Three and a half years ago my family said goodbye to a dear friend. Our 15 year-old golden retriever-lab mix, Haole, had been in declining health for about a year. He was having trouble walking, and was losing his vision and hearing, He’d lost weight and had begun lashing out violently at our other dog, who had been his faithful companion for over 12 years. He was fading, and we knew his life was nearing its end. He’d had a very good life, but it was hard for us see him declining like that.
One evening I came home late after leading a full day seminar for a group of doctors. It had been a long day and I was worn out. Haole often slept on a cushion in our garage and he’d developed the habit of ambling in front of the car as I pulled in, moving aside at the right time. That evening, as I slowly pulled the car into the garage, I felt, and heard, a sickening crunch beneath one my front tires. I immediately realized what had happened, and will never forget that immediate feeling of dread and despair. Haole hadn’t gotten out from in front of the car this time. I saw him scurry away from the car, so at least I knew he was alive, but I also knew he was injured—probably badly. I sat there for a minute, immobilized, gripping the steering wheel. I broke out in a sweat, and pushed back the urge to vomit. I remember thinking that if I stayed in the car, I wouldn’t have to see what I had done. It wouldn’t be real. I imagined the pained expressions on the faces of my wife and children when I told them what had happened.
Finally, I got out of the car and found Haole crumpled in a heap in the corner of the garage, whimpering and licking his hindquarters. I felt around, certain that something was broken, but couldn’t tell what or how badly. I sat next to him cradling his head as he looked up at me with affection. I gently carried him into the house and laid him on his pillow bed. At that point he didn’t seem to be in terrible pain, so after some discussion, we decided to wait until morning and then bring him to the vet to assess the damage.
The next morning he was in the exact same position we’d left him in. My wife, our son Levi, who was 5 at the time, and I took him to the emergency vet hospital.
The vet thought he had a fractured pelvis. We talked about his physical decline and the vet said that he most likely had a serious, probably terminal, illness as well. He offered us a number of options, including x-rays and other diagnostic studies, possible surgery, etc. He figured that Haole probably wouldn’t have lived very long even without the injury, but couldn’t estimate how long that might have been. After a long discussion about the various options and likely outcomes, we chose to have the doctor give Haole a lethal injection and allow his life to come to a peaceful and merciful end.
Sandy, Levi and I spent about an hour with Haole in the quiet, tastefully decorated Family Room, caressing him, reminiscing about our life with him and feeding him sausages. Then we hugged him, said our goodbyes, and left. We went to a park and took a walk along the beach. About an hour after we left the vet, while we were walking on the beach. Levi looked up at Sandy and me and said, “I think Haole just went to heaven.”
That was a traumatic experience for us. But looking back on it, I feel a sense of peace. Haole was spared the additional suffering that would have likely been his path if that injury hadn’t occurred. The end of his life was dignified, compassionate, and peaceful. His actual suffering was brief. This was a gift.
I’ve heard it said many times by many people that we treat our pets better than we treat humans when it comes to caring for them at the end-of-life. There’s definitely some truth to this.
We often give our pets the gift of a peaceful and painless exit, while we force our human loved ones to struggle with pain, isolation, and other indignities for days, weeks, months or even years.
As a nation, we are afraid of making sweeping policy changes because of concerns about abuses occurring and people somehow taking advantage of more compassionate end-of-life policies. Some states have made progress by passing laws that allow physicians to prescribe lethal doses of medication for people with clearly terminal illnesses, but those who don’t qualify for this must suffer or resort to extreme measures on their own.
We can, and we must, do better. We can, and we must, find a way to ease the suffering of those who are unable to advocate for themselves.
A few years ago I transitioned from being an emergency physician to being a palliative care and hospice physician. For several years before that I’d been pulled toward working with seniors and finding a way to have a greater impact.
Then one night I had an epiphany.
I realized that my true calling in life is to help people die. To help ease them out, celebrating the life they have lived and assisting their loved ones in creating the most peaceful and transformational end-of-life experience possible.
I now realize that one of the greatest gifts I can offer my patients and their families is the assurance that when their final days approach, they will not need to suffer. I will be right beside them to ensure that they are comfortable. They, or their loved ones, often need to choose between comfort and awareness in those final days, and they typically choose comfort. I know I would.
Life is precious. I have profound reverence for life and believe we each have a unique purpose for being here and we each contribute meaningfully to the fabric of life.
But life ends for every one of us. There is a time for us to enter the world and a time for us to leave it. We should celebrate and honor both of these amazing events with awe and gratitude.
As I finish this post our 12 week-old Golden Retriever puppy, Lily Joy, is resting her head on my lap and looking up at me with those loving, wistful eyes. After all of the loss we’ve experienced in my family the past few years, it’s wonderful to have her new life energy in our home. I’ll try to remember that the next time I clean up one of her messes or find another one of my shoes destroyed.
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