I got my first King Charles cavalier spaniel in 2007. I was going through a divorce and didn’t want to come home to an empty house. I drove to a farm in Quakertown, Pennsylvania to pick up a male named Ruben. I had seen a picture of Ruben online; he looked like a black Adonis. I did not know if we would get along. There is a chemistry between dogs and people and I was concerned that he and I might not be a good match.
Life was idyllic. In spite of my pending divorce, I had a steadfast companion in a dog and the company of a child who came over every weekend. There was Peace in the Kingdom at last. So, what could be the harm in taking Ruben back to the farm exactly one year later, so that he could see his other dog friends again? I offered this plan to Caroline, and she snatched it up like a golden egg nestled in a garden of sweet peonies.
I know what you are thinking already. Looking back on this idea, I must agree. What kind of imbecile would take a dog-loving child back to a farm where there are dogs? Well, it was a lovely drive in early fall and I knew that I was going to give my niece and my dog a cool experience. The sticking point occurred when Caroline was informed that Ruben’s sister Mitzy just “happened” to be up for adoption. Mitzy had birthed two litters of puppies and was retiring from her job at age 3. This gave me further assurance on what I had already believed about this particular farm. They were ethical people and did not overbreed dogs, which is a common problem in today’s world. And that was great! Ethical dog breeders were becoming popular. How enchanting!
Mitzy did not have Ruben’s Adonis-like looks, so classic of this breed. No, she was overweight from stealing food from the other dogs at the farm and had an atrocious haircut, rendered by a handheld buzzer. Mitzy had large, bug-like eyes and a small head. It was not her appearance that had won Caroline over, however; she had the sweetest personality and burrowed her body into the chest of anyone upon whose lap she sat. Did I really need two dogs? This was a bit ridiculous. During the drive home from Pennsylvania after my foolish mission, with TWO dogs in the car, Caroline turned to me and stated with authority, “You HAD to get this dog, Mitzy. Because you don’t say no to wonderful.” I had been hoodwinked, and I knew it.
A few years later, both of the dogs began going grey on their muzzles. I took them faithfully to their vet appointments. They both had heart murmurs, but were healthy as seniors. It was not until this past Thanksgiving in 2017 that I began to notice Mitzy’s breathing change. She had forced exhalations and her ribcage began to flare and become barrel-like. This is characteristic of Congestive Heart Failure. I had witnessed the course of this disease in humans for years at the nursing home. Excess fluid builds up around the heart and lungs, and carbon dioxide cannot be expelled from the body in an efficient manner. The standard medical treatment for this condition is heart medication and diuretics, so that the body can release the fluid buildup.
When Caroline observed Mitzy’s new breathing pattern, she commanded, “Something must be done!” She was now 17 and full of opinions on everything. I explained to my niece that I was not going to treat this disorder in an animal. That Mitzy’s life would not be prolonged much if I did and that she would urinate all over the house if I put her on diuretics. That she would feel demoralized and sad. “What about diapers?” Caroline asked me. While I knew that Caroline was kidding, I strongly shook my head no.
It was merely six weeks later that things took a turn for the worse. Mitzy’s exhalations became sharper, her chest was growing in size. She ballooned with water weight and could no longer get on and off of the sofa. The dog was so uncomfortable that I knew it was likely time to take her to the vet to be put down. It was the humane thing to do. I work in healthcare, and have watched people starve for air in their final hours. I was never going to allow things to get that bad for Mitzy.
Only on the very same morning that I came to this realization, a blizzard hit the area. People were warned to stay off of the roads. I knew that shoveling us out would be an impossibility and the roads were too dangerous to get to the vet’s office. My plan to spare Mitzy from starving for air was rapidly failing. She sat next to me as she huffed and coughed. Her brother Ruben, ever her protector, looked up at me as if to say, I am letting her down. I cannot fix what is wrong. What are we going to do?
It was a horrible span of time. I stayed up all night through the storm with both dogs. Mitzy began pacing with agitation; this is common with the dying. Ruben tried to get close to her; at some moments she would allow it, but at others she just gasped and squirmed, longing to be set free from her agony.
It was not until the next day that I bundled up Mitzy to take her to the vet. I put Ruben in his crate alone, as I knew he could not endure being around for what would happen next. I heard his whimpering cry in my ears all the way to the vet’s office. The office took in Mitzy immediately to Treatment Room Number 6. A lovely animal tech named Diana listened as I sobbed. She told me that she would get the on-call vet right away.
The vet was an enormous man. It was not his being overweight that made him so heavy. He had a barrel chest and panted with the slightest of exertion. Even talking made him gasp. “I believe your dog has Congestive Heart Failure,” he announced. No shit, I longed to reply. You appear to have a case of it yourself.
“Are you aware that there is medication for this disease?” The vet continued. “I have a chihuahua who is on eight pills every day to treat this same condition.” It must be so nice that you do not have to pay for all of that medication given your line of work. Or the vet visits, for that matter.
I said none of these things. I simply requested that we move things along to get Mitzy out of her suffering. The vet left the room to get ready for the procedure. Diana gave Mitzy a shot in her rump to sedate her for the next ten minutes. It was then that I heard Mitzy snore like she was a young puppy again. She closed her eyes and let me hold her.
The vet returned with a few butterfly needles and some vials of sodium pentobarbital. He tried to find a vein in all four of Mitzy’s limbs and couldn’t. This was because the dog’s organs were shutting down and fluid was flooding her system. There was no direct route to get the medicine inside her to stop her heart.
It was Diana who saved the day. She carefully shaved Mitzy’s right hind leg and felt for her vein, like strumming a very delicate guitar string. She inserted the smallest of needles, attached the vial of sodium pentobarbital and pushed the fluid inside. For some people, this is the most awful moment during the process of euthanasia. For me, it was the finest. I felt joy for dear Mitzy. She had been freed from a body that could no longer contain her exuberant spirit.
After this strangely poignant and glorious goodbye to my female dog, I returned home to her despondent brother Ruben. I felt his sadness, but even he seemed to understand the horror of the last 24 hours and that fear was now gone. We were all going to be okay. But wait…I had not told Caroline the news. During the prior weeks, I had carefully tried to warn my niece of Mitzy’s declining health. But Caroline insisted that I was being overly dramatic and that I was around death too much to see the situation clearly.
On the same day that Mitzy’s heart had stopped, I drove to Caroline’s house with Ruben in the backseat. I entered the home to talk to my sister and we waited for Caroline to return from swim practice. As I opened the front door for Caroline, she knew instantly what had happened. I hugged her and smelled the chlorine in her wet hair as she wept soundly.
Looking back at all of this, I am grateful that Mitzy only had a really bad span of time on this earth which lasted no more than 36 hours. Had it not been for the blizzard, she would have suffered for less than one day. But that was not up to me. The blizzard had arrived, and I had no choice but to kneel before Mother Nature.
This is perhaps, one of the trickiest lessons in life. When do we tinker with nature? Should we medicate dogs or people for Congestive Heart Failure? What do we do for creatures who cannot talk to us and tell us how they feel, whether they be animals or adults with dementia? All of these questions weighed on my mind after I lost Mitzy.
It was not until today, when the ferocious weather broke and the sun began to shine and warm the Earth that I came to peace with all of it. I had tried to respect nature, by giving Mitzy a brief and organic finale to her life. But I had also needed the help of some sodium pentobarbital. And from the lovely Diana, who saved Mitzy when the huffing vet could not.
It had all come down to one simple secret that Caroline had told me years ago. It has become my mantra during the last week. As I grieve this loss and assist my patients in the numerous losses and storms that shall always find us, I say it out loud. You don’t say no to wonderful. It had all been worth it; and I will never say no to wonderful again.
People born in the Dominican Republic are some of the cleanest people on this planet. They take housekeeping very seriously. For Dominicans, cleaning is an art form. I feel I can say this with authority, because I am a homecare physical therapist who works in the town of Perth Amboy, in the great state of New Jersey. There are many people from the Dominican Republic who inhabit this small city.
I began working on a case this past November, treating a gentleman named Ramon. I knocked on the door and a woman answered it, with a mop in her hand. She was around my age. “Come into the living room and meet my father,” the woman said in Spanish. I walked into a room with white tiled flooring, a fireplace, and a man lying on a hospital bed. The woman who had answered the door resumed mopping the floor and I introduced myself to Ramon.
"What country are you from?” Ramon asked me in Spanish. I told him I was American. “Where did you learn to speak Spanish so well?” I explained that I began watching novelas (Spanish soap operas) in my early twenties, and that I used to put the closed captioning on the bottom of the screen, so that I could read the words and listen to them simultaneously. Ramon laughed, and we began discussing the various novelas that we liked.
Ramon had undergone an abdominal surgery a few months back. Something had gone terribly awry, and he went into septic shock. This had resulted in a seven week long hospital stay, wherein Ramon had lost his strength to walk. When he returned home, his family had no choice but to rent a hospital bed and place it in the living room. Right next to it sat a commode, as Ramon could not walk across the apartment to the bathroom. I realized then what a tremendous sacrifice this had been for his daughter, as she cleaned throughout the entire duration of my first home visit. I could tell that she used a very specific ammonia-based product to clean the floors. It is called Fabuloso, and is violet in color. People from Hispanic culture commonly use this cleanser. It is supposed to smell like lavender. While you may not imagine yourself in a field of purple flowers in Southern France if you buy it, this product has a good aroma and is very effective. I use it myself.
For his first visit of physical therapy, Ramon stood with a walker for three whole minutes. This was not only exciting for both me and my patient, but his four year-old grandson came into the living room with pristine floors and shouted, “Abuelo, you are standing up!” This boy had round, dark eyes and a widow’s peak. His name was Juan and his grand-father called him Juancito. (This translates as Little Juan).
As time wore on, Ramon learned to walk a few feet. He did his exercises faithfully when I was not around, which is not typical of my patients. His goal was to walk forty feet to get to the bathroom, so that he would no longer require the commode at his bedside. And on the day that this happened, Juancito was there to rejoice with us. “Abuelo can walk to the toilet!” Ramon let go of his walker with one hand and gave me a fist bump.
Now that the Christmas season was upon us, I came to Ramon’s house on a day that it was snowing. I felt guilty as I entered the home, knowing that my boots were snow covered, and that Ramon’s daughter would have to mop the floor again after I left. (Of course, she would not mind this. Cleaning was her personal joy.)
I entered the living room and saw Ramon standing up. The commode had been removed, and in its place stood a Christmas tree. My patient was decorating it and beamed when he saw me. “Look what I can do now! This is going to be a good Christmas!” He exclaimed. I was jealous of his glee. I have never really been a Christmas person. There are so many heightened expectations of having transformative experiences on Christmas, à la Ebenezer Scrooge, when in reality, very little actual magic occurs.
On that snowy day, Ramon and I finished up our physical therapy session and his daughter offered me a plate of mangu. This is a Dominican dish made of mashed plantains and garlic. The smell of the cooking and the cleaning product Fabuloso intermingled and I savored each bite of food. Ramon had returned to lying on his hospital bed and was chatting away about his favorite novela.
Juancito was playing with trucks on the floor and his grand-father told him, “It is your naptime now. Go to your room and lie down.” But Juancito ignored this and climbed into the hospital bed to snuggle up to Ramon. I typed a report on my computer, trying to delay finishing it, for I did not want to leave. But I knew I needed to, and by the time I was done with the report, Juancito was fast asleep. He was curled under the crook of Ramon’s shoulder and the twinkling lights of the Christmas tree alit the two in beauty.
I trudged through the snow, back to my car, and drove to see my next patient. The snowflakes covered my windshield, and I thought to myself, Maybe Christmas will be okay this year. As I decorated my own Christmas tree, I tried to summon the magic I had witnessed between Ramon and his sleeping grandson next to his own tree. But I felt nothing and shrugged it off.
When Christmas does not deliver the potency we had counted on, New Year’s Eve spans that dreadfully dark week as a beacon for something wonderful to happen. Right? The only fly in the ointment here is that the week between Christmas and New Year’s often feels like a let-down. The pine needles on our trees turn brown and cover the floor. The Christmas gifts we did not like have to be returned in crowded malls. The wrapping paper goes back to the basement, and gains cobwebs and mold for another eleven months.
It was on the Wednesday after Christmas that I had my final physical therapy session with Ramon. He had met all of his goals and I was glum about the thought of not visiting his lively home anymore. Juancito was at the home of another family member, so our last day together was even more lackluster. I kissed Ramon farewell, as his daughter led me to the front door.
“It is so cold outside,” she said in Spanish. “Please take this hat. I got it for Christmas, but you need it more than I do.” She pulled a grey woolen hat over my head and grinned.
“I cannot take this hat from you,” I told her, as I reached to pull it off.
She grabbed my wrist to stop me. “Of course, you can take this hat. You got that commode out of my living room,” she replied.
“How did you do it?” I asked her. “All of those weeks. You never said a word about the commode. You never complained.”
“Because he is my father. That is how I did it. Happy New Year!” I walked to my car on that bitterly cold day. The sun was setting at 4:58. And it finally hit me. I remembered seeing my father this past summer. He was in need of a total knee replacement. He could barely walk and I felt the lining of my heart rip open as I watched him stumble when hobbling on uneven sidewalks.
It is one thing to watch people get old and feeble. It happens to everyone after a certain age, and we all get annoyed when shopping behind someone slow with their walker at the supermarket. But when that person happens to be your parent or loved one, something very different is at stake. Seeing my father become an old and feeble man had been dreadful.
I had known that feeling last summer, when my Dad could barely walk. When the world was open and the sun was high. It had not been open for me then; not with my father becoming that old person who could no longer get his mail on the front porch. Where was the able-bodied man who had gone to little league games, weddings, baptisms, graduations? Where was the man who had crouched under my trundle bed to do puppet shows when I was Juancito’s age?
Yet something did happen. I recently saw the man who had written my term papers as a teenager. I saw my father on Christmas, since his total knee replacement. He was walking around like a young person. There was still a limp, but it was barely visible. Something magnificent had come back.
I had received the hat from Ramon’s daughter in the piercing cold weather. She had wished me a good New Year. I thought of what it meant to watch an old person do younger things. I thought of her words. Because he is my father. That is how I did it. That is how she had cleaned her living room with a commode. I decided in that moment that 2018 wasn’t just going be a good New Year. It was going to be Fabuloso. People from the Dominican Republic know what this means. Now I do, too.
*Ramon’s name has been changed to protect his privacy under the Health Insurance Portability and Accountability Act.