Working for Hel


abbiThis is Abbi.  Or was.  We got her for my youngest son many years ago after his pet rabbit died.  He said he didn’t want another rabbit because they die too easily.  So we went to a rescue place and she won our hearts.  Her full name was Abigarrada, which in Spanish means ‘varigated’ and as a calico she certainly was that!

Her other name was usually “Pissy Girl” which should give a clue as to her personality…we often joked that she was Liz Taylor reincarnated (though Liz lives still).  Attitude was present in elephant size for this little body!

She was very very smart, too.  We used to have our extra dining room chairs next to the front door and the master bedroom door.  Well we had to move them because she figured out how to stand on the chairs and use both paws to open them.  Since this was before we had a screen door, she would get out – and if we didn’t know it, we would (of course) close the door and she would be stuck out there til we let her back in.  She, of course, would be quite miffed that the door didn’t magically open for her at her desire to come back in and would cop QUITE the attitude when she did get back in.

She learned English, which probably isn’t so surprising; I suspect most pets do if they’re at all bonded with their owners.  What was surprising was that she ALSO learned to spell.  For nearly 17 years we would give her a little half and half every morning when we got it out to put it in our coffee.  Naturally she came to expect it, and to ask for it by name:  milk.  (she actually said mawk, or maak)  She became such a pest about milk that we had to start spelling it when we were talking about it for any reason.  THEN she put two and two together and realized that M-I-L-K was the same thing!  So we had to start spelling it backwards.  For some reason she never did figure that one out, though it’s most likely because once we realized she knew when we were spelling it we got a lot more circumspect about discussing her “drug of choice” when she was around.  She knew other words too and could say them with varying degrees of clarity:  out, mom or mama (she literally called me this), up, treat (every treat was maak), and night-night (some weird ngy ngy sort of word).

She was heartbroken when youngest son moved away and would stand in front of his door yowling for him for hours.  It was very sad and we learned not to say his name so as not to provoke another outburst.  She eventually seemed to get over it and I became her number one human.

About 8 months ago Mr. TF said to me that she is getting to be quite geriatric.  I hadn’t noticed, to be honest.  She was just my little pest, my little minion, always nearby or behind my shoulders if I’m on the couch, behind my head if I’m in the easy chair, next to my head or on my chest if I’m in bed.  So I watched.  And he was right.  Some time after that she quit jumping to the top of the refrigerator, and a few months after that she started having trouble jumping on the kitchen island directly – she could jump to the chair then to the table then to the island, but straight there seemed to be out of her capability.

Last month she started vomiting every time she ate, and she was losing a lot of weight – and she was never a heavy cat to begin with.  Mr. TF did some research and began treating her for a hairball.  She puked up two huge ones and then she really seemed to rebound to her old self.  She even became as sociable as she had been when she was young and came out to greet visitors.

We went camping over Halloween weekend and when we came home she was alert, happy to see us, and gave her usual coo of affection when I scratched her ears.  She really seemed happy and healthy, like we had underestimated her.

Then, Monday at 1130pm, she woke me out of a sound sleep.  “MAMAMAMAMAMAAAAA!”  Over and over again.  I knew there was something wrong, I could hear it in her voice.  I finally found her, on the floor practically under my dresser.  She quit crying out as soon as I touched her but I could tell there was something wrong.  I picked her up and I knew she was dying as soon as I did.  She was struggling for air, she had dried poop on her bottom, and she was wheezing and limp.  I turned on the light and called for Mr. TF to wake up.  We had a tense discussion over what to do and he stayed with her while I spent FAR too much time trying to find a vet office we could take her to at this late hour in our rural area.

It was the longest ride to the vet’s office I think I’ve ever had.  Mr. TF drove, I had Abbi in the cat carrier in my lap with it open so I could stroke her head and try to reassure her.  A sheriff’s deputy made a U turn and followed us for a couple of miles – I prayed to who ever might be listening for him not to pull us over.  We weren’t speeding but a car out that late on a weeknight is definitely grounds for investigation, I can see his point, but not now, please not now.  Thankfully he didn’t.

She began seizing right after we got to the vet’s office, I had already called them to alert them and told them we just want to euthanize her, she’s old and we know it’s beyond hope, we just can’t bear to see her suffering.  They scooped and ran with her, and gave her oxygen to stop the seizures while they started an IV.  I know she was beyond hurting at that point but I am so glad they did that.  When they gave her the medicine I was there, stroking her head and scratching her ears the whole time.  It was a true relief to see her take her last breath and relax at last.  And so very sad.  I honestly had not realized how very much I cared for her.  I’ve never been much on pets as family members.  Now I wish I had paid more attention to her in her final months.

They were also kind enough to keep her in their cooler until we could dig her grave.  Mr. TF and I may disagree on many things but this was definitely not one of them.  She was coming home, she was not being cremated, and we were going to make a place for her.

I dug her grave Tuesday night after I got off work, in the front yard in view of the window she used to sit in and watch for birds, under our mulberry tree.  It seemed fitting that it was raining; I was grateful for it since the ground was softer and easier to dig – we have clay and calechi (look it up) so it wasn’t as hard as it might have been though I did have to use the pick and mattock.

Wednesday we buried her; the next door neighbor was kind enough to take her out of the plastic they had her wrapped in and wrapped her in a towel.  We buried her with a toy and a bowl of milk.  We didn’t say anything.  It’s too new, too raw.

abbigraveWe plan to paint her name on the center stone later this year or after it warms up again next.  I’m glad she’s home.  And I’m glad she’s not suffering any more.  The vet said her kidneys were probably failing and that’s why the loss of weight, the vomiting, and, in the end, the fluid filling her lungs.

So what does the title of this post have to do with working for Hel?  Well, I have spent most of the last quarter century dealing with people’s last days in some fashion or another; my husband is a hospice nurse and also spent most of the last quarter century dealing with the same.  We have spent a lot of time in the company of death.  So this blog post by Darksarkasm really hit home for me. I hadn’t thought of my intense desire to end Abbi’s suffering as work for Hel, but I suppose in its way it was. As was digging her grave.

Goodbye Abbi. Welcome home. You will nourish the tree and live in our hearts.

Life is Terminal.


death

I have had a hard time at work this week.  I have been yelled at and insulted by family members, had attempted intimidation by family members, and been asked straight up if I’m “resistant, am I sensing you are resistant to what I’m saying??”  by family members.  All four of these incidents are stemming from family members who are in either rehab or in long term care and on hospice; all of the the patients are in their 80’s.  All have conditions which are ultimately terminal.  One has end stage COPD (emphysema) and has dementia, one has colon cancer with two operations to remove sections of bowel, one has a surgically repaired fractured hip and dementia, one has Parkinson’s and advanced dementia and a surgically repaired fractured hip on top of it.   None of these family members has come to terms with mortality — not in themselves, and most certainly not in their family members.  They take their fear and lack of maturity regarding this oh-so-integral part of life out on us, the staff, by attempting to use yelling, name calling, insults, and intimidation to force us to *make* their family member our special priority and use our super powers to reverse fate.

You will notice I used lack of maturity in regard to them.  I truly believe this is so.  Once up0n a time, death was common and untimely death was more so.  Everyone had a death they had witnessed, everyone had  a funeral or three they had attended.  Death was something that was immediate, commonplace, an ever-present possibility.  One’s own death was contemplated as a religious observance:

“Dying used to be accompanied by a prescribed set of customs. Guides to ars moriendi, the art of dying, were extraordinarily popular; a 1415 medieval Latin text was reprinted in more than a hundred editions across Europe. Reaffirming one’s faith, repenting one’s sins, and letting go of one’s worldly possessions and desires were crucial, and the guides provided families with prayers and questions for the dying in order to put them in the right frame of mind during their final hours. Last words came to hold a particular place of reverence.”   – Atul Gawanda The New Yorker, 2009

I give you  Catholic, Muslim, Jewish, Buddhist contemplations on death.

Medicine, in particular Western medicine and the doctors who practice it, are in large part responsible for the change in our culture from contemplation and acceptance of death to refusal to accept death in any form, any time, whatever.  Doctors themselves are uncomfortable with death, and often refuse to acknowledge the possibility even to themselves, let alone to their patients or family — hence the focus on endless medical interventions even in the face of – frankly – futility.  One can always find stories that showcase the 15% of patients who defy the odds and do well, like this one but the reality is that 85% of people (more in my experience) do not do this well at all.  In fact, they usually go from hospital to rehab facility back to the hospital to rehab to long term care and then, if they’re lucky and their family is compassionate and mature, to hospice.

I am of the firm conviction, having worked in the medical field for more than 20 years, that contemplation of death is a healty thing to do.  Not only is it healthy, but it is necessary for full maturity as a human.  Those who refuse to accept mortality, in themselves or in their family members, have not matured into a full human adult.  They are eternally teenagers, thinking they are the exception to the rule and that they are immortal — or even worse, thinking that if only their loved one could go on forever (or at least until after they themselves are dead) then everything will be just dandy.  I would say that this way lies madness, but I think it’s even worse than that:  this way lies unutterable cruelty.  The family members are not there, day after day, to see the misery and decline of their loved one.  We are.  The family members are not there in the dark hours of the night to see the suffering and despair.  We are.

Who are we?  We are not the doctors – they come in for 30 minutes perhaps daily, perhaps once or twice a week.  We are the nurses and nursing assistants, the social workers, and the ancillary staff.   We are the ones who are left hanging out to dry by our administrators when we don’t meet the expectations of the family, who are usually making the decisions for their loved ones.  We are the ones who see the suffering and try, as best we can, to comfort and support.  We are the ones who are trying to follow family dictates, however fanciful, and provider orders, however unrealistic.  We are the ones *with* your loved one.  Because you cannot deal with their mortality.

Please, if you love your family members, if you have respect for yourself, begin a contemplation of death.  Decide, with those closest to you, how you want your life to go if you cannot make those decisions for yourself.  Write them down, and ask your family members to abide by them for love of you.  Think carefully, for miracles do not exist, only blips on statistical charts.  Do not think yourself so lucky that you will be the blip.