Wednesday, April 8, 2009

Sick Puppy and Other Considerations

My dog has Alzeheimers. She’ll stand and stare at a blank wall for a looooong time, then turn around and stare at another wall. If a door is shut, she scratches at it until it’s opened, then she walks away. She’ll step outside, look around her, and turn around to come back in. And she’ll do it over, and over, and over, until we start ignoring her requests to go outside. She’s started prowling around the house all night, scratching to go outside at 3 or 4 in the morning, not to do any dog business, just to pace the yard once. When she gets back inside, she immediately wants to repeat the process.
She’s deaf, her back legs have arthritis and she has cataracts, the dog version. She can’t jump up on the couch any more, she gets stuck in places because she can’t remember how she got in them, and she has a hard time eating her food. When she remembers she has food.
This is not a blog about my dog. This is a blog about growing old. I see the changes in her, in the quality of her life, and I wonder what I’ll want when I reach that point. I’m thinking about living wills, about medical care directives and how invasive I want a doctor to be in order to maintain my body. Because if my current rate of deterioration is any prophesy, I’m afraid I won’t be one of the spry old women who keep working until they’re in their 90’s. I already feel so tired, so creaky and slow; never mind that I can’t remember common words or details that ought to be second nature to me.
Fresh Air had a program about dying. Specifically, about how hard it is for hospitals to let people die. I don’t know because I’m not in that position, but after watching my dog, I wonder if it isn’t better to provide comfort and love and say ‘goodbye,’ rather than the constant back and forth to hospitals, doctors’ offices, side effects of medication and procedures, etc, etc. I’m not saying I think knees shouldn’t be replaced or pace makers put in. I’m saying it shouldn’t be a given that those things will occur. What if, when I’m 80, my doctor tells me I need a pace maker, but I can’t remember an event 10 minutes after it occurred? What if I can’t remember my children, my husband or even my name? Is keeping my body alive morally right? Do I want that sort of existence? The problem turns out to be one of timing. When I’m in that position, I can’t make the decision. It has to be made, documented and notarized before I get anywhere near senility. (Too late, I’m thinking.) A file has to be kept, and given to each doctor every step of the way. The hospitals, when I arrive, have to be given copies. My husband, my children, my parents, my sisters, all have to know, in case they’re in a position to make decisions on my care. And they have to be willing to help the doctors make those tough decisions, like saying 'no' to certain procedures or medications. And they have to be willing to argue for my position, whatever position that turns out to be.
And here’s another problem. It’s an ugly conversation to have. Basically I’m saying to my husband, “Hey, I’m not so upset about the whole death thing. Just make me comfortable (morphine is lovely) and let me go.” You don’t want to hear that from your spouse. You don’t want to think about the imminent death of someone you like to wake up next to. And you certainly don’t want to think that it may occur soon, because of a car wreck or a difficult birth or a genetic glitch. And you especially don’t want to think about it at the beginning of Spring, when life seems so everlasting and you can’t imagine that winter will ever come again.