Wednesday, July 20, 2005

Going Out Gracefully

Twelve years ago, when our kids were little, an attractive, injured, and very friendly calico cat came wandering by our home in the farmland. The kids already had a pet cat, Peaches, that their babysitter had given us. I'm not a fan of cats, and even sent one to cat heaven with an arrow as a teenager when I caught it digging baby bluebirds out of a birdhouse my Dad and I had built. But Peaches was a nice cat who was very interactive and very little trouble. So when this beat up stray showed up, it didn't take a lot of convincing for me to agree to take it in.

So the wife hauled the cat off to the vet to get it patched up, and we were informed that it was pregnant (after one additional experience like this, I've come to believe that ALL friendly stray cats are pregnant). The kids wanted the whole experience of her having the kittens, and I thought it was a good thing too. So some weeks later, she blessed us with a litter of eight kittens as I recall. Then she promptly got nasty -- towards both the humans and Peaches, who by this time was a much loved member of the household. The kittens were a nice variety of colors and patterns. We told the kids they could keep one kitten, but the rest, including the turncoat mother, had to go. A few were adopted by friends, and the rest ended up on the farm of the babysitter's sister. I hope that nasty mother cat enjoyed eating farm rats the rest of her life.

The kids picked a long-haired black kitten with a white underbelly, naming him 'Oreo.' It wasn't the color that attracted the kids to him, it was his goofy behavior. As he grew into a mature cat, we became convinced that his goofiness was due in large part because he was missing something upstairs. He pretty much kept to himself for ten years, responding to attempts to pick him up or pet him with growls and bites. During that period, Peaches died (and was bured in a sunny place in our back yard), and not long after we took in another stray. This new cat, Dusty, was really nice and has stayed that way. So we remained a two cat household, but Oreo was mostly an invisible entity, making his presence known primarily through his prodigious production of hairballs.

Then suddenly a couple of years ago, Oreo started getting more social. It was like someone flipped a switch, and we've never understood the cause. Maybe something in his brain just changed. Whatever the reason, he became a good, if somewhat eccentric, member of the household.

One day about a year ago, I noticed that his pupils were dialated and that he was walking into things. He always kind of slinked around, but this behavior seemed weird even for Oreo. With a few experiments, I concluded that he was blind. Through some quick web research, I found that this kind of sudden onset blindness could be caused by hypertension, and that sight could be restored if treated quickly. So I ran him over to our vet, and a $100 or so later found out that it was indeed severe hypertension, and that he also was moderately diabetic. So the vet prescribed medicines for each malady, and now we have to get him to take two pills every day. The wife has figured out a technique for burying the pills in treats, so he takes them pretty well. His eyesight was restored and all seems normal. Except he added one more behavior to his repertoir: he now crawls up next to me every evening, and rolls over to have his belly scratched.

Over the last few months, he's been losing weight. It wasn't apparent because of all the hair, but one day when I was petting him, I noticed that he had gone from a large 15lb cat to skin and bones (and hair). Another trip to the vet and $200 in tests indicated that his diabetes had become uncontrolled, and he was going to need to go on injected insulin to thrive.

The wife and I had a discussion before we took him to the vet. The question was, "what if the vet says the cat needs a level of care which is annoying to the cat (like daily injections), intrusive on our lifestyle (with the kids out on their own, we are spending more time traveling), and expensive?" Our answer was that we would allow the cat to enjoy whatever comfortable life he had left, and either die a natural death in our home, or if in pain, to be euthanized by the vet (we had euthanized Peaches when the pain of her cancer became too much -- you could see it in her eyes).

Interestingly, at least to me, when the vet said the insulin would only cost about $40 for a three month supply, I backtracked and said we should at least see how the cat tolerates the shots.Maybe he'll do okay, or maybe he'll go berzerk every time. If that the case, then I'll feel like he's voted -- no shots -- and he can live with the consequences. If we're going to be gone for a week, he'll have to do without. This may cause a permanent degrading of his health, but he's living on borrowed time anyway as far as I'm concerned.

This isn't really an essay about cats. While everything I've said is true and factual, the more important conversation is what we as humans should do when our life reaches the place where Oreo is right now.

I believe we, as a society, need to develop the guts to accept when the final illness is upon us, and be willing to take the journey to our mortal end without selfishly -- yes, I said selfishly -- consuming resources that will benefit others much more. A friend who is a nationally known expert on health care economics recently told me that something like 80% of the total lifetime spending on healthcare takes place during the final illness.

This is a major contributor to our escalating healthcare costs. What gives us the right to consume all those resources which could otherwise be used by our children, or our neighbors? Legend has it that the custom of the Native Americans was for the old people, when they began consuming more than they contributed, to walk off into the woods and relieve the tribe of the burden of caring for them. It makes sense that such a custom would develop -- it certainly would improve the survival chances for the community. Most animal species allow their old and weak to be captured and eaten by predators. In some species, the predator may be another animal of the same species. Sounds grotesque, but it is better for one of the same species to make use of the protein than let another species have it. I'd like to think the old Indians die peacefully in their sleep, dreaming of past glories and eternal grace.

I'm not proposing that sick or old people be required to commit suicide, as in the movie "Logan's Run", or that we recycle human protein, as was the case in "Soylent Green." But when the doctors say, "you're gonna die in 5 years with expensive and debillitating treatment, or 2 years without", isn't the 2 year option the right one?

I hope I don't need to make this decision anytime soon...

Update: In February 2007, Oreo began to act weak and sluggish. We noticed that he had been losing weight, and guessed that his diabetes was out of control and his insulin dosage needed to be adjusted. He had also developed a raspy cough. So we took him to the vet, who took x-rays and blood tests to find out what was going on. The x-rays showed that he had advanced lung cancer, with a tumor is his right lung about the size of an apple. I think they expected us to euthanize him immediately, but he didn't seem to be telling us that he was suffering. So we brought him home for his last days. When he could no longer get up, and was struggling for breath, we took him to the vet and ended his suffering. He is buried next to Peaches. Thanks for sharing your life with us Oreo.

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