Saturday, June 16, 2012

Westside Dirty Benjamin, '12

First year, I rode it as my second-ever gravel ride & second-ever century. Last year, we had a wedding to attend, so I helped out, which was great, but not the same as riding. This year, I went for the singlespeed century. Instead of Almanzo's blistering heat and winds, this race pelted us w/ rain for the first hour+, then left us to squish along somewhat drying out until next squall rolled through. Only a couple patches of unpleasant heat; unfortunately for me, the highest temps came right as I bonked. So be it.

In my worried weather planning, I nearly short-shrifted myself for food. Rain jacket? Change of socks? Short sleeve jersey? Sure, I packed all three.

Martin Rudnik, Jason Stukel, and the crew put their backs into making this low-fi event a smooth, interesting, positive challenge. High praise and thanks to their efforts and sacrifices.

We rolled out and, literally, within ten minutes the rain arrived. No major first-miles' wipeouts that we saw. Reminding myself not to push too hard, to go out too fast, to get sucked into the adrenalin at the outset, particularly with only one gear. I fell in with a group that by and large held together for twenty plus miles, then as people rubber-banded up and down the road, trying to find their best pace, a group of fifteen to twenty rolled together for a little while, and then the majority of them gained a gap (due to a guy who was struggling but wouldn't pull over). They rolled over hill and dale, we pursued but were losing ground steadily. Four of us started to bridge up to them...and then we didn't. I realized it would tax me hard just to reach them, and once there, I'd get spit out the back shortly. So four of us fell in together, and we covered the next thirty plus miles together. One was Ken from Cat 6 racing, whom I'd met back at the Slick 50* (64). He was single-ing it, too. The other was a woman training for Lutsen 99 next weekend; she was geared and pulled us a good deal. The fourth guy fell off, leaving the three of us to roll, picking up or passing various stragglers. Good company, good working together.

We were running on collective and individual vapors in the final miles to the checkpoint (mile 61+). My cue sheets fell out, so I was relying on those around me. I had another bottle of water in my trunk but no one wanted to stop so I pushed on. Bad move. We had bad navigator and went 1.5 miles wrong way from checkpoint, then turned around--bringing total miles at finish to 110. At the place, I swapped my drenched, sweaty, dirty pocked long-sleeve jersey for a clean one. I should have taken more of a break but my companions were itching to make up time lost on detour so we pulled out after perhaps five minutes.

In my haste, I left all my second-leg food in my drop bag. And I didn't get enough water on board before starting up. As a result, I downed one of my three bottles in first five miles, and I found myself short on caloric intake. And then, the bonks came raining down. I pulled a while through Luce trench, but right after that were rolling, sun-exposed hills, and I just dropped away. The other two hung back for a bit, but I was broken, so they went on.

I rolled solo, slowly and more slowly. Beautiful countryside out there. I found a convenience store, grabbed some stuff, felt better, and faced the final 25+ miles.

Martin made it good with the trail section at outset, including the large fallen tree; the woods after the checkpoint; the sudden Brrap section of mud and vegetation; the backside course was far hillier than the front, and though small, the hills were unforgiving on tired legs.

I missed sub-seven hours but had a great day. Hard and fun. Great seeing so many now-familiar faces out there.

Tuesday, June 5, 2012

No Such Thing as the Death Fairie

This is older but the song remains the same...



Killing My Dog  

Several years ago I took a community creative-writing class. It was swell, largely innocuous, a gaggle of adults who had the time and money to sit in a room discussing stories they’d written about themselves. The first meeting the instructor apologized for being a bit distracted; she informed us she was struggling with a serious personal crisis. Her dog was sick. A pall fell over the room. We were empathetic and respectful of her possible loss. We were writers, after all. The specter of sick-dog trumped everything and we all mourned, uncritically. In subsequent weekly meetings, class discussion circled back to her dog. Always. Before class, during the break, afterwards: One or two people would hover and bend her ear with their sympathies–which flowed seamlessly, and quickly, into their own personal sick-dog stories.
Everyone, it seemed, had lost a faithful companion. Here was a universal theme.
The class became less about writing than about communal canine grief. No matter the topic of discussion, the mention of a dog crisis, or the sentimentally righteous testament to the unassailable Truth about Noble Dog, and literary merit be damned. We had a circle of nodding, knowing heads filled with love for man’s best friend. 
Now, I’ve had dogs all my life. Likely I’ll force dogs on my family forever. I love dogs, prefer them to most people. But I had some issues with the class: Hey, what about Writing? The word dog isn’t a substitute for critical thought or feeling.  Spending seven grand to replace an eight-year-old beagle’s hips is NOT a given, not in my world. I felt like Scrooge, or a seal-stomper. Parading the images of dead, sick, or suffering dogs around a room does NOT make one more compassionate, nor a better writer. 
My objections had plural roots, the first of which was my childhood dog. She was a great, sweet, goofy, wholly untrained Golden retriever, the first to make it more than a year with us. Our first three or four met untimely ends before Holly, who arrived when I was in seventh grade. She lived fourteen years, but she should have gone at twelve. My family loved her too much to end her misery. Nothing complicated: We couldn’t bear to be the instrument of her death, so she struggled on, limping, wasting–suffering. It takes a deliberate mental jump to collectively ignore the sick dog in the living room. She fell at twelve, breaking her leg. Yet instead of ending it then, mercifully, in the vet emergency clinic, we spent hundreds of dollars to ‘save’ a dog who dragged herself around for another nine months. Embarrassing. And by the end, when we could accept it was time, the painful truth was that it was far past time. More embarrassing. 
I swore I’d never be so lovingly blind again–not for a dog, not for a person.
Another issue I had with the uncritical support group was that I’m a Minneapolis firefighter and EMT. Most every shift for the past twelve years, I’ve seen, heard, touched, and smelled the undeniable truth of life’s end. Death. Not only death: dying. My job–the human suffering and loss I encounter and must deal withclarifies my perspective on life and death. Thrust suddenly into the ghastly or tragic or absurd points on the spectrum of human experience, we do what we can, absorbing the victims’ or the survivors’ grief, fear, and pain. Then we leave and wait for the next call. 
It’s a great job, an honor, but it changes how one views the world.
My first day in the stations, early summer of 2000, I was a wreck. More nervous about fitting in than the emergencies to come, to be honest, I sat at the table listening to the coarse rhythms of station banter. I leaped into a conversation about dogs. A safe topic, men and their dogs. We commiserated with a guy whose prize lab pup had gotten plowed by a three-quarter-ton pickup out in North Dakota. Though my dog wasn’t trained to chase buck-shot fowl, Watt was a husky, macho and impervious to the elements. So, dogs. The guy and another firefighter had been scouting for the upcoming bird season. Three dogs in the back of the truck, two guys chewing Skoal and telling tired jokes. The pup had bolted. Smushed right in front of dogs and men. 
‘Sad,’ we said. ‘That really sucks.’
The guy shrugged. ‘Would of been a good bird dog, dumb son of a bitch.’ He shook his head. ‘Then Lucky got cancer. Had to put her down, too. Just got back last night.’
More commiseration. ‘Two in a month. Fucking sucks.’
‘Yeah. Kids won’t stop crying. The wife’s upset, too, like it’s my fault or something.’
I asked about the older dog, how old she’d been. Lucky was only six. Watt’s ten, I said. I dreaded the day he got ill. The guy shrugged again; he said his dog took it pretty okay.
‘The ride to the vet?’ I asked. ‘Watt hates the damn vet. Gotta beat him into the truck to get him there.’
He stared at me a moment. ‘No, the whole thing. We were up to the cabin, I took her for a walk along the lake. I knew which clearing I wanted, back from the shore and any kids playing.’ He chuckled to himself. ‘She took it easy on me.’
My turn to stare. ‘How so?’
‘Didn’t look back. She sat, I stroked her head a couple times, then that was it. I had the pistol under my shirt. Luck didn’t turn around. If she had, one look and I’d have shot myself.’ He stared through me, his face tight. ‘One shot, down she went.’
Everyone murmured firefighter’s version of condolences:  ‘She was a good dog.’ 
‘Yeah.’ 
‘That sucks.’
‘Yeah.’ 
‘Well, too bad.’ 
‘Yeah.’ 
‘Always hard.’ A pause. ‘So, who’s cooking dinner?’
‘That’s you, Rookie. Better be good.’
Dinner. My next biggest fear: Cooking for this devoutly meat-and-potatoes crew. A grown man with a college degree and a decade working as a professional, I was keenly aware that at this job, one fits in, or one doesn’t. It mattered what these folks thought of me. Not that the crew would let me die in a fire, butthe shifts are long. A hostile crew could make life hard. Yet all I could think was, ‘Oh, I see. They shoot their dogs here. We shoot our dogs.’ 
It wasn’t the time to debate arms control or my fervent opposition to the NRA. These guys owned guns. They used guns. They shot, cleaned, and ate animals. I shopped at the organic market. They put their pistol to their dog’s head and ‘put him down clean.’ My family had ignored our dog’s misery while waiting for the Death Fairy to come in the night and leave a puppy on the hearth. 
This was a new world for me. I sipped my coffee and tried imagining shooting Watt. And because it’s the fire department, without missing a beat someone built on this story, ‘Better than what happened to Smith.’
‘What?’
‘Same deal. Old dog, deaf and half-blind, couldn’t drag itself to piss. The bastard finally admits it’s time, takes him out to the woods. They stop and right as he puts the barrel against the dog’s head, the damn dog turns and looks at him. Smitty starts to bawl. He pulls the trigger, Bang! but he just wounds it. Dog goes screaming through the bushes. Smitty has to chase it down. Fat fuck nearly had a coronary. So he catches the dog, it’s a bloody mess.’ The guy paused, snorted, ‘He was so gassed from the chase, he ended up shooting three more times to kill that poor mutt.’
People chuckled and cursed Smitty’s bad aim and Bud’s worse luck. I nodded again, half-wondering who in the room was armed. I decided it wasn’t the best time to mention I was a vegetarian.
Three years later, I’d survived rookie probation and landed with a good crew in a bad area. Poverty, ignorance, despair make for hard living; violence is generally the first resort. The majority of our calls were ugly. Seeing the dregs and dross, the endless despair, I came home hungry for my family–I cherished my wife and daughters. We’d adjusted to the schedule. Life went along, busy but good. Except, my dog was failing. 
I bought Watt from a sled-dog guy in the backwoods of Colorado. I was living there while looking for teaching jobs. Got a sled dog, then promptly moved to Chattanooga, TN. Not much dog sledding in the Bible Belt. I was twenty-three and trying to get my life together. The name is from a Beckett novel and the bass player from the Minutemen–not Reagan’s toady. The dog ran me ragged while I got sober and became either my new self or just my better self. Tennessee was hot, and full of ticks and fleas. And poison ivy. And snakes. We survived, though, and I moved to Minneapolis largely to make it up to him. Watt certainly thrived in snow and sub-freezing temperatures–which meant I did too (sort of).
A gloriously stubborn prick for 13 years, there was no reason to expect him to go peacefully, in his sleep. He couldn’t reliably manage the stairs. His life was limited to lying on a rug near the door, lying in the dirt outside, eating, sleeping, waiting. He could walk up the block, but much more and his hindquarters would fail him.
I worried that, despite my vows after Holly’s death, I’d become one of those people, the desperate dog people who refuse to admit Time has claimed Fido. We’re so adept at rationalizing, at denying what’s right before our eyes, limping and sighing along. ‘Oh, he’s just tired today...’ Those people who construct sleds, carts, and hoists, dragging the all-but-deceased canine around, steely in their grim determination to stave off death. Dropping thousands on supplements, homeopathic remedies, holistic massage, Chinese herbs, crystals, steroids, amphetamines, voodoo–anything to keep the dog going. ‘I owe it to him,’ they say. ‘Seven grand is nothing if it gets us another year.’
These people love their dogs–without question. But that love and its blinding sentimentality can overwhelm humans’ humane logic. The more technology advances, the more distorted our understanding of–our connection to–the natural process. Buying a pet is not an obligation that supercedes the bounds of nature.
Watching the old boy totter across the yard, I told Annie it was time. Meaning, we had to admit Watt was close to dying; meaning, we had to prepare to put him down. Annie found the concept–putting him down, deciding it was ‘time’–disturbing. ‘It seems cold,’ she said. ‘Heartless. How can we just decide when he should die?’ 
I shrugged. 
‘Well, what if we weren’t around?’ She stroked his head. ‘In the wild, what would happen?’
I pointed at him, splayed on the ground. ‘He’d get eaten.’ 
She frowned, ‘Or left for dead. Starving would suck.’
She couldn’t lift Watt alone. If he went down hard while I was working–what then? He’d shriek in agony, lolling on a failed haunch until Annie could find a neighbor to help hoist him. But what about the girls, she couldn’t leave them alone to run for help. How could she get howling dog and terrified kids all the way to the vet? What could the dog, or Annie, endure? What about our daughters?
Talking over this scenario that night, and I muttered, ‘I’d strangle him. End it fast.’ 
Annie looked at me. ‘You’re joking, right?’
‘Well–’ I shrugged. ‘What else?’
‘He’s your dog. After so many years...’ She frowned, tracing an idea in the air. ‘The last thing he’d know or feel would be you–his beloved master–choking him to death. That’s just horrible.’
‘If his leg’s snapped, or his back, he won’t know a thing. It’ll be the most awful, the most gruesome noise imaginable. What’s better for him: ending his suffering fast or driving all the way to the vet, him insane in pain and fear, just so they can stab him with the fatal needle?’ At work, I’ve held people’s hands as they take their last breaths. Natural causes, where they drift away, and trauma cases, where their life blood literally drains away. I stroked his head. ‘If he’s that hurt, broken-hurt, he won’t know anything, only pain.’
Hmmm. We were in ugly-truth territory. I got a “just how well do I know this person sharing my bed?” look from Annie. We left it unresolved; I promised not to garrote anyone overnight.
How could I kill a dog that wasn’t obviously suffering? Euphemisms abound, but they are weak: put down, assist to die, mercy-kill. I was waiting for the catastrophe that would justify the needle–the final accident that rendered permissible, necessary, the ending of his life. That galled me. Needing a near-fatal fall to justify putting him down, so I could call myself humane. Watt himself was the final reason I objected so strongly to the class mantra of Holy Dog. Watt: I’d raised him by myself and traveled the country with him and gotten sober with him and become a ‘real’ adult with him. He was old, he was failing. It was time. If anything, the bromides and emptily universal truths about dear-old-doggy clarified my belief that we are too disconnected from life, that we think medicine should cure everything. In that writing class, one man made a point of stressing the mercy part of mercy-killing. He said it frequently, with the emphasis heavily up front. I objected, finally, observing it’s killing regardless. Irked, the man tried to bludgeon me with good-will semantics, ‘That’s utterly different! Killing is bad. Mercy-killing is an act of mercy, of love. It’s merciful. Don’t you understand? Mercy!’
‘I understand that, to you, it’s important to stress the merciful part,’ I replied. ‘But you’re taking a life–thus, killing–no matter your motivation. The dog is dying, however you choose to label it.’ I wasn’t calling him a murderer; I also wasn’t accepting the avoidance of responsibility for a hard decision. He was the one needing benediction for his guilt.
As firefighters, we show up and deal with what we find. It takes common sense, focus and calm. We are trained to expect the worst-case scenario; disaster is inevitable. Life is precious, although for many, many people it’s brutal and squandered. Death is certain. I am privileged–and forced–to see life as a process, a cycle.
There’s still no antidote to death, yet we act surprised. 
I doubted I could actually strangle Watt, either physically or emotionally. In the moment, it would be too much. Yet, imagine enduring the canine equivalent of someone begging to be killed. My various dog-owning friends agreed the equation was a balance between Watt’s pain level, his quality of life, against our patience and resources. Wait and watch, basically, knowing the circle was closing ever tighter. 
While I conducted my polls about what constituted or justified a mercy killing, one point came up: ‘Man, it’s hard, but do it before he’s miserable with suffering. That’s one thing you can do for a dog that we can’t for humans. End it mercifully. Better than with my –’ And each person would tell of a relative or family member’s horrible lingering end. 
Many have experienced the agonies of a long-suffering relative’s decline. Daily our crew visits the hellish limbo of understaffed, underfunded nursing homes, where we provide absurdly irrelevant care to festering souls. They are alive technically, but suffering until the release of death. Their families endure months of agony. The person who once-was is long-lost; what remains is the shell. We’re raised to think that doctors, that ‘medicine’ will help. The reality is, medically we can keep a body functioning. But is that Life? 
People are surprised by death so frequently, it’s startling to me. Recently, we had a call where a 54-year-old man with terminal cancer fell into a seizure. His anguished family hovered about, devastated, while we looked at this poor fellow. No paperwork had been completed: no living will, no advanced directive, no DNR/DNI. We were required to work this body. It was horrible, ghastly, inhumane. The family mourned and wailed, their grief massive and palpable. We asked why no one had done anything preparatory. ‘He’s been doing all right,’ the wife said. ‘We didn’t want to upset him.’ 
We nodded and continued our pointless, invasive, distressing ministrations. What we didn’t say was, ‘It’s TERMINAL cancer: There’s no mystery, only a clock. What do you gain by denying it’s coming? Have you made him feel better? How about yourselves?’ Not to be cruel, but when one sees it repeatedly, the stalling and denying and ignoring just get tired. Wholly avoidable abuse. Sparing his feelings, at what expense? 
Nobody intends this.
When it comes to a pet, it’s easier, perhaps–a clearer decision, but then so naked it’s painful. We can act for them; they can’t say what they want, ever.
I doubt I’ll want to live when I should be dead, when I’m half-dead. I hope Annie or our kids will have the courage and sense of humor to cut me free sooner. They won’t ‘spare’ me the awkward conversation about my imminent demise. My wishes will be in writing, in triplicate, stapled to my chest.
I took Watt up north later that autumn, deep into hunting season. I wanted to see the top of Minnesota–International Falls, touted as the ‘Nation’s Icebox.’ I grew up in DC, where a five-hour drive got me to NYC. Here, that’ll get me to the Dakotas, Iowa, Wisconsin, almost to Canada. I had to lift Watt into the truck now, and he could descend only with difficulty and my encouragement. Open trails would be a good change. It would be, I knew, our final trip.
We were going for a three-day jaunt, driving, hiking, roaming the woods. The trees were radiant with fall foliage, the land mostly open and flat. I could see a storm coming and I drove on, hoping to get somewhere before it settled in. I had a tent, and the truck. We’d be fine, like old times.
Every mini-mart was festooned with wind-whipped plastic banners proclaiming Hunters Welcome! and product placement for beer, chewing tobacco, or ammo. I had nothing in blaze orange or tree-toned cammo; Watt certainly wasn’t a retriever. I had no weapons to speak of. I didn’t stock up on beef jerky and Skoal. I failed at standard hunter chit-chat. Inability to make hunting jokes while perusing munitions called me out as a fraud. Just a guy passing through.
A couple hours along, I realized I wasn’t going to find anyplace that wasn’t wet and chock full of hunters. Hunters and deer hiding on all sides of me. I was just dumb enough to get shot in the woods–dumb enough to go for a ‘nature hike’ without a speck of orange on my body. Serves the bastard right, I imagined them saying at the firehouse, dumb-ass vegetarian takes a slug to the lung, drags himself five miles into the brush, then his dog eats him.
We pulled down an old logging road with No Hunting signs posted (Yeah, right, I thought). I drove in a mile or so. By the map we weren’t far from several unincorporated towns, small hamlets amid the trees. It felt like fifty miles from anything. I parked in a clearing and coaxed Watt out of the truck. We stood knee-high in scrub bushes. In the drifting cold rain. He stared at me with that familiar enduring contempt: ‘What now, you idiot?’
‘Okey-doke,’ I said, laughing at myself. ‘Let’s go get wet.’ I began walking vaguely north, thinking, This is dumb. I looked back. Watt was unable to get his balance on the knotted shrubs; his legs couldn’t support him. I waited for him to come my way. We looked like two turtles pacing ourselves in a marathon. 
Ten minutes later he got close enough to me that I could pet him. ‘Good boy.’ I turned west. ‘C’mon, old man.’ He sort of followed, lurching and limping. I stopped again, waiting. ‘Okay,’ I announced to the cloud-mottled sky, ‘this really sucks.’ I cut back southeasterly. In thirty minutes I’d completed a fifty-yard circle. A decade previous, he and I had climbed Mount St. Helens. Watt barely made it to the logging path. His face was blank, eyes neither unhappy nor engaged. Pain and exertion drained his expression. I watched him, forcing myself not to look away. It was awful.
It didn’t matter if we walked five miles or five feet. We weren’t going anywhere. I knelt, stroking him. ‘Sorry, boy. I’m so sorry.’ He didn’t respond, too spent to lick me or move away. I spied the carcass of a mid-sized creature, a racoon or woodchuck perhaps. Only slightly scavenger-torn, its bones retained their basic imprint in the ragged grass. Watt sniffed it but couldn’t investigate further. He looked at me vaguely. My dog, I thought. Oh, my dog.
We were alone under a rainy sky in late-autumn. Snow would come soon, the long brutal winter inconceivable to people not from cold places. Watt used to thrive at five-above to fifteen-below, making me suffer for his pleasure and birthright. He wouldn’t get any pick-up this year. With the ice and snow, just getting down our front steps could be lethal. I sighed. My old man limped toward me. ‘I’m sorry. Sorry, sorry, sorry,’ I cried. I pulled his head to mine. That familiar, pungently unwashed smell. What did he have left? My head was pulsing. Should I put him down, now, here, far from everyone and everything? I was dizzy with the weight that he would die–that certainty–and the cold truth that I could do it now. The shift from thought to action. We could end it now. Be free, skip the painful, grotesque end-game. No human would witness the act.
Had I been planning this? I must have known we’d end up like this, far from anything, just me and him. How could I not? My friends had even jokingly warned, ‘Don’t you come back alone.’
Was dying in the woods better than on a vet’s bleach-scrubbed linoleum floor? Would I be doing him a service putting him down out here, rather than dragging him home to wait for him to slip and crack his hips?
Maybe I had intended to kill Watt. I didn’t run from the thought. I sat with it, wondering at the perversity of human behavior that could half-conceal such a plan. I tried to figure out how one would do it. Not ‘one,’ but me. How I would go about killing my dog. Mercy killing: it held both parts, the mercy and the killing. 
No gun. I had a knife–which seemed a messy, low-percentage option. 
I could try talking him to death, but if he’d survived 13 years of my blather, not likely. 
Tie him up and drive away fast? I laughed at myself: Why tie him? He couldn’t walk more than fifty feet. 
I looked down at him, hoping he might offer some suggestion, even a nod that let me know it was all right. He’d rather go this way.
Was I more worried about the implications on me as a supposedly compassionate person than about the practicalities of the act? You’re cracked, I decided. Ditching the dog is cowardly. Either do it or don’t: You planned this shitty trip into the woods in the rain, what else could you have been thinking? I looked at my battered, slumped old friend. ‘Oh man, it’s a hard road.’ 
Maybe because I’d tricked myself into being ‘surprised,’ I wouldn’t do it. I hoisted him back into the truck and we went home. Screw the state parks. It was raining and my dog was hobbling. We would wait for whatever came along, so-called natural causes.
‘How did it go?’ Annie asked, knowing it hadn’t. What could I tell her, that I almost killed him? That there’s no point to any of it? That we kid ourselves, both about our virtue and our courage?
He made it another four months. I found a vet who did at-home euthanasia. Funny initial call. ‘Hi, you don’t know me but I want you to come over and kill my dog.’
‘Okay,’ the woman said, ‘well, hmm. Generally we like to, you know, meet the dog first. Have some experience with him–before, you know, before we just...’ 
We arranged to meet, and she agreed on the severity of his condition. Final plans were drawn up. And here things got complicated. Try explaining death to a three-year old. My older daughter is sharp, scarily astute the way kids are. Like dogs, they can smell fear and deceit. ‘Watt’s old, and soon, one day real soon, he’s going to go to sleep and never wake up.’
‘Grammy’s old. Will she die, too?’
‘No. Well, yes. Not yet. See, we all do, but not any time soon.’
‘I don’t want Grammy to die.’ Fair enough, who does? But that became, ‘Are you gonna die tonight? I’ll be sad when you die. Who’ll be my new Papa when you die tonight?’ Which became, ‘I don’t want to go to sleep–I don’t want to die!’ 
And we tried to parse that semantical sandwich, doggy-death foretold vs. parents won’t die tonight. Then the pickle of explaining to her how Watt was going to die. You can’t say Vet, Doctor, Shot, Needle, Pills, because any connection–literal or figurative–between the vet euthanizing an old dog would wreak havoc on any future trips to the pediatrician. Plus, we’d gotten a puppy, both in expectation of Watt’s passing and to give him some puppy love at the end. Wouldn’t the pup be traumatized by the scent of the vet showing up to kill her big brother? 
Soon we were talking about Annie hiding with both the pup and the kids upstairs in the bathroom so we could put Watt down without triggering long-term mental anguish for pup and children. I balked, finally. ‘For all this, why not just do it at the vet?’
  Which we did. We gathered around him at home, gave him the sedatives, let him loll in the snow until I trundled him into the truck one last time. He was pretty much out already, and the shot took him quick. I held his head, saying goodbye. For once, Watt took it easy on me. Within a minute he was gone, the tremendous body drained of life. I sat a while holding him, smiling through my tears. I wasn’t sad, though. He got a good end. No mystery, no myth: He’d lived a good life, he got old, he was dead. It hurt like hell, of course.
The vet was solicitous, asking how I was, reassuring me Watt was in a better place.
‘Well, that’s for sure.’ I laughed. ‘We had a great run,’ I said. ‘C’mon. He was old and hurting. I couldn’t have asked for more time or a better dog. I’m lucky.’ 
Driving back from the vet I stopped at the dog park, a sudden impulse. I kept to myself, not wanting to bring dead-dog juju around the dog-lovers. I definitely didn’t want strangers’ heartfelt but generic sympathies. I wanted to see their dogs. Amid the canine frenzy a young husky ran wild. Gorgeous, lanky, almost feral–blissfully ignoring his owner as Watt had ignored me. I recognized the beyond-frustrated tone in the owner’s futile commands. And the dog was beauty in movement. I had to smile: That was a husky. My dog had been gone a while. He’d limped and shuffled about long enough that the ‘real’ Watt was a memory: a memory contained in the aged body. I’d looked through the hobbled flesh and fur to the living ghost of my youthful dog. Now, he was free, too, and it was all memory.
Biographical: Jeremy Norton lives in Minneapolis, MN with the performer Annie Enneking and their two daughters. He is a Fire Captain for the Minneapolis Fire Department and trains dogs as a hobby. He has an M.A. in Fiction Writing from Boston University, which certainly comes in handy on emergency response calls.

Sunday, June 3, 2012

Doctor, Doctor, you give me the blues...



Hard Wednesday:
My first five runs the other day left me grasping for a teddy bear, but the way the shift was spinning, the bear would have been mangy, missing its legs, and suffering a suppurating ear infection. The trajectory from professional medical indifference or incompetence to the depths of unsolvable misery stamped sorrow and anguish into our minds and hearts.
Right away as the shift was starting, we were called to the clinic down the block (one of two medical facilities within six blocks of each other along Bloomington Ave, but not the one we burned to the ground last winter: that’s a nice empty lot currently). A woman was having a ‘Severe Allergic Reaction,’ according to Dispatch’s comments. We arrived at the clinic and were escorted through the maze of hallways and cubicle-offices until we reached the room where a 50-something woman was sitting on a chair across from a doctor typing into a computer. The woman was lumpy and fleshy, but she was not presenting with allergic symptoms--certainly not severe reaction symptoms. Now, doctors have far more training than I do, so I defer to them in these situations. I asked him what was going on, and as he narrated what he’d been typing, I assessed the woman. Christie provided her an oxygen mask and took her vitals. Everything checked out in the normal range. 

The doctor’s report stated she had had her medications switched recently and now she felt she was having an allergic reaction. He said she’d stated she was having chest pains, difficulty breathing, prickles up and down her arms, and swelling all over her body. He said she’d come in this morning to have her medication checked again, but when she complained of an allergic reaction, they’d called 911.


I was listening to him, but I was focusing on the patient. The woman was breathing quickly but without strain. There was no swelling, no redness or blotching, no hives. She looked fine, basically. ‘Ma’am, do you have other medical issues?’
‘Oh yes,’ she said, nodding vigorously.
‘Do you have anxiety issues?’
‘Oh yes.’
‘Ma’am, let’s work on slowing down your breathing. You don’t seem to be getting enough oxygen, and that makes things tingle.’ We cut off the oxygen. Christie tried to get her to slow down. I asked the doctor what made him think it was an allergic reaction. ‘She said it felt like an allergic reaction and she was worried her throat might be closing.’
‘Did it appear that she was in a medical crisis?’
‘She needs her meds re-calibrated, so we thought it best she went back to where she got them.’


The paramedics arrived. I explained what we’d found. The patient was breathing much better, but still, she insisted, she was worried she might be having an allergic reaction. The medics smiled and patted her hand, then had us load her onto the stretcher.




I was fuming: a medical doctor calls 911 (has his staff dial 911) because a patient with anxiety history claims she thinks she’s having an allergic reaction--despite presenting with nothing more than anxiety-based shallow breathing. For a code-three EMS response and an ambulance ride to the hospital. A medical doctor.


Back on the rig, we pondered whether he was that cynical, lazy, or incompetent that he simply passed her onto the next facility rather than explain to her she was fine and to slow her breathing, or to have her schedule another non-emergency appointment with her regular doctor to check her meds.
We were finishing our morning station duties (mopping, cleaning bathrooms and common areas, checking the rigs, arranging inspections) when a call for Difficulty Breathing came in. We dropped the mops, phone, paper and headed out. Our patient was another 40ish-going-on-66 year old. She’d recently been diagnosed with congestive heart failure (CHF) and CHF-related asthma. Their apartment was thick with recent and ancient cigarette smoke, with teeming ashtrays perched on multiple surfaces across the rooms. The woman was sitting stiffly on the edge of a chair, laboring for breath. One look at her, in her eyes, and we could see she was deathly scared. Her failing lungs were literally suffocating her. Insufficient air exchange meant there was always fluid accumulating in lungs and in body, slowing choking her. We slapped the 02 mask on her and took vitals. Her blood pressure was over the moon. We tried to calm her and had medics bring their canvas in. 


There is a feral agitation to folks suffering this form of CHF. Both drowning and suffocating: hell of a slow death. And it is slow, and constant. They rushed her to the hospital, where the staff would give her a series of meds to drain the fluids and open her lungs. She’d feel better, briefly, and they’d release her. Within hours of getting home, the symptoms would return, and soon she’d be struggling to get enough air in, straining and fighting against the elephant foot of death grinding dead-center of her chest. We felt for her--that panic and fear are very real. Yet she and her husband would continue to smoke until they couldn’t lift the butt to their twitching lips any longer. Slow suicide.
We were between an inspection and shopping for lunch and dinner when the next call came in. A Possible Heart at the oncology unit of the medical complex on Chicago Ave. Hey, kids, want a really depressing field trip? Let’s go to the cancer ward! And off we went. It is strange to respond to these medical clinics and doctors’ offices. We are barely trained clods with 02 and AEDs--why do the medical professionals need us? I try to be inconspicuous, or at least unobtrusive, when we walk through the expansive, always crowded waiting room. So many people with cancer...


Our patient was a mid-50s woman with pancreatic cancer. She’d just had her second run of chemicals and was feeling very ill. ‘Are you having trouble breathing, ma’am?’ I asked. She shook her head. Her daughter said the first run, the previous week, had made her feel very nauseated. I asked if she felt similar now. She nodded. The woman looked ill. We took her vitals, which were on the lower side of normal. She was breathing normally. Not a heart attack. The daughter offered that her mother had been indicating her abdomen when she told the nurse she was having chest pain.


The woman made a urping sound and reached her hand toward her daughter, who swiftly grabbed and handed her mother the emesis bag. The mother vomited. The daughter was skilled at caring for her. ‘This is similar to response she had the first time?’ I asked the daughter. She nodded. I looked at the woman, who was vomiting discretely, almost calmly. She finished. Her daughter took the bag from her; I peered into it to ensure there was no blood. The mother looked much better, less pale green. ‘Do you feel better, ma’am?’


She nodded.
The primary side-effect of chemo is nausea and vomiting. This is a doctor’s office specializing in cancer treatment. A patient complains of pain in her abdomen after her chemo run. The don’t ask any follow-up or substantiating questions but call 911 for a possible heart attack.


I wanted to scream.
This woman was dying of pancreatic cancer. There’s no cure. She was clearly suffering from symptoms of the cancer and its treatment. WHY would we heap insulting, futile non-treatment with a dumb ‘emergency’ call that will only keep her away from her own bed and trapped in bureaucratic revolving wheel of waiting rooms and paperwork--how DARE we be so venal?


My best friend’s mother died from multiple myeloma a couple years ago. She was sick for over six years, nearly dying early into it, recovering/stabilizing for three, then going quickly. She had great pride and dignity, and the endless humiliating routine of office visits, waiting, disinterested treatment by the doctors and nurses, waiting, and the sickness itself wore her out. The indignities of being a patient, a number, were almost as bad as the cancer itself. I think of her whenever I’m in these offices. It’s just wrong. 


When the paramedics arrived, I explained to them that there had been a miscommunication, that there was no emergent issue, and encouraged them not to transport her. Too often, the medics arrive to something clearly not-serious and transport anyhow, because the risk or threat of being sued by a malcontent or scammer for mistreatment or dereliction trumps common sense. It’s easier to throw one more body into the churning machine than to help people help themselves.
We were unloading the groceries and settling down to lunch when the next call came, for an intentional overdose. Some self-harming calls demand we stage until police secure the scene. Others, it’s the captain’s decision. The comments stated the patient had taken too many meds and was semi-conscious in the front yard. I said we’d go in on our own. 


The address was two blocks away; we got there fast. I recognized her as soon as I stepped off the rig. A former frequent flier who broke my heart: young woman in a wheelchair due to losing use of her legs before she was thirteen. Poor, angry, bitter, fucked. A raft of associated illnesses, constant infections, miseries--to be so young and so trapped. I know there are many inspiring people who overcome disabilities. This woman isn’t one of them.


For a few years, she had lived in a dumpy apartment three doors up from the stoop where she was now nodding off. She, her capable and stressed-out partner, and their young daughter, in a dingy, cigarette-saturated efficiency. We’d respond because she was feeling ill, or she was in pain, or she needed more meds, or she was mad they hadn’t given her the right meds to address skin lesions, bedsores, chronic UTIs--the list was depressing. She had the curdled disposition of one long in pain and helpless to solve her own problems. We’d arrive, see that she wasn’t in acute distress, and then try to get her down to the ambulance. The landlord refused to put in a ramp, so her partner had to wheel her up and down the steps, a bumpy, jolting ride made worse by four to six months of snow and ice here. 


I tried several times to get her a case worker. When she stopped calling 911, I thought they’d found a solution. Or she’d moved and was now someone else’s problem.


It turned out I was right on both counts: her old man said he’d moved out over a year ago--couldn’t handle the stress of living with her, as well as taking care of her. He had sole custody of their daughter. He said they’d found her a live-in care facility, where she’d been for most of the past year. Except she’d just been evicted for failing to pay and for being unpleasant. She’d called him before the cab brought her to this stoop, informing him she’d been evicted and that she was OD’ing on pain meds.


Their daughter was clinging to the legs of a woman I deduced to be his new girlfriend. He told me the stress of the woman’s instability caused their daughter to rip her hair out. I looked again and could see a shorn, patchy scalp beneath her Twins cap. There wasn’t a lot of light or intelligence radiating from her eyes. Scared, dull, sad. I smiled and waved at her.
  Futility.


We had 02 on the woman and got her vitals. Her head was lolling onto her chest unless we held it up. She mumbled or slurred a few incoherencies if I pinched her shoulder to rouse her. I told her ex I was sorry--for him, for their kid, for her--and tried to patch some recent info together. It’s not his fault he fell for someone so fucked; it’s not his fault he moved on. He said she took the pills deliberately before getting in the cab so they’d take effect by the time she arrived. ‘To mess with you?’ I asked.


He shook his head. ‘Not even. To get to Abbott so she can get her infections treated.’ He explained that she had deep open wounds on both haunches, bed sores turned septic (with MRSA). Incredibly painful and hard to heal, these needed treatment but she couldn’t get it at the care facility. She had open sores on her ankles, too.
  ‘So, she OD’d to get into the hospital for some care?’
  ‘And a place to sleep. She can’t stay here. It’s unfair, too upsetting for our daughter.’
      I nodded. We kept her semi-conscious and breathing comfortably until medics arrived. MPD squad arrived and signed a psych hold for the medics (standard for someone self-harming, especially those incapacitated), earning her a three-day minimum stay on the psych ward.


I wished the guy and his kid well. We got in the rig and rolled slowly back to the station. The other two were unfamiliar with her and her story. I wanted to see a unicorn soar over a rainbow or something cuddly. Instead, I wrote up the reports directly, including potential exposure to MRSA. 


Life isn’t fair. We get that. Many people make the best of horrible situations. Many others flail and thrash and dig themselves even deeper into the mire. And some are just fucked for fair. I doubt I’d have a sunny disposition if I’d lost my legs at 12 and suffered chronic bed sores. I might make different choices, but, from a position of health and relative wealth, I don’t have a fucking clue how I’d react to hard times.
Aaaannnnd, speaking of which, we responded about ninety minutes later to the lobby of Rainbow Foods, our regular grocery store. Dispatch stated it was a man complaining of a GI bleed and said he was uncooperative on the phone, possibly drunk.


Yes, yes he was. He was uncooperative. He was certainly drunk. A chronic alcoholic homeless Native, one we see making rounds from Franklin Ave. to Lake Street. He was slouched against the Coke machine in the lobby of Rainbow. He was grouchy and eyed me suspiciously. I get that frequently. He was on a different wave length and had no patience for my patient interview. The wispy hairs of his mustache were three times over the legal drunk limit; his breath nearly melted my badge. We bantered. I kept my balance steady, ready to defend a blow if his drunk temper surged. Mostly he gave me shit. Which was fine. He was a homeless alcoholic with nasty sores all over his body, a failing liver, skin disfigurement from Vitamin B deficiency (from alcohol abuse--either B or C). He was on his way to the ER, unless the cops put him in Detox first. I could entertain some abuse. After all, it’s what I get paid to do.