Authors: Steven Wolf
Now, however, any illusions about what the future might hold for me evaporated. My pain specialist had called me in to review with him one of the quality-of-life charts that I periodically completed.
“Take a look at this,” he said. “It wasn't too long ago that you were at level ten.” I peeked at the paper.
Level 10: Go to work/volunteer each day. Normal daily activities and social life. Active family life.
“Despite what we've been doing, you're now at a two or less.”
Level 2: Get out of bed but not showered and dressed. Stay at home all day.
“Steve, we need to change our approach. Some of my patients are having great results with the fentanyl transdermal system. I think you should tryâ”
“Wait a minute! Isn't that the stuff I heard about on the news? It's two hundred times more powerful than heroin! Didn't they say it used to be sold on the street as something called China White?” Comet stood as my voice got louder and she was now stretching in front of me, inviting my touch. I ignored her. I knew that the minute I started petting her, my indignation would lose some major velocity. But Comet's intrusion into the conversation had already had its effect. I lost my place in my planned pontification about God, flag, and the American wayâjust say no to drugs.
“Listen to me, Wolf.” The doctor's sharp tone made me snap my mouth shut. “Pain is sometimes useful. It can force a patient to rest or to stop doing a harmful activity.” But, he explained, untreated pain is like a muscle conditioned by lifting weights. The nerves become more effective at sending pain signals to the brain, so that eventually the brain will flinch even at harmless stimuli. The same input that was once tolerable hurts in increasingly damaging ways. Most medications cannot keep up with the escalating pain cycle without causing stomach ulcers or kidney damage. Strong narcotics can.
“We can get rid of most of the other medications that are causing you a lot of side effects,” he concluded. My regimen of antidepressants, painkillers, and pills to quell the side effects of other pills had become so complicated that no one seemed to know where my medical problems stopped and the pharmaceutical ones began. I could see the doctor's point. “Quit being so paranoid about addiction,” he reassured me. “Your body will come to need this medicine, but you won't turn into a drug vampire, constantly craving more and more.”
And so I had agreed. It would take me a while to wean myself off the other medications and get used to the patch and the repulsive fentanyl “lollipops” that would stem any breakthrough pain, but I had plenty of time.
After the hectic first round of doctor appointments, I noticed that while I wasn't alone in my life, I was lonely. A few years back, another pain specialist had told me about a phenomenon he felt deserved some hard research. He had observed that a troubling emotional distance often develops between chronic pain sufferers and their friends and families. I didn't know it, but what I was beginning to perceive as tightly restrained anger and frustration in conversations that were directed at me was a common emotional response. People like me, who struggled for extended periods from conditions that couldn't be seen or given easily identifiable names, began to be cast in a different light over time.
What was beginning to plague my relationships with family and friendsâa curse that would baffle me for the next several yearsâcould be best summed up by a comment most patients with chronic back pain are subjected to sooner or later: “Shouldn't you be feeling better by now?” It's a stigma never voiced to amputees, or to those who are wheelchair-bound, or to patients diagnosed with cancerâthose ailments are obvious or have a recognizable diagnostic label. What does pain look like? And if it's spinal pain, the tag assigned will most likely be medical mumbo jumbo not at all familiar to others. Degenerative disc disease.
So what? We all get older.
Postlaminectomy syndrome.
Huh?
Kyphoscoliosis and pseudoarthritis.
Oh, come on!
Ultimately, if there isn't any available medical cure:
Maybe it's all in your head.
The sufferer is then faced with an isolating conundrum. If I talk about my misery, I risk being viewed as a hypochondriac, a Debbie Downer who wreaks havoc on any normal social setting. On the other hand, if I hide my pain, I'm viewed either as a hopeless stoic who refuses help or someone who would
have
to be complaining if he were in that much pain. Current research not only validates these types of anecdotal observations, it also shows that this stigmatization actually magnifies the patient's physical suffering. That shouldn't be a big surprise. Depression and pain often use the same nerve pathways.
At the time, though, all I was aware of was antipathy, somewhat vague but unmistakable nonetheless, which was focused at me. Family and friends were progressively absent from my life. Associates stopped returning my phone calls. Daughters didn't come home for the weekend. Freddie started working later. Friends were always golfing or out of town. Nobody said it to my face, but I knew what they were thinking:
You're addicted to medication
. . .
You've let your body go to hell
. . .
You need to see some better doctors
. . .
You haven't explored new treatments
. . .
You're doing things that make it worse
. . .
You're just not trying hard enough.
Was I really that much of a miserable son of a bitch? Or was my distrust valid? It was easy to be paranoid when the only other thing I could think about was that I hurt like hell. Only Comet, Cody, and Sandoz seemed to enjoy my company.
Those poor dogs! They became my full-time companions and psychologists. My health complaints were directed at three creatures who would much rather have been racing down the beach. They patiently listened, occasionally raising their eyebrows or cocking their heads as I muttered a nonstop inventory of past mistakes. Comet attended every one of my doctor consultations and ego-sucking tests. My handicapped Jet Ski was a river casino of wild thoughts about the future, captained by loyal Cody, who was now crawling to the dock almost as slowly as I was.
It's a shame that it had to be Cody who roused me from my self-absorption. At about 3:00 a.m. one morning I was awakened by a raspy, coughing choke coming from the floor. It had started a couple of weeks earlier with an occasional cough followed by a retching noise that made me think a fish bone was stuck in Cody's throat. I couldn't feel any foreign objects when I thrust my finger down the length of his tongue, nor could I detect any lumps from a physical exam of his throat. The vet wasn't excited about subjecting a thirteen-year-old dog to x-rays. I bought a plastic syringe and began squirting cough medicine into his mouth before bedtime. Tonight, though, the sound had changed from retching to the wheeze of labored breathing.
“It's okay, buddy.” Cody was trying to get to his paws, but I gently lowered him to his bed. “What's the matter?” The question was part of my rubbing investigation of his neck. I didn't expect the answer I got: a round mass beneath the fur just below his throat.
Cody was the gentlest, most obedient dog I have ever had the pleasure of knowing. He insisted on walking into the vet's office that dawn, but he could no longer leap onto the exam table. He allowed me to help the vet lift him onto the stainless table without protest. He always trusted me. But on this occasion, Cody's black eyes staring from beneath prominent raised eyebrows pleaded with me to take him out of there. The streaks down my cheeks told him I just couldn't do that right now. I should have. A lump was clogging Cody's airway, making it hard for him to swallow anything. It was as if the thyroid tumor diagnosis was what my longtime friend was trying to avoid. As long as Cody didn't know how sick he was, he could go on forever. Once voice was given to the problem, it was as if the knowledge killed him. Cody was gone within the week.
A few days after his passing, despite intense pain shooting down my legs into my toes, I floated on the lake long into the afternoon. I knew the pontoon boat's batteries were nearly as exhausted as I was, but I still couldn't perform this final task. It felt like it wasn't just an end; it was the end. After a day spent blistering my nose and shoulders, I couldn't find any answers, other than that I was lost. Saying good-bye shouldn't have been on my summer itinerary. I dared anybody to tell me that life was fairâor worse, that this was just part of living. I couldn't have hated being alive more. I dumped Cody's ashes into the lake.
All summer long, the normal colors of home seemed diminished, as if I were viewing them through a dingy filter. I was continually stalked by an old guy with a beard asking if he could harvest my oats with his scythe. Instead, he found Cody. I couldn't get out of Nebraska fast enough.
11
MID-SEPTEMBER 2001âARIZONA
Freddie smiled briefly and waved from the window of the airport shuttle, and as it pulled away I lifted my hand in a salute. This time there had been no tears or urgent pleas for me to take better care of myself. “And that's a good thing,” I said aloud as Comet and I turned and walked back inside the Sedona house. But a nagging worry lay just beneath the surface. The damping down of Freddie's emotions had me concerned, especially because once she admitted what was causing it, I might become a permanent resident of Arizona. We were farther apart than ever, yet I didn't know what I could do about it.
Unlike me, Comet was blooming with health and eager to explore the savory Sedona autumn. Emily was growing up and less likely to be around to walk Comet on a moment's notice, so Comet worked out her own solution. After one early afternoon nap I grudgingly peeled the sheets away, intending to let her out back for her break. She refused to exit. “Fine. Don't go to the bathroom. I don't care.” I left her by the slider and closed my bedroom door. Comet opened it. I slammed it shut. Comet opened it. I glared at her shameless expression.
“What?”
I demanded.
I settled on the end of the bed and peevishly watched Comet trot out of the room. I was just about to slam the door again when she returned, lowering her chest and thumping the floor with her front paws in a drum roll, repeating the sequence several more times with a couple of spinning twists thrown in for dramatic effect. I rolled my eyes in frustration, recalling Mark Twain's astute observation: “Comet, I want you to know that few things are harder to put up with than the annoyance of a good example.”
I felt like Victor Frankenstein. Comet was my monster. She now had a job to do, and she was going to do itâperiod, exclamation mark. Her duty didn't end at getting me out of bed; it included getting me out of the house. She was through with allowing me to skimp on her daily walks. Within a few days, I found that the time outside cleared my head. After a week, I had mentally assembled a to-do list for Comet and me to tackle together. The first item on the list was something I knew would take a burden off Freddie: I wanted to be able to travel without her help. Now that I was using a fentanyl patch, I had to get recertified at my Omaha doctor's office every few months, but the drive was too grueling for me to tackle alone. I was going to have to fly back and forth either by myself or with Comet. Luckily, most of my trips began and ended in Phoenix, where my mother lived, or in Omaha, where I had family to pick me up. I could always check my bags at the curb. That left just one hurdle: getting from the curb to the gate on time. Although every airport has porters who can push a wheelchair or provide a cart for transportation, at busy hubs like Phoenix the odds of getting that help when you need it are remote. A better way would be to have a personal assistant pull me through the terminal.
Pulling something, especially if it's heavy and hard to get moving, is not a natural activity for dogs. Huskies are trained to pull sleds, but would Comet be strong enough to pull a wheelchair with a full-grown man in it? I had no doubt that she would. Not only are greys strong, they also have a high pain threshold and know how to use their energy efficiently. A greyhound probably couldn't pull a heavily loaded sled through the snow like a husky, but I wasn't asking for that. I didn't even need to start with a wheelchair.
“Comet, you have no idea how much I hate trying to grocery shop while pushing that damn cart,” I told her. My little pride demon kept me from using the motorized carts at the store. A shopping cart could be an ideal vehicle for Comet to practice on before we braved a wheelchair in an airport. My first step would be to get her accustomed to being in the grocery store while I pushed the cart. Weber's IGA would be a good place to practice. It wasn't a large supermarket, and the staff knew every regular shopper by name. The family owners had allowed Maggie to conduct greyhound fund-raising on site for several years, and they had come to adore the breed as much as I did.
On our first visit to the IGA, I walked inside with Comet as if we shopped together all the time. Looping one end of her leash over my left wrist while I leaned on the cane in my right hand, I slowly nudged a shopping cart down an aisle. The assistant manager, who examined Comet's service vest and the card explaining the ADA, spied on our circus act from the fresh vegetable section, then lurked behind us and monitored our progress from aisle to aisle. Dogs were prohibited from entering the store for good reason, and he wasn't about to be fooled by this service stuff, even if I was somebody he knew. After all, who wanted dog hair in their celery?
Comet and I inched our way down the aisle, Comet tracing my steps from the shelves back to the cart. Then I would try to balance on my cane as I pushed the cart with one hand, often leaning on Comet for support. It was a ponderous, time-consuming process but surprisingly enjoyable. I found myself watching Comet like a proud daddy as her nose twitched, absorbing yeasty fresh-baked-bread smells mingling with metallic, primal blood odors from butchered slabs of steak. Although her eyes hungrily scanned the slick packages of meat and poultry, she refrained from ripping open the prizes inside.
Good girl!
By the time we reached the frozen food section that ran down the center of the store, we were a well-coordinated vision of competence. I was a rooster at dawn as we strolled along, silently crowing about Comet's working attitude. She didn't even startle when I dropped grocery items.
At the far end of each aisle I could see Inspector Clouseau of the IGA peeking around the corner, probably anticipating Comet attacking the nearest shopper like a starving hyena. He was rewarded only because my path to the checkout lane took us through an assortment of dog food and pet supplies. I didn't see Comet's head move at all, but there was no mistaking the squeaking noise as she crunched on a rubber bone.
“Comet! Give me that!”
“You're going to have to buy that toy. There's no way we could sell it now!” An
I knew it!
expression radiated from Clouseau's red face.
“Is Comet's breath so bad that it scarred that bone for life?” The employee squirmed and looked at me uncertainly. “I'll have you know that she has stolen toys from better places than this without anybody protesting. She is, after all, Comet,” I proclaimed.
“Well, I suppose we could put the bone back on the shelf.” He reached out and tried to swipe the toy from Comet's mouth. Comet clenched down on it and ignored him, fixing her glare on a shelf over his shoulder as if to indicate that she did not understand his peasant language. I decided some mercy was in order.
“Oh, I guess we'll just have to buy the darn thing,” I said, laughing. “Come on, Comet, let's go check out.”
Before our next in-store session, I made sure Comet's kleptomania was extinguished. Figuring that her attraction to a squeaky toy would be far less intense than her slobbering desire to nab a liver treat, I placed said treat at nose level on the kitchen table. It took me less than an hour to teach Comet that when she was wearing her service vest she was not entitled to grab a treat or anything else. During our training excursions, I had noticed a subtle change in Comet's posture whenever someone exclaimed, “You look so pretty in your purple vest.” Her head would rise a few inches and her ears would almost imperceptibly perk, a canine version of a puffed chest. Comet had gradually connected her finery to her right to adopt a standoffish attitude around strangersâ
You can look, but don't touch.
That was precisely the type of demeanor that I wanted when she was wearing her working clothes. On those occasions, she should focus on me unless I gave her express permission to do otherwise, and that included resisting toys at the grocery store.
After several successful training forays into the IGA, I felt comfortable enough to proceed to the next step. Freddie was coming to Sedona for a brief visit, so she could team-teach with me. This time I would pick her up at Phoenix's Sky Harbor airport. I was hoping that in Phoenix I could find a crucial item that none of Sedona's pet supply stores seemed to carry, a working harness for Comet. None of the harnesses I had found were designed for an abnormally large chest that tapered sharply to a dainty stomach more suited to a toy poodle. I had seen boxers wearing harnesses, and their anatomy was not entirely different; it was just smaller. My best chance of finding something like that was at a large chain pet supply store, one of which was on the way to the airport.
“What do you think, Comet?” She and I stood just inside the store entrance. My question was rhetoricalâComet's ears were pointing straight at the ceiling, her eyes were stretched wide, and her nose twitched at the mysterious scents flying through the air. Her body was frozen in place, shivering with delight at the sights and smells.
If ever there was a kid in a candy store
. . . She was so entranced that she didn't even notice the other dogs and owners wandering through the store. I decided that a tour was in order, giving Comet's mind a chance to catch up to her vibrating senses while she examined hamsters and snakes, fish and reptiles, and every type of pet food known to mankind.
As we approached the back of the store, a painfully high-pitched shriek blared from a far corner. Comet stopped in her tracks. Her body began to palpitate so rapidly I thought her heart was fibrillating. Suddenly she yanked on the leash and started dragging me toward the sound. Seconds later we were standing in front of a parrot cage, where the orange and green bird strutted back and forth squawking and screeching. Ears perked and eyes like lasers, Comet hunkered down into a stalking-cat position, ready to pounce. “No!” I shouted, tugging her away. “I can't afford a thousand-dollar bag of feathers.” From that day forward, any time we entered a large pet store, Comet prowled around looking for that annoying parrot.
We had better luck in the leash and harness aisle. After wrestling Comet into a number of harnesses, I settled on a black and saddle-toned rig with gold fittings. Comet approved. The look was striking against her cinnamon and black striped coat, and I think she knew it. She didn't object one bit when I left the harness on her for our drive to pick up Freddie.
As we approached the airport, it occurred to me that Comet might have a complete sensory overload if I took her into the terminal. But the greyhound's enthusiasm with her new harness was infectious. “I guess you'll have to get used to the airport sometime,” I said, attaching her leash. Comet jumped from the back hatch with the alacrity of a panther.
We took the elevator from the parking garage and exited on the third floor. As we rounded a corner, the retail midway of Sky Harbor unfolded in a splash of neon signs and an undulating rainbow of cultures and clothing. The air was humming with cell phone conversations, laughter, a loudspeaker announcing arrivals and departures, and the eager voices of hundreds of travelers. Comet's jaw all but dropped.
I vividly recall my first time at the circus: flashing lights, air-whistling calliope sounds, smells of cotton candy and peanut shells, lions and elephants, freaks of the midway, and sequined aerialists swinging through the smoky heights of the big top. It was a sensory banquet so rich that I was dizzy, almost ill, even before my cousin handed me my first cigarette. I'm sure I looked as dumbstruck as I felt.
The same openmouthed, eye-bulging expression was on Comet's face as we took in the sights and sounds of Concourse A. She repeatedly stopped in the middle of traffic, her eyes roaming in a 180-degree panorama, digesting everything in sight before turning her body in the other direction to complete the dazed inventory. It was one of the few times in our relationship that Comet had no idea if I was anywhere in the vicinity. When we spotted Freddie at her arrival gate, Comet pranced at the end of the lead as if she couldn't wait to tell her about the astounding experience that lay in store for us on our journey back through the crowds.
“Comet, you look so elegantly professional in your new outfit,” Freddie gushed. We giggled like a junior high couple on a first date as we followed Comet back through the terminal. Now she sped along as if she owned the place, tugging us this way and that to show us the scent of cinnamon rolls or grilling burgers. We were barely at one location before Comet zoomed off toward something else.
After we climbed into the SUV and Freddie settled into the driver's seat, she grinned at me. “I was going to tell you how pale you look, but I'd rather talk about that big smile stuck on your mug. I didn't realize that you missed me so much.”
“I can't even tell you how much fun that was!” I chortled, quickly adding, “But I'm smiling because you're here.”
“That's okay, Wolfie.” There was a quiet pause as our eyes briefly locked. “I almost forgot what a happy Wolf looked like.” She glanced at Comet in the rearview mirror. “We might have to get Comet a different outfit. That purple vest under the harness won't be up to her standards.”
The drive back to Sedona gave me time to explain my thoughts about flying home with Comet as my assistant. “My plan is to train her to pull a grocery cart first, then a wheelchair.” Freddie's eyes narrowed in an amused squint as she continued driving. “You got here just in time to help.” Her eyebrows shot up and her mouth pursed in an “uh-oh” shape, but at least she didn't say no.
I gave Freddie a full day to unwind before hustling her over to the IGA. Because Comet was now an accepted customer, Inspector Clouseau no longer tailed us. I filled a shopping cart with a few heavy items, looped Comet's leash through the front frame of the cart, and handed the leash to Freddie. “Snap that onto Comet's harness,” I directed her. “The cart has some load, but I don't think it's too much to start out with. I'll handle the cart from behind so it doesn't run into Comet's heels when she stops. Plus she'll get used to me being back here while she's working.”