jeudi 22 juillet 2010

Rest, Baccarat. Rest, Good Dog

The empty bench

You have to imagine Sam and I sitting here, eating our tortilla wraps (and he his roast beef sandwich on industrial baguette) the other evening. He came after work, taking the RER from Nanterre to the Gare de Lyon, and another to Alfortville, after a long day at work. Dr. Gouni waited for us. She said she had work to do, anyway, but she's like my husband. I know what that means. She thought it was important for Sam to see Baccarat again before the surgery because we cannot know how it will turn out.

Earlier, I told Baccarat that Sam was coming to see her, "Sam! Ton Sam va venir!", and her eyebrows jumped up her forehead, her tail starting to brush the flooring in cardiology with all the enthusiasm her heart can manage. Everyone laughed. She knew exactly what I was talking about. I know you are thinking, "It was the tone of voice she heard, not what you said."

No, you are not thinking that. You know, just like I do, that they understand that much.

It was like the day when my husband came to see her, arriving after Sam and I had. It was the first morning of her hospitalization at our veterinary clinic, and she was collapsed on the floor after a very brief walk, but when she saw him walk around the standing display of flea products and dog pheromones, "for a happy dog", her head shot up and her tail started cleaning that darker gray flooring.

"C'était seulement qu'elle pensait que j'allais la ramener à la maison, puisque vous ne l'avez pas fait," he joked. He knew that she was just happy to see him, too.

It was just past 7 pm when I went to pick him up on his way up the Avenue Générale de Gaulle on my motorcycle. He had walked enough for the day, and Dr. Gouni was already so kind to wait. She took us up to Baccarat's cage and left us with her.

We were tired and hungry, our heads aching, by the time we thanked Dr. Gouni for letting him come as late as he had to to be able to see her and emerged on the sidewalk.

"There's the Casino over there," I looked up the avenue, past the post office and towards the traffic circle, beyond which the A4 leads to the Péripherique and the A13 home. "We could get something to tide us over until dinner, maybe some sandwiches, and I need some things for dinner. Oh. There's not much room in the top case. I forgot."

"I have my backpack, Mom. We can put some stuff in there," he offered, still standing there on the same spot on the sidewalk. We weren't deciding anything very fast. The sidewalk is where we decompress.

"What do you say? Should we go get something, or just head home? My head is killing me." I had barely eaten anything since my scrambled eggs long ago that day.


"Okay, then, let's go." We stood there another second. He had joined me in my state of suspension.

We got sandwiches from the display at the entrance to the store, looked at the soda. Found a sandwich the color of the salami of which was too gray to be considered consumable and gave it to the guy at the "welcome" desk.

"I know just how he feels," said Sam, "when someone finds a sandwich that's gone off, someone's going to make a complaint. You try to get them before anyone else does." His job this summer has been refilling vending machines for his uncle at one of their biggest clients in Suresnes. He knows about sandwiches and standards of freshness, margins of profit on soda and coffee. "There's a Coke Lite left, Mom," he added.

He stuck his hand in the water vapor over the fresh vegetables.

"What's that?"

"Water to keep them fresh." We looked for the string beans, if there were any, and picked up some organic bananas. "I'd better get a small bunch, for the backpack, but you'll eat one, maybe?"

"Yeah. I'll eat a banana," he said. We still hadn't found any green beans and made another trip around the vegetables.

"My hand doesn't get wet when I put it in the gas," said Sam.

"It's not a gas; it's a vapor," I replied.

"Vapor is a gas, Mom," he said. He was right. We wandered off, looking at the meat, looking for jambon de pays for the melon I had picked up and put back down, thinking of space. I remembered and left the jambon de pays. We walked through cheeses, and Sam picked up a package of prewrapped cheese slices for Croque Monsieur sandwiches.

"Now this is what I am going to need," said Sam, with a new energy we had been lacking.

"But, I buy those already. Usually the cheddar ones for your cheeseburgers," I said. I thought he had seen these a million times, in our fridge, but certainly at my husband's parents' home, where it is staple to feed the army of grandchildren a light supper.

"Oh. It's just the cheese," said Sam, disappointed. "I thought it was the sandwiches."

"Sam, it's really easy to make the sandwiches from the cheese slices."

"I am going to buy lots of pre-made sandwiches, all ready to heat."

"You're going to need much more than that, if you are going to survive law school." He looked back toward the soda and headed off, returning to tell me the last Coke Lite was gone and he had decided against a Coke for himself. He seemed disappointed for me. I rarely drink Coke Lite. It was considerate of him, anyway. "Where are the smoothies," he asked. "I am in one of my healthful foods phases," he added. "The other day, in the Marais, I got an oxygen water. Twice the oxygen of normal water."

"They're right here." I pointed to the juices, just next to where we happened to be standing, still looking toward the display of Coke and Coke Zero, back across the tables of fruits and vegetables, appearing fresh under their streams of gas.

"I want mango and passion fruit."

He compared the Tropicana and the Innocent ones and found the Innocent less expensive. It looked like more, but it was the same size as the Tropicana. A lesson in packaging, but he already knew that. He knows how to look for the price by weight or volume, and read a label.

We headed past frozen foods, and along to the end of the store, scanning the shelves. I didn't know what I wanted. I couldn't concentrate. He was patient, or the same as I was. We had cheese, bananas, dates, sandwiches, fruit smoothie. We negotiated the self-check and headed to sit on the bench, eat our sandwiches and watch the students and residents leave the school and the hospital to enjoy the regular lives on a warm July evening. I watched the vet in her last year of residency who took care of Baccarat last week cross the street, thinking their lives go on; it's normal.

Yesterday, Baccarat and I lay on the ground under a chestnut tree on her last afternoon before surgery. It was cool, and there was wind. It would rain later. I gazed up at the undersides of the chestnut leaves and watched the students walk the dogs who could run and chase sticks. Baccarat watched, too. She knows she can't.

They had found the mass in her heart quite changed, and they were inside meeting about her case, while we rested together outdoors, I on my back on my big cotton scarf, the one I bought in Petit Andelys last summer. The mass had gotten smaller, from a peek of 7 cm in one direction, to 5 cm, and it had moved further into the ventricle from the atrium. Some dark spots in the area where it was thought to be connected to the heart wall had appeared.

"Ce sont des petits endroits de liquide, comme dans son abdomen," said Dr. Gouni. "C'est normal qu'on les trouve là si elle a de la liquide dans le ventre. Mais, on voit que ce n'est attaché que par des filaments, ce que donne l'impression de quelque chose moins tumorale, et plus de thrombose." There were little areas of liquid visible where the mass attached to the heart wall, which is normal, since there is liquid in her belly, and it appeared now that the mass was attached by filaments, and not to a tumor. This, she said, does give the impression that it is a clot, and less a tumor.

"Mais les filaments peuvent être cancereux," I asked. She nodded. They could be cancerous, too.

It was also much darker in appearance, indicating that her body was doing what it is supposed to and working to degrade the clot part by lysis, which confirms it's appearing to be smaller. New clot formation shows as white areas, and when Dr. Gouni showed me the images later, I could see that it was no longer white, only white in small areas.

She pointed to the valve in the right heart, visibly opening and closing with the beats of her heart, but there was no valve visible on the left side. The mass is keeping it open, all the time. She thought she could see a bit of it, and I could see a white bit, similar to those of the valve on the right, held close to the wall of the left heart. She explained that this can damage the valve, and that they have a valve ready for Baccarat, in order to replace hers if it is determined necessary.

"On préfère ne pas le faire," she told me, "si on peut l'éviter. C'est déjà une intevention très --"

"Lourde," I finished, trying to be helpful. She nodded.

"Oui, très lourde. Si on peut éviter de faire plus, on l'évitera pour elle, mais je pense que la valve doit être bien abîmée."

"On peut avoir l'impression d'être chez le garagiste, avec le remplacement des valves," I joked, weakly. She smiled and explained that the valves are given to the research center by the laboratories. They use them to do research. This valve had been given to them; it is worth 6,000 euros, but we would not pay for it, and it was, she explained to me, already prepared for another dog, who was to have been operated on at the beginning of the month. The owner never showed, and never called. They could not reach her. She and her dog disappeared.

"Le chien," she told me, "fut un Labrador." I already knew that.

But, Baccarat will never need that valve. The phone rang some minutes ago, too early. Too early for good news. Baccarat had a hemangiosarcoma, possibly a rhabdomysarcoma (embryonal) and it was bad. They had removed the tumor, and they could wake her, but it would come back, maybe as soon as in only two weeks.

I understood. It was time to make the decision. I knew what my husband thought, and I knew in my heart that he was right. Even if a dog's threshold of pain is much higher than ours, we would put her through recovery only to see another tumor replace this one in less than a month, only to have to let her die later, when she could go now, knowing nothing more than what she has been through already, after our afternoon yesterday, when I had told myself to live each minute, see the colors, feel the warmth of her body against my legs, the weight of her head on my arm, watch her eyes and her expressions to never forget them.

I handed him the phone.

She is gone now. We will pick her up later. They asked if they could keep her heart. It doesn't happen often that 4-year-old dogs are diagnosed with hemangiosarcomas or rhabdomyosarcomas, much less that they are operated on. Her heart will give them information, and perhaps her case will one day help another dog, another family. Perhaps the University of Colorado and the University of Pennsylvania's veterinary clinical studies will yield hope for preventing or curing hemangiosarcoma before anyone else has to watch their beloved animal go so quickly.

We will take her ashes to la Moraine, and leave them under the peaks of l'Aiguille Verte and Les Grandes Jorasses, where we walk under the boughs of the giant firs and feel the sky like a ceiling just above our heads. I am tempted to lie down on the earth there, as though it has a special power to bring peace and safety. It was her favorite place to run and play, in the snow, pushing her head and cheek into it like a snowplow, rolling, running, jumping in the deeper snow until I thought her heart would burst. Let her lay down there to become part of the mountain, the firs.

The mountains offer another form of peace, the rest of eternity. While I walk through the forest at their feet and feel the urge to lie down on that cold earth that beckons kindly, watched over and protected by the eternal peeks and soaring trees, promising to cradle me gently under the night sky, others climb the rock faces and the glaciers and find their rest and safety below the cold ground and snow.
-- "Rest", The Sisyphus Journals, February 24, 2009,

She will always be there, waiting for us, Sam and I.
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