The cat wholl live forev.., p.16
The Cat Who'll Live Forever, page 16
The next day, I took my cat uptown—to the Upper West Side this time—and we went to the cat oncologist.
Remember my unpleasant interlude with the East Side rich cat vet? Well, this was even more unpleasant. I stood by while Norton went through a battery of tests, mostly with nurses, and then the doctor himself came in. He was perfectly nice and recognized both how nervous and upset I was. He gave me some literature to read, pamphlets that explained exactly what cancer was and what the various treatments were, and then he explained to me about the chemotherapy. It was to be administered via shot once a week, as I recall, for six or seven weeks. And before the shots commenced, Norton was to immediately start taking something called prednisone twice a day for two weeks. I tried to ask reasonably intelligent questions but I was in that nether land where nothing seemed quite real. I do remember asking two questions, however. One, would the shots make my cat sick? And two, what would they actually accomplish? In other words, Was I going to be ruining my cat’s life just to keep him alive? And if so, for how long would he actually be kept alive?
I also remember the doctor’s answers very clearly. He explained to me that chemo on cats doesn’t cause the same side effects it does on people. He said that Norton would not get ill from these shots. Not at all. And then he said that with the shots, Norton could live as long as nine months. Without them he’d definitely be dead in two months.
Excuse me?
Those were my exact words. It was all I could manage to get out of my mouth.
And he repeated what he said, unemotionally, a throwaway: If I gave him the chemotherapy treatment, my cat had nine months, tops. Without it, it was absolutely certain he couldn’t live more than another eight weeks.
I started stammering: “But . . . but . . . but . . . Dr. DeLorenzo said he could live quite a wh-wh-while.” I started to explain that Marty Goldstein even said the cat was fairly healthy other than the cancer but it sounded kind of ridiculous coming out of my mouth.
The oncologist shrugged and said, “It’s your choice. You can do what you want.” It was as if he lost interest the second I hinted that I was questioning whether or not I’d go for the chemo. “All I’m saying is that if you don’t do it, your cat’ll be dead very soon.”
That was the end of the consultation. Except that he told me I should make up my mind quickly. If I waited more than a few days, it would be too late.
When I left his office, I felt as if I’d been hit over the head with a sledgehammer. And needless to say, my trip back downtown with Norton was not a happy one.
The second I walked in the door, I called Marty. He calmed me down, talked me out of my hysteria and told me to bring Norton up to his clinic the next morning. Before hanging up, he said, “Hey, I told you not to worry and I meant it. Your cat’s going to live quite a while yet.”
Not worry?
Oh sure. No problem. Dr. Frankenstein had just told me I had two months left with my favorite creature on earth and I wasn’t supposed to worry? Right.
Do I have to bother to say it? I spent the rest of that day and night doing nothing but worrying. Then Norton and I got up bright and early the next morning and drove to South Salem.
Marty did his usual gentle poking and probing with Norton, elaborated on a few of the things I’d already heard about his latest tests, x-rays and biopsies, and then said, “It’s like I told you. Your little buddy’s got cancer—but other than that, he’s pretty healthy.”
“But the oncologist,” I started to moan. “He said—”
And then Marty Goldstein said nine wonderful words: “Doctors are not gods. Sometimes we get things wrong.”
I didn’t realize you were allowed to say that about doctors. Once the realization sunk in that you were, boy, was I happy.
Marty then went on to elaborate. What he said was that it was certainly a viable option to put Norton on the chemotherapy cycle. He was very reasoned about it and said that it definitely could and probably would help. But he also said that contrary to the oncologist’s assertion, there was at least a fifty-fifty chance that the treatment would make Norton sick, to a lesser degree than it would with a person, but sick nonetheless. Marty said that I couldn’t make the wrong choice—whichever way I went would be correct. When I asked what he would do, he said that if Norton were young, say five or six, rather than fourteen, he’d give him the chemotherapy. His system could withstand it and it could conceivably knock out or at least slow down the cancer. But at Norton’s age, the question was, was I going to go for quality or quantity. He said he could keep Norton healthy and happy for a fairly long time without poisoning him, which is essentially what chemo does. My wonderful, perfect cat wasn’t going to live forever, Marty made sure I understood that. But he was not—repeat, not—in immediate danger. He was not going to live for just two more months. In fact, Marty doubted very much that the oncologist’s nine-month projection was his limit. He said, again, that my pal was happy, felt good and had a genuinely strong will to live. Marty says stuff like that—things like one’s cat has a strong will to live—and at first I thought he was pretty much full of it. But he wasn’t. And in this instance he was as right as anyone could ever be.
He told me that he wanted to put Norton on an elaborate new system of supplements. He said that I should get blood tests on a regular basis with Dianne DeLorenzo, so we could monitor his progress. If I didn’t like the way things were going, I could always go back and opt for the chemo (although Marty would never say this, my interpretation was that the oncologist was full of shit when it came to that, too: there was no reason I had to make my decision overnight). And then Marty said that he wanted to put Norton on a two-day continuous supplement drip to flush out his entire system. I asked how I could keep him on an IV for forty-eight hours and he said that I didn’t have to, I was going to leave Norton with him. I started to protest, but he said it was important. He also said he wouldn’t leave Norton alone in the clinic overnight—he’d take him home with him.
I took a deep breath, decided I felt a little bit like I was sending my cat off to Mexico to get treated with apricot pits, and said okay. I bit my lower lip to keep from sobbing again, kissed Norton goodbye, got in my car and drove back to the city.
For two days, I paced around my apartment, went to the dog run by myself and felt like an idiot, and worried like crazy. The first night, I called Marty at home to see how Norton was doing. The report came in: Just fine. And he was getting along with Marty’s various cats and dogs like gangbusters. In fact, it was going so well, Marty wanted to keep him for one extra day. “Really,” he said. “Trust me.”
At the end of the seventy-two-hour period (and yes, in case you’re wondering, I did call a couple of more times to check on my cat’s progress; well, okay, more than a couple—I called about ten times), I headed back upstate and picked Norton up. Naturally, he had totally charmed everyone in the clinic. They were not at all happy to see me, knowing I was there to take him away.
Marty told me the treatment went well. With a big smile, he instructed me to take Norton back to Dianne and, in twenty-four hours, to get another blood test. After that, he said, I should start the new program of supplements and vitamins and get a blood test every three to four weeks.
I said okay, drove back to the city, petting my cat—who, I have to admit, looked particularly healthy and perky—the entire way, and made an appointment at the Washington Square Hospital.
When I got to her office, I told Dianne that I’d made my decision. I was going to see how Marty’s treatment went and, for the moment, I was going to pass on the chemo.
I don’t think she approved, but she was very understanding. She, too, said I could change my mind at any time. She even said that she could administer the chemo shots, if that would make me more comfortable, as long as the oncologist prepared the proper dosage. I said that it would indeed make me more comfortable, but at the moment I was going to see how this played out without it. I had thought long and hard about this. I really tried to keep it in perspective and I kept telling myself I was talking about a cat, not a world leader or a relative or even just a regular, normal human being. Nonetheless, perspective be damned, I felt as if this were one of the most important decisions I’d ever had to make and I felt very strongly that I had to trust my instincts. And my instincts were, overwhelmingly, to go for quality over quantity. They were to go ahead and do what I’d done so far during all the years I’d spent side by side with my beloved little pal: give him the best possible life he could have, so when it ended there would be no regrets for either one of us.
Once before I’d been faced with a similar situation. When I’d gotten the word that my father was dying, I flew (actually, Norton and I flew together) to be with him. He was still in the hospital then and it looked pretty bad. His doctor pulled me aside and said that when the time came, if I saw my father was in too much pain or had passed the line where we thought his life was no longer worth continuing, he could do something about it. Lowering his voice, he said that he could increase the morphine drip, gradually put my father into a coma and . . . He trailed off but the end of the sentence, the words he didn’t and couldn’t say were, “and kill him.” There was no question in my mind that it was a humane offer. And one I would jump at if it needed to be done. I thanked the doctor—who made it clear that, officially, we had not had the conversation—then I went and explained the situation to my mother and brother. My mom said that she felt it was the right thing to do if the time came when we thought he was suffering too much or if his brain stopped functioning. My dad had made it very clear that he did not want to stick around in any kind of vegetative state. But she also said that she couldn’t be the one to do it. My brother was in total agreement but wasn’t a hundred percent sure if he could do it, either. I knew that I could and I told them that. So we tacitly agreed that if things got worse, I’d tell the doctor and no one would ever know—including them.
Luckily, it didn’t come to that. Just because I could do it didn’t mean that I wanted to. My father perked up slightly, enough to let us know that he wanted to die at home, which is what he did a few days later—naturally, with no artificial acceleration.
I remembered that conversation as if it had happened yesterday and strangely enough, this situation with Norton was a more emotional decision for me. I was weirdly unemotional when talking to my father’s doctor. I do know the difference between humans and animals, don’t worry. I haven’t totally crossed that line yet. But with my dad, it was a question of days, possibly even hours. And it was a question of relieving rather than prolonging the suffering. I didn’t even think it was a difficult decision—it struck me as the only decision. Now, however, if the oncologist was to be believed, what I was doing was, by my gamble, possibly taking six months to a year from the life of the sweetest, gentlest, most genuinely loving creature I’d ever encountered. I didn’t know what kind of suffering would be involved either with or without the treatment. I didn’t have a clue. But I tried to think what I would have done for myself—and I realized I’d be doing exactly the same thing. I’d never actually faced up to this question before. Yes, I wanted to live as long as possible. No question about it. But that desire was not as powerful as my longing to live as well as possible. If it were me, I’d try for quality and I’d try for natural.
So that’s the decision I made for my cat.
When I realized I’d made the right call was when Dianne called me the day she got the results of Norton’s latest blood test.
“I don’t quite know what to tell you,” she said. I prepared myself for the worst, but that wasn’t what she meant at all. “I don’t understand it,” she went on, “and I don’t see how it’s possible . . . but after whatever it was that Marty did up there with that drip, the results of Norton’s blood test are exactly as if he’d had a very successful chemo therapy treatment.”
Thus began my new stage as primary caregiver to a cat.
When we were out in Sag Harbor, I made a special trip over to see Drs. Turetsky and Pepper and I told them about the cancer. They were genuinely sad. I think their sadness stemmed partly from the fact that they were compassionate people and loved animals and they didn’t like the idea of any of their patients getting cancer. But I also think there was something more going on, particularly with Turetsky who had treated Norton since he’d been a kitten. They had come to be attached to my cat. They liked him, and I think they recognized that elusive will to live, so part of their sorrow was personal. They didn’t want to lose him. While I was there they asked about the treatment he was getting and I described everything that had happened so far. Naturally, they put themselves at Norton’s disposal but during the next few months, we were mostly going to be in the city, so their contact would, at best, be on the occasional weekend.
Because we were spending more time in Manhattan, my wonderful new apartment soon took on the air of the emergency room at St. Vincent’s Hospital. I had the IV drip bag hanging from my shower curtain at all times. In my pantry were several large Baggies filled with needles. Marty said that Norton needed to receive certain new supplements via hypodermic needle, so I had hypodermics lying around, too—and not only did I use them on my cat, I got pretty good at using them.
Feeding Norton was now nearly a full-time occupation.
When Marty sent me my latest box of supplements, it came with an official-looking sheet that had scribbling all over it and a box that explained the codes used so I could understand the scribbling. There were thirteen supplements, each one listed on the left of the sheet. If a liquid, it would indicate that I was to give two or three drops or a third or a half of a dropper. If it was a pill it would tell me to use the whole pill or half or a third (just for the record, it’s really a lot of fun to try to chop tiny little pills into thirds!). If it was a powder, I’d get the dosage in teaspoons: a third, a quarter, a half. On the right of this piece of paper, and corresponding with each individual supplement, there were things written such as OD AM O/F. There were also things like BID and EOD and A/D. Thank God for the key code because, even with it, it took a lot of studying before I eventually figured out that OD meant that Norton was supposed to get that particular supplement once daily. BID was twice daily. TID was three times per day. EOD = Every other day. OCC was once or twice per week. A/D meant alternate days, O/A was orally alone, O/F was orally or with food. F/D told me I was supposed to follow the directions on the bottle and A/N was as needed.
So in addition to cooking his fish, chicken or shrimp with rice or pasta and fresh, green vegetables, my routine was as follows:
Every morning, as soon as we were both awake, I would head into my pantry, pick out several small bottles, place Norton on top of the butcher block kitchen counter and give him half a dropper of something called Super Glandulars, which was described on the label as high-concentration 1050, liver and B-12 glandular. I also gave him half a dropper of something that Marty concocted that was simply labeled “kidney.” I can’t say Norton loved taking this stuff but he never complained, rarely even squirmed. I’d pet him, he’d open his mouth and in the stuff would go. Next, every morn, was Hepaticol Drops, four drops’ worth. The label described this tasty brew as Homeopathic Endocrine Sarcode Combination HHD. Yum yum yum. Every other day (EOD if we remember our secret code) in the morning, Norton got two or three drops of Milk Thistle Seed. Each evening he was given different drops. His predinner warm-up was small doses of Renal Drops and D.A. Gland Formula 1010. For pills, in various combinations at various times during the day, he got Cod Liver Oil (softgels), some truly weird-sounding thing called Tang-Kuei 18, Lipotrope, Beta-Thyme, Hemaplex and a very foul-smelling Raw Kidney Concentrate which had to be crushed up into a powder. As if this weren’t enough, he also got two additional powders mixed in with his meals, Psyllium Husks Powder and Vet-Zimes Formula V5. And I’m not done yet, because Marty gave me some additional pills that basically had many features of the chemotherapy treatment: Natural Cortisone. To top it all off, Norton was quite often nauseous, so Dr. Pepper gave me an antinausea prescription for something called Metoclopram while Marty provided the all-natural version. Both pills were a great help but even with them, for some periods of time Norton would throw up once or twice, even three times a day. This was practically the most heartbreaking thing of all for me, listening to him cough and choke and spit up, knowing there was nothing I could do but hold him and rub him and try to soothe him. Often, in the middle of the night, I’d hear him down on the floor, giving that little cough of his that I came to know so well. It meant he was struggling to get something out of his system. He never did it in bed—he’d always hop down on the floor and try to do it as discreetly as possible—so I’d swing myself out of the covers, find him, and spend five or ten predawn minutes petting him and talking to him to keep his spirits (and mine) up.
The hardest part of all this was getting my stubborn little friend to swallow pills. The drops were no problem, he took those like a champ. He wasn’t wild about the various powders that went into his food, but eventually he’d get hungry and have to eat. But the pills. Damn, those were tough! If I cleverly tried to mix them in with his food, I’d come back to check when he was done eating and all the food would be gone—and the pills would be there in the middle of the bowl, licked clean but absolutely whole. If I tried to force them down his throat—and I was terrible at doing this; it’s the one thing in which I never got even close to vet-level skills—I’d be positive he’d swallowed, go away satisfied, then an hour later I’d see the very same pills lying on the floor in the kitchen, where he’d somehow managed to not only spit them out but leave them in a very visible spot so I’d be sure to know that he’d outsmarted me. Eventually I was able to figure out a way to get them inside him 90 percent of the time. After all, I was the one with the larger brain (and if you believe that, I’ve got a uranium mine in Asbury Park I’d like to sell you). My trick was that I wrapped the pills in a tiny dab of peanut butter, which Norton loved. It also was pretty amusing to watch him eat, because the stuff was so good but so sticky that he’d be licking his lips for half an hour afterward. Even with the peanut butter (either smooth or crunchy, he wasn’t fussy), occasionally he’d still manage to spit the pills out, but not nearly as often.
