom said she would send me a sign and that song was it. My Mom loved Tom Jones so much and was one of those women who went to his concerts and threw her panties on the stage. But his song about returning home and being lain underneath the old oak tree in the green, green grass of home told me that my Mom was perfectly fine. And now I am, too.” I had forgotten this story until recently. My husband Freddy and I owned a dog named Roxie. She was one of a pack of dogs, and she didn’t seek to be the star of the group. But she was so feisty and would stand up to anyone who threatened the others; she was small, but mighty. We had no idea how old she was, because we rescued her from an abusive situation and the vet couldn’t discern her age when we got her years back. In the middle of this September, Roxie developed a round, hard belly. We took her to the vet and an X-ray revealed that there was a mass inside of her, but the vet couldn’t figure out what was the cause of this new growth. We were offered an abdominal ultrasound and biopsy to the tune of $900, and declined to look further. After all, Roxie was old and we didn’t want her to undergo probing and prodding, given that she was so happy and still wrestling with the other dogs.  Whatever was in Roxie’s belly grew rapidly. It became hard to watch her body expand, while her extremities became thin as her abdomen quadrupled in size. I was glad that doggies don’t look at themselves in mirrors, because it seemed that Roxie had no awareness that she was so misshapen. Yet when she stopped eating, Freddy and I knew that it was time to take her to the vet and put her down.
We carried her into the vet’s office and were immediately ushered into a private room. Freddy cradled Roxie as the worker told us what would happen next. This wasn’t our first rodeo in this department, but choosing to end the life of a pet always comes with a unique sense of loss. While we knew it was time for Roxie to leave us, and the workers assured us that we were doing the kindest thing for our baby, it was still a terrible sensation. There is a lining that surrounds the hearts of human and animals and it is called the pericardium. Losing a beloved pet feels to me as though that lining of the heart is being peeled away. But something was distinctly different about this day at the vet for us and for Roxie. First, we never had to endure sitting in the waiting room, with all the other dogs and happy owners who were there. Secondly, the kind workers in the office took Roxie into the back room to sedate her so she wasn’t afraid. They also inserted a catheter that went straight to her little heart, so that when she was ready to fall asleep, they wouldn’t have to poke her while looking for a vein. (I’ve watched that happen with one of my other dogs and the vet couldn’t find a vein, while the doggie was in agony and needed more expeditious help). Lastly, they wrapped Roxie in a blanket and nestled her back into Freddy’s arms. The workers gave us a little button (it looked like a doorbell), and told us to take as much time as we needed alone with Roxie until we were ready for the vet to come in and give her the injection. All manner of thoughts went through our minds. We wept and shared memories of her strength and tenacity as she looked at the both of us in wonder. When it was time, I pressed the button. A lovely vet entered the room. She crept behind Freddy’s chair and attached a syringe to the catheter on the dog as her owner held her close. Roxie’s heart stopped beating and she fell sound asleep at last. We were then told to take our time and press the button again when we were ready to leave the building and say goodbye for good. When we did, another worker took Roxie from Freddy and carried her away, still wrapped in a blanket. I’ve never seen the death of any creature, human or animal, handled with such grace. Most of the time, animals are placed on a stainless steel table for the End Of Life moment and the humans must crouch down to look at their faces and touch them. This was the first time I have ever witnessed the animal being wrapped in a blanket and held by the human who was the one who loved her best. It was also the first time that I observed the vet’s presence in the room as stealthy and deft – that vet was like a little ninja who crept about and allowed us to mourn without interference. And finally, Roxie was not left alone on the stainless steel table, but was carried away by a person. Everything about this day of letting go of Roxie reminds me of Dawn and her Mom. Dawn had feared the loss of her mother for so long, she had tried to anticipate the loss before it happened, she had checked on her Mom each morning to see if she were still alive. It wasn’t until she left the house and surrendered control of the situation that she heard the “Green Green Grass of Home”. I suppose what we fear most about death is surrendering control. I am reminded of how scary that is, but from this day with Roxie, I also have respect for this surrender. This respect was possible because of the manner in which Roxie died. She was held by Freddy in a blanket with few other people around to confuse her. There was no stainless steel table, no long explanations from the staff, just a seamless attachment of a syringe to a catheter, followed by deep rest for Roxie. I know the feeling that Dawn had when she came home to find her Mom in deep rest on the sofa. She was no longer afraid. Whenever I think of Roxie now, I recall the words of that poignant song by Tom Jones…”Yes, they’ll all come to see me in the shade of that old oak tree, as they lay me ‘neath the green green grass of home.”
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I like living with Freddy. When I was a younger pup, I used to sit in his living room and wait for him to come home. Freddy worked a lot back then. He left me alone each morning, but I kept myself busy. He bought me a black leather sofa and the sun streamed through the windows of the living room. There were little specks of dust in the sunshine and I used to leap up to catch them in my mouth. I can’t jump anymore, because I am twelve years old. But I remember when I could. Freddy had a black box and out of it came vibrations that soothed me while he was gone. He called it “spa music” and he turned it on before leaving each morning. After the sun went down and there were no more specks in the sun to catch, I waited by the door for Freddy to come back. It was that time of day when I knew how much he needed me. He crouched down and kissed my head and told me that I was the best girl ever.
The years flew by. I began to get some pain in my hind legs. Freddy was going to get me surgery on something called my “ACL” but I got so angry in the surgeon’s office that he decided against it. I learned how to keep walking on my back legs, but my left one hurt a lot when it rained or snowed. Freddy brought me to a very kind doctor (a man, thank goodness), who gave me little white pills in a beef flavored snack. This helped my pain and I was still able to climb stairs for a long time. Then, things started to change. I got nervous when Freddy began putting all our things into boxes. He even got rid of my black leather sofa. I became quite angry with him. I turned my butt in his direction while more and more items left our home. But every night I forgot to be angry when Freddy lifted me up on his bed. The woman with the pale hair was also with us. This woman seemed less sad than she used to be. Both Freddy and the woman talked about a place called Florida. Were we going someplace else? Why hadn’t they consulted me? I didn’t want to go to Florida! One day, Freddy lifted me into his truck. I like rides. But this one felt different. Freddy sat in the front of the truck and held a round wheel. The woman with the pale hair sat next to him. I sat in the back seat and felt very confused. This trip was taking a very long time. I began to notice the vibration of the truck. I didn’t like it. My back legs started hurting. I began to gasp from the pain and Freddy stopped the truck and gave me the white pills in the beef flavored snack. He even put on the “spa music” because he knew I liked it.  The trip continued. Freddy pulled the truck over. He knew not to bring me into a motel. I hate motels. The carpets and the sheets smell like strong chemicals. This makes it so I cannot breathe right. We stayed in Freddy’s truck and there were lights overhead. Next to us were other long trucks. The air was hot. Freddy played the “spa music” as we all tried to sleep. But I couldn’t sleep. The woman with the pale hair couldn’t either. She looked back at me every so often. She was worried about something big. Freddy woke up and the vibration of his truck started again. The trip wouldn’t end. It was taking too long. I started to have more pain in my legs and couldn’t breathe. Freddy kept stopping and putting me on the ground but it smelled totally different. There was mold everywhere. There were different plants on the ground. I kept hearing the word Florida and knew that we were here. But if we were here, why did we have to get back in the truck to keep traveling? And what did Freddy and the woman like about Florida? I was feeling worse with each moment. Why couldn’t we all go back to the black leather sofa with the specks inside the sunshine through the window? It was then that I peed all over Freddy’s truck.
My legs no longer hurt me. My body settled into the black leather like the shape my body had made in the sofa from Freddy’s house. I no longer minded the idea of Florida at all! This was a beautiful place…except that Freddy wasn’t part of what was happening now. He wasn’t part of the sunshine and the specks of dust. He couldn’t see that I could jump again.
I didn’t know what to do. I had to make a choice. I’ve always put Freddy first, always taken care of him and have always been his best girl. How could I possibly leave him alone? What would he do without me? I tried to focus on the hurt in my legs and my difficulty breathing, but I knew I couldn’t stay with him. I remembered the smell of my father when I was a pup. I remembered going to Freddy’s house for the first time. And then I knew what to do. I nuzzled my snout against the elbow of the woman with the pale hair. I spoke quietly, so that only she could hear me. “Tell Freddy that I have to go someplace now. I wish I didn’t have to. He isn’t going to do well without me. But you know how to take care of him like I do. I want you to tell him I am worth crying for, and he will cry every day for a really long time. Also, I don’t like girls, but you’ll do in this case.” The woman nodded. She placed her hand on the top of my head and I closed my eyes. I let out a very long sigh. The Florida sky led me right to where I am going to stay forever. I’ll be waiting at Freddy’s door. It was twelve years ago when I was working in a physical therapy clinic and met a woman named Joan. She was coming for treatment because she had received surgery to her spine for lumbar stenosis. Joan was accompanied by her daughter, Elisa, and this duo of women was extremely entertaining. We laughed so hard during our first few sessions together that after the third session, Joan’s daughter Elisa asked, “Can we be friends?” It was an unusual question posed by one adult to another. Grown-ups speak in the world of nuance. When adults meet like-minded souls, they find ways to keep the connection going via joint activities of their children or following each other on social media. Yet Elisa, the daughter of my patient Joan, had cut right to the chase. Much like children do. She asked me directly if she could be my friend and if I could be hers. I responded to Elisa back then by telling her, “I’m kind of short on friends right now. Yes, we can be friends.” Fast forward many years later to the present. Elisa and I are roommates and best friends. Her mother Joan died several years ago, and I have become so close to the family that I mourned her death just as much as her own daughter did. Elisa was a superb caregiver for her mother and I helped as much as I could to ease the burden for both women. It is hard to watch loved ones lose their memories, their ability to care for themselves. Yet somehow, and with unwavering bravery, Elisa watched her mother’s decline until her heart stopped beating. It wasn’t until the year of 2020 that I needed a caregiver for myself. I was living with terrible low back pain and discovered that I required a lumbar surgery with screws and rods. I didn’t want to hear this news; but it was Elisa, my best friend, who pushed me to pursue it. This surgery was accompanied by a three-month recovery period, where the patient (me), would be unable to bend at the waist, twist the spine, or lift any object greater than 10 pounds. That sounded impossible to me. How many times does anyone bend at the waist to reach for an object during a given day? How often do we twist our spines to reach for cell phone in our purses? Elisa dropped me off for my surgery on a frosty morning in December. I tried not to look at her as I got out of the car, for I knew how concerned she was. I was going to do this alone and I didn’t want to put my fear upon anyone else. Little did I know what I was up against. Anyone who has gone through major surgery knows just how awfully vulnerable it feels to be naked in a hospital gown, awaiting anesthesia and the deep sleep which precedes what is a violent assault to the human body. I spent three nights in the hospital. Elisa came to visit on the second afternoon, bearing chicken shawarma from a local Middle Eastern venue. I didn’t eat the food, because my pain was rising to an astonishing degree. I saw visions of Dante’s Inferno, the fiery depths of hell, as I prayed for relief from what is commonly referred to as “post-surgical pain”. It finally stopped, this hellacious discomfort, and I was able to go home.
For several weeks thereafter, I was unable to dress, turn on the water for a shower or prepare meals for myself. Elisa was the person who adjusted the water temperature so that I wouldn’t have to bend down to get to the faucets in the bathtub. Elisa was the person who made absurd amounts of food for me to eat (though because she is Italian, and she never thought the portions and variety of the food to be absurd), she made sure that the food was always on the top shelf of the refrigerator so that I could reach it, and she placed everything that I needed during the day on a small table with wheels so that I wouldn’t bend or twist my spine. Laverne the dog watched over me like a lioness. I was her cub, I was weak and I needed the care of a child. It was a very strange time. I have been a caregiver for my entire life. And at age 45, I needed to be cared for. It felt demoralizing. I couldn’t don pants or socks by myself, and it was a cold winter. I remember asking Elisa, the human, if she could help me change clothing before she left the house for a few hours. “Do you have time to change me?” I requested. Elisa laughed and replied, “Of course!” She then returned me to the sofa and the dog Laverne nestled her body close to me, though as never to cause pain.  Something strange occurred as time passed and Old Man Winter unfurled his steely presence in the Northeast. About one month after my surgery, my mind began to go down different paths. These were imaginary foothills, remarkable lands that I hadn’t traversed since childhood. I spent hours day dreaming, I stared at the falling snow, the grey skies shape shifted like the fingers of God in soft putty.
Elisa continued to care for me, with unerring grace and hilarity. She never missed a beat. Even when I was ornery and obnoxious, she made chicken seared in oil with garlic and hot sauce, she laundered my clothing and cleaned the house to spotlessness, and she made certain that I would not bend down to set the water temperature in the shower. (Even when I wanted to and told her that I was bending down correctly, that I am a physical therapist who knows what she is doing and that I do not need help from her anymore!). What I realized through the time of being on the flip side of caregiving is that it is really quite illuminating. It can return the patient to feeling like a child, in all of the wonderful ways that we associate with childhood. A child does not have to plan meals, or shop for the ingredients of food. The child is simply fed lunch. Whether it is delicious or not (mine always is), the lunch is the lunch. The adult must plan accordingly to make this happen. The child simply eats the food. When the snow falls outside, the adult must shovel, buy salt for the steps and ensure that everything is in the house in case of a blizzard. The child has none of these concerns. The child sees only the magic of snowfall, the anticipation of a day off of school and the potential for igloo or snowperson building. In some ways, it is really nice to be a child. It is even nicer to experience this as a 45-year-old adult. I was afforded this because of my caregivers. Elisa provided a safe haven for my recovery in terms of doing basic life tasks for me. The dog Laverne sensed my weakness and gave to me what makes dogs famous, their ability to look within humans and say, in no uncertain terms, “I love you. I will not allow anything to harm you. I will do anything to help you feel better.” In all of my years of caring for others, it has taken this surgery to show me what caring for others really means. To be a caregiver means that you will buy groceries when you are tired and have worked all day, you will prepare food for someone when they are not always appreciative, you will put pants on someone when they are moaning in pain, you will shovel snow in biting cold while the person you are caring for is marveling at the wonder of snow, and you will have to plan your entire day around that person’s shower. And that is impossibly annoying! Yet as a caregiver, you are also doing something amazing. You are allowing the person whom you are caring for to return to childhood. I am now able to dress and bathe myself, though I still don’t like grocery shopping or cooking. Elisa the human still does an excellent job taking care of the household and I can pull my weight. Laverne the dog knows that I am stronger, though she still glances at me with concern when I overdo things. I have very little pain after my surgery. What has remained is a sense of childhood wonder and excitement. Witnessing the changing of the seasons is nothing short of miraculous. A well-prepared hot meal is delightful. Spending time with animals is enchanting. As is the thrill of asking another person what Elisa asked me years ago: “Can we be friends?” |
