Heroic Measures Read online

  “There is a gasoline truck stuck in the Midtown,” Ruth announces.

  “At least there’s no fire,” the cabbie says.

  “Police are evacuating the tunnel in both directions, people are abandoning their cars and running,” she interprets the radio’s faint mumbles for Alex. “Aren’t we on top of the tunnel now?”

  Alex, Ruth, and the driver all look down just as a crosstown bus grinds into motion and a passageway unlocks in the bulwark of cars. The taxi rushes through and once again, albeit slowly, they are rolling up First Avenue.

  “The tanker jackknifed; it’s blocking all in-bound lanes,” Ruth continues. “Police don’t know if it was an accident or if the driver swerved on purpose. The mayor is asking everyone to remain calm and to not drive into Manhattan tonight. Who would come into the city tonight?”

  Five blocks short of the hospital, they jerk to a standstill again. Tunnel traffic is being detoured onto the Fifty-ninth Street Bridge. The old four-lane structure can’t accommodate the overspill. Up ahead, signals change and change again, and nothing gives. Eventually even horns stop honking. Left and right, fares begin deserting their cabs to continue north on foot. They carry their belongings in their arms: cleaning, groceries, children, strollers, a full-length mirror with the price tag still on it.

  “It’s too cold for her,” Ruth says.

  “We have no choice.”

  Ruth doubles the blanket over Dorothy while Alex pays. Despite the urgency he feels to get Dorothy to the hospital, and the electric panic in the air, and the rumbling of fear under his feet (the low vibrations from thousands of trapped engines gunning in place), and the adrenaline pumping through his frame, preparing him for flight, Alex can’t help himself, he asks the driver for a receipt.

  “Driver’s licenses? Picture IDs,” says the guard, a moonfaced young man posted inside the overheated animal hospital’s lobby, beside a metal detector.

  Ruth and Alex are panting from the hurried, five-block journey, tear-blind from the cold. In the first blast of steam heat, Ruth feels Dorothy’s shivering subside and her peculiar rigidity grow loose again. She releases her grip on the blanket, even though she’s worried her grip is all that’s holding Dorothy together, while Alex gently sets the cutting board on a card table near the guard. They produce their picture IDs—a gym membership card for Alex and a twenty-five-year-old teachers’ union card for Ruth (at fifty-two, she had looked like Imogene Coco in thick glasses).

  They pick up the board and ferry Dorothy through the metal detector, Alex first, backward. The buzzer sounds. They step back, lower Dorothy onto the card table again, and empty their pockets of keys and coins. They start through the electrified field once more, but the buzzer goes off again. Alex removes his wristwatch, Ruth hands the guard her purse so he can inspect its contents— pencils, a cell phone with two years’ worth of flashing messages (neither Ruth or Alex know how to retrieve the messages), a cellophane bar code that has peeled off the back of her library card, a sandwich bag of dog treats. They pick up Dorothy one more time and try to cross the threshold, but the buzzer rings and rings.

  “Can’t you see she’s in pain? Is this necessary?” Ruth asks.

  “It’s for security, ma’am.”

  “Who would blow up a hospital full of sick cats and dogs?”

  Alex touches her sleeve: he’s found the source of the alarm, the metal buckle on Dorothy’s faux leopard collar. Ruth had bought the collar because she though it gave Dorothy a risqué, haughty look, an old dominatrix, say, whose specialty was biting. Ruth watches as Alex unclasps the buckle at the nape of Dorothy’s neck with intimacy and caution, a husband removing his ill wife’s necklace.

  The emergency room’s front desk is glassed-in, like an aquarium. The receptionist, a large powdery woman in a pink cardigan mottled with cat hairs, looks up over her half-glasses. “Name? Address? Phone number? Pet’s name?”

  “Dorothy,” Alex answers.

  At the mention of her name, Alex notices the blanket stir on the board. Under its hem, in a tent of ratty wool, Dorothy’s one visible eye looks up at him.

  “What’s wrong with Dorothy this evening?”

  The eye casts about to see who else knows her name, and for a moment, it seems to Alex that if he lifts the blanket, there will only be an enormous trusting eye beneath it. “She doesn’t seem to be able to move her back legs,” he says. With disbelief, he watches as the receptionist writes down paraplegic.

  “Any other symptoms?”

  “Isn’t that enough?” Ruth says.

  “How long has she been down?”

  “It happened during dinner,” Alex says.

  “Take a seat. Someone will call you shortly.”

  “Please. It took us almost two hours to get here. It’s an emergency” he says.

  The receptionist makes a small lateral motion with her head and stares past him and Ruth and Dorothy with such deliberate, barefaced pity that he can’t help but follow her gaze. In a row of plastic chairs facing the desk, sits a businessman and a Pomeranian, an old woman and a Chihuahua, and a Spanish lady and a Saint Bernard. The Pomeranian’s left eye has somehow come loose; it dangles, as round and red as a maraschino cherry, from a tearing socket. The Chihuahua moans in a yellow towel. The Saint Bernard is swaying dramatically from side to side, as if the floor were pitching.

  Alex and Ruth take the three empty chairs next to the Chihuahua’s owner and place Dorothy on the seat between them.

  “What’s your baby in for?” the Chihuahua’s owner asks.

  “We think it’s her back,” Ruth says.

  “I found her walking in circles this morning,” the Chihuahua’s owner whispers as if the two dogs might overhear her.

  “Our vet says it’s a fat deposit,” the Saint Bernard’s owner says, lifting the rocking behemoth’s ear to reveal a mass the size of the Chihuahua. “Does this look like a fat deposit to you?” she asks. “Because I know my fat deposits. Trust me, that’s not fat.”

  “She’s blind now, but you’d never know it,” the Chihuahua’s owner continues. “We’re both diabetic. We use the same brand of insulin; it makes life easier that way.”

  “Will Dorothy’s owners please go to exam room one,” the receptionist’s voice floats out of a speaker in her glass enclosure.

  At the announcement of her name, Dorothy rouses once again. This time Alex takes off the blanket. Neck rigid, back as bowed as an archway, tail crushed beneath her, hind legs folded at odd, disturbing angles, Dorothy still manages to look up at him with unsullied trust. He picks her up off the cutting board, and he and Ruth take her to exam room one. In his arms, she weighs no more than a game hen.

  “They’re our angels,” the Chihuahua’s owner calls after them.

  The examining room contains only a metal table, two chairs, a clear plastic rack filled with drug brochures, a cartoon of a little dog, a stick, and an elderly couple scotch-taped to the back of the door (Man: Fetch. Little Dog: Oy, I got a pain in my tail from wagging so much, my stomach hurts from that lousy dog food, when are we going for a walk already? Woman: He thinks you said “kvetch”) and a for gotten X-ray clipped to a light box on the white wall. It doesn’t take a doctor to read the film; a white mass fills most of the animal’s lungs, though Alex can’t tell what kind of animal it is: the lungs look human to him.

  A medical student, a boy of about twenty-five holding a clipboard, comes in and closes the door behind him. “I’m going to take Dorothy’s history, and then Dr. Rush is going to examine her.”

  “Should I put her on the table?” Alex asks.

  “You can hold her for now,” the student says. “Tell me what happened?”

  “She may have hurt her back this morning running down the stoop,” Ruth says.

  Alex looks at her; her eyes are bright with tears. “Why didn’t you tell me?” he asks.

  “I didn’t know anything was wrong until dinner. You don’t think I would have told you?” Ruth turns to the medical student
, “Normally, she gets to the table before us.”

  “We found her on the kitchen floor, sitting in her own urine,” Alex says. “When I picked her up, she screamed. She doesn’t seem to be able to move her back legs.”

  “We even pretended we were going to take her to the falafel stand,” Ruth adds, “but she wouldn’t come.”

  “How has her appetite been lately?”

  “She didn’t touch her breakfast today,” Alex says.

  “Any vomiting or diarrhea?”

  “Last week.”

  “But it passed,” Ruth adds. “We think it was the pâté.”

  “Any changes in behavior? Sleeping more? Not wanting to play?”

  “She’s been extremely nervous lately,” Alex says.

  “Everything scares her,” Ruth adds. “Loud noises, sirens, strangers, even being left alone in the apartment for an hour or two. It’s not like her; she’s always been such a brave dog.”

  “The vet put her on Clomicalm,” Alex explains.

  “Any other medications?”

  “Zubrin twenty-five milligrams, Soloxine for her arthritis, and Atopica for her rashes.”

  “Allergies?”

  “Strawberries and coconut.”

  The doctor comes in. He’s wearing a necktie patterned with cows, a whole herd. His face and neck are pitted with acne scars, making his blue eyes seem especially kind.

  “You can put Dorothy on the table now,” the medical student tells Alex.

  “What did you do to yourself, little hot dog?” the doctor asks, introducing himself to Dorothy by offering her the back of his hand to sniff. Alex takes note of how gentle a hand it is, but Dorothy ignores it; she doesn’t even seem aware that the doctor is there.

  Without seeming to cause Dorothy any needless pain, the doctor palpates, prods, pokes, and listens. He uses his pencil’s eraser to check her reflexes: her nerves are that small. He taps her withers; the front legs jump. He taps her hips: the back legs hang. Supporting her under her belly, he stands her up on all fours, and lets go. He watches as her hind end slowly sinks down, as if Dorothy were deflating. Next he puts her on the floor. “Call her,” he says to them.

  Alex walks to the far corner and faces Dorothy. He can sense that she, too, suspects the hopelessness of the test, but he can also see, by the alertness of her ears, that she will try her utmost to reach him. He beckons to her.

  Dorothy scratches at the linoleum with her blunt nails, belly crawling to Alex, her back legs dragging behind, like knotted rags.

  “I can’t watch,” Ruth says and escapes into the hall, leaving Alex to suffer Dorothy’s ordeal alone.

  The doctor stops the test and calls Ruth back inside. “It’s most likely a ruptured disc,” he tells them. “But it could also be neurological. It might even be a tumor. We won’t know until we x-ray her.”

  “But you think it’s only a slipped disc?” Ruth asks, hopeful.

  “Ruptured. That would be my guess. It’s fairly common in chondrodystrophoids, short-legged, long-bodied dogs. Dwarfs, really. Imagine a suspension bridge without the cables. It’s only a guess, though, until I see X-rays.” He pats Dorothy’s head and whispers, “Don’t worry, we have a special wiener x-ray machine.” He disappears with her down the hallway.

  “You can wait here,” the medical student tells them.

  Alex and Ruth sit down on the two chairs.

  “Do you think a ruptured disc is fixable?” Ruth asks.

  “I hope so.”

  “Why didn’t you tell me she hadn’t eaten her breakfast?”

  “I didn’t think it was important,” Alex says, but even as he says it, he realizes it’s not true. He, too, should have known that something was wrong with Dorothy this morning. He found her trembling on his studio floor soon after Ruth and she had returned from her walk. Assuming she was cold, he picked her up, tucked her into his bathrobe, and stroked her fur until her shivering ceased. In his arms, next to his skin, Dorothy soon began sighing, long, deep exhalations of such contentment he ached to join in, to give voice to his own exhaustion and yearnings, to just breath in and out and not have to think about him and Ruth starting over. Now he realizes that the moans issuing from Dorothy weren’t sighs of contentment; they were whimpers of pain. He’d been wearing his hearing aids this morning: he should have discerned the difference.

  “How long does an X-ray take?” Ruth asks, hoarse. To distract her and himself, he reaches for a handful of drug brochures, and shows her the picture on the top one, a picket line of cartoon cats holding up protest signs. He reads the caption aloud, “Join the Revolution. In the campaign against parasites, we know our only solution is Revolution. ”

  “Do you think the truck crashed on purpose? Is it rigged to explode?” Ruth asks.

  “I hope not,” he says, and turns to the next brochure, a bulldog grinning in a dentist’s chair: Clavamox keeps more than your pet’s teeth from decaying. The dog’s teeth are whiter than his.

  “Should we have sold last year, Alex? Did we wait too long?”

  The doctor returns: he isn’t carrying Dorothy. No one has to tell Alex this isn’t a good sign.

  “It’s as we suspected,” the doctor tells them, “Dorothy has suffered a ruptured disc. We’d like to start her on prednisone and see how she does during the next twelve to twenty-four hours. Some dogs respond extremely well to the steroid therapy.”

  “The ones that don’t?” Alex asks.

  “The spinal cord is very fragile. Once it’s damaged, it can’t be repaired. Dogs are remarkably adaptable, though. With the help of wheels, I’ve seen dogs with full paralysis chase balls. They accept their fate with a lot more peace than we do. The paralysis sometimes seems harder on the owners than their pets.”

  Does he really believe that? Alex thinks.

  “The rupture occurred between T-13 and L-1, about two-thirds down her spine. At the moment, she’s lost mobility in her hind legs, but she’s still experiencing deep pain.”

  “Can’t you do something for the pain?” Ruth asks.

  “We want her to experience deep pain. It means her spinal cord has at least one live wire running through it. As long as she feels pain, we have hope.”

  Pain equals hope? Ruth thinks.

  “If she doesn’t get worse during the night, we’ll continue the course of steroids and see how she does.”

  “If she gets worse?” Alex asks.

  “Surgery. We perform a hemilaminectomy as soon as we can schedule one, remove any bone and disc material pressing against the cord. But even with surgery, the prognosis still depends on how acute the rupture is. You should also know that the surgery carries risks, especially at Dorothy’s age. Surgery is an option you might have to consider, though. Meanwhile, let’s hope the steroids work. A nurse will phone you if there are any changes.”

  In the waiting room, the cutting board and blanket are just where they left them.

  They lay out all their credit cards on the cashier’s desk. A card trick, Ruth thinks, shuffling through them in search of a magical one that still has enough balance left to conjure up payment for Dorothy’s procedures—steroid treatments, and if those don’t work, a hyperosmolar agent, and if that doesn’t work, a myelogram and hemilaminectomy. The costs are listed on a permission form she and Alex have been asked to sign. Dorothy’s back could run to the thousands. Ruth signs for everything and anything, and then hands the form to Alex. She watches him as he initials, from all Dorothy’s options, the one that harbingers the worst possible scenario: Do Not Resuscitate.

  “What are you doing?” she demands.

  “At her age, I don’t think we should let them take heroic measures.”

  “That’s not your decision to make alone. When were you planning on telling me? After they pull the plug?”

  “Let them try the steroids, even surgery if it comes to that. But when they open her, if it looks like she’ll never walk again, maybe we should ask the doctor not to wake her. Our Dot’s had a good life
. If she can’t walk, she’ll need to be helped to the bathroom. Every time. She might even be incontinent. I don’t know if we should put her through this, if she would want us to.”

  “I don’t mind helping her.”

  “She might mind.”

  IT’S NOT AS IF DOROTHY DOESN’T KNOW where she is, she’s seen her share of doctors: when she swallowed a pound of Brie at Alex’s gallery opening, tore off her nail on a hook rug, had a seizure at the falafel stand, sampled rat poison at the park, was attacked by a pack of Chihuahuas; the time a stranger with a kind face beckoned her to him with the promise of salami, then kicked her in the ribs for no reason; and just last month, when the anxiety of being left alone in the apartment became too much for her again, particularly as dusk fell and nocturnal shadows grew menacing, and her sense of loneliness and old age became inseparable. She barked until she heard Ruth and Alex inside the building, howled for them to hurry up the staircase, and when they finally appeared, couldn’t stop whimpering. They brought her to the doctor’s the next day.

  But Alex and Ruth have never before rushed her to a place like this. This is a skyscraper-size warren of illness and emergencies. Every passageway the nurse carries her through smells of blood and urine, and she’s so tired from the pain, so ready to let go of it and nestle inside woolly sleep. But she stays vigilant, keeping track of every odor, and the saturation of the odor’s age, and the direction of its musk, so that she can find her way back to Alex and Ruth.

  In a small room lined with cages, the nurse sets her atop a steel gurney and wheels her under a bright lamp. The nape of her neck is shaved. Clumps of her fur land all around her. Something sharp and cold jabs her between the shoulder blades and she screams more in fear than in pain: after the orange explosion, she has a whole other appreciation of pain. When she’s able to turn her head, she sees she’s been tethered to a bag of liquid. The bag is almost as big as she is. Now, even if she manages to escape the nurse and get down from the table, how will she find the strength to drag both her hind legs and the bag of liquid in search of home?