Surviving Worry

With Cats, some say, one rule is true:
Don’t speak till you are spoken to.
Myself, I do not hold with that –

~T.S. Eliot from “The Ad-Dressing of Cats”

A true story I wrote 15 years ago…

Considering myself a Dr. Doolittle of sorts, always talking to the animals, I reach out to pet a stray cat sitting quietly outside our barn one evening while doing barn chores. This is a grayish fluffy cat I see around the barns every few months or so–he doesn’t put in frequent appearances and reminds me of a kitten we raised on this farm a few years back, though his markings are a bit different, so I know it is not our cat.

We have 6 cats to pet here who claim “us” as their home and family, so there is no lack of fur balls to love. There are probably that many more who hang out,  now and then, considering our farm fair game and looking for an occasional free meal. This cat just seemed to need a reassuring pat at that moment – or maybe I needed the reassurance. 

Wrong.

I found myself with a cat attached to my wrist by teeth and claws. It took a bit of an effort to shake him off and he escaped into the night. I then surveyed the damage he inflicted and immediately went to wash my wounds. They were deep punctures near my wrist joint–not good.  Lucky for me I was up to date on my tetanus booster.

By the next day the wounds were getting inflamed and quite sore. I know all too well the propensity of cat bites to get badly infected with Pasteurella multocida, a “bad actor” bacteria that can penetrate deep tissues and bone if not treated with aggressive antibiotics. After getting 6 opinions from my colleagues at clinic, all of whom stood solemnly shaking their heads at my 12 hour delay in getting medical attention,  I surrendered and called my doctor’s office. I pleaded for a “no visit” prescription as I was up to my eyeballs in my own patients, and he obliged me. I picked up the antibiotic prescription during a break, sat in the car ready to swallow the first one and then decided to wait a little longer before starting them, knowing they wallop the gut bacteria and cause pretty nasty side effects. I wanted to see if my own immune system might just be sufficient.

So the bacterial infection risk was significant and real but I was prepared to deal with it. For some reason I didn’t really think about the risk of rabies until the middle of the night when all dark and depressing thoughts seem to come real to me.

I don’t know this cat. I doubt he has an owner and it is highly unlikely he is rabies vaccinated. My own cats aren’t rabies vaccinated (and neither am I) though if I was a conscientious owner, they would be.  Yes, we have bats in our barns and woods and no, there has not been a rabid bat reported in our area in some time.

But what if this cat were potentially infected with the rabies virus but not yet showing symptoms? Now my mind started to work overtime as any good neurotic will do. Last summer a rabid kitten in North Carolina potentially exposed 10 people when it was passed around a softball tournament, no one aware it was ill until it died and was tested. Lots of people had to have rabies shots as a result.

This cat who had bitten me was long gone–there was no finding him in the vast woods and farmland surrounding us. He couldn’t be kept in observation for 10 days and watched for symptoms, nor could he be sacrificed to examine his neural tissue for signs of the virus.

I called the health department to ask what their recommendation was in a case like this. Do they recommend rabies immune globulin injection which should have been done as soon as possible after the bite? I talked with a nurse who read from a prepared script for worried people like me. 

Feral cats in our area have not been reported to have rabies nor have skunks or raccoons. Only local bats have been reported to have rabies but not recently. This cat would have had to have been bitten by a rabid bat to be rabid. This was considered a “provoked” attack as I had reached out to pet the cat. This was not a cat acting unusually other than having wrapped itself around my arm.  No, the Health Dept would not recommend rabies immune globulin in this situation but I was free to contact my own doctor to have it done at my own expense if I wished to have the series of 5 vaccination shots over the next month at a cost of about $3000. Yes, there would be a degree of uncertainty about this and I’d have to live with that uncertainty but she reassured me this was considered a very low risk incident.

I knew this was exactly what I would be told and I would have counseled any patient with the same words. Somehow it is always more personal when the risk of being wrong has such dire consequences. 

I could see the headlines “Local Doctor Dies From Rabid Cat Bite”.

This is not how I want to be remembered.

Rabies is one of the worst possible ways to die. The cases I’ve read about are among the most frightening I’ve ever seen in the medical literature. Not only is it painful and horrific but it puts family and care providers at risk as well. It also has an unpredictable incubation period of a up to a month or two, even being reported as long as a year after an exposure. What a long time to wait in uncertainty. It also has a prodrome of several days of very nonspecific symptoms of headache, fever and general malaise, like any other viral infection before the encephalitis and other bad stuff hits. I was going to think about it any time I had a little headache or chill.  This was assuredly going to be a real test of my dubious ability to stifle my tendency for 4-dimensional worries.

I decided to live with the low risk uncertainty and forego the vaccination series. It was a pragmatic decision based on the odds. My wounds slowly healed without needing antibiotics. For ten days I watched for my attacker cat whenever I went to the barn, but he didn’t put in an appearance. I put out extra food and hoped to lure him in. It would have been just be so nice to see his healthy face and not have to think about this gray cloud hanging over me for the next few months, as I wondered about every stray symptom. 

No gray kitty to be seen.

Almost a month has gone by now and he finally showed up last night.  I could have grabbed him and hugged him but I know better now. No more Dr. Doolittle.

He is perfectly fine and now so am I, cured of a terminal case of worry and hypochondria which is not nearly as deadly as rabies but can be debilitating and life shortening none the less.

From now on, I’ll be contented to just “talk to the animals” like any good Dr. Doolittle.  I don’t need to cuddle them.

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One Old Dog Has Gone Away

Two old dogs out doing chores.
One on two legs, one on four.
Side by side, they water and feed.
Caring for others daily need.

Two old dogs make their rounds
Well worn paths on familiar ground.
To greet the day or say goodnight
Side by side, their friendship tight.

Two old dogs with dish and pail.
Singing songs and wagging tail.
Slower now, than in the past
But that just makes the good time last.

Two old dogs, both muzzles grey.
Aging joints sometimes curb play.
Companionship a simple joy.
His old dad; Dad’s old boy.

Two old dogs, and then one day
One old dog has gone away.
The other left to carry on
Two legs to barn and field and pond.

One old dog, eyes full of tears
Can still feel his old friend walking near
A reminder in the morning dew.
Just one path, instead of two.

When one old dog has no more chores
And walks through heaven’s golden doors
He’ll see that face he can’t forget.
A kindred spirit, not just a pet.

So many old dogs, made whole; anew
Reunion of a loyal crew.
Never again to be apart.
Many souls. But just one heart.

~Jeff Pillars “Two Old Dogs”

I knew this day was coming. Samwise Gamgee, approaching age 14, had been hinting that he was getting ready to leave for the past couple weeks. He was much slower following me for chores, his appetite wasn’t quite as robust as usual, and his hearing was fading.

Life had become an effort when it had been a lark for 13+ years.

But yesterday morning, he perked up enough to do his usual rounds on the farm, poke around the stalls in the barn, check the cat dishes for morsels, and bark when a strange car drove in the driveway.
Then last night he ignored his supper, laid down and closed his eyes, having used up all his reserves.

This morning, he was gone, leaving only a furry shell with big ears behind.

He had joined us on the farm as company for our aged Cardigan Corgi Dylan Thomas, who died two years after Samwise arrived. Then Sam himself needed company, so another Cardigan corgi, Homer, arrived.
They became a happy Corgi team on the farm.

Sam had a great dog life, with the exception of getting lost once and one overnight visit to the emergency vet hospital for treatment from poisoning from ivermectin, the horse worming medicine he somehow managed to lap up quickly off the barn floor when a horse dripped the paste from her mouth. After that he promised to never need a vet again.

His peaceful passing is a reminder of our temporary stay on his soil.
He’s smelling the flowers and watching the sunrises and sunsets from the other side now.

I honor Samwise’s long life with the photos I have compiled over the years.

Till we meet again, old friend.

photo by Nate Gibson
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The Cat Knew…

This was our pretty gray kitten,
hence her name; who was born
in our garage and stayed nearby
her whole life. There were allergies;
so she was, as they say,
an outside cat.
But she loved us. For years,
she was at our window.
Sometimes, a paw on the screen
as if to want in, as if
to be with us
the best she could.
She would be on the deck,
at the sliding door.
She would be on the small
sill of the window in the bathroom.
She would be at the kitchen
window above the sink.
We’d go to the living room;
anticipating that she’d be there, too,
hop up, look in.
She’d be on the roof,
she’d be in a nearby tree.
She’d be listening
through the wall to our family life.
She knew where we were,
and she knew where we were going
and would meet us there.
Little spark of consciousness,
calm kitty eyes staring
through the window.

After the family broke,
and when the house was about to sell,
I walked around it for a last look.
Under the eaves, on the ground,
there was a path worn in the dirt,
tight against the foundation —
small padded feet, year after year,
window to window.

When we moved, we left her
to be fed by the people next door.
Months after we were gone,
they found her in the bushes
and buried her by the fence.
So many years after,
I can’t get her out of my mind.

~Philip F. Deaver, “Gray” from How Men Pray

Our pets witness the routine of our lives. They know when the food bowl remains empty too long, or when no one offers their lap to stroke their fur.

They sit silently waiting and wondering, a little spark of consciousness, aware of our family life. They know when things aren’t right at home. They hear the raised voices and they hear the strained silences.

Sometimes a farm cat moves on, looking for a place with more consistency and better feeding grounds. Most often they stick close to what they know, even if it isn’t entirely a happy or welcoming place. After all, it’s home; that’s where they stay, through thick and thin.

When my family broke as my parents split, after the furniture was removed and the dust of over thirty five years of marriage swept up, I wondered if our cat and dog had seen it coming before we did, witnesses to the fact. They had been peering through the window at our lives, gauging what amount of spilled-out love might be left over for them.

I still can’t get them out of my mind – they, like me, became children of divorce. We all knew when we left behind the only home we had ever known, we could never truly feel at home again.

AI image created for this post
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Like a Cat Asleep

All that matters is to be at one with the living God
to be a creature in the house of the God of Life.

Like a cat asleep on a chair
at peace, in peace
and at one with the master of the house, with the mistress,
at home, at home in the house of the living,
sleeping on the hearth, and yawning before the fire.

Sleeping on the hearth of the living world
yawning at home before the fire of life
feeling the presence of the living God
like a great reassurance
a deep calm in the heart
a presence
as of the master sitting at the board
in his own and greater being,
in the house of life.

~D.H. Lawrence “Pax”

When you notice a cat in profound meditation,
     The reason, I tell you, is always the same:
His mind is engaged in a rapt contemplation
     Of the thought, of the thought, of the thought of his name:
          His ineffable effable
          Effanineffable
Deep and inscrutable singular name.
~T.S. Eliot from The Naming of Cats

The fat cat on the mat
may seem to dream
of nice mice that suffice
for him, or cream;
~J.R.R. Tolkien from “Cat” from Tales of the Perilous Realm

I don’t know where prayers go,
or what they do.
Do cats pray, while they sleep
half-asleep in the sun?

Is a prayer a gift, or a petition,
or does it matter?
The sunflowers blaze, maybe that’s their way.
Maybe the cats are sound asleep. Maybe not.

~Mary Oliver from “I Happened to be Standing” from A Thousand Mornings

Our cats seem to have no sense of time — until it is mealtime.

Otherwise they pussyfoot through the hours of the day, unworried about what comes next, or what just happened. They find a convenient patch of sun, or a particularly soft cushion, or sometimes a most unlikely place like a cardboard box or pile of shavings or top of a fencepost.

Then they yawn, become rubber-boned and curl up for a nap.

How do they contemplate the fact of their existence?
How do they appear so relaxed, in peace and serenity?
Do they understand their place in creation and give thanks?

God wants us to rest comfortably in our own skins, as adaptable as a sleeping cat. And He wants us to count our days without wasting a moment for thankfulness. We are meant to be more than just hungry and sleepy and rubber-boned.

We are created in His image, acutely aware of the privilege of our existence.

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Alms to the Poor

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That year I discovered the virtues
of plants as companions: they don’t
argue, they don’t ask for much,
they don’t stay out until 3:00 A.M., then
lie to you about where they’ve been…

I can’t summon the ambition
to repot this grape ivy, or this sad
old cactus, or even move them out
onto the porch for the summer
where their lives would certainly
improve.  I give them
a grudging dash of water-
that’s all they get.

The truth is that if I permit them
to live, they will go on giving
alms to the poor: sweet air, miraculous
flowers, the example of persistence.
~Jane Kenyon from “Killing of Plants”

During my dorm room years
and city apartment dwelling days,
this former farm girl was reconciled
to no pets allowed,
so I surrounded myself with an indoor garden,
every square inch of window sill
occupied by a living thing
whose survival depended only partially on me.

Those plants sustained me,
cheered me, moved me,
moved with me to windows
with better light and grander views.
Despite my neglect,
they persisted, often thrived,
and gave back to my shriveled city spirit
far beyond any water or repotting offered.

Somehow these miracles in chlorophyll
knew just what I needed when I needed it:
they fed me when I was starving
for something live,
something beautiful,
something that knew exactly what to do
and what to become
when I had no clue.

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Lean on Me

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Thanks to changes in laws mandating reasonable accommodation of mental illness disabilities, we are seeing a boom in requests from our patients for documentation to keep emotional support animals with them in on and off campus housing, classes, public transportation and other public places.   Patients desire an animal support to lean on through their stress.  Within the past year, the population of dogs has exploded on the University campus where I serve as medical director — dogs leashed and (usually) obediently following their student, faculty and staff owners to classes, meals, and back home to the dorm.  As a relatively outdoorsy, green and tolerant northwest University campus, the presence of animals on campus has yet to seem like a big deal, but as the numbers inevitably increase due to 25% of the college student population nationwide currently carrying a mental health diagnosis, it soon will be a big deal as individuals insist on exercising their civil rights along with their dogs.

And it isn’t always dogs.  There are cats, along with the occasional pocketed rat, hamster, guinea pig, flying squirrel, and ferret not to mention emotional support pot bellied pigs, tarantulas, ducks and geese.  And at least one snake.

Yes, a snake.

As a physician farmer concerned with stewardship of the patients I treat and the land and animals I care for, I’m emotionally caught and ethically bound in this new trend.  The law compels clinicians to write the requested documentation to avoid accusations of potential discrimination, yet I’m more concerned for the rights of the animals themselves.   I’ve loved, owned and cared for animals most of my sixty years and certainly missed my pets during the thirteen years I was in college, medical school, residency and doing inner city work (my tropical fish and goldfish notwithstanding).  I neither had the time, the money, the space nor the inclination to keep an animal on a schedule and in an environment that I myself could barely tolerate, as stressed as I was.   That is not stopping the distressed college student of today from demanding they be able to keep their animals with them in their stress-mess.

As a clinician, I’d much prefer writing fewer pharmaceutical prescriptions and help individuals find non-medicinal ways to address their distress.   I’d like to see my patients develop coping skills to deal with the trouble that comes their way without falling apart, and the resilience to pick themselves up when they have been knocked down and feel broken.   I’d like to see them develop the inner strength that comes with maturity and experience and knowing that “this too will pass.”  I’d like individuals to see themselves as part of a diverse community and not a lone ranger of one, understanding that their actions have a ripple effect on those living, working, eating, riding and studying around them. Perhaps corporate work places, schools and universities should host a collaborative animal center with rotating dogs and cats from the local animal shelter, so those who wish to may have time with animals on their breaks without impacting others who aren’t animal fans, or with potentially life threatening animal dander allergies.

I didn’t go through medical training to write a prescription for a living breathing creature perceived by the law as a “treatment” rather than a profound responsibility that owners must take on for the lifetime of the animal.   The animal is not disposable like a bottle of pills (or a human therapist) when no longer needed and needs a commitment from its owner beyond a time of high personal stress.

Pardon me now while I go take care of my dogs, my cats, and my horses and yes, my goldfish.  They lean on me.

 

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