First my friend tweets that he thinks he may be dying,* then I hear that someone else has skin cancer,** then… Mark wins round trip tickets for two to Paris. And he invites me to go with him!
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* He’s now in the ICU but appears to be making a full and speedy recovery.
** Which is expected to be fully and speedily recovered from, but still.

A very dear friend Twittered last night that he might be dying.*

Depuis 15 h, ma température est passée de 99,3 à 100,7. Je suis conscient que ma vie peut se jouer dans les heures à venir. Sentiment d’aventure…

He’s worried about the folks he’d leave behind.

Il y a des gens ici qui ont besoin de moi. Je ne dis pas émotionnellement, bien que cette dimension soit évidemment présente, mais directement, de manière très concrète, parce que leur vie est imbriquée dans la mienne. Je ne connais pas de tristesse plus profonde que ce sentiment de devoir, peut-être, abandonner ces gens qui m’ont donné leur confiance. À nouveau se battre.

He has a form of muscular dystrophy. Ten years ago he weighed 56 pounds, including the three steel rods in his spine; today he probably weighs less. He has trouble breathing because of his muscle wasting and he has just caught some sort of nasty cold from one of his staff. She was really really sick, so he is expecting to get really really sick, and when someone in his condition gets that sick they don’t always get better. He was watching his temperature go up last night and wondering whether to call an ambulance to be taken to the Montreal Chest Hospital. I’ll be making calls later this morning to find out the outcome.

He and his sister (who has the same genetic condition and lives in an adjacent apartment) do some wonderful, intensive work for people who are marginal in our society. They have employed illiterate people, drug addicts, people without family, and immigrants – particularly from Haiti. They employed me. They don’t pay much: they receive an allowance from the government to hire staff for a little over minimum wage, so the staff they hire are people who are unable to find better-paying work. They teach them french, they coach them in relationships, they explain Québec culture and help people figure out how to cope with their new situations. They have shared their living space. Whatever they can do to help someone develop their full potential. Most of all, they offer profound, unjudging friendship.

My friend is a disabled man without paid employment, but far from being a burden on society he is a householder who will leave behind people who will be poorer for his loss.

We all know he is going to die. We first met in the late eighties, when he was seventeen. He thought he might have ten years left then, for the last five of which he wouldn’t have the strength to lift a pencil. He’s outlived everyone’s expectations. But we all hope… not yet. Please.

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A friend responds, “What an incredible opportunity to thank him for all that he has meant to you and the world.” Wise advice, and I will follow it.

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* If you’re wondering why these tweets are longer than 140 characters, it’s called Twitlonger.

I went to the Stade Olympique yesterday for my H1N1 vaccine, my first-ever influenza shot. I’d never bothered before because it had always seemed like too much trouble and I wasn’t in a risk group. But for H1N1 they’ve made it really easy and I’d taken the day off work anyway so I could do it whenever and wherever it was convenient.

I still had to think about whether protecting myself against a deadly strain of influenza virus was really something I wanted to do. A likely outcome is that I will have a longer old age, which is not something I necessarily want. (Healthy but not particularly long would really be the ideal for me.) But another likely outcome is that I will not be a vector transmitting H1N1 to other people who might actually be gunning for that long, productive life but who might not be in a condition right now to be vaccinated: small babies, for instance, can’t be effectively immunized against influenza. My friend with cancer, who most definitely wants to live, may get only limited protection from a vaccine and is largely dependent on the people around him to not transmit it to him. The girlfriend of the woman who is dying of lung cancer in the apartment upstairs will not be able to point the finger at me as being the one who infected her with her final illness. And I will not interrupt the old ages, happily surrounded by children, grandchildren and great-grandchildren, of my old relatives.

So I got the H1N1 vaccine and will get the seasonal flu vaccine when it becomes available. If I ever decide my old age is dragging on too long there are ways around that that do not involve making other people sick.

Last night Mark came to bed and Pepe wasn’t there between us. He brought Poupoune into the bed as a substitute, but she isn’t as soft and snore-y as Pepe was. Mark broke down in inconsolable sobs. “I miss Pepe!” “Pepe didn’t want to die!” “He was so happy on his walk.” “He was so helpless. I looked after him!” … and finally, “He needed me.” I cried too, because I was sad for Mark.
 
Today we talked about why he is so much more affected than I am. One reason is Mark’s greater experience of loss, having lost both parents as well as his country and old friends. Intellectually he thinks the decision was probably appropriate, but he feels it to be painfully wrong.
 
Another reason is my own experience of suffering. I spent years trying to get my depression taken seriously so that I could get effective treatment for it, only to be repeatedly told that as long as I could function a little bit that I wasn’t depressed enough—probably not depressed at all. I got treatment after having lived in a dysfunctional relationship for years because I didn’t have the financial or psychic resources to leave; having become unable to do any kind of work; having lost contact with my friends; and having been reduced to walking the sidewalks with tears streaming down my face. As long as I wanted treatment I was denied it. When I no longer wanted it, when I had given up all hope and wanted only to die, it was suggested that I was possibly depressed and would I consider accepting treatment for depression?
 
I am still angry today at having been forced to suffer as much as I did, forced to endure completely unnecessary losses, in order to qualify for intervention.
 
Mark may be projecting his own sense of abandonment, but I am also re-enacting my own story, this time re-written to include the recognition of suffering and need given promptly and lovingly, without begging.

We found out about the brain tumour on a Friday. Over the weekend I called the people who needed to know (the dog lady; my ex) and mentioned it to the neighbours. By Monday I had made up my mind, so I called the vet to book the final appointment. Pepe was not in immediate distress, so I just asked for the first sunny day… which turned out to be Tuesday, the next day. I called Mark to tell him, but he just wasn’t ready. I asked if he wanted to wait, and he said yes. So I cancelled the appointment.

 
 
Over the next few days Pepe had ups and downs. Sometimes he would eat; other days he would just sleep. I asked Mark if I could make another appointment, and he agreed so I did. This appointment was again on a Tuesday, a week after the first one.

 
 
On the weekend we took Pepe on a nice long walk along the river.

 
 
When we got back we dug a nice big hole under the patio stones in the back yard.

Pepe tried out the hole and approved it.

 
 
Today I came home from work at mid day and we took the dogs out for a sunny walk in the park. Pepe peed on things.

 
 
I took off his harness and he stolidly pressed on and followed me. This was poignant because Pepe runs away and is not bright enough to come when called. Today he was slow and tired enough that for the first time ever I could let him off leash and he could walk around on his own.

 
 
When Pepe got tuckered out we dropped our other dog off at home, picked up a towel and continued to the vet.

 
 
The vet handled everything beautifully and quickly. She reassured us that we were not being premature.

We held and petted Pepe for a few minutes after his heart stopped until we were sure he could not be conscious any more, wrapped him in the towel and carried him home. Mark wanted to bury him right away, but I felt as though he were just sleeping so I insisted we wait until he got cold so that he would feel dead.

 
 
After about an hour I acknowledged that he was cold enough. We put him in the hole.

 
 
I didn’t want dirt to get in his eyes so I put a paper towel over his head. Mark filled the hole halfway with dirt, I used the hose to fill it with water, then Mark filled it in with the rest of the dirt. I put the patio stones back to cover the spot. When the soil settles Mark will reset the patio stones so they are level.

We went into the house to put away his things – collar, winter sweaters, the baby carrier I used to carry him when we went for long walks, his basket. Then we went out to a Mexican restaurant in his honour and came back to no trace of him left in the house.

(No need for sympathies in comments or emails; he had a good life and we’re fine.)

Pepe has his final appointment at 14h40 on August 4th. The receptionist at the clinic offered me the choice of two vets, both of whom I like, so I told her to choose whichever one coped best with performing euthanasia. “It’s hard on both of them.”

Yeah, I figured as much. That’s why I had been kind of hoping it would be the vet I like less.

I’m ok with it. I’ve been reviewing my dates and I think he’s 15 years old. It’s just hard getting the balance right: you don’t want to drag an animal’s life out with indefinite suffering, but if the only goal is to spare suffering you might as well drown them at birth. 

Of course it’s going to upset me more than I think, but I’ll worry about that when I get there.

Next decision: shall we spend our weekend digging a nice deep hole in the back yard?