Good dog

NOTE: It’s March 4, 2017. I’m thinking about a friend who has entered hospice. His cancer has gotten to that point. He used to like hearing about my dog before my dog’s cancer got to that point. I wrote this in Fall 2015. A version of this story appeared originally on the WBUR blog Cognoscenti.

We met our dog in a secure, subterranean kennel. My wife, daughter and I sat on a cold linoleum floor, in a long, fluorescent-lit hallway, and waited for the veterinarian to bring her out. He told us the dog would be more at ease if we sat.

The Hepa-filtered atmosphere was thick with metaphorical particulate: the hallway a threshold, the veterinarian a gatekeeper in the long corridor between medical research and care. For a family newly rescued by stem cell transplantation, not even the dog treats were simply that: MarroBones.

The dog concealed any enthusiasm for the occasion. She was shy, seemingly penitent, her long, soft ears dusting the floor as she hugged the wall and crept forward. We tried to win her over with caresses and MarroBones. Her tail stayed tucked like a comma.

Most surreal for me was this: My family had spent about 20 months in isolation, with my daughter at extreme risk of infection because the immune system she was born with had ceased to function. Now she had a new one, the gift of a generous stranger and decades of bold, visionary, often disheartening science.

You might say I also had my tail tucked. Just as I was learning to trust this new immune system, and my daughter was being cleared to escape her “bubble,” we met a dog we hoped to adopt in the clean environment of a research kennel. We all had to put on clean suits, to protect the animals from what we might have brought with us.

That was the day my daughter stopped being the vulnerable one, and we began a jarring transition to yet another new normal.

The veterinarian cried. Not loud wails or sobs, but real tears. He wiped his eyes and apologized. He said he’d never seen one of the animals he cared for meet a child who would live because of the research. Such is the disconnect between medical research and care.

Two days later, the dog would come home with us. We named her Hutch, for the place in Seattle where the cure and so much of the science behind it took place.

Research means keep looking. So my dog was a research animal in more ways than I knew, because she was always looking for something to eat, determining after the fact the morsel’s actual digestibility. Often she was wrong with her initial thesis, I’d clean up after her, and she’d go off looking some more.

Hutch was mostly beagle with a little basset, but I thought of her as a lab-beagle mix because of the five weeks she spent as a subject in research on bone marrow transplantation. My family adopted her at age 3. She’d been in a kennel under the care of a

veterinary staff most of that time, but spent five weeks on the animal equivalent of the transplant ward where my daughter’s cure took place.

She was thin when we adopted her. We fattened her up.

On the August 2015 morning when my wife and I spread Hutch’s ashes on a beach in Martha’s Vineyard, where for several years the dog had expressed joy like nowhere else, the wind was swirling, and we were uncertain which way to offer her up to the elements. We looked to the flagpole and waited till stars and stripes flapped steadily toward the northeast and the water. Then we opened the pine box, relatively small but shaped unmistakably for the occasion, and brought out the clear plastic bag of ash.

The contents were not what I expected. I imagined something more like wood ash from the barbecue that I’d taken to the compost heap the day before. What was left of Hutch seemed more like grains of sand and pieces of shell, the blend she would soon become part of.

After we released the ash, and sat on a boulder and shared some memories, I played a Bob Dylan song for my wife. Once, on a walk, I noticed Hutch’s wagging tail kept perfect time with “Duquesne Whistle.” Even my wife liked the song, which is unusual, because Bob Dylan.

Until age 3, Hutch’s name was a four-digit number, tattooed in her ear. I wrote a book about my daughter’s cure, and yet I still don’t truly grasp how my daughter could be cured of a disease that would have killed me as a child. Between the 1950s, when I was born, and my daughter’s 2006 experimental treatment, research became cure.

At the time of my daughter’s transplant, in Spring 2006, the treatment was still “last ditch” and followed failed interventions and about 80 blood transfusions. Now, physicians recommend bone marrow transplant sooner for patients with severe aplastic anemia — not out of desperation so much, though that remains a factor, but because increasingly it works so well.

Cure is by no means a sure thing, but it is a surer thing. My dog played a role in that. Shortly after my daughter’s transplant, the dog received virtually the same course of chemotherapy and radiation, then was transplanted with her own stem cells. What specifically the scientists learned from this experiment on my lab-beagle mix, I cannot say. But I can say this: transplant is better now. The balance of risk to benefit weighs ever more heavily toward the latter. My daughter’s experimental transplant protocol has become standard of care.

When my wife and I spread Hutch’s ashes, our daughter was away at a summer camp for the physically and cognitively disabled. She was a counselor. Her camper was a Down’s adult about twice her age. My daughter knows the value of a human life better than anyone I know.

Having lived more of her own life since the transplant than before it, she is going on 18 with an immune system going on nine.

Hutch was nearly 11 when she died. The cancer wasn’t caught until it was in too many places to be treated. In the end, she couldn’t stop bleeding, which was the symptom my daughter’s disease chose to reveal itself.

I recently read about a mixed-race kid, the hardest to find a matched donor for, cured of aplastic anemia by cord-blood transplant. Meaning, in short, she could once again make blood and stop bleeding.

I miss my dog.

 

About paulcmclean

I'm a husband, father, and writer, which is another way of saying I have the best gig there is. I'm an accidental bioethicist, occasional children's chorus chaperone, a bit over the top in the Springsteen department, and have a daughter who was cured and a beagle with a story. Some call the beagle a rescue. What they don't realize is, I'm the rescue.
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