A Creature’s Purpose
My Subacute Unit was a deeply tragic place, filled with people so damaged they’d spend the rest of their lives in a coma, on a ventilator, or both.The only moments that stand out for me as moments of sublimelove were when the SPCA brought in their dogs and cats (and the occasional goat or iguana). The volunteers lifted the animals onto the beds beside of one after another brain-injured, unresponsive patient drenched in sweat, their muscles in terrible spasms. Here was a tabby nudging a twisted shoulder. Over there, a Nubian goat licked at a lifeless hand. An old gal on a ventilator seemed to cuddle into a beagle’s warm, moist breath on her face. Before our eyes, the muscles soothed. The tension went out of the skin. The air seemed to clear of its sickly miasma. Often, a tear would fall from eyes so long lost to us it seemed a message from a place very far away. The MRIs and CT scans showed such damage that there was no way this person could have been aware of the pet near them. Yet, by the grace of God, the pets proved our studies wrong.
Elon was a young man destroyed in a car accident. After he’d spent 12 months on our subacute unit, his family finally decided this was not a life he’d have wanted. We told them what to expect after taking him off the ventilator: hopefully a quiet death of which he was unaware, probably breathing for a few hours or a day—hard for us stuck in the conscious world, but peaceful for him. I reminded them that ethically we could give any meds necessary to control his discomfort, even if as a second effect those drugs shortened his survival. But we could not give any medications specifically to cause death unless they had another primary purpose.
So with the family’s consent, we removed the ventilator. Eleven days later, he was still alive, but his blood pressure, muscle spasms, rapid breathing and profuse sweating suggested that at some deep level he was suffering terribly. The exhausted family and staff begged me to make it stop. The charge nurse asked if we couldn’t just plug his tracheostomy to end everyone’s distress. Alas, our ethical considerations couldn’t include family, staff and unconscious distress. The principles of beneficence, nonmaleficence, guidance, autonomy and societal responsibility do not give the suffering of families and staff any standing, but apply only to the patient. In these cases we’re unable to be sure what the “patient” is experiencing.
Late one evening as I was walking out, his parents grabbed me in the hall. “Doc, this has to end.” I told them I agreed, but it was illegal. Thinking back to panels in which I’d participated, I asked them what final scene their son and the family would wish they could have to remember.
“Well, Elon was inseparable from his Lab, Heidi. She always slept next to him, nudged him awake in the morning, cuddled with him at night. That was the happiest we’ve ever seen him. He’d want her to be with him.”
“I hear you,” I replied—words I probably say way too seldom.
Ignoring hospital protocols, we brought Heidi in off hours. Elon’s folks were going to place her at their son’s side, but she’d already jumped up to be by him. After a couple of licks and a snuffle at his left ear, she simply lay there, her eyes wide as she tucked deeper into his side.
The tortured boy of the past year was gone. His vital signs normalized, the tension went out, his fingers curled around her rump in the position his folks said was just how they slept at home. By next morning, he was somewhere bright, calm and very far away. Heidi accompanied him through the end of this part of his life.
A program, I believe it was at Children’s Hospital in Denver, worked with desperately ill children. They were given plants and pets to take care of. The caregiving children stroked their charges, arranged their leaves or fur, reassured them, explained that the shots they were going to give them were out of love and were all to make them happy. As I remember, the children not only tolerated their own harrowing treatments better, they actually experienced them as less onerous and had better outcomes.
What is it in a living creature that can so open our hearts? I imagine ancient times when frail, rough people hunched against a worldof vast cruelty. Only three things stood betweenthem and abject brutality: a small fire; their children; and theirherds. In a movie called A Dog’s Purpose (2017), one dog dies and is reincarnated several times, bonds with successive humans, and finally his original owner again. After all these lifetimes, the dog discovers that a good life is about having fun, helping and saving others, finding a human companion, and living for today, without undue worry about the future or the past. Though only a fiction, the film perhaps unintentionally challenged our attitudes toward animals epitomized as selfless servants, versus the animal rights advocates who challenge the presumption that humans are the pinnacle of all God’s creation. In fact, mightn’t we be important not only to ourselves, but also as providers of food, shelter, and care for creatures who have their own purposes and motivations, and creating for them a livable environment?
I lean toward the hypothesis that cats and dogs domesticated us, not the reverse. They found a species that had food, shelter, garbage, fear of the darkness and not very sharp talons. Those nonhuman creatures, animal or plant, won if they best fulfilled our needs for protection, companionship, needing to be needed (to provide for them), and a soft place. Even at the end of our lives, they save us by letting us save them.
When we find ourselves powerless before immense, incomprehensible forces, or at the mercy of The Predator, children and pets can remind us that the joyful wonder that is theirs lives on, waiting, deep within us, to be set free.
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