I entered the exam room as an intravenous catheter was being inserted expertly. The procedure had been explained to me. I wanted to be there to comfort my friend in his last moments. Life had been getting difficult and the infirmities and pain too severe. The doctor entered the room with an appropriate look of sympathy on his face and reviewed the case agreeing that my friend’s quality of life was severely impaired.

The sodium pentothal was slowly injected IV. I saw a questioning look on my friend’s face, he then slumped to the table and died. Being unconscious, his breathing almost immediately stopped, then the heart beat ceased a few minutes later. It seemed so fast.

I loved my friend, my companion, my dog. We walked in the park or on the beach every morning. He greeted me, my wife, my children, and my grandchildren each day like long lost friends. His goal in the yard (thus in life) was to be protective seemingly at all costs.

Today we grieve, but not like when I lost my mother or father, or when I lost a patient. It’s a mixture of sadness for our loss, but contentment that he didn’t suffer and could have a peaceful end.

Many patients over the years asked me for a peaceful painless end. Before hospice and palliative care, a patient would often sense abandonment or a loss of control at the end saying, “Doctor, my dog was treated more humanely at the end than my father was.” Ironically, my experience today has brought me to question how humane we humans really are in our treatment of each other at the end. Do we have lessons to learn?

It was Trevor’s first weekend to relax since moving to Seattle.  He was out in a park walking Bailey, his year old lab, when his pager unexpectedly beeped.  He called in to the operating room office, where the frantic head nurse told him he had to come in.  The scheduled anesthesiologist was very ill with the flu, and no one else was available.  He had to come in for at least two cases, perhaps more.

Trevor pleaded, “Can’t you find anyone else, it’s my first weekend off, and I doubt if I can find anyone to watch Bailey.”

“Sorry, we need you – now!”, came the curt reply.

Trevor called his only friend so far but got no reply.  He hadn’t had much contact with neighbors yet, so didn’t think he could ask them to take care of Bailey.  So having no other choice, he packed Bailey along with water and dog food into his Subaru hoping that Bailey wouldn’t mind hanging out in the car.

Bailey barked annoyingly as Trevor parked the car in the shade, cracked the windows a bit, and headed for the OR.  The case was easy and lasted about an hour.  Trevor headed quickly out to the car finding Bailey trying to dismantle it.  There were scratch marks on the door and a tear in the seat cover.  This just wasn’t working.

So Trevor walked Bailey, now happy around to the back of the hospital, entered the service entrance and took the back service elevator which came up just outside the anesthesia call room.  He stayed with Bailey making sure he had water and food and a comfortable pillow, then was called in for the next case.  Bailey seemed content to wait for him.

The case was an appendectomy.  The patient was anesthetized in the usual fashion and Trevor settled in to watch the monitors and patient while the surgeon went to work.  Strangely he felt pressure and a cold wet sensation on his left leg.  Looking down with dread he saw Bailey looking up with a happy face and wagging tail.  The OR nurse screeched, “Where in the hell did that dog come from?  Get him out of here.”

The surgeon didn’t miss a beat, “At least give him a mask and dog booties.”

The patient, of course, was peacefully oblivious.

The dog was watched by security, who cared for him until Trevor could leave, red faced and worried about repercussions.  I’m happy to report that the unsuspecting patient did well, Trevor kept his job, and that Bailey probably wondered what the fuss was all about.

Of course the  hospital administrators had their fur ruffled, but were happy that no one leaked the story to the press.

Comment:  True story!

Sue P. recommends this Op-ed piece by David Brooks from the NYT. It deals with the healing effects of eating and sharing around the dining room table. The power of this is amazing for the young people with fragmented lives and dysfunctional homes. Click here for the article “The Power of a Dinner Table.”

I happened to have two “dinner table” gatherings last week. The first was with a couple in New Jersey. We had a four and a half-hour lunch marathon – sharing stories and finding out how much we had in common. There seemed to be this magical space for conversation as we dined together. The second was at a class reunion in Bryn Athyn, PA. There was a sizable gathering at a friend’s house and several of us ended up eating around a large dining table. Suddenly the stories and reminiscences began to pour out over two hours – varying from funny to poignant to remembering those who have passed. We learned new things and reaffirmed old friendships.

Benjamin Franklin had a love for dinner table discussions saying something to the effect that he couldn’t remember the food having enjoyed the conversation so much.

Brooks notes that the dinner table carries a special meaning for the disadvantaged – it can become a place for hope, civility, sharing, learning and even crying. No cell phones allowed. Perhaps young families with children can begin to emulate and provide this fertile experience needed for bonding and growth.

In terms of Skyline, it’s an important part of our daily lives here – that magical place, the dinner table.