Michael remembered Hamlet. The famous soliloquy, when Hamlet speaks to the audience of life and death, had been heard so many times that it had become a cliche, almost a joke. But there was nothing funny about it, Michael knew, when you found your own life broken, when you were wondering whether to put the pieces together and try to start again, or to let it all pass you by, and die. There was nothing funny about it, to the thousands of people every year who found themselves at the same crossroads that Sally had found herself at, and that Michael found himself at now.
Michael remembered what Walt Whitman had to say about death. When he was forced to come to terms with his grief at the murder of Abraham Lincoln, when he had to find some deeper meaning in the loss, to find a reason not to be afraid of death, the cantankerous American poet had written: ‘Come lovely and soothing death ...’ That was how Michael felt about death. It called him, like an old friend. And he had no fear of it. These were the dangerous thoughts of a depressed man, a man without fear.
Michael wanted to find that kind of peace, that kind of conclusion to his life. He wanted to make the decision to die. He felt the same feelings that so many people who had taken their lives felt, the same crushing emotions and the same empty despair. The fact that Michael had read a lot of books as a boy only meant he could put that despair into words in his mind, as Sally had put them into words in her diary. People scoffed at suicide, people who had never been in that situation, but many young people had died without ever being able to put their terrible emotions into words.
Michael thought his dangerous thoughts every day. He twisted things around in his grieving mind. He didn’t make the distinction, in his own mind, between death in general, and suicide. He didn’t understand that Whitman was writing about death coming to us in the natural scheme of things, not about taking one’s own life. Michael especially pushed out of his memory the words which might most have helped him. Even an alcoholic could write them and could know their truth: ‘Do not go gentle into that good night. Rage, rage against the dying of the light.’
Michael pushed the words of Dylan Thomas out of his mind. All those stupid poems written by people long since dead, what did they mean? They were just a bunch of lofty books for people with fancy educations like himself, Michael thought. The kids in the dying country towns and on the troubled farms who ended their lives with a rifle, or the kids in the cities, from the troubled families, who ended their lives with drugs, had never read any of those stupid poems. What did a drunk like Dylan Thomas know about life, to tell us to rage against death, to tell us to fight against it? What did he know? And what about the psychiatrists, what did they really know about pain, about what it feels like to have nothing ahead of you in life, to face total emptiness? Nothing, Michael thought angrily. Those who know are those who have died, or those who might have died.
And that was why Michael read Sally’s words.
Tuesday, 20 June, 1995
Dear Diary,
Today I was so upset, I actually cried in the consulting room. I’m used to putting animals to sleep by now, but that doesn’t make it any easier. Today I had four euthanasias at the clinic, and I had to go to the pound in the morning and put down ten dogs ...
The long June day was breaking Sally’s heart. Sally hated putting animals down. She was a soft-hearted animal-lover. Nothing depressed her more than to have to do several euthanasias in a single day. Nearly every day there was at least one animal to be put to sleep. When disease became too much for an animal and it was suffering pointlessly, it was the duty of the veterinarian, Sally knew, to put that animal peacefully to sleep using an overdose of anaesthetic. Not only was it the vet’s responsibility to discuss euthanasia with the owners of the animal, and to help the owners make their own decision about when the time had come, the vet was also faced with the onerous task of helping the owners cope with their grief, especially in the minutes leading up to the euthanasia and just afterwards. It was easier when the owners did not want to be present during the euthanasia, but often people wanted to be present right to the end – these were the most difficult and heartbreaking cases for the vet. Sally, like all vets, had learned to distance herself from the powerful grief that the owners experienced, while at the same time being sympathetic and supportive towards them, for otherwise she simply would not be able to do her job. Someone had to remain cool and calm in order to properly inject the intravenous anaesthetic in a way that the animal would peacefully fall asleep without any stress. Sally had learned the art of doing this, but she still hated it.
It was one thing when an animal in pain had to be put to sleep, but it was quite another when an animal had to be put to sleep because the owner could not afford to treat an expensive or complicated illness. There were always the harsh economic realities of practice to be taken into account. Sometimes owners would put an animal to sleep because they could not afford orthopaedic surgery to fix a broken leg. That was especially depressing, but occasionally it simply could not be avoided. There were also those terribly sad cases where a disabled or elderly owner would not be able to cope with a pet which had chronic diabetes or spinal injuries, and so they would sadly put their animals to sleep. Lastly, and worst of all, were the animals that were just not wanted. Sally preferred not to think about what happened to some pets that were no longer wanted – many of them were simply abandoned, or worse, but most dogs ended up at the pound. And someone had to put all the unwanted dogs at the pound to sleep, because despite the best efforts of local councils, many of them could not be rehomed. That person was the vet. It was a terrible job to have to do.
Sally had been to the pound that morning. It was a rainy winter’s day. She had greeted the two rangers as cheerfully as she could, and the three of them had tried to maintain a veneer of good humour. They knew that if they allowed themselves to get sad about it, they would not be able to do the job, and it was a job that had to be done. Sally had seen many mistreated and neglected dogs in her time, and there was no doubt at all that it was far more humane to put an unwanted dog to sleep than to have it stay with an unsuitable owner who might well dispose of the dog by inhumane means. Veterinary practice was not a field in which one could remain sheltered from the harsh realities of life.
Sally knew all this, but when she had ten dogs to put to sleep in a single morning, like she did today, it depressed her. Sally simply couldn’t help it. Nevertheless, she made jokes about the weather and tried to keep the rangers, a man and a woman, smiling and talking as much as possible. They would talk to each dog brightly, pat the dogs cheerfully and try to behave normally around them, so that the animals would feel comfortable and relaxed and would not feel stressed at all. As far as the dogs were concerned, they were just feeling sleepy all of a sudden, and, with a yawn, or a little exhalation of breath, peacefully lying down to have a sleep, as Sally painlessly injected the anaesthetic. It was not stressful for the dogs – it was the people who were stressed, for it was the people who understood that although this was like a normal anaesthetic in every other way, these dogs would not be waking up again. The pound was a depressing place for people to work, although it housed the dogs quite comfortably, and Sally could not wait to jump in her car and rush away from it as soon as she was finished.
So she wished the rangers a good day and bade them farewell until next week. In her car, Sally checked she had put everything back into her medical bag: used syringes, a stethoscope, needles, and the big, 500 ml bottle of pentobarbitone sodium. This was the anaesthetic which, when injected into a vein in the foreleg, humanely sent the dogs to sleep. The so-called green dream was very effective, and it gave Sally some comfort to know that the dogs never suffered once they had been given the lethal anaesthetic. The end was always peaceful and humane.
When Sally got back to the clinic, it was a relief to do some surgery and to get back to the happier business of treating sick animals and making them well again.
Her heart sank when Heather Lorayne came to the operating room and told
her that they had four clients coming in to have their pets put to sleep that same afternoon.
“Oh, God,” said Sally, as she sutured up the abdominal incision of the Jack Russell Terrier she had just spayed. “Four? I’ve just done ten!”
“Sorry,” said Heather. “You can look at the appointment book if you like, but there are four. A Mr Mitchell is bringing his Blue Heeler in to be put to sleep. It’s savaged a child.”
“Oh,” said Sally. “That’s awful. Fair enough.”
“Then there’s Miss Liu, with her rabbit.”
Sally spoke as she placed another stitch. “Flopsy didn’t get better, then? No improvement at all?”
“No. He’s much worse.”
“That’s sad.” Sally had been treating the rabbit for a serious pneumonia, caused by a Pasturella bacterium, but even when she first saw Flopsy, she thought he would probably not make it.
“She says he’s just lying in his hutch now, and he won’t eat or move about. Miss Liu says she knows he has come to the end, and she doesn’t want him to suffer any more.”
“Okay. What about the other two?”
“Mrs Gianelli rang up to say her old Dachshund hasn’t improved. That’s the one that Thomas saw, with the spinal paralysis. It’s fifteen years old. The lady’s going to come in with the dog, and the kids, to have it put it to sleep this afternoon.”
Sally groaned. “With the kids? Oh, no. I remember the case, though. You should have seen the X-rays. Poor dog’s spinal cord has had it. I’m not surprised we didn’t get a response. Is she really going to bring the kids in, to see it put to sleep? Are you sure?”
“Apparently,” said Heather.
Sally stopped stitching. “Oh, that’ll be awful.”
“Do you want to hear the bad news?”
“The bad news?”
“Your last appointment for the day is Mrs Polanski and her daughter. You remember the phone call we had the other day, from the daughter?”
“You mean the one who’s trying to get her old mother to put her cat to sleep? The cat with kidney disease?”
“That’s the one.”
Sally shook her head, and started stitching again. She had closed the muscle layer and the subcutaneous fat, and was now putting non-absorbable sutures in the skin. “So, Mrs Polanski still doesn’t want to do it?”
“Apparently not. The old cat’s a walking skeleton, but she can’t bring herself to put him down. The daughter’s furious. She’s bringing her mum, and the cat, down to see you tonight.”
“That’ll be a nightmare! Thanks a lot.”
“They wanted to see you,” said Heather. “They don’t like Thomas. The old lady reckons he doesn’t seem to care.”
“And I’m supposed to look caring by telling them to put their cat to sleep? She’s really going to love me for that.”
“You know it has to be done, Sally. The cat’s on its last legs.”
Sally sighed. “Yeah, I know. I’ve just had enough of death for one day, you know. It gets me down.”
“Hmmm,” said Heather. “Well, are you finished, there?”
Sally had just tied the knot on her last stitch. “Yep. You can turn the anaesthetic machine off and wake her up.”
“Sure,” said Heather.
“Thanks.”
Sally took off her gloves and walked out of the operating theatre. She went to the office and made some tea. It was a miserable day. Rain dribbled down the pane of the little office window and the sky was dark with clouds. Sally really didn’t want to have to face up to all those people with their dying animals.
When evening consultations began, there was a waiting room full of people, their barking dogs and frightened cats. By the time Sally had called the Gianelli family in, with their little paralysed Dachshund, the waiting room was half-empty. Mrs Gianelli, a pretty, young Italian woman, carried the old dog carefully in her arms. She was followed by her husband, a man of few words. He was wearing dusty khaki trousers and a heavy, blue shirt. Sally knew he was a building contractor. A little girl was holding his hand. She must have been only six years old. Her brother, who looked about ten, came into the consulting room last of all.
Mrs Gianelli put the dog on the examination table, after laying out a little blanket for it to sit on. The dog’s hindlegs were useless, totally paralysed, and the back end of its body flopped to one side. On its stubby little front legs, the dog held itself up as best it could.
“We have to carry him everywhere, doctor,” said Mrs Gianelli, in her Italian accent. She and her husband were first-generation immigrants. Their children, raised in Perth, spoke with Australian accents, but the dog was five years older than their son. The little animal had come with them all the way from Italy. It had seen them build a new life in Australia, and the children had grown up with the dog as a constant companion. Giotto was, to the Gianellis, a member of their family. The thought that this was the end for him was unbearable to them all. The little boy already had tears welling up in his eyes. He stood at the rear of the consulting room, afraid. “He’s not going to the toilet, doctor, and he ... he just lies in his own wee. I don’t know, but he looks in pain. He won’t even look at his food.”
Sally examined the dog carefully. She pinched the toes of its hindlegs. There was no reflex reaction at all. The dog was hopelessly paralysed, a paraplegic, and it had not responded to treatment. In fact, it had lost weight and obviously hadn’t been eating, despite the anti-inflammatories and painkillers which Kellerman had prescribed. Its eyes were cloudy from advanced cataract. Its teeth were yellow and the mouth smelled foul. The old dog’s cheeks were hollowed. It looked uncomfortable and tired. “Poor little Giotto,” Sally said softly. “You’re not feeling the best, are you?”
Mr Gianelli spoke. “He’s dying, doctor, isn’t he?”
Sally sighed. “Yes, I’m afraid so. Fifteen years is very old for a Dachshund. If he were a human, he’d be something like a hundred years old. At his age, the spinal injury is just too much for him. The nerves to his bladder and rectum have shut down, so he’s getting constipated and his bladder just overflows.”
“We’ve been squeezing it, like you told us,” said Mrs Gianelli.
“Yes, that’s good, but he hasn’t eaten a thing, has he?”
“No. Nothing.”
“I hate to say it, Mrs Gianelli, but I think that’s because he’s in pain from his back. You remember when I showed you the X-rays, how the discs had prolapsed and were pressing up on his spinal cord? Well, that can be very painful. It’s okay to see if we can get a response to treatment, but now it’s past the point where he’s got any real chance of getting better. In a younger dog, you could try surgery, but in a dog as old as Giotto, that would be an awful lot to put him through. He’s just too close to the end of his life. And, anyway, it’s so severe – I really don’t think he’s going to come good.”
“Yes, we know,” said Mr Gianelli. “We told the other doctor, we don’t want Giotto to go through any surgery. It’s too much for him.”
“I think the time has come, don’t you?” said Sally.
Sally wished the children were not in the room. She hated discussing putting a family pet to sleep when there were children present. But some people, she had found, preferred their kids to have an early introduction to the realities of life. Sally tried to couch her words as obscurely as possible, so that the children wouldn’t fully follow what was being said. Often children wanted their pets to be kept alive at any cost, even when they were suffering badly, because they couldn’t bear to part with them. It was awful to have to watch a parent telling their child that, no, the pet would have to be put to sleep, and seeing the grief and disbelief of a crying child who thought their own mother or father was betraying them. “What do you think?”
“Yes, yes. We know it is time,” Mrs Gianelli was doing her best not to cry, but she was beginning to lose the battle. “I ... I told the kids today, before we came here, that we had to say goodbye ... say goodbye to little
Giotto, because his time had come. He’s just suffering now, and we don’t want that.” She looked at her children. “Right, Giovanni? We have to say goodbye to Giotto, don’t we?”
The little boy was crying. He nodded, as bravely as he could.
“We don’t want Giotto to feel bad, do we, Susi?”
The little girl shook her head. “No, Mama.”
Mrs Gianelli looked at Sally. “We have made our decision, doctor. We would like you to put Giotto to sleep, now.”
“That’s okay. And, I agree. It’s definitely time.”
“Thank you, doctor,” said Mr Gianelli.
In a couple of minutes, Sally had fetched Heather, drawn up some pentobarbitone sodium into a syringe, and returned to the consulting room, where the entire Gianelli family was going to be present for the euthanasia. Sally knew that the little dog would have died over the next couple of weeks, anyway, and it would have been in pain over that time, so she did not feel bad about putting the dog to sleep. But it was terribly difficult, with two crying children and their distraught parents watching her every move.
“What we do is inject an anaesthetic into his arm-vein, and he’ll just fall asleep. It’s just the same as a normal anaesthetic. They just relax, and get drowsy, and then they fall asleep. Once they’re fully asleep, we give them a little bit more anaesthetic and they just pass away very peacefully. They don’t think anything bad is happening. They just fall asleep.”
“Okay,” said Mrs Gianelli.
“So, what you’ll see is that he’ll just relax and lay his head down. It only takes a few seconds. And, sometimes, once they are fully anaesthetised, they can make a gasp, like a big breath, but it’s just a reflex – they’re not feeling anything, so don’t be alarmed if that happens.” Sally hoped, fervently, that it would not happen. It was rare, but sometimes the lungs would take a reflex, gasping breath, or two, due to high carbon dioxide levels. The heart could even have already stopped, but sometimes the carbon dioxide reflex caused the respiratory muscles to contract and take a reflex breath. Sally knew that this was nothing to be worried about, but it could be very upsetting and alarming to people if they were not expecting it.
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