So *this* is why I'm trying to arrange for a PhD in food studies

A conversation with my vet last week:


Me: Wait. I have one more question. Do you think I should put him on a raw food diet?

Him: (Long pause.) The short answer is no. I know a lot of people who swear by it.

Me: He get Nutro, now. It does seem to have a lot of nutrients. Like cranberry extract.

Him: I think: this is the best that people with PHDs in NUTRITION come up with. These people know more about utrition than I would EVER WANT TO.

Me: (Suddenly remembering that I am supposedly writing an exam proposal ON FOOD AND NUTRITION, though since I'm an English major this is, shall we say, a tall order, having to be routed through citizenship and all). (Silence.)

Him: Some people are very in favor.


****

For kicks here's a conversation I had this morning with the neighborhood Alpha Cat, Buster.

Buster: rrrrrrrROW! MROW!

Me: My cat has cancer? So you aren't allowed to yell at him that way anymore, on his own porch at least.

Buster: rrrrrrrrrrrrr.

Me: Get on! Go on! You're a nice boy, but please do take it into the alley. Thank you.

My other obsessions include TV

Silly Fox. Buffy, Firefly, now this. And I'm not, to be clear, talking about the cancellation of 7th Heaven.

Note to Self: Don't research cancer in the morning

I'm having that thing again, that guilt thing after looking up "spindle-cell carcinoma." Can respond to radiation and/or chemotherapy if it is a low grade! If you got it out completely it might not come back! I'm no expert, and neither is my vet, and that's why he wanted us to go to the oncology specialist.

Remind myself how much the cat hates to travel, how much he's not fond of spending the day at the vet being poked and caged instead of sitting contemplatively on his mat outside, or something. Also how its weird in the mouth, how it is in front of and in back of his teeth, so you can't very well chop ALL of it out without removing damn near his whole head. Those other prognoses I was reading were about spindle-cell in a dog, who had a tumor on his LEG. Way different.

But his chest X-ray was clear! No metastasized tumor in his chest! By not trying to find a way to scrape out all the tumor, I'm basically just asking the cancer to kill my cat!

Don't mind me. I'm just feeling a little guilty about my decision not to try to fix the cat -- even though obviously I DID try to fix the cat, and I'm still reasonably sure this decision is the right one. (Let's rehearse now: 1)The process would be miserable for him. Chemo? Are you kidding? Plus we'd have to drive him how far for each treatment? 2) It's in his mouth so prognosis is on the bad side even w/aggressive treatment or so my vet has me believe, in fact since it looks like its spreading all throughout his palate it could be even a qualified oncologist would admit a grim prognosis and 3) let's not forget the ridiculous amount of money this would all demand.)

Ah. Anxiety and its though patterns, er, thought crop circles. Gotta love it. And though I have some Paxil sitting on my kitchen table, I'm reluctant to start with it because I sort of like having the ability to think really fast, also the ability to orgasm, cry and sleep. Still, there are drawbacks to the unmedicated way of life. (Also, I'm clearly not sleeping so well on my own steam right now since I'm up typing.)

That air of gravitas

Diagnosis: spindle cell carcinoma. “Quite malignant.” “I’m so sorry,” the vet says on the phone after he’s given me the news. I say, “It’s okay, it’s not your fault.” I always say stuff like that. In this case I worry afterwards I sound too flip, but it is hard for me to feel emotion on command. I have to deflect attention away, protect my emotion so that I can feel it without having to perform it.

I feel relatively peaceful. We had a good week, cat-wise. During the surgery last week for the biopsy, the vet took a chunk off the tumor “the size of the top of my finger,” as he said. Cat was fine that evening, seemed to feel a little slow the next couple of days. But we nursed him very carefully. Petting and coaxing him to get him to accept the lozenges of meat rolled around his pills twice a day. Feeding him treats like tuna, which I’ve never given him before and which turns out he loves. Much petting and attention (not that he hasn't always gotten an overabundance of those things). He didn’t lose more weight and got some back. He was fluffy and happy. Contenment rolled off him in waves.

We had, in fact, one entirely pathos-free day: Wednesday. It’s hard to explain it. I thought it immediately: cat seems totally well. No long, contemplative instances of sitting and staring. No flopping over on his side when we petted him as if he’s grateful not to have to resist gravity. I think the posture of his head was different. My husband noticed it too: “He seems better.” For the whole day, he was just a cat.

Yesterday that part was already over and what I’ve begun to see as the cycle was rebeginning. The gums and leftover tumor places looked very red. The cat had again that air of gravitas. His shoulders felt very warm. Also he was extremely sweet. Actually I first began to worry it was starting when, first thing Thursday morning, he spread himself adorably across my chest as I lounged on the couch, and stayed there purring. Illness makes him an angel.

Last time, which I think was also a Thursday, the day of sweetness, heat, and red gums came just three days before I was freaking out that the tumor was the size of a golf ball. (An exagerration, of course.) So I expect it will become bad very quickly. When it’s begun to seriously affect his ability to eat even tuna and he’s losing tons of weight and becoming miserable, we’ll have him euthanized: it’s terminal, and I’d rather not have to watch him starve to death. When he licks his lips he makes a gluey sound – its rather awful.

But I do feel glad that we made him well for a couple of days. We all feel more loved because of it.

Don’t feel too sorry for us. Save that for after its over because we’ll need it more then.

Biopsy tomorrow

I want to say thanks first of all to everyone for kind wishes about my cat. In fact his tumor is not the size of a golf ball, and the first biopsy did not actually say "cancer" -- it said: undefinitive, maybe this is plaque related? Because you never brush the cat's teeth? It's only the fact that a second tumor suddenly appeared that made my vet freak out and feel totally un-up to the task. That and all the many weird red spots going all the way back the roof of his mouth down his throat. Anyway, the cat is about as he's been lately, and the tumor is not bigger today than yesterday, though certainly that's big enough.

Platonic Fall

It is the most outrageously perfect fall day. If you set out to design the perfect fall day this is what you'd order up. Perfect temperature: warm sun, cool fresh air, no cold wind. Perfect jeans-and-a-light-hoodie weather. Perfect colors: blue sky elaborately empty of clouds, yellow leaves, some chartreuse and orange and umber. Red pineapple sage sparklers in everyone's leftover gardens, some late pink roses and some late purple mums. (I think they're mums.)

I wish that called off business for weather on both ends of the spectrum. Of course we call off business when there's snow and ice and rally as a community in the face of weather that is extremely bad. But how about if the superintendent got up in the morning and thought, Holy Cow, it's dangerous to keep people INside in weather like this! and cancelled the schools and the meetings and most of the businesses opened late and closed early. And as a community we could rally around the extremely good weather. A day for frying the green tomatoes and harvesting the leftover herbs and having a chance to visit your friend who lives down the street but who you never see.

Meat

Me: (picking up the pain pills at the vet) So how I give these to him is I smear them with peanut butter? Oh wait, that's for a dog.

The Clerk Lady: Well, you can fold it in some turkey or some salami, or we sell some things called "Pill Pockets" that are salmon flavored or something.

Me: (the world is totally recalibrated. This sounds dumb but I had totally forgotten that you could go to the store and buy meat.) Oh yeah. Right. Thanks.



***

So I have some questions. I read online that organic ground beef is a totally good food for cats and also that cats should eat a mostly raw diet. I tried to buy some organic ground beef but it was so BLOODY. It's not that I mind the blood, it's just that I couldn't quite believe that I should give it to him raw so instead I copped out and went with a tiny bit of roasted chicken from the deli. Does anyone actually have experience with feeding non-processed food to cats? Do you seriously just like plunk down a hunk of raw beef and say, have at it, kitty?

Tumor

I can't believe how fast this thing's growing. It's huge and it seems like it gets huger by the hour.

Mental disjunction. Happy kitty in the yard today, following birds! Eating more than he has in days as I coax him to eat the pain pill wrapped in roasted chicken (I BOUGHT ROASTED CHICKEN), then coax him to his kibbles. Kitty feeling good, being normal.

Kitty tumor growing by the hour, probably by the second. The many blood vessles in the palate so efficient at pumping all those cells around, dispersing.

I've given the cat up for dead but I don't think that I understand that this means he is actually going to DIE. I'm still operating on the feelings of deferred knowing and the idea that the biopsy COULD say something surprising...

Except that on the other hand by Thursday perhaps what began four days ago as a pencil eraser will be the size of a golf ball. CAN THIS REALLY BE HAPPENING THIS FAST? My mind's boggling, I'm still operating on the part of the plan where there are some weeks I get to treat him with meat and he's really happy.

The choice

I spent the weekend researching on the internet and coddling myself in the warm bathwater of guilt. I was five days late this month applying his Revolution; probably he'd gotten bit during these unprotected days by a flea and had contracted kitty plague. "I think my kitty has the plague!" I announced to my husband, who scoffed. The plague though: it exists. The kitty was unvaccinated through several of his first weeks as a newly outdoor cat. Probably he'd got bit by infected rodents or breathed on by sick cats and it was ALL MY FAULT.

The result of this was that I was not surprised by the vet's decision yesterday that likely this was terrible, terrible cancer in my kitty's mouth. My husband, on the other hand, who had decided it was a bee sting, felt rather more stunned.

This is not a post about feeling sad or numb or mourning, though. I am not those things right now. This is a post about feeling sort of bullied and mad. The vet, he wanted to refer the cat to a specialist, a team of specialists, dentists and vets and oncologists. They would test the kitty thoroughly and proffer a diagnosis. Here's the rub: the diagnosis alone was very likely to be $1000, and could be much more, like $1500.

This latter number is somewhat more than I make in a month, so money obviously is what they call a "concern." Plus this doesn't include treatment, or the operational cost to my nerves of forcing my poor sick cat who hates to ride long distances in the car to drive two plus hours to the specialist, have tests all day, drive home. The operational cost to my sanity. Plus, if it IS one of the unfortunately rather common malignant carcinomas, the prognosis is not that good anyway.

The vet assured me that the other option, having a re-biopsy performed here in town to confirm the suspicion of cancer and working to make the cat comfortable, was NOT a decision that made me a bad mother, that even the decision only to administer cortisone and hope was not a bad one. That the vet himself, if it were his cat, would likely opt for the re-biopsy and re-evaluation.

We have opted not to go to the specialist. We are having the second biopsy and giving the cat pain medications. I am also considering diet therapy, like making him a nice steak dinner.

But even were money no object, I would hate to take the kitty to the specialist. The car ride would stress HIM out, and thus stress ME out. The prospect of trying to help a very sick cat cling to life just to keep him from being dead depresses me. I myself am imminently depressable and probably need to go back on antidepressants. I am not working at a job that fulfills me very much right now. I can't see how taking on the project of a long and institutionalized illness, especially one with such a poor prognosis, would help anything in my world or the world in general.

I love my cat very much. It is probably the closest thing I've experienced to the love of a parent for a child, as the cat has very often been a pain in the ass with whom I've had to remain patient, and just as often has been a total joy, and this mixture of emotion and long relationship and working out the kinks of how to live together is all folded together into a beautiful complex experience. I have done all I can to ensure he has a high quality of life: premium food, necessary checkups and medication, tons of affection and playing.

Yet in spite of this feeling, if he is quite sick I don't want to struggle to keep him alive, even if the struggle affords TINY odds that he would recover. If going to the specialist resulted in ninety percent odds he'd recover, probably I'd do it, put it on the credit cards and be damned, even though just last week I wailed about how I couldn't go to therapy because I couldn't afford the $80 a month or whatever it would cost.

But I'm just not sure about the ethics of medical technology. I don't mean this to sound reactionary. I have some reservations about it for humans, too. Those spectacular rescues you hear about, where thousands of dollars are spent for a helicopter to fly in and remove a critically wounded hiker from a canyon. I think it's wonderful. But I also think it's awful: what about all the lives that could be saved or improved if the same thousands were administered as vaccines to poor children? I know this is a simplistic analogy, but I can't help hating this society, the bullying power of money. How, because we CAN, we sometimes devote disproportionate resources to a single or a few lives, but fail to allocate BASIC resources to all. I don't think I could stomach it, spending all that money on my cat when I didn't even contribute to the relief efforts for Hurricane Katrina.

My cat is a beatiful orange loaf and I love him. But I hate the way that this possiblity -- the specialists who only possibly, not probably, could save him -- makes me feel that if there are two choices, a pile of money or my cat, of the two I'd choose the money. It isn't like that.

But of the choice between a painful and medicalized and financially and emotionally draining process vs.the feeling of my sick but peaceful cat purring comfortably in the crook of my arm: yes. I would choose the second one. I will research nutrition supplements and cook concoctions and pet and coddle my kitty, will stay awake as I did last night for long hours just to stroke him gently as we all slept together on the bed with all the rain outside. Did I know a practitioner, I would totally get him some kitty acupuncture.

Knowing that others would choose the other, would say keep the cat alive at all cats and DAMN THE COSTS, continues to prick at me, to make me feel alternately angry and guilty.

Meantime the kitty has gotten up and his frisking around the window, looking at birds. I'm going to go to the vet and get some pain medication for kitty, and then perhaps I will write a novel.

The scenario

The cat, he is probably very sick. I owe a post about his miraculous creamy belly, his stripes which alternate the colors of graham cracker, wild flower honey, toffee, butter brickle, scotch, butterscotch, and your lighter varieties of bourbon. He is a delicious dessert of a cat with a pink studded collar and an oral tumor.

He has been an indoor-outdoor cat since the day of my wedding reception with Mr. P, the day all of the Pipestem relations (let's pretend for ease that the mister and I share a last name) wandered in and out of the house and accidentally let the cat out of the house. There I stood on the sidewalk, ten minutes after I had wanted to be at the golf club house that was our reception site to check that the relatives had gotten the decorations right. I was in my wedding dress, a long and plain white silk one, with bright pink slippers and orchids in my hair, calling out the kitty's name, hoping the neighbors would all look out and see me in this sunbeam in my dress and know my cat was lost, right here on this my pseudo-wedding day.

If this turns out to be not only our reception day but also the day my cat got hit by car, this is going to put a damper on my memories of it, thought I. Instead, there was Cat in the headlights when I pulled into the driveway that night, chasing another cat off his yard as if he was born to run.

Before he became, somewhat against my will, a declawed indoor outdoor cat, he was a fluffy overweight indoor mackerel tabby rescued from the pound by me on December 31, 1999, who chewed my books and papers, woke me up at 4 in the morning, and purred me through all the major happenings of my late and middle twenties.

As an outdoor cat, he turned out to be a success. He lost weight, didn't roam too far, and was seen to catch at least one tiny rodent (we tried to save it) and one bird (which we did not let him eat).

Here have been his weights.

**Eighteen pounds when I stood with him on a scale this summer.

**Seventeen pounds six ounces in September, when he first went to consult the vet about the weird way his gum had suddenly grown over top of his tooth.

**Sixteen pounds October 10th when he had his gum snipped and his tartary teeth all cleaned. When I rejoiced because my formerly fat cat was now a lithesome beast who no longer chewed my papers to shreds but spent his days in the sun out back, running after birds.

**Fifteen pounds, seven ounces yesterday when he went to the vet again for the new tumor which appeared on his palate like a semi truck, between Thursday and Friday of last week.