Ethan, Jess and I got to my book signing with about five minutes to spare. We have an amazing used bookstore in Howard County, in Glenwood, called “Books With a Past.” Recently, the owner, Erin, branched out and opened another location in Savage Mill, an actual textile mill that’s been turned into a shopping and dining venue, plus art studios. The new store is more focused on new books and book-related knick-knacks, and Erin says science fiction does better there. That maybe because the Family Game Store, of which my old friends Laura Burns and John Cmar are part-owners, is next door.
I spent the next two hours texting back and forth with Renee, and trying to be upbeat. Fortunately we didn’t get a lot of customers. That’s an awful thing to say, but, if we’d had hundreds, I don’t know if the stress might have broken me. In text messages, I learned that Lazarus definitely had pancreatitis, and that that could be caused by Feline Leukemia and Feline AIDS. So we were testing for that. After that, he needed to go to the ER for at least the rest of the weekend, and Renee would drive him there.
The Leukemia and AIDS tests came back negative. That was a relief on more than one front, as Jess reminded me that Feline Leukemia can be transmitted by saliva—like via the water bowl the three cats share. At this point, Dr. Ward as attributing his condition to things like age, diet and stress. She had reminded me that morning that dry cat food was evil, and basically just a bagful of kitty carbs.
At the ER, just like at a human ER, Renee had to wait. It was at least 30 minutes before a doctor could see Lazarus. Fortunately, he had already had anti-nausea meds, a 14-day anti-biotic shot, and morphine. I asked what the ER was expected to do, and Renee reminded me that his condition was life-threatening, and he needed constant treatment for any chance of recovery. Unfortunately, it was going to be very expensive.
At this point, I started asking the questions that make a you feel like a stone-cold bastard when you’re asking them about your pet: How expensive is very expensive? What were the chances of this very expensive treatment saving his life? If it did save his life, would it be worth living?
Renee texted back “Call me. We need to make some decisions.” I excused myself from the last twenty minutes of my signing. It was okay. Bob Greenberger and Howie Weinstein were with me, and they were the only ones selling books anyway.
“Very expensive” translated to $2500 – $3000 for the weekend. That was assuming it was “simple” pancreatitis, and treatment would clear it. Beyond that, something more could be wrong, and would cost more money to treat, if it could be treated.
This was on top of $1100 already paid for his morning treatments. I said that I really wished I could just hand them a blank check and say, “Fix him,” but that just wasn’t possible. Then it hit me that the contents of my bank account might be dictating whether my friend lived or died—my friend, who counted on me for everything and gave me unconditional love (yes, some cats are capable of doing that).
And then I wasn’t good for saying very much else.
They wanted to do an ultrasound, which was $400 if the ultrasound sonographer was onsite. But he wasn’t, so it was $700. I said go ahead, and then we’ll have more information on which to base a decision. After I hung up the phone—I had by now wandered to the North side of Savage Mill, to a bench overlooking Foundry Street and the Bollman Bridge—I sat and took a moment, hoping that no one passing by would notice the state I was in.
I texted the kids and said I’d meet them at the pub, and please clean up my stuff, put it in the car, and pay Erin for the book I’d grabbed off her sale cart. The Ramshead Tavern of Annapolis, the intimate music venue, has a location in the Mill. It’s one of my family’s favorite places. Every Christmas, when Christian would sing at the Mill with the Long Reach Madrigals, we’d have lunch there. Many family birthdays had been spent there, including my father’s.
Dad: “Don’t you have Diet Coke?”
Sassy Waiter: “We only have Coke, sir. And Sprite, and Tab.”
Dad: “I’ll have the damned Sprite!”
Sassy Waiter: (Smiling) “One damned Sprite coming up, sir!”
My mother was not amused. The rest of us were too busy laughing to notice.
Dr. Ward called. I told her the results so far, and she told me it was probably cancer. She assured me, though, that a cat can live a long time with cancer, and be a happy boy. We’d get through it together. I promised to text her with the test results.
One somewhat sad dinner and two Copperhead Ales for me later, my phone rang, and Dr. Hutt, the ER vet, introduced herself. She explained that Lazarus’s pancreas looked fine, but his liver was abnormal, and there was fluid in his abdomen. She wanted to take a sample and test it. I said go ahead. She also discussed a tissue sample of the liver. I said maybe not so much.
We headed to my Mom’s, because it was closer to the ER. Friends had texted during dinner to ask if we wanted to come over tonight. I explained the situation, and they offered to come to us. So we prepped my Mom’s house for its first reception of non-family guests in decades. (My Mom’s house is a story unto itself, and will be coming to these pages soon.)
While we cleaned, polished and organized, I called Dr. Hutt again. She said that the fluid in Lazarus’s abdomen was blood, that it had a blood cell count of 31%, as opposed to 20% in his veins, and that its presence in his abdomen suggested an explanation as to his anemia. He had either a bleeding tumor, although the ultrasound had not revealed one, or some kind of internal tear. She suggested that it could be that he’d swallowed rat poison (which is possible. We don’t use it, but we live in a very old house), but that wasn’t consistent with his other symptoms. A clotting factor test would tell us. If he was poisoned, his blood would not be clotting appropriately. For about a hundred dollars, we could know. I said go ahead.
“I’m sorry,” she said with real feeling. “I wish I had better news for you.”
The call came not long after. His blood was clotting fine. Our last option was exploratory surgery to find the cause of the bleed. $5,000 to $7,000 for the surgery, and he would require transfusions, probably multiple, at $500 to $800 each. I asked what would happen if we didn’t do any of that. What would a natural death look like? Dr. Hutt explained that she had recently lost her own cat to cancer, very sudden onset, just like Lazarus’s condition. She said she would never want to see a natural death for such a patient. Dr. Ward and I were texting. She advised against surgery. Dr. Hutt offered to consult with her to discuss options.
After the two doctors had talked, I spoke to both of them. Basically, they were in disagreement. Dr. Hutt wanted to either intervene with rigorous, in-patient treatment or euthanize. She felt that anything else was subjecting Lazarus to suffering. He could not come home in the state he was in. Dr. Ward was against surgery, against transfusions, against “heroic measures” in general. But she still believed that Lazarus could be treated and have some quality of life. “There’s just no roadmap,” she told me. She did agree with Dr. Hutt, though, that he needed to be stabilized. Leave him in the hospital for one night, she said, and let him get hydrated and treated for pain. “I want to remind you, though, Steve, that the worst thing that can happen to any of us is to die alone in the hospital.”
“You’re telling me he might not make it through the night.”
“It’s possible. We just don’t know.”
“So I should go see him?”
Yes, she said, let him know you’re there.
Dr. Hutt was thrilled that we came to see Lazarus, and very cooperative about the decision we had come to. We drove over to visit, and they ushered us to an examination room. When Lazarus was carried in and placed on the table, I knew we’d made the right decision. This was not the nigh-unresponsive cat I’d brought to Dr. Ward this morning. He was bright-eyed, purring, rubbing against us. He did cry a little when Dr. Hutt picked him up, but she explained his morphine was wearing off. She would give him a four-day Fentanyl patch for pain, and we could pick him up in the morning.
We sadly said goodbye. I kissed his nose and told him firmly that he was not to go anywhere while I was away. I’d be back for him in the morning.
Returning to my mother’s, I was grateful for my friends, who had kept the beer cold and the atmosphere warm. It wasn’t easy to sleep, and I stayed up way too late playing Star Trek Trivial Pursuit.
But Lazarus was still here, still fighting, and not ready to give up. Neither was I.