Monday, November 28, 2011

Requiem for a true friend

On Thanksgiving Day before my brother and his wife and my sister and her husband arrived for the weekend, I got in a workout at the gym and then met a friend afterward for lunch. We went to Chinatown on the north side in Uptown and ate at Pho 777 where Stephen filled me in on how his medical internship was going.

Stephen speaks English very well. He’s from Taiwan and here on a visa completing a medical residency/internship program that has been really difficult for him at a Chicago hospital. Although he speaks English very well, his listening comprehension isn’t quite as good, particularly if the English speaker is a non-native English speaker. It’s been very stressful for him; at one point he was ready to give up and go back to Taiwan where he is already a licensed radiologist. But he selected internal medicine for his residency program in the U.S.

Anyway, we had lunch and I listened to him, encouraged that his really difficult rotations were about to end. He was optimistic that his next two rotations won’t be as difficult.

After lunch I returned home knowing that I would need to feed Symba again. Following the surgery in early October that removed a horrible infection in his mouth – and which revealed that he had a very aggressive form of cancer – he could only eat soft food from a can. The surgery removed most of his teeth and he needed to gain weight. His appetite was voracious, and he managed to keep the food down as well. His coat was gradually getting shinier, although he wasn’t grooming himself. However, brushing him we both enjoyed as it gave me some quality time with him. I knew his days were numbered.

When I returned home Symba was snoozing on his usual spot – a small pile of brown grocery sacks on the kitchen table. He perked up when he saw me, anticipating his feast as I got the canned food out as well as some dishes. He meowed nosily as usual. When he jumped down from his spot on the table I noticed some dried blood on his right front leg. There was no injury to the leg, but it looked like he may have been bleeding from the mouth. This happened before and the incident was brief despite being quite alarming. It was a small amount of dried blood, so I just made a mental not to keep track of these incidents.

Symba wolfed his food as usual. It was quite obvious there were no issues with his appetite, not that there ever was really. I gave Tazz some soft food also, although just a tiny amount as Tazz was able to eat the dry food left out for him. I then went to clean up some new hairballs Tazz had hurled on the carpet. I had returned to the kitchen where I was rinsing out the rag I used to clean these spots up when I noticed Symba at the kitchen doorway.

Although sitting on his haunches, he was very unsteady, his body teetering side to side, and there was bright red blood dripping from his mouth. He then took his paw and furiously pawed at the side of his head as if there was something crawling all over his face. I crouched down next to him to get a closer look, to try and determine what happened, what I should do. I petted him as I examined his mouth – he immediately sensed my petting and responded with affection – and saw with this incident there was a lot more blood than before.

And he was still bleeding.

Then the most extraordinary event occurred, something I will find hard to forget. Symba’s entire front end, his front legs and all just collapsed as he fell face-first to the floor, his hind legs still up. His body was stiff and he uttered a baleful meow that was quickly followed by his back end falling sideways to the floor.

Alright, I’m not sure of the exact sequence of events, but somewhere in all this I got my phone and called my vet, who I knew wouldn’t answer, but I also knew the message at the office would have the phone number for the pet emergency hospital. Symba seemed to recover somewhat. He sat up, shook his head, which nearly knocked him over because he was so unsteady, and then he got back up on the kitchen table to be on his pile of grocery sacks just like he always did after eating. The hemorrhaging had abated, but there were drips of blood coming from his mouth. Symba looked really out of it.

I got the pet emergency hospital on the phone and began describing what was going on. When Symba collapsed, it was just like the videos I had seen in the past of farm animals when they founder – the collapse begins at the front of the body with the back end falling 2 to 3 seconds later. I got directions to the hospital, then went to get the travel cage as I called my brother to find out where he and his wife were. It was about 3 p.m. I think and I was expecting them around 5. He said they were in Indiana, so they weren’t that far. I told them I might not be home when they got to my apartment, so would they mind waiting in the street until I got back?

“I think Symba is dying,” I said.

It was difficult for me to drive at first. Seriously, I was freaking out and starting to cry. Symba was starting to bleed again. But I told myself it wouldn’t do anyone any good if I crash the car because I’m blubbering and couldn’t see the road or wasn’t paying attention. So I pulled it together and began the drive. One thing nice about Chicago on Thanksgiving: traffic is not a problem. Symba traveled as best as can be expected, but I think he went through another one of those collapses about half-way to the animal hospital.

The pet emergency room was a bit busy when I arrived with at least a dozen other people there. I put the pet carrier on the counter as I told the receptionist I was there and that I had called just a bit ago.

“And what is Symba’s problem?” The receptionist kindly asked. Consternation is such a mild term, but it described her expression as she looked at the pet carrier while I spoke.

“He’s hemorrhaging from the mouth and I think he’s been seizing.”

I didn’t have to wait; she took me to an examination room and called for a physician. They began examining Symba as I retold the sequence of events. When they went to weigh him, he seized again as he was being placed on the scale. They took Symba to another examination room where they sought to raise his body temperature and observe him. The doctor came back and we talked options. She explained that she believed that he was almost blind, that he saw motion, but it didn’t appear that he could clearly see forms. The size of his head and the shape of his skull suggested that the cancer was not just in his jaw, but very likely in his brain. There were tests if I wanted them done …

I had heard enough.

They brought Symba back to me. He was wrapped up in soft blankets to keep him warm. I held him in my arms and gently stroked the back of his head. I was left alone with him for a while. He responded affectionately to my petting, pushing his head against my hand as he always did. But one thing I noticed right away: he wasn’t purring.

After a few minutes the doctor returned and explained the procedure. I requested that I be allowed to hold him when it happened. They took Symba for just a few minutes to insert a catheter into his left foreleg, then returned him to my lap. First they sedated him. He quietly went limp in my arms. Then they injected him with propofol, the same drug that killed Michael Jackson.

I kept petting Symba as I told the vet about how I had Symba since he was a kitten, that he was rescued from the pound when he was 6 weeks old. I then handed Symba to her. Would I like to take his ashes home, she asked?

I shook my head. “Symba’s gone. That’s just a body.”

They did make a paw print, however, and gave that to me. A very cute Asian boy cleaned the blood out of his carrier for me. And then I drove back home to meet my brother and his wife. We later went out to eat dinner.

So why am I telling you all this? It’s not for sympathy. I guess it’s partly to get things out of my head in a thoughtful, cogent way. But it’s also to talk about kamma.

Yes, I created some kamma that day when I agreed to have Symba killed. You can call it euthanasia, “putting him down,” “putting him to sleep,” whatever pretty little name or phrase you like. It doesn’t change the fact that Symba is dead because I killed him. You can rationalize all you want, but Symba died at the moment that he did die because I authorized someone to kill him. You can say he was going to die anyway, but that can be said for all of us. We’re all going to die. In this case I deliberately and with forethought had Symba killed.

But here’s where I think many are wrong. Some may say that it was the compassionate thing to do. Perhaps. Some may say that by my doing this, I’ve interfered with Symba’s experiencing his own kamma. Maybe. I say the truth lies somewhere in the middle.

Symba’s kamma and my kamma are not isolated from one another. Just as the Buddha taught, kamma is not linear, but involves multiple feedback loops over time and even lifetimes. With the simile of the Salt Crystal the Buddha teaches us that even with very bad things that we’ve done, we have every succeeding moment to work through and eliminate the kamma we create.

But we don’t create kamma alone. My own kamma and Symba’s kamma were intertwined. We were both suffering. While one may say that to kill him would be interfering with Symba’s kamma, one may also say for me to allow “nature to run its course” could potentially interfere with my kamma. It’s simply not black and white.

No living creature wants to die. Even the tiniest spider will do all it can to preserve its life. Heck, even an amoeba will flee from pain. Which is why, when given the opportunity and even the advice to kill Symba earlier on as soon as cancer was even a possibility, I rejected the idea of killing Symba despite most advising it. If that’s really how we’re going to manage life, then my parents should have killed me when I was 2 years old and stricken with pneumonia. We’re all going to die anyway, right? Why go through all that suffering?

Symba didn’t need the power of speech to tell me he didn’t want to die. And it’s not difficult to conclude that I didn’t want to see him suffer any longer. What I wanted to avoid for both my own and Symba’s sake was turning this event into a matter of convenience.

Some may say my decision was still ultimately made around a notion of convenience. I do not disagree. Just remember, you weren’t there.

Symba: May 1, 1996 - Nov. 24, 2011