“I’m not sure if he can get the time off work.”
“It would be helpful if he could come. That way I can answer all your questions, and you can both feel comfortable taking Zeke home.”
“How long will we need to feed him?” she asked.
“I don’t know. Sometimes it’s a few weeks, sometimes a month or two. It depends on when Zeke decides to start eating on his own.”
“A month or two? That long? You better start eating before that, Zeke, you hear me?”
I smiled. “When the time comes we’ll talk about how much Zeke should be eating. It’d be ideal if he could lose some weight. It would be better for his body, and make this less likely to happen again.” I looked at Zeke, not wanting to catch his owner’s eye.
“I know. We all could, couldn’t we, Zeke?”
I laughed unconvincingly, ashamed that I’d transmitted my judgment.
“I’ll have Shannon come in to do the feeding with you.”
“All right, I suppose we’ll give it a shot. What do you say, Zeke?”
I backed out of the room, hoping that Shannon would be her most patient self while going over the feeding instructions.
* * *
—
Zeke made it home, and I monitored him at weekly rechecks. His liver enzymes and bilirubin normalized and his appetite gradually returned, incredibly, with the same gusto he’d had before. I enjoyed Zeke’s visits. Each appointment was a step closer to him becoming a normal cat again. His list of medications shrank, and his owner relaxed with each reduction in his treatment plan. I had grown fond of him and his owner. I enjoyed listening to the stories she shared of Zeke before he was sick, and eventually I started hearing stories of his current behavior as he returned to the companion his owner had been scared she’d lose.
At his second-to-last visit, six weeks after his hospitalization, I removed his feeding tube. I snipped through the thick black suture holding it in place and pulled the snake of red rubber catheter through the hole in his skin. I gently cleaned the small puckered mouth of tissue that was all that remained. Once his hair grew back over the area—it was already trying—there would be no lasting evidence of his illness. No lingering abnormalities on serum chemistries, no visible scars, no change in his demeanor. It almost seemed miraculous, except that I understood every step his body had taken back to health.
On his last visit it was time to relinquish his care back to his family veterinarian. Zeke could return to the world of sparse vet visits for vaccinations and teeth cleanings. I was delighted that he’d recovered, but I would miss the familiarity I’d found with his owner over his visits. When Mrs. James left the examination room for the last time with Zeke barely contained in his plastic carrier, she turned and handed me a small package.
“Zeke and I wanted to say thank you,” she said.
“Thank you,” I replied. “It was my pleasure.”
“We’ve got our old Zeke back,” she said. “And we thought we might lose him. Thank you.”
I hugged her, trying not to push her off-balance with Zeke dangling in his carrier. I felt a surge of pleasure erasing the arguments with Shannon, my disturbed sleep during his hospitalization, the frustration of not knowing if his owner would proceed. This is it, I realized. This is what it means to be a veterinarian.
“I was looking through some old photographs the other day,” she said, “and wanted you to have this one, to remember Zeke by.”
“Thank you. I’m going to put it in pride of place on my desk.”
I turned and walked back along the corridor to the double doors that opened into the treatment room. I gripped the rectangular package, reluctant to unwrap it until I knew I’d be alone. I looked at my watch. I had time to sprint downstairs to the office before my next appointment, where I could open the gift and take a moment to compose myself before moving on to the next pet and the next problem.
The picture was taken in a kitchen. It was a candid shot of Zeke caught doing something he shouldn’t. A camera grabbed from a drawer when his owner had happened upon him and an open tub of food—busted. A door to a pantry in the background stood half-open. Had Zeke worked at the handle, knowing what was inside, until he figured out the exact amount of pressure to apply? Or had his owner gone to get something and left the door ajar? I liked to think that Zeke was the perpetrator; it fit how I saw him more completely. In the foreground of the picture was a tall, slim Tupperware container; through the clear wall you could see the contents—small brown kibbles. The cat stood on his back legs, his head buried in the container. It was difficult to see his face, but I recognized the closely striped black and silver-brown of Zeke’s coat, with its perfectly alternating regularity. His desire to get to the food was both fitting, given the size of his belly, and comic, given his precarious position for his unscheduled snack.
The frigidly bland air of the basement office made me miss, for a moment, the sweltering Philadelphia summer I’d left. It was quiet. There were no pagers bleeping, dogs barking, or monitors alarming. I placed Zeke’s picture next to my computer monitor, the first one at my new desk, and clutched my white coat around me. I’d saved Zeke without a senior clinician’s advice or an ICU team’s monitoring. I grinned thinking of Zeke perpetually captured eating—the very thing that had got him into such trouble. No wonder he got lipidosis, I thought, and then stopped myself. Just enjoy it. Just enjoy this moment.
CHAPTER SIX
Sweetie
I spent two years in Baltimore, achieving board certification and finding my feet as a fully fledged internal medicine specialist. And, although my social circle had shrunk, I was lucky to make the perfect friend to explore my new city with. Robyn was the same age as me, and her exuberant, generous spirit always made me feel I was part of something amazing. She was the head technician for the surgery department of the practice where I worked, and because I never set foot inside the surgical suite, we enjoyed an easy friendship with no work-related conflicts intervening. Robyn was tall with long blond hair, cute dimples, and a personality that made men stare. After three years of veterinarian friendships, it was liberating to not be discussing the most recent Journal of Veterinary Internal Medicine article about canine lymphoma on a night out. We spent our weekends shopping, talking, drinking, and chasing boys. It was the most human I’d felt in years.
One Friday in early October 2003, I’d decided on a lazy night in after getting back late from the gym. However, a frantic phone call from Robyn, who’d returned home from work to discover her idiot boyfriend moving his stuff out of their shared apartment, unannounced, instantly changed my plans. We agreed to meet at Kooper’s—a bar at walking distance from my apartment, named for the owner’s yellow Lab—for sympathy and slander. I’d quickly changed into jeans and my favorite David Gray T-shirt with the provocative lyric IF YOU WANT IT on the front, and COME AND GET IT on the back. I didn’t think too much about my outfit; this was going to be a girls’ night.
We arrived at Kooper’s, grabbed a high-top table against the wall of the bar, and settled in. After gulping down our burgers and pints, we got in a second round of drinks and moved on to lamenting the dearth of smart, interesting, and available men. A speed-dating episode the previous week had failed to supply me with any viable candidates, and I was feeling pessimistic.
“What about these guys?” Robyn asked, nodding toward the entrance of the bar and a group of men, obviously friends, arriving.
“Definite potential,” I replied, sliding round to Robyn’s side of the table to get a better view. One of them was tall and slim, with a beard a few shades lighter than his thick, dark hair. He wore glasses that were hip before hipsters existed. “That guy with the beard and glasses looks cool.”
“Yeah, the blond is cute, too—a bit young, maybe?”
We watched them order drinks, and before I could look away, the guy with the beard and his blon
d friend approached us.
“We were wondering if you could settle a bet,” the bearded guy said.
“Okay,” Robyn replied, smiling.
“We’re betting on whether or not this jacket is real leather. What do you think?”
I reached for the orange-brown fabric of his seventies-looking jacket and rubbed it. The material was slick and light. “No way,” I said. “Definitely not leather.”
“Naugahyde, then?” he asked.
“What? You just made that word up. There’s no such thing. Nauga—what did you call it?”
We chatted until last call about music, Baltimore, and the things people who’ve just met in a bar talk about on a Friday night. At closing time, he offered me his business card. Lame, I thought, but Robyn and I couldn’t stop talking about him on the walk home. Two days later, I was with Robyn and another friend at the annual Fells Point street fair, still talking about the guy from the bar, Rob, when we ran right into him. A chance in thousands.
It was that second meeting that sealed the deal. After I ditched my understanding friends we visited the beer garden, then the Wharf Rat pub, and then a small Egyptian pizza restaurant. He was the man I’d marry. I had no doubt. Rob fit me, and I could see a better version of myself with him around, something no one else had made me feel.
Weekend dates for dinner, drinks, and movies at the indie cinema in town quickly progressed to breakfast at the Blue Moon Cafe the next morning and days exploring Baltimore neighborhoods. “What are you doing tonight?” became “What should we do tonight?” And I figured out exactly how long it took to walk the couple of blocks from Rob’s house to my apartment, shower, change, feed the cats, and get to work. When my lease was up at the end of the year we moved into Rob’s row home, with only minor adjustments to the décor needed for the four-legged members of the family.
At the hospital, my caseload continued to grow, and even with my new boyfriend waiting at home, I struggled to define the boundary between my work and private life. I persisted in sacrificing dinner plans, social engagements, and sleep for my patients. I was fortunate that Rob was patient and understanding and was self-sufficient enough to not require constant attention.
John, as head of the internal medicine department, continued to warn me that expecting everyone I worked with to share my commitment was unrealistic. The technicians were unhappy, and I was upsetting the balance of the practice. I needed to back off.
But I couldn’t do it. No matter the words of warning, or my efforts to “take it easy,” when the opportunity to see a case arose, I always grabbed it.
Ultimately, I realized that my philosophy, and that of the people I worked with, was never going to align. I could’ve looked inward to discover why I couldn’t calm my relentless drive, but I wasn’t ready. Instead, I chose to move on.
* * *
—
Rob and I moved to San Diego in the summer of 2005. Having lived most of his life in Austin, Texas, Rob was tired of the Baltimore winters, and I’d found what I thought was the perfect practice. He proposed during a Hawaii vacation that summer, and by the following February we were married. But work continued to consume my life, and now I had the full support of a boss whose boundary between work and private life didn’t exist.
In contrast to the hospital in Baltimore, my San Diego practice could only be described as old and a bit shabby. The building was barely big enough for the patients, clients, specialists, emergency doctors, interns, and support staff, and the worn floor and scuffed walls showed the strain. A set of thickly painted blue double doors led from the treatment room to a narrow corridor that accessed the six consulting rooms. The constant traffic of people and animals through the doors meant they were a poor barrier between the hospitalization and client areas, and the unpleasant smells generated by sick patients permeated the entire building.
By the end of my first year in San Diego, I was struggling. Despite the long hours I spent in the hospital and the high caseload, I still felt out of place and uncomfortable. In Baltimore, my practice had been the only specialty hospital in the metropolitan area. In San Diego, there were at least four other large emergency and specialty hospitals. Rather than a collegial atmosphere among referral clinics, I’d entered a competition ring. I couldn’t say no to any case because, if I did, I’d lose that referring vet’s favor. Practicing medicine had become a popularity contest, and I was plunged back into the disorienting social sea of school all over again.
Taking every case meant I had a constantly changing schedule; I had to double-book appointments, and perform unexpected emergency procedures in the middle of the day, which delayed every other patient. My shift didn’t finish at a set time; I was done when the last patient was seen and the last record written up. I no longer canceled dinner plans, because I’d learned there was no point in making any.
Though I was spending long hours at the hospital, Rob and I were strengthening our life together. We’d moved into a modern apartment in the central district of Hillcrest. It was a popular and trendy neighborhood, but there was something bland about the bars and restaurants we visited. San Diego was nice—nice weather, nice beaches, and nice people—but it wasn’t great. The diversity and texture I’d come to appreciate on the East Coast seemed to have been smoothed away by the surf and sand in sunny SoCal. I missed the tiny Ecuadorean restaurant a block from our Baltimore row home that served the best fried plantains, and our tiny local pub where we knew all the bartenders and they knew what we liked to drink. I missed houses built from bricks, and, when summer changed into fall, most surprisingly, rain. Nevertheless, living in San Diego was fun, and setting up a life with Rob was a shared adventure. I never heard Rob, or the cats—who now had swaths of sunshine to bathe in for days—complain about the new climate.
* * *
—
Although my childhood dreams had always included a pet dog, once I’d adopted my feline family and realized how well-suited they were to my long work hours, I didn’t consider dog adoption until Rob became a part of my life. Rob, who was tolerant of the three-cat family he inherited when we met, was not a cat person. The feline behaviors I considered endearing, or at least as part of the package, Rob greeted with less enthusiasm. There were times I felt guilty for my cats’ exploits—when Harry vomited in Rob’s work shoes or when an anonymous poop appeared in the clothes basket. But my tolerance for cat escapades was significantly higher than my significant other’s, and I was sure I had all the pets I needed. However, after Rob had generously put up with the cats for several years and he told me he wanted to add a dog to our family, I couldn’t summon valid resistance.
I’d considered myself immune to the homeless dogs I regularly encountered at the hospital. I felt the initial flush of compassion for the individuality, cuteness, or heart-wrenching story of every abandoned, rescued, or abused dog that arrived in our emergency room, but my enthusiasm was quickly cooled by the practical implications of caring for them, and the reality of my long hours.
Professionally, it was prudent to mark the boundaries of my compassion. Internally, I took patients home with me every day. I took records to review at the kitchen table, and I stored lab results in my head to fret over at dinner, in the shower, or in bed at two A.M., but I remained unconvinced that an actual dog would be coming home with me anytime soon. Regardless, dog adoption became a frequent topic during dinner conversation.
Rob erased the lines I’d drawn in the sand, and nevers became maybes, became probablys, became yeses. I realized that, for the man I loved, I could tolerate, at least, a four-legged companion of the canine persuasion.
It happened about a year into my new job. I was dodging through the treatment room one day when a patient in the cage closest to the laboratory distracted me. Huddled against the back of the metal cube was a shadow of a dog. Her right hip was up, and the fur was clipped in a neat rectangle framing an incision punctuated
by regularly spaced sutures. Her exposed skin looked gray from the black hair follicles crowded beneath the surface. She was quiet, shuttered, separated from the bustle by more than the bars on the door of her cage.
I was drawn to her, forgetting my waiting client. I knelt at the front of the metal cage and looked into her dark brown eyes. She raised her eyebrows in that quizzical, uniquely canine way, but didn’t wag her tail or lift her head.
Who was this dog? I didn’t know anything about her, but I could guess. She was another abandoned pet whose owners couldn’t afford her care, dropped at the shelter after being hit by a car. She was a pit bull mix with an injury too severe for medical management, slated for euthanasia because the San Diego Department of Animal Services didn’t have the finances for surgery—especially not for a breed already over-represented in their crowded shelter. No one would’ve argued with the decision to put her to sleep; left to heal on their own, her pelvic fractures would’ve caused chronic pain and lameness. But someone must have contacted a rescue organization that arranged for her to be taken from the shelter to our hospital for surgery, paid for by fundraising and charitable donations. Someone had saved her life.
I unlatched the cage and sat, the metal floor’s sterile coolness on the back of my legs. I could see, now that I was closer, she was not all black; there was a stocking of brindle creeping up each leg, a flash of tigerish stripes on each cheek. Her coat was dull and dusty; when I reached to pet her I felt dirt from the road on her fur. I imagined the smack of the fender, the dull thud of energy absorbed into muscle and bone.
She was unknown, anonymous, defined only by the card on the front of her cage: “Emma.” She had no history other than the few words scribbled from the shelter—no likes or dislikes, no favorite toy or special treat. She had no last name, no owner, no home. The cute stories of her as a puppy—I could imagine her as a puppy—were remembered only by those who’d given her up.
My Patients and Other Animals Page 14