Ever by My Side

by Nick Trout

  I knelt down to introduce myself properly, hesitating for a split second, as my recollection of golden retrievers in England brought to mind a certain lion-hearted example of the breed. Fortunately, there was no chance of a Mr. Hyde transformation with Gracie. She had her flirty routine all ready to go—work the muzzle under the free hand, beat the veterinarian to death with the tail, roll over and flash the belly, defying him not to offer a scratch. Sometimes I wonder how I might feel as the owner of such a dog: proud of her trusting, friendly demeanor, troubled by the ease with which she betrayed me for anyone who showed her affection.

  “Hope you have a decent alarm system at home. If someone broke into your house Gracie might love them to death.”

  Nurse Carey smiled, but it never connected with her eyes, her mind was elsewhere.

  “They said she’s got a diaphragmatic hernia, that she needs surgery.”

  “They’re right,” I said. “When the X-rays were taken some of her intestines were trapped in her chest. Has she had any problems eating or drinking?”

  “Not really. But she did throw up the other morning. Is that what made her sick?”

  “It could be,” I said. “Either way, I need to get everything back in its proper place and close up the opening in the diaphragm. She might be with us for a day or two but then she gets to go home and recuperate with Danny.”

  The willful effort to curl up the edges of her lips began to intensify, as though my reply had sliced through the invisible strings that were keeping the smile in place.

  “Here’s the thing,” she said, “Danny’s in the hospital himself. Has been for some time now.” The smile had essentially vanished and I could feel the pain coming off her, shimmering like desert heat. “He’s recovering from a serious head injury.” She let the statement hang there for a second, not for effect but because saying it out loud to a stranger had been an effort, an uncomfortable acknowledgment of the severity of her son’s situation. “He was …” and I lost her for a second. “God, you’d think I’d be over this by now, I’m sorry.” She took a deep breath, extended her hand to pat me on the arm, confirming her apology, and set off again. “He was with his buddies, riding in the back of a pickup. Don’t ask me what he was thinking. Well, he obviously wasn’t thinking, was he? First sharp corner, out he goes, landing on his head.”

  A hint of anger flashed behind her eyes, fueled by her son’s stupidity.

  “But I swear, he’s coming back, slowly, every day, a little bit at a time. Dr. Trout, what you have to understand is how important Gracie is to his recovery. Danny can’t really speak, no more than a few words, but he can see and he can touch and every time this dog pays him a visit he lights up, as though he remembers, like I get a little glimpse of the boy who used to be my son.”

  And like that, she had me, tears welling up in my eyes with the empathy that comes from witnessing the pain of another vulnerable parent. Even for a child with perfect health, the future will always be fraught with uncertainty. The only thing we can control is the attitude with which we embrace this future.

  “I wanted you to know what Gracie means to my son so you’ll take extra special care of her. Promise me you will.”

  And I did, without hesitation, taking comfort in my previous surgical experience dealing with the problem at hand. Her confession prompted me to open up a little about Emily. Like her, I was awkward, my feelings new and difficult to articulate, but she got it in the same way I got her.

  “Believe me,” she said, “I’m not trying to put you under too much pressure. I just thought it might help, knowing where I’m coming from.”

  I assured her it was all good, that I completely understood and I was all in. Only later would I berate myself for forgetting one of the cardinal rules from my surgical training—the more emotionally invested you become in a case, the more problematic it is destined to become.

  Gracie’s hernia repair went well. The challenge lay with the lazy loop of bowel that had become pinched off. Its blood supply had been compromised, an extensive length of the intestinal tract left purple and lifeless. It needed to be cut out and the two fresh, healthy ends sewed back together to restore normal continuity. Not a problem until a few days after the surgery when Gracie spiked a fever.

  I placed an urgent phone call to Nurse Carey.

  “Her temperature’s one hundred four point five Fahrenheit and she’s got free bacteria in her abdominal cavity.”

  She didn’t need an explanation. She understood that Gracie’s intestinal surgery had to be leaking, spilling bacteria-laden fecal contents into her abdomen. A raging peritonitis was a given. Getting her guts to heal in the face of overwhelming infection and contamination was going to be a major uphill battle.

  “Do what you need to do,” she said, her tone surprisingly calm, as though nothing could be simpler. Why wasn’t she furious, cursing my incompetence? Why wasn’t she reiterating the essence of my mission—save the dog to save the boy?

  Humbled but determined, I took poor Gracie back to surgery, going with a simple plan—unzip the previous midline incision, find the leak, repair the leak, clean up, and get out. But when I looked around the abdominal cavity I discovered fine particles of partially digested food liberally sprinkled over every organ like seasoning. Imagine your dinner guest tells you she is highly allergic to pepper and you have to go back and remove every last grain from every steak waiting its turn on the barbecue. You might as well invite her to uncap the needle on her EpiPen syringe because the chances of you getting every ground and dusting of the condiment are slim to none. The same held true for Gracie. I could do a decent job, but even if I removed every obvious piece of contamination those invisible bacteria would still be lurking in their gazillions.

  “The surgery went well and the leak’s fixed but I had to leave Gracie’s abdomen open.”

  Sometimes, working with a nurse can make life a whole lot easier. An “open abdomen” meant that I had not stitched up Gracie’s belly, at least not to the extent of making a tight, permanent seal. I needed to let the “bad vapors” out because I couldn’t risk locking all the residual bacteria inside, so I had loosely whipped the walls of her abdomen together. This afforded her some natural, gravitational drainage into a meticulously applied sterile bandage wrapping its way around her entire abdomen, a bandage that helped hold her guts and every other abdominal organ in place. It would have to be changed at least twice a day. There was a significant risk that more bacteria might get in than got out, but given the amount of homespun pollution I had witnessed I felt as though I had no choice.

  Ms. Carey instantly grasped the gravity of Gracie’s situation, the touch-and-go nature of her dilemma, but she also understood that I would not have gotten into this situation through carelessness or negligence or hasty judgment. She let me know that she lived the uncertainty of modern medicine every day. She made sure I felt her trust. In short, she was the one reaching out to me, doling out the reassurances. Relieved and grateful, I shared my unwavering commitment to do the only thing I could guarantee—my best.

  It is nothing short of amazing what animals will tolerate in the name of veterinary health care, all the unnatural interventions we impose on them. Having had my appendix out I know what it’s like to have your belly cut open, but if I were left with some halfhearted attempt at closure, stitches like loose shoelaces, wondering if I were going to spill my guts every time I coughed or sneezed, I’d be inviting my surgeon to get himself a good lawyer! But here was a dog who greeted me twice a day for her bandage change as though I were a long-lost relative flying across an ocean from afar, and she was there amid the smiling throngs, waiting for the moment I burst through the arrival doors after clearing customs. Ironically it was her desire to please that created one of the biggest challenges to her recovery, her feathery tail wagging into the sterile surgical site, her proclivity for rolling on her back in need of a belly rub when I needed her to stand still. We place so many strange demands on our patients, make them en
dure interventions that would be so much easier to deal with if we could communicate our intent. Remarkably, despite these drawbacks, our patients are largely cooperative. Gracie certainly was, and after one more minor surgery I am happy to report she healed like a champ.

  In the end Ms. Carey and I never had a specific conversation in which she told me her secret for moving forward with her life. She didn’t need to. It was written all over her, woven into her body language, her attitude, intrinsic to the way I perceived her. She made me understand that she had no choice in the matter, that drowning under the weight of grief and pain helped nobody, certainly not the person who needed her help the most. What was the point of believing her son would never get better at this stage of his recovery? What kind of future can you possibly offer your child if you are constantly saying goodbye?

  Perhaps you are hoping I can report that Gracie resumed her responsibilities as Danny’s dedicated therapy dog, that slowly but surely, his muse cast her golden spell, worked her feathery magic and helped him step back into a world of recognition, higher thought, and independence. In truth I don’t know exactly what became of Danny. What I do know is that I played my small, indirect, complicated but ultimately successful part in helping a sick young man through the power of canine companionship. Here was my lesson in the reach of veterinary medicine, in how an animal doctor may not be the one standing up when disaster strikes and someone shouts, “Is there a doctor in the house?” but occasionally, if he or she is lucky, a vet can help heal a sick loved one.

  Gracie was the perfect case at the perfect moment. Her story made me realize something so simple, yet something I had been unable to see. It doesn’t matter who it is you love—a son, a daughter, a dog, a cat—just get busy with the loving of life. For the first time after Emily’s diagnosis I realized it was finally time to stop saying goodbye.

  10.

  The Secret to Normalcy

  Every now and then children wield their uncomplicated perception of the world like a scalpel cutting through all the fluff and social niceties, deconstructing a complex situation into its basic elements. Whitney was one such child and when she gave me the benefit of her keen understanding, the simplicity and painful honesty of her words reached deep inside me.

  Emily had returned home after spending two weeks in the hospital undergoing all manner of torture in the name of modern medicine, and neighborhood friends kept dropping by to wish her well. Every time the doorbell rang the irresistibly cute kid in the footie pajamas knew she would be the recipient of another gift, and we were all so caught up in having her home, no one thought to ask about her older sister. Eventually, as the parade of visitors began to subside, I went looking for Whitney and found her hiding on the other side of a closet door, able to listen in on Emily’s fanfare.

  “Whit, what are you doing hiding round the corner? Why not come out and say hello?”

  Nine-year-old Whitney looked up at me and in a conspiratorial whisper said, “But I don’t want them to feel bad.”

  “Who’s them and why would they feel bad?” I asked, taking her hand.

  “The neighbors. Because they forgot to bring something for me.”

  I whisked her up and into my arms and gave her a hug. This moment summed up Whitney, sensitive and selfless, the sibling of a child with a chronic disease, grounded in values beyond her years—supportive, resilient, and secretly afraid for her little sister’s future. We had been caught up in our shock, just trying to survive, and as a result, an innocent little girl had suffered. This wasn’t neglect, there had never been a double standard, but I ached over the possibility that she felt forgotten. How best to put this right?

  In the two years that we had lived in Arizona, Reginald C. Cat had flourished. With hindsight we must have been mad to let him outdoors—too many predators and not enough knowledge of the locality—but cats adapt and Reggie was smarter than most. So, convinced our cat was settled and content, we began to entertain the notion of a canine companion, and though the choice of dog would have the appearance of a unanimous family decision, secretly Whitney’s input took precedence. And please, don’t be thinking this was conceived as a bribe. Rather, our goal was to make Whitney feel grounded in a normal family, to offer her some companionship, fun, and distraction, to counter some of the difficulties of her situation. To her credit, Whitney never showed any hint of resentment, but I worried that with time and fear, she might try to build a defense against the uncertainty her sister’s future. Her parents would always be there, but here was a chance to confide, share, and vent with a creature guaranteed to become a sounding board and best friend, a family member for whom you were always the center of attention.

  I had no preference either way, big or small, mutt or pedigree, though quite what possessed my wife to agree to a rough-coated Jack Russell terrier I will never know. One day I came home to find a white and tan Tasmanian devil sprinting around the house, intermittently attending to furniture that, in her opinion, could clearly benefit from a good gnawing to achieve a fashionably distressed look.

  “Isn’t she cute?” said Whitney, scooping her up. “Don’t you love her?”

  The tiny terrier was placed in my hands and, in all fairness, like virtually every puppy in existence, she was irresistible. In England, Jack Russells are a popular breed (often ranked around number four in popularity), with a reputation for being feisty and ornery in the hands of a veterinarian. Right now this little girl with symmetrically tanned ears and two large brown circles on her back remained amiable but squirmy, wanting no part of my embrace, way too much exploring to be done.

  “What are we going to name her?” I asked.

  “Wishbone,” announced Whitney, with a triumphant tone of finality.

  “Isn’t Wishbone a boy?” I asked.

  Wishbone was a children’s TV show on public broadcasting featuring a talking Jack Russell terrier. Was the choice of dog Whitney’s cry for help, her need to have someone to talk to, to share her secrets with when those around her weren’t listening?

  “The only Jack Russells I’ve ever seen have been short-haired but one thing’s for certain, the breed originally comes from England. So why not give this little girl an English-sounding name?”

  Whitney wasn’t convinced but she played along as I teased her with Ermintrude, Priscilla, and Clarissa before focusing on Olivia, Jessica, and Lily.

  “What about Sophie?” said Whitney.

  After a pause marked by raised eyebrows, sage nods, and good-natured approval, our little JRT was christened Sophie. So what if the name, though popular in England, originated in France!

  It was always going to be an awkward conversation. My only advantage came from knowing with some certainty how my father would respond to the news.

  He and I had gotten into a routine, alternately calling each other every weekend to discuss the minutiae of life in the Dales, my mother’s health, the adjustment of being retired, and last but not least, “the pups.”

  “How’s Bess enjoying life among the sheep? Have you dared to let her off leash?”

  “No, son, and I’m quite certain I never will. I’m sure she pines for those days when she ran loose across the fields, but it’s just not worth taking the chance. Besides, last thing we need as we settle into a new community is a reputation as irresponsible dog owners.”

  And with that, I took my cue.

  “Talking of owning a dog, we’ve finally gone and got one.”

  “Well, by heck,” said Dad, “that’s music to my ears. I had begun to worry you were never going to get a lion-hearted fellow of your own. Isn’t that right, Whisk? He says it is.”

  I could picture the scene, Mum working her knitting needles, Dad with the newspaper in his lap, both seated in front of a roaring coal fire, Whiskey perking up at hearing his name.

  I hesitated, a part of me hoping the pause might serve as fair warning for what I was about to disclose, knowing full well that our choice of dog was very different from what he would have chos
en.

  “So what is he? Or she?” He added the phrase with an air of self-congratulation, as though pleased with himself for being politically correct.

  “She is a Jack Russell terrier. Rough-coat, not short. And the girls want to name her Sophie.”

  I imagined him pulling the telephone receiver from the side of his head and inspecting it, as though a communications gaffe had occurred in the intervening thousands of miles, with some stranger jumping in on the conversation.

  “Huh,” was all he could muster, and then, “I never reckoned you for a small dog, son. Didn’t you once tell me Jack Russells can be a little—”

  “Snappy,” I broke in.

  “Exactly.”

  “But I was referring to my experiences in the examination room. It’s hardly the same as the domestic situation.”

  “Aye, but it’s still the kind of dog you need to be careful with around children.”

  Here was a classic passive-aggressive maneuver, a throwaway line with a “told-you-so” punch to be pulled out at a later date if necessary. To some extent Dad was right, but this held true for any dog, and with appropriate socialization, that is, something more effective than I had witnessed with poor Patch, I was confident a regrettable mauling was not in the girls’ future.

  “Don’t say you’ve forgotten all about Marty.”

  “Of course not,” I said.

  “And how are you going to take her for a walk?”

  For a second he lost me, until I realized what he really meant was “How are you going to feel taking her for a walk,” a small furry creature dragging you down the street.

  “Why don’t you come right out and say it—in your opinion, a Jack Russell is not a real dog.”

  “Now, son, that’s not what I’m saying. It’s just … they seem so strong-willed, and as for their bark … well … talk about piercing.”

  In the phrase “strong-willed” I heard something else, something I had known for some time about his relationship with Whiskey, but until now kept to myself.