I have seen the ‘angel of death’ 4 times in my life. Two times i watched uncomfortably, not knowing what I was witnessing. Within a few hours it was obvious. The 3rd time I did recognize it, and aggressively told him off and bought his target 9 great years. The last time, i quietly ignored “death” and removed his target buying a few more weeks. They were not good weeks, but had some wonderful and meaningful hours in them. Loss of dignity, unending pain is not meaningful, heroic, desirable or necessary.
It is now my belief when we prolong, life or death, by some artificial means that death may not return at an appropriate time and place. Once I take that responsibility of caregiver, it is incumbent on me to discharge it ethically and morally.
Life and death are a balance. To buy 9 good years is worth a fight. To buy a few bad weeks may well be counterproductive. Do we prolong life, or do we prolong dying? What metrics do we use to decide? The ‘deal’ we made with my mothers doctors were 1 bad week of chemo would yield 3 good weeks. A no-brainer. Near the end we were trying for a few good minutes out of a single month. The metrics change, without notice. “Hi, I’m home, are you still alive?” becomes normal. Is s/he still breathing? One thing that does not change is the last trip home, everyone fears and knows it’s the last trip, but it is unspoken. Another that does not change is the last trip to the hospital. At some point the realization hits that there are a finite, countable number of heartbeats left. What does it feel like to wish your loved one dead? Not for my own convenience, which is meaningless, but so the inevitable ends the continuous suffering.
When s/he with a cancerous tumor stops eating, do we stimulate the appetite, insert a feeding tube, only to realize we are feeding the tumor more than the victim? How we strike the correct balance is a conscious continuous ethical and moral choice. This is the most difficult choice a caregiver can make. When the time to end treatment (except for palliative) or euthanasia becomes obvious, that decision becomes relatively simple. Never easy, but simple. “Today is not the day” becomes “Is today the day?” becomes “i fear I’ve waited too long.”
I first saw Winston before he was born.
Dudley was a nexus cat of spirituality. in his final months there were spirits literally running around my apartment. Others experienced them, all kinds of manifestations, which I carefully documented, were happening. The day after he died it went SILENT.
Dudley was a surprise and he was the cat of my adulthood. He wasn’t supposed to be in the litter of 4 (he was #5) and he was at least 3 times the size of the other kittens. Even as a newborn he had a proud, confident aura about him. We called him “The Bruiser.” I was always his human, even in-vitro, but he was really my mothers kitten. Dudley gave her great joy as she was dying a brutal death from malignant ovarian cancer. He used one of his lives up as a young kitten and mom saved his life. While she was dying she also saved the life of a newborn/stillborn Scottish Terrier puppy of Gwendolyns. Mom pulled the puppy out, pumped his chest, blew breath in and didn’t stop until the puppy started breathing. Mom was like that, a mixture of fearless, stubborn and moxie. Just now I realize, I watched my mother save the life of a puppy by standing up to the angel of death. The older I get and the more I look back I think that’s what bound my mom and dad, their moral compass.
She used to look at Dudley and ask him “what are you good for?” Then she would answer “Loving and being loved.” Dudley eased her transition, it was his purpose and destiny, fulfilled before he was 1 year old. Then Dudley was my cat for the next 19 years. He was a Chief Executive Cat, pure bred Blue Point Himalayan, unflappable and had not a clue that anything in the world could hurt him. I used to joke that his survival instinct had been bred out generations earlier. In his almost 20 years he was sick only three days in his life.
Dudley was loyal, protective and my familiar, my one and only cat for the duration of his life. Late one night I heard him SCREAMING downstairs, BRAH BRAH BRAH, nonstop. I jumped out of bed and ran downstairs past the kitchen. Out of the corner of my eye I saw a little white kitten on the kitchen floor, playing rolly polly around. My mind registered it but Dudley was in distress, he was my priority.
I had left the living room window open a few inches and squall blew in and the wind and rain was blasting through the open window. There was my elderly, fragile, courageous, loyal cat, protecting me with his body while sounding the alarm. I closed the window, calmed him down and carried him upstairs back to bed. I glanced in the kitchen but of course, nothing was there. I saw what I saw and at that point I was used to all kinds of visitations. Dudley seemed to not notice them at all, but he was clearly the nexus. Dudley died peacefully in my arms during a full moon in August in 2004, nearly 20 years old. I buried him in a shroud made from my fathers green bathtowel which had followed me, unused since my fathers death, 28 years earlier. My house became immediately quiet. The next spring, 2005, I rescued Velcro Kitty from Yoshi’s yard and bottle fed him, the only survivor of his litter. Then a few months later I rescued Steinway Kitty from yoshi’s yard.
Winston called me on the phone from Cleveland Ohio in the winter of 2006. I got a phone call from my friend Mark Winston in Ohio. They were having a brutal winter 0 degrees, 3 feet of non-stop snow and there was this flamepoint cat outside yowling at his window. Mark didn’t want to feed it because then it wouldn’t go away. I heard a cat desperately SCREAMING and said “what was that?” Mark said: “that’s the cat”. I said: “I thought you said he was outside.”, Mark said: “he is.” It was so loud it sounded like the cat was screaming directly into the phone. I told Mark to get a box, put blankets in it and feed the cat. He didn’t want to because then the cat wouldn’t go away. I said: “do it NOW and I will come and get him.”
I drove 1,000 miles to rescue Winston kitty. When i arrived he immediately walked up to me and sat down next to me. While I didn’t recognize him, it seemed that he recognized me (cats are funny that way). He just got in the car and home we went. Winston complimented my management style. He is a non-authoritarian alpha cat. Sort of like a *Scrum-master of cats. He immediately looked at me as the kindly inn-keeper and took charge running the the household. He moved on up to a de-luxe apartment in the sky. I think that the rolly poley white kitten on the kitchen floor that stormy night was Winston Kitty.
Winston has outlived all of his friends and colleagues. His once proud pride is long gone.
He and Tadeusz Kitten have become close friends, but in the past two weeks the torch was passed.
Tadeusz Kitten takes his responsibilities very seriously and is caring for his elderly, frail friend.
He rarely leaves Winston’s side
They had a party last night and didn’t come to bed until dawn. I wasn’t invited. Winston feels better for the moment. We have a rally, I hope it’s not the last.
With that smile on his face I know he’s not in pain and I know –
Today is not the day.
*Scrum is a framework for project management that emphasizes teamwork, accountability and iterative progress toward a well-defined goal. The framework begins with a simple premise: Start with what can be seen or known. After that, track the progress and tweak, as necessary.