XX
dr. death and dr. berry
ONE EVENING, AFTER we had moved into our new house, Trix and I went to the backyard so she could pee before bed. Inside once more, as she preceded me up the back stairs, eager for the cookie she would receive from her kitchen stash, she suddenly let out a thin but sharp yelp, a single fraction-of-a-second cry, and froze with her back legs and forelimbs on different steps. She turned her head to stare at me with alarm. I could not persuade her to lift a single paw. She seemed prepared to stand there forever, and her flanks were trembling. Shaken by a presentiment that this was the first moment of a living nightmare, I carefully lifted her and carried her up to the kitchen.
When she was on a level floor, she appeared to be fine. She padded directly to where her cookies were kept and favored me with one of her you-know-I-deserve-a-treat looks. I wanted to believe the moment on the stairs had been without serious meaning, but I knew better. Fearing for her, suspecting that one kind of suffering or another lay ahead of her, I gave her three cookies and would have given her the whole jar if she hadn’t turned away after three and gone to her water bowl.
We rode up to the master suite in the elevator, avoiding the stairs. This was a larger, more modern, and more professionally installed elevator than the one that we had in the previous house. Instead of clattering up and clamoring down on cables, the cab was on the end of a hydraulic ram that raised and lowered it quietly, without any shrieking apes in the attic. Trixie had no reservations about riding in it.
To spare Gerda from a sleepless night, I didn’t tell her about the scary moment on the stairs until morning. After breakfast kibble, when I took Trixie out to toilet, she had difficulty getting her bowels started. She squatted, began to strain, immediately stopped and crabbed forward, tried again, stopped, crabbed forward, as if the straining caused her discomfort. Finally she managed to do her business.
I took her to her vets at the animal hospital, and they X-rayed her spine. The preliminary diagnosis was that Trixie had a spinal problem and would need to undergo an MRI before it could be determined whether she required surgery.
We made an appointment with a veterinary surgeon who had the best references. After two days of avoiding stairs, we took Trixie in at five o’clock in the morning for an MRI. We were told that we could pick her up twelve hours later, at five in the afternoon. This seemed an inordinately long time, but they explained that she needed to be fully recovered from sedation before they would release her.
At five o’clock sharp, when we returned, a veterinary assistant brought Trixie out to the reception lounge. Our girl was in shocking condition. She wobbled when she walked, and her legs repeatedly went limp under her, dumping her on the floor. Her lower eyelids were so prolapsed that her thoroughly bloodshot eyes looked as if they would roll out of the sockets, and they were weeping copiously. She did not appear to recognize us, neither wagged her tail nor responded in any way when we touched her and spoke to her.
We knew that the veterinary surgeon was still in the facility because we heard the receptionist speaking with him on the intercom. Gerda told the vet assistant that we wanted to see the doctor, but the doctor declined to come out and speak with us.
Although she is petite and soft-spoken, Gerda can put a steely menace in that gentle voice without raising it. The vet assistant backed off a step when Gerda said, “He won’t come out? This dog has been grossly oversedated. Where is he? We’ll go to him.”
By the alternately defensive and aggressive—and entirely inappropriate—reponses of some on the facility staff, we suspected that scenes like this had occurred before. After originally telling us they would not release Trix until she was completely recovered from anesthesia, they now insisted there was nothing to worry about if we took her home even though she couldn’t stand up and didn’t know who we were.
No doubt the doctor had skedaddled out a back exit, and we would get no satisfaction even if we kicked open every door in the place to track him down. Trixie was our first priority. I carried her to our SUV, and we took her home.
Expecting that she might vomit or void in some other way, we bedded down, all three of us, on the kitchen floor, where we were close to whatever we might need: cold water, ice, all the cleaning materials in the nearby laundry room, an outside door. Trix seemed as unable to sleep as she was unable to walk. Lying on makeshift bedding with our girl between us, we stroked her and spoke softly to her, worried that she had suffered permanent brain damage by reason of reckless over-sedation, and we worked up the kind of quiet rage that usually leads to shotguns and Molotov cocktails.
Near midnight, Trixie was finally able to rise far enough to lap some water from a bowl. She started dozing on and off, but she showed no sign that she recognized us until four o’clock in the morning, eleven hours after we brought her home. She was not fully herself until around five o’clock the next afternoon, twenty-four hours after we brought her home from Dr. Death’s Hospital of Horrors.
Adding a rotten cherry to this toxic sundae, Dr. Death’s office called to inform us that the MRI had not produced sufficiently clear images to make a diagnosis. I wanted to know what combination of illegal drugs the doctor himself used on the average day, but his staff was reluctant to disclose this information.
I TOOK TRIXIE next to a neurosurgeon, Dr. Wayne Berry, who came into the examination room, at once got down on the floor with Short Stuff, called her “Cookie,” and won her adoration in about one minute flat. He had taught veterinary surgery at South Africa’s largest university, but he had immigrated to the United States with his family some years earlier. He was ex-military, with the rational self-confidence, air of competence, and efficient manner of a man who knew the value of discipline and who had a sense of honor about how he lived his life and performed his surgery.
Wayne wanted another MRI. He assured me that it would provide a definitive diagnosis because he would be present during the procedure and would insist on redoing any slice of the image that wasn’t clear. I needed to return with Trixie by five thirty Wednesday morning.
I explained the condition in which Trix had been delivered to us by Dr. Death. Wayne guaranteed that when he met with me at eleven thirty to deliver the diagnosis, she would be recovered 100 percent from the anesthetic.
Wednesday morning, when I took Trixie down in the elevator to the lowest floor of the house without stopping at the kitchen, on the main level, to dish up her breakfast kibble, she hesitated at the door to the garage, waiting for me to realize my mistake. When I said, “Let’s go,” which was not just a suggestion but a command from her CCI training, she favored me with the Ross look. I explained that because of the anesthesia, she could not have any food in her stomach during the test, lest she regurgitate and aspirate vomit into her lungs or choke to death. If I say so myself, I have a talent for illuminating complex concepts for the edification of dogs, employing pantomime and sound effects to define and supplement the words they might not know. My aspirating-vomit illustration would have made Dustin Hoffman weep with envy. Trixie still gave me the Ross look and seemed to be on the verge of a bucket-bottom move.
I resorted to what always works when all else fails in these situations. Squirming with pretend delight, I spoke in a voice breathless with excitement, words tumbling over one another: “Let’s go to doctor! Trixie go, doctor, doctor! Holy moly, fun, fun, Trixie, Dad, doctor, fun, fun! Play dog doctor game, fun, fun! Go, go!” Dogs are strongly food oriented, but if they think a great good time is being had somewhere and they can be part of it, they will accept a delay in mealtime in order to get to the party.
Considering how well dogs read us the rest of the time, I’m surprised how reliably this cheap trick can whip them into a state of excitement and distract them even from breakfast. I would think once in a while the dog might realize, Waaaait just a minute. The last time there was going to be a holy-mol-fun-fun-go-go thing, I ended up with a needle in my arm, a cone around my head, and a thermometer up my butt. Their perpetual readiness for play is endearing, and their willingness to forgive deception time after time is one of the key differences between the heart of a dog and the human heart.
Trixie bought my wriggling, breathless promise of fun. She allowed me to lift her into the SUV, and as we drove off into the still-dark morning, she panted at the windows, anticipating a grand adventure.
I felt like scum. Not the worst kind of scum. Not the kind of scum you’d scrape off a kitchen floor in Hell. I felt like the kind of scum you sometimes find on the skin of a tomato that’s two days past overripe, but that was bad enough.
We arrived at Dr. Berry’s facility early, just as the mobile MRI arrived aboard an eighteen-wheeler. The truck was so huge, it looked like the transport that a villain in one of Roger Moore’s James Bond movies would use to haul around a doomsday weapon in search of the most visually exciting landscape in which to have a chase scene.
Trixie pranced to the reception desk, and the women there cooed and fussed over her. After giving me an I’m-all-right-Dad look over her shoulder, she went with a veterinary assistant through a swinging door, where she would not find the promised party.
At home, with more than five hours to kill before we would have our girl back and hear what surgery she might require, I could not concentrate to write. I could pass the time doing correspondence, a mountain of which looms constantly in a writer’s life, or I could spend the morning sulking in an armchair, looking through magazines, and binge-eating cookies. By cookies, I mean the human kind, not the dog kind; this was not a self-punishing Freudian guilt-fest. As I stuffed myself with cookies, I did to some degree consider it a form of penance for deceiving the Trickster: If I keep this up, I’m going to be gross, I’m going to be as disgusting as Jabba the Hutt, the Beautiful People of Newport Beach will recoil from me in revulsion, and that’s exactly what I deserve. Okay, no more of those regular chocolate chip. Time for some of the chocolate chocolate chip.
Gerda and I met with Dr. Berry at eleven thirty. He clipped the MRI pictures of Trixie’s spine to the display board and asked if we could see the problem. The images were so crisp and clear that even Dr. Death might have been able to see the problem, assuming sobriety. Our girl’s spine was revealed as an exquisitely regular series of black and white forms—until near the base, the pattern compressed, deteriorated. One of the spaces that allowed a spinal nerve to pass freely from the spinal cord, between the vertebra and spinous process of vertebra, was drastically narrowed by excess bone that pinched the nerve.
I hasten to say that I’m not necessarily describing Trixie’s condition in correct medical terms. I didn’t ask Wayne Berry to proof the previous paragraph. I want to convey how his explanation sounded to me, an ignorant layman alarmed by even the most benign medical terms like “intravenous injection” and “Band-Aid,” because it made my heart heavy with worry. Spinal conditions, I thought, frequently brought with them the possibility of paralysis.
Short Stuff could not climb stairs without pain. Lately she had not been in a mood to chase a tennis ball, obviously because of the pinched nerve. At every toilet, she made multiple attempts at a bowel movement, awkwardly and repeatedly crabbing forward in her squat before at last making a successful effort, because straining at stool stressed the affected nerve. She required surgery to grind away the excess bone and allow the nerve free passage.
Gerda looked grim when she asked what might go wrong during such a procedure, and Wayne was admirably direct and succinct. If damage occurred to the spinal nerve during surgery, Trixie’s back legs might be paralyzed for life. Or she might be incontinent for life. Or both paralyzed and incontinent.
He gave us a moment to absorb those possibilities, and then with a quiet confidence that had about it no slightest quality of a boast, he said, “But neither of those things has ever happened to an animal when I’ve done this surgery.”
As we scheduled the procedure, they brought Trixie to us, fresh from her MRI. The difference between her condition after surviving Dr. Death and her condition after going through the same test under Wayne’s care could not have been more dramatic. She was wide-awake and delighted to see us. She needed neither pantomime nor sound effects to convey to me how much she wanted the breakfast that she had been tricked out of seven hours earlier.
Wayne said, “In her condition, she’ll have moderate to severe discomfort through a wide range of motion. But you say she only cried out that once on the stairs.”
“And maybe once when she was chasing a ball the day before,” I remembered. “It was a thin, sharp sound, very brief. At the time, I wasn’t even sure it was Trix. But it was similar to the sound she made when she froze on the stairs.”
He shook his head. “She’s a very stoic little dog.”
I nodded because I could not speak. When we have the deepest of affection for a dog, we do not possess that love but are possessed by it, and sometimes it takes us by surprise, overwhelms us. As quick and agile and strong as a dog may be, as in harmony with nature and as sure of its place in the vertical of sacred order as it may be, a dog is vulnerable to all the afflictions and misfortunes of this world. When we take a dog into our lives, we ask for its trust, and the trust is freely given. We promise, I will always love you and bring you through troubled times. This promise is sincerely, solemnly made. But in the dog’s life as in our own, there come those moments when we are not in control, when we are forced to acknowledge our essential helplessness. To want desperately to protect a dog and to have to trust instead in others—even a fine surgeon—compels us to yield to the recognition of the limits of the human condition, about which we daily avoid consideration. Looking into the trusting eyes of the dog, which feels safe in our care, and knowing that we do not deserve the totality of its faith in us, we are shaken and humbled.
Again I think of lines from “East Coker” by T. S. Eliot: “The only wisdom we can hope to acquire / Is the wisdom of humility.”
Within a couple of days of her second MRI, Trixie underwent spinal surgery. No complications ensued. She was neither left paralyzed nor incontinent, and she had no more pain.
She needed three weeks to convalesce, half the time required when she had surgery on the elbow joint. She couldn’t reach the dorsal incision, which meant she didn’t have to wear a cone.
Because I was working on a deadline to complete Odd Thomas, Trixie’s care fell mostly to Gerda through those three weeks. Odd Thomas is a novel about perseverance in the face of terrible loss, about holding fast to rational hope in a world of pain, about finding peace—not bitterness—in the memory of love taken by untimely death.
Trixie’s back was decorated with twenty-nine steel sutures, like a long zipper in a dog suit. I called her Frankenpuppy. She didn’t think that was as amusing as I did.
This surgery gave her years more of a high-quality life, during which she fully enjoyed the fenced acreage of our new house. As any dog is remarkably grateful for each kindness it receives, Gerda and I were grateful for every day this joyous creature graced our lives. The only wisdom is humility, which engenders gratitude, and humility is the condition of the heart essential for us to know peace.