Monday, October 4, 2004
The Truth about Cats and Moms (and Me)
After a very long session with our very patient, excellent vet, I've decided to have an esophageal feeding tube installed in The Big Girl tomorrow. The procedure is a temporary measure to insure that The Big Girl receives enough nutrition and medication to turn the tide on her fatty liver, the cure for which is to eat, which The Big Girl is accomplishing at only a below moderate level. Day by day over this weekend she has appeared to me to be reviving but not fast enough to reverse any of her conditions. Depending on how quickly The Big Girl returns to a normal weight and begins to recover from her pancreatitis, her diabetes (which the vet believes is temporary) and her fatty liver, the feeding tube could remain bandaged to her neck for anywhere from a week to a month. Although I'm sure that The Big Girl's pancreatitis (and her attendant diabetes) is due to her ability to stress herself over the slightest things, I was mystified regarding the cause of her fatty liver until I explained to the vet today exactly the extent of her ability to stress herself out. The vet said that in a cat such as The Big Girl who is fed an excellent diet and is otherwise well cared for her periodic and frequent refusal to eat and hydrate when she becomes stressed can very easily cause this syndrome. I also asked the vet whether there exists some sort of pet approved psycho-pharmaceutical that might help The Big Girl lower her stress level. There is such a product, a natural herb tincture, the name of which escapes me at the moment, available at a natural food store here, that does have a calming effect on animals with The Big Girl's temperament. The vet is going to email me with this information along with a proposal she is drafting for continued professional care of The Big Girl. I'm choosing a conservative approach with slight modifications depending on how she does. The vet is going to write up and suggest several options. Interestingly, when I mentioned that I expected The Big Girl to require fairly frequent and intense veterinary care for the rest of her life the vet said she felt exactly the opposite and that once we control this particular crisis, which shouldn't take long, considering The Big Girl's desire to live, The Big Girl and I can both expect for her a life as care-free as a normal, healthy cat, provided we can get her stress level under control. The insertion of the feeding tube tomorrow will also include a liver aspiration/biopsy so the vet can see what's going on with her liver and whether her hunch that "all" she's suffering from, hepatically, is a fatty liver," is correct. She's been on target with all her hunches so far, so I'm expecting good news tomorrow.
My mother's distress over the involved treatment of The Big Girl continues and is compounded by her short term memory loss. After explaining three times between 0745 and 0900 why I was taking The Big Girl back to the vet today, when she asked a fourth time I said, "Mom, you know, I'm very sorry that you can't remember what I've told you about this three times already this morning but I don't want to repeat it again, nor answer your questions again. You'll just have to trust me that I'm doing the right thing by The Big Girl and that we are solvent enough to be able to afford her care." Her brow wrinkled but she accepted what I said. Amazingly, she did not ask again.
She does, however, continue to recall as fresh information my aborted decision to euthanize The Big Girl. We've had two extended discussions on this topic, one last night and one this morning. Her feelings are that while people can before or at the critical time express their desires about whether or not they wish to be euthanized, domestic animals cannot. "They trust us," she said, "and putting them to sleep without being able to determine whether this is what they want is an abuse of that trust."
I could not let the discussion go without a specific plumbing of more of her thoughts. I asked her if she thought that it was difficult to determine whether an animal was suffering.
"No," she answered.
In that case, I asked, was she saying that she believes it is preferable to allow an animal to suffer when there is no remedy than to end the suffering.
"Well," she said, "maybe it isn't as easy as we think to tell how much an animal is suffering."
I asked her if she thought I am incapable of determining whether either of our Girls was suffering.
"You were wrong Saturday, so I'm not sure."
I reminded her that when I realized I was wrong I changed my mind. Had this not make an impression on her?
Yes, she said, it had, but she is still concerned that "people" tend to interpret their own convenience as the suffering of an animal, thus put animals down when "the animal still has a chance".
"Are you saying," I asked, alarmed, "that you think my internal debate over whether to put The Big Girl down and my final decision, which I reversed, were based on my convenience?"
The gravity of her possible answer registered in her face. She was silent for some moments, then said, "I don't know."
"You've watched me over the last week or so take intense care of The Big Girl, care, I might add, which The Big Girl, for the most part, was unwilling to accept. You've watched the struggles that have ensued. You've watched me doggedly search out information and agonize over it in order to make the right decision on behalf of The Big Girl. You've watched me reverse decisions more than once. Do you believe that any of this was 'convenient' for me to do?"
Once again she was silent while she contemplated what I'd said. I could tell that she was trying hard to remember all the images she'd gathered over the last week plus of me being so concentrated on The Big Girl that my expressions of affection and assurance toward The Little Girl lagged, my ability to finish the sale of the Mesa home was pressured beyond belief and my care of my mother fell a bit left of my target.
"No, you're right, it wasn't. It hasn't been convenient for any of us."
I sighed my relief. "I know, it hasn't been. From now on," I said, "I think it might be a good idea if you trust me to make appropriate decisions about The Girls' health care. You trust me to make these decisions about your own health care. Do you believe your trust has been well placed?"
"Absolutely. I trust you over the doctors."
"Then believe me, Mom, when I tell you my love for The Girls is in the same category as my love for you."
"I know."
"The only difference is the mode I have to use to make decisions. I can't consult with The Girls in the same way I can consult with you. I can't, for instance, after noticing that something seems to be off, ask them 'where it hurts'. Sometimes I have to be even more vigilant of them than of you in order to figure out whether professional care is necessary, what kind is advisable and whether that care will turn out to be beside the point or cause even more problems. Do you trust me to do this with The Girls with the same level of astuteness as I do with you?"
"Oh, yes."
Finally I asked, "Mom, if I had determined, irrevocably, that The Big Girl needed to be euthanized on Saturday, would you have resented me for that decision?"
Once again she had to think about this. "I wouldn't have resented you," she said carefully, "I would have resented your decision."
"Let me explain something to you, Mom. You saying this is akin to someone saying to, for instance, an artist, 'I'm not rejecting you, I'm rejecting your work.' The truth is that a person's work is that person. So is a person's judgment. I don't care that the prevailing feel-good theory is 'it's not you, it's what you do', that theory is a lie. We are all no more and no less than what we do. All of us face rejection and all of us have more than enough opportunities to learn how to get over it and go on. So you can't duck the question with a platitude, not with me, anyway. Let me see if you agree with this: Do you believe that I'm capable of making sound decisions across the board?"
"Yes."
"Do you believe that I'm capable of seeing my decisions through and taking responsibility for them regardless of whether anyone else agrees with me?"
She laughed. She has seen me make very unpopular and highly challenged decisions many times in my life and many times on her behalf. "No question!"
"Then," I asked, "do you feel that regardless of whether you resent my decisions, and, thus, me, I am capable of seeing to it that my decisions make the best of whatever situations in which we find ourselves?"
I expected hesitation but I was wrong. "Yes. I'm sure of that."
The ultimate importance of the two versions of the above discussion we had isn't whether The Big Girl is allowed to live through the weekend. The month of September contained yet another life altering decision I made on our behalf that my mother found stressful and did not always consider wise: The sale of our mobile home in Mesa. It is now beyond her to understand that we haven't been able to afford that home for almost two years. Throughout the last month Mom has had periods of trying to figure, in her now limited capacity, how we could keep both places. She has no understanding of how difficult it has been, both financially and circumstantially, for me to negotiate us living in both places. She does not even remember that her health has "stuck" us in one or the other of the homes when our enforced stays have been convenient medically but wildly inconvenient from every other perspective of our life. She ultimately had (and has) to trust that my decision on selling the Mesa home is the best for our family. She did so grudgingly and under protest. She continues in some ways to protest and grieve this loss. The two discussions we had gave her a chance to consider that I do not lightly beset us with loss and the possibility of grief. I do not make a decision that involves a loss for us without first going to sometimes ridiculous lengths to retain whatever it is we stand to lose. I am not incapable, as well, having made such a decision, of reversing it if the circumstances warrant. Now that she's considered these aspects of my ability to care for our family I think it will be easier for me to handle our life without undue stress to my mother. She may not remember the discussions but I think, somewhere in the depths of her psyche, she will remember that she came to a settlement within herself that I can be trusted to handle our life to best effect for both of us. This is what is important.
My mother's distress over the involved treatment of The Big Girl continues and is compounded by her short term memory loss. After explaining three times between 0745 and 0900 why I was taking The Big Girl back to the vet today, when she asked a fourth time I said, "Mom, you know, I'm very sorry that you can't remember what I've told you about this three times already this morning but I don't want to repeat it again, nor answer your questions again. You'll just have to trust me that I'm doing the right thing by The Big Girl and that we are solvent enough to be able to afford her care." Her brow wrinkled but she accepted what I said. Amazingly, she did not ask again.
She does, however, continue to recall as fresh information my aborted decision to euthanize The Big Girl. We've had two extended discussions on this topic, one last night and one this morning. Her feelings are that while people can before or at the critical time express their desires about whether or not they wish to be euthanized, domestic animals cannot. "They trust us," she said, "and putting them to sleep without being able to determine whether this is what they want is an abuse of that trust."
I could not let the discussion go without a specific plumbing of more of her thoughts. I asked her if she thought that it was difficult to determine whether an animal was suffering.
"No," she answered.
In that case, I asked, was she saying that she believes it is preferable to allow an animal to suffer when there is no remedy than to end the suffering.
"Well," she said, "maybe it isn't as easy as we think to tell how much an animal is suffering."
I asked her if she thought I am incapable of determining whether either of our Girls was suffering.
"You were wrong Saturday, so I'm not sure."
I reminded her that when I realized I was wrong I changed my mind. Had this not make an impression on her?
Yes, she said, it had, but she is still concerned that "people" tend to interpret their own convenience as the suffering of an animal, thus put animals down when "the animal still has a chance".
"Are you saying," I asked, alarmed, "that you think my internal debate over whether to put The Big Girl down and my final decision, which I reversed, were based on my convenience?"
The gravity of her possible answer registered in her face. She was silent for some moments, then said, "I don't know."
"You've watched me over the last week or so take intense care of The Big Girl, care, I might add, which The Big Girl, for the most part, was unwilling to accept. You've watched the struggles that have ensued. You've watched me doggedly search out information and agonize over it in order to make the right decision on behalf of The Big Girl. You've watched me reverse decisions more than once. Do you believe that any of this was 'convenient' for me to do?"
Once again she was silent while she contemplated what I'd said. I could tell that she was trying hard to remember all the images she'd gathered over the last week plus of me being so concentrated on The Big Girl that my expressions of affection and assurance toward The Little Girl lagged, my ability to finish the sale of the Mesa home was pressured beyond belief and my care of my mother fell a bit left of my target.
"No, you're right, it wasn't. It hasn't been convenient for any of us."
I sighed my relief. "I know, it hasn't been. From now on," I said, "I think it might be a good idea if you trust me to make appropriate decisions about The Girls' health care. You trust me to make these decisions about your own health care. Do you believe your trust has been well placed?"
"Absolutely. I trust you over the doctors."
"Then believe me, Mom, when I tell you my love for The Girls is in the same category as my love for you."
"I know."
"The only difference is the mode I have to use to make decisions. I can't consult with The Girls in the same way I can consult with you. I can't, for instance, after noticing that something seems to be off, ask them 'where it hurts'. Sometimes I have to be even more vigilant of them than of you in order to figure out whether professional care is necessary, what kind is advisable and whether that care will turn out to be beside the point or cause even more problems. Do you trust me to do this with The Girls with the same level of astuteness as I do with you?"
"Oh, yes."
Finally I asked, "Mom, if I had determined, irrevocably, that The Big Girl needed to be euthanized on Saturday, would you have resented me for that decision?"
Once again she had to think about this. "I wouldn't have resented you," she said carefully, "I would have resented your decision."
"Let me explain something to you, Mom. You saying this is akin to someone saying to, for instance, an artist, 'I'm not rejecting you, I'm rejecting your work.' The truth is that a person's work is that person. So is a person's judgment. I don't care that the prevailing feel-good theory is 'it's not you, it's what you do', that theory is a lie. We are all no more and no less than what we do. All of us face rejection and all of us have more than enough opportunities to learn how to get over it and go on. So you can't duck the question with a platitude, not with me, anyway. Let me see if you agree with this: Do you believe that I'm capable of making sound decisions across the board?"
"Yes."
"Do you believe that I'm capable of seeing my decisions through and taking responsibility for them regardless of whether anyone else agrees with me?"
She laughed. She has seen me make very unpopular and highly challenged decisions many times in my life and many times on her behalf. "No question!"
"Then," I asked, "do you feel that regardless of whether you resent my decisions, and, thus, me, I am capable of seeing to it that my decisions make the best of whatever situations in which we find ourselves?"
I expected hesitation but I was wrong. "Yes. I'm sure of that."
The ultimate importance of the two versions of the above discussion we had isn't whether The Big Girl is allowed to live through the weekend. The month of September contained yet another life altering decision I made on our behalf that my mother found stressful and did not always consider wise: The sale of our mobile home in Mesa. It is now beyond her to understand that we haven't been able to afford that home for almost two years. Throughout the last month Mom has had periods of trying to figure, in her now limited capacity, how we could keep both places. She has no understanding of how difficult it has been, both financially and circumstantially, for me to negotiate us living in both places. She does not even remember that her health has "stuck" us in one or the other of the homes when our enforced stays have been convenient medically but wildly inconvenient from every other perspective of our life. She ultimately had (and has) to trust that my decision on selling the Mesa home is the best for our family. She did so grudgingly and under protest. She continues in some ways to protest and grieve this loss. The two discussions we had gave her a chance to consider that I do not lightly beset us with loss and the possibility of grief. I do not make a decision that involves a loss for us without first going to sometimes ridiculous lengths to retain whatever it is we stand to lose. I am not incapable, as well, having made such a decision, of reversing it if the circumstances warrant. Now that she's considered these aspects of my ability to care for our family I think it will be easier for me to handle our life without undue stress to my mother. She may not remember the discussions but I think, somewhere in the depths of her psyche, she will remember that she came to a settlement within herself that I can be trusted to handle our life to best effect for both of us. This is what is important.
