Love Is the Best Medicine (27 page)

Helen’s chest tube was removed the day after surgery. She was going for walks unassisted. A good appetite and drinking on her own meant that her catheter and intravenous fluids could also be discontinued. Her tether to the hospital was stretching and fraying one filament at a time until, just two days after the surgery, it snapped, and she was free to go home, receiving no more special care in the hospital than she could receive from Eileen and Ben. For all the talent of our nursing staff, we know when we are beat, unable to compete with the healing power of familiar surroundings, unwavering attention, and unconditional love.

T
HE
power of Helen’s recuperative prowess was intoxicating. How many of us would be trotting out of the hospital so soon after major thoracic surgery? It wasn’t as though we were strapped for spare beds,
cutting costs and corners by turning over cases as fast as we dared. Helen was home because she was feeling good and I wanted to believe that this was partly because the tumor was gone. So what if I was a victim of overconfidence and no small measure of hope? Sometimes this job has more than its fair share of bad news. Why not allow myself to bask in the simplicity and humanity of Eileen’s dream for this dog? I had tried to create the impossible and wanted to believe I succeeded.

Carried along by this wave of optimism, I carved out some time to finally share the news with Sandi. I decided to write her a letter, to tell her about Helen and about Eileen’s motivation for the surgery. Of course there was a hidden agenda to my urgency. In part, it was prompted by a fear of things going wrong. Helen was making a fabulous recovery but what if things changed? Surely it was better to capture the feel-good factor while it was still strong? And if I’m being honest, there was also an element of catharsis, the relief of dispatching a written version of events and fulfilling my obligation. I wasn’t sure how much good it would do, but I had made a promise to a woman who wanted to give back when all she held dear had been taken from her.

Alone in my office, I sat in front of my computer, opened a new file in Microsoft Word, and tried to imagine the spaniel’s first trip to the beach. I’ve never been to Prince Edward Island and I have never seen Helen together with Didi the Newfoundland, but thanks to Google Earth and to having met both dogs separately, I believed I had a pretty good idea of how this might play out. Naturally I pictured a balmy summer evening and generic golden sand, west-facing dunes and gentle breakers—their reward for the sixteen-hour car ride from Massachusetts.

Didi, the veteran summer beach bum, would be in an expectant frenzy as soon as she caught her first whiff of briny Nova Scotia air. The car pulls over, the passenger door swings open, and Didi is gone, a bouncing ebullient shadow on a mission, never looking back once to see if her adopted sister is in the chase.

Helen remains on her blanket on the backseat, the breeze rustling her hair, and she is trembling. Perhaps it has all been too much, this final leg of her final journey, but Eileen comes around, scoops her up, and lowers her to the ground. Helen’s elbows and knees lock in stubborn extension, turning her into a canine piñata. Her paws slowly sink into the sand as she maintains her defiant rigidity, head pointed out to sea, carefully aligned so as to make watching Didi’s aquatic antics unavoidable.

At first nothing happens. Space, big sky, and the simplicity of horizontal lines appear to overwhelm Helen. But then, off in the distance, Didi breaks free of the surf and prances in her direction, dropping down on her front legs, delighting in taunting her. Lip-reading is not necessary. Even at this range there is no mistaking the mischief in Didi’s big brown eyes.

Helen sniffs the air between them, raising her nose, hoping to catch a scent or hoping to appear aloof. Eventually she loosens up, giving her body a good shake all over before setting off at a slow, indifferent walk.

Didi holds her ground, thrilled to have a showdown. She shimmies left, fakes right, maintaining eye contact, neck outstretched, her bark deep and booming, until the gap between them shrinks to a couple of yards of paw-print-laden sand and Helen comes to a stop on the precipice of the lapping surf.

Maybe she’s afraid of the water? Maybe she’s afraid of the black monster lurking in its depths? No matter, because Didi reads her hesitation and all the meaning in how far her little sister has come and she knows she must act. The gentle giant wades back into the shallows, close enough to offer a quieter word of encouragement, close enough to put Helen in the splash zone as she shakes herself down and unleashes a tropical downpour. And just as Didi hoped, the little black cocker spaniel takes her cue and with a short retaliatory bark, leaps into warm foam for the first time ever.

I huffed and smiled to myself. Why shouldn’t it end like that—dusk on a secluded beach on PEI, a filthy, abandoned, insecure little dog getting the chance to play in the sea and sand. I could believe in it. I could slap on my rose-colored glasses and make Helen’s future look pretty sweet because Eileen’s hope for her dog was that simple. And shouldn’t the best dreams be kept simple if they are to stand any chance of coming true?

S
UDDENLY
the glare from the monitor snapped me out of my reverie, and I realized its brightness was caused by the relative darkness of the room, an angry thunderhead overwhelming the daylight outside my window. Electrically charged and roiling heavens prepared to unload their wrath on downtown Boston. April showers becoming April monsoon—welcome to the unpredictable joys of New England weather. I turned back to my desk and as I did a message popped up in the bottom righthand corner of the computer screen. It was a Microsoft Outlook announcement—Helen’s pathology report was in my e-mail in-box.

Hand to mouse, mouse to icon, double-click, double-click, window expanding to fill the screen, I took in the report, eyes scrolling faster than my hand, my mind playing catch-up as I read the language of pathologist-speak.

Translation: “Yes, it’s a tumor!”

Translation: “Don’t tell me you’ve forgotten basic pathology! ‘Highly variable’ means indiscriminate and unpredictable, two of the
trademarks of a malignant tumor.” (Mitotic index is a measure of the rate at which cells are dividing. The higher the index, the more rapid the division, the more aggressive the tumor.)

Translation: “Your dog’s tumor had gotten so big, so greedy, it had outgrown its own blood supply and parts of it were starting to die.”

I couldn’t stand it anymore. I scrolled down to the end.

Translation: lung cancer.

No surprise here. However, the last sentence of the entire report hit me like a sucker punch to the gut:

I read it again—the words of a detached pathologist reminding me of my fallibility.

Translation: “You didn’t get it all. You came close and you might have thought you did, but you didn’t. Your margin was at best questionable, at worst, contaminated with cancer. I’m happy to give you the diagnosis. Too bad about the cure.”

Of course there was nothing mean spirited in the report itself. This was me twisting the sentiment, interpreting the abrupt and
cold, but necessary, addendum as the authoritative proclamation of what felt like failure. I rocked back in my chair, letting the weight of my head snap my neck, and sighed. Close but no cigar. Was it going to be enough? Could I justify all that I had put Helen through? If tumor cells remained, how long before they grew back? Would there be time to fulfill Eileen’s dream? Could I have done something more, something different, something better, to have stood a chance of getting every last cancer cell out of Helen’s body?

The “letting down” thing became contagious. Not only was there Helen and Eileen to consider, but, by association, also Cleo and Sandi. Of course I recognized the stupidity of my naive and selfish desire for a happy ending, but I couldn’t help feeling like this had been my shot at some measure of redemption and I had missed. Helen’s had been a unique, challenging, and laudable case, and best of all, she had found me, not the other way round. But suddenly I saw how ridiculous and self-serving this venture had been, my conceit ruined by a pathologist’s conclusion. How could the spirit of a dead dog become my talisman? Who did I think I was? It had taken the objectivity of written truth—dependable, scientific, and entirely void of emotion—to bring me back. So obvious now, the way I had fashioned a fairy tale. Driven by guilt and vanity. I had searched for salvation, and all that remained was the unfairness of Helen’s cancer and the certainty of Cleo’s tragic death.

I knew that inside another digitized envelope, inside another computer in another part of the hospital, there was another copy of Helen’s pathology report, waiting to be read by Dr. Able. He was, after all, the primary clinician on the case and as such, normal protocol would require him to make the difficult phone call to Eileen, to inform her of the diagnosis of cancer and the likelihood that tumor cells had been left behind. He would be the one fielding the “whys” and the “why nots,” the “how long?” and the “when will we know?” But why should he? It wasn’t his fault, it was mine. Dr. Able wasn’t
even there. They say, “Don’t do the crime if you can’t do the time.” Who was more responsible than me for Eileen’s inevitable questions? Even though I didn’t have all the answers, at that moment I felt like the least I could do was to be the one to field them.

I found Eileen’s contact numbers from the computer record, picked up my phone, and decided to try her cell.

“Hello.”

Only one word, but it came out fast, with unmistakable stress, and as I made my introduction I could hear the beat of windshield wipers trying to keep up with the steady booming percussion of rain on glass. I imagined her trapped inside her vehicle, caught in the storm that had eclipsed my office, only she was in the torrential downpour phase, cell phone squeezed between a shoulder and an ear, white knuckles on the steering wheel, negotiating rush-hour traffic and pooled floodwater on the highway. This was hardly the time to receive bad news.

“Did the biopsy come back?” she said.

Hanging up or claiming the call got dropped didn’t seem right. And so I told her. I told her Helen had lung cancer and I read the pathologist’s final comment verbatim.

“What does that mean, ‘cannot be confirmed’?” she said.

“To me it means there’s a good chance I left microscopic tumor behind.”

After a pause she said, “Okay,” sounding anything but.

I kept going, veering away from technical excuses, apologizing for my failure, insisting she call me anytime if she had more questions, if there was anything more I could do.

Throughout our conversation, Eileen kept her responses abbreviated, interspersing the occasional “uh-huh,” “I see,” “right,” and “okay.” Much later she would apologize to me for sounding dismissive and unmoved by my news. She had been petrified, juggling the call with horrendous driving conditions. In fact, my interpretation of
her response was anything but indifference. The panic I’d heard in her voice made sense, laced as it was with the kind of flat tenor born of prophecy, of having braced for this confirmation for some time.

When I hung up I felt empty and restless and angry at my self-pity. Any sense of relief at having done what I had to do was tarnished by a feeling of deceit, as though I had taken advantage of her distraction, delivered my lines, fulfilled my obligation, and gotten off too lightly. I had decided not to mention Cleo and my assignment from Sandi. This hadn’t seemed like the time to tell her. Thinking about what might happen to Helen over the next few months made me wonder if there would ever be a good time.

Surgery isn’t meant to be like a game of weekend T-ball. There are no trophies for participation. Not every case will be a winner and it was time to get over my pathetic validation issues. And so I thought about what would have happened to Helen if Eileen had not come along. The lung cancer would have borne down on her just the same. Would the chef and wait staff at the restaurant have noticed her absence? Would she have slowed down, running no longer an option as her lung capacity rapidly declined, reduced to a trot, easy pickings for a hungry coyote, vulnerable to a speeding car, clipped as she misjudged how fast to cross the highway? Would anyone have noticed her niggling cough, her disinterest in food, how much weight she was losing? Would anyone even have noticed when she never came home?

Perspective changes nothing and changes everything. Half full or half empty, take your pick. It’s like one of those optical illusions, the ones where there are two pictures in one, teasing your perception, asking whether you see the young girl or the old hag. It was time to adjust the light, squint a little, and choose the right perspective. There was still much to celebrate.

I called down to surgery.

“How are we doing with my golden?”

“She’s just got back from radiology,” said Jez, one of the anesthesia supervisors, “and about to get her epidural.”

“Great,” I said, hanging up, grateful for all that copious golden fur and the certainly that I had at least twenty minutes before my next patient was inside the OR.

There probably wasn’t enough time but I knew it was the right moment to get back to my letter to Sandi. I pulled up Cleo’s file on the computer and straightaway I saw that I had a problem. There was only one contact name and address—Sonja Rasmussen, Sandi’s daughter living in Bermuda. I had forgotten to get her mother’s address in Canada. I would have to ask Sonja to forward the letter to her mother. I hoped this would not be problem.