Where Do All the Dogs Go?
A dog with cognitive dysfunction and its owner made a lifetime of memories.
Posted Mar 03, 2016
I had to call a family audible on Super Bowl Sunday, amidst the Ooh-Rah for Peyton Manning and Cam Newton— a wrenching down-and-out, an end-life pattern I will never forget.
Changing a play at the family scrimmage line is an intense ordeal, fraught with anxiety. Several years ago I had to call an audible, telling my children I was diagnosed with Early Onset Alzheimer’s and carried a key marker gene—the fifth family member to battle dementia. Now I had to break the news that our 14-year-old family dog, a stunning, loyal yellow Lab named Sox, who had defined us with unremitting faith, hope, and love, and was my guidepost in this disease, was going to die that night. Failing kidneys, internal bleeding and neurological complications were overcoming Sox, and I was to be the executioner.
There are no playbooks for such talk. I had to scramble. For most of my adult life, I’ve made a living with words; now they escaped me—blanks, just blanks, as I fought off my own incapacity to connect the dots. In recent years, the family has witnessed my own progression in Alzheimer’s; now Sox, who had been a family caregiver of sorts, was failing. The metaphor was unavoidable.
“It is time,” my wife Mary Catherine and I told our adult children, Brendan, Colleen and Conor, who in many ways were raised by Sox. I could hardly get the words out. There will never again be a family dog that raises our children. And they knew that.
Instinctively, I fumbled for ways to keep Sox alive for just another day at the emergency animal hospital on Cape Cod where she had been taken. The caring veterinary physicians were willing to oblige, but stressed that Sox, namesake of the Boston Red Sox, was in great pain and would likely die alone that night.
That’s all I needed to hear. Sox would pass peacefully on my lap.
“Sox’s functions are shutting down,” the attending physician explained, “and she has neurological issues of confusion and disorientation.
“What do you mean?” I asked.
“It’s as if Sox has dementia, Alzheimer’s,” the doctor explained, unaware of my diagnosis. “That’s the best way to explain it.”
My wife and I were stunned. Sox and I had come full circle.
Our loss is no more heartbreaking then that of other individuals and families in our place. So I write in the midst of our own grief to give collective voice to a bonding, brand loyalty, that lasts a lifetime and beyond.
Sox, a purebred female with boundless verve and devotion, was a “Sweet 16” birthday present for our daughter Colleen, who had been lobbying for a dog for years, and now is a teacher in inner city Baltimore.
“Daddy, please!” she would ask with a gaze that melted my heart.
An old salt of an investigative reporter, I probed breeders throughout New England and found one outside Boston with a newborn yellow Lab, the color of my daughter’s hair. The Lab had been spoken for, but, on reflection, the prospective owner, a cancer victim, wanted the pup to have a secure and loving home, and passed Sox on to us. When presented with her birthday present, our daughter beamed with the energy of pounding surf on the Cape, as she held this wiggly ball of fur in her hand.
It wasn’t long before Sox became the alpha female in the family, the gender opposite of the barreling Labrador retriever in the celebrated movie, Marley & Me, an adaptation of John Grogan’s fine book. Sox darted through screen doors, peed on the wide pine wood floor in the family room, shed hair faster than Donald Trump, and ate just about everything in sight. When we had to correct her, she bowed her head in shame, sheepishly peering up with soft brown eyes to see if the lecture was over. Early on, Sox had the oomph of a racecar, running in circles around our house until she collapsed in exhaustion. We used to call these laps the “Sox 500.”
Like Marley, Sox also flunked her obedience class in Chatham. The trainer was not impressed.
But we always were, as Sox over the years stole our hearts and taught us about life and how to love unconditionally, and to growl when needed, not to bite. Endearingly simple and a contradiction of sorts, Sox had the gut instincts of a savant and the curiosity of a kindergartener: she always waited for us by the door, wagging her tail in delight as if we had been gone for a year; she could catch a tennis ball in mid air, and fielded grounders like an All-Star shortstop; she picked up sticks in the backyard like a master landscaper; and Sox, I believe, sensed I had medical issues and was always by my side at home, licking my face for reinforcement or lying with me on the couch; she was faster than a speeding bullet, and able to leap tall buildings in a single bound…
Sox had religion, too. When she occasionally slipped away from the house I often found her down the street in the church parking lot at Our Lady of the Cape; maybe she thought she could light candles for us. Do dogs go to Heaven? Many years ago, Pope Paul VI consoled a tearful child with the hope that it might be possible—the reference more recently was incorrectly attributed to Pope Francis. Perhaps Sox hedged her bets.
Sox also loved the salt water and the beach. In summer, she would sit on guard at the bow of my boat on Pleasant Bay, her face pointed at the sea like Leonardo DiCaprio in Titanic. On ocean excursions to the outer beach, Sox always would devour the sand, then run up to the shoreline and drink as much salt water as she could. We scolded her every time, but she didn't care. Sox knew best. That is until one day when she coughed up what seemed like a gallon of the Atlantic, and pooped sand on someone’s blanket.
There were the tender moments. Sox was on Crosby beach with Colleen and her husband-to-be Matt Everett when he proposed. A moment frozen in time.
The end was no surprise; we saw it coming for many years—loss of weight, loss of hearing, loss of energy, and great difficulty walking. Still, she was in the moment. When the kids were young, Sox would leap up the stairs to their bedrooms at night, making the rounds like a duty nurse. When she could no longer climb, Sox would patiently wait at the bottom of the stairs until they awoke.
As her health deteriorated, our roles changed. I became the caregiver for Sox. She didn’t sleep much at night, awakening about every two hours to urinate in the backyard. The water was going right through her failing kidneys. So for months I slept nearby on the family room couch, just so Sox knew she was not alone. At regular intervals, I walked her to the backyard and we peed together, and afterwards I fed her as much as she could eat. She poo-pooed the dog food, so I gave her boneless Perdue chicken and meatballs. Still, you could see her ribs, yet she wouldn’t give up while she had a prayer. We bonded in new ways.
It wasn’t until later in this full circle walk with Sox that I learned about dog dementia, formally called “Canine Cognitive Dysfunction/Dementia,” or CCD. Sox was a poster child for the disease with progressing symptoms. I had been in denial, as many do in Alzheimer’s: her pacing in circles; incontinence; getting lost in familiar places; not able to retrace her steps back into the house; staring off at times into deep space; not responding to directions she once knew; and sleeplessness at night. I promise, she didn’t drink out of my bowl. Sox, the caregiver, had met me in my place.
When I saw our champion Super Bowl Sunday night at the emergency animal hospital, I knew in my heart it was time to let go, though I struggled with it. Sox just lay motionless on the floor, staring at my wife and me. She knew the end was near. The kids, sucked into a black hole of emotion, all wanted to say goodbye, so we Face Timed Brendan, Colleen and Conor. We all felt as though the wind had been knocked out of us.
Colleen was first to console Sox, a time when love speaks louder than words. She could hardly talk.
“Is she in a lot of pain?” Colleen asked quietly. You could hear her reach for breath. Sox was reaching, too.
“She’s going to sleep, honey, where there is no pain,” I told her.
“Can I see her one more time, Daddy please?”
I cradled my iPhone above Sox, and she made eye contact immediately, those piercing brown eyes that said to us: I’m not leaving; I’m just going away.
“Daddy, please kiss her for me…”
Conor, the youngest in the family, was overcome in numbness.
“Can you just scratch her head for me?” he asked. “Can you give her a hug?”
The moment gave new definition to FaceTime.
Brendan, the oldest, closed the loop.
“Love you so much,” Brendan said, with my phone on speaker next to Sox’s ear. “Hey, it’s me, buddy, Brendan…”
It’s hard for one to catch a breath, releasing raw emotion.
“I love you so much, Sox! You’re the core of this family. You made me smile; you made me so happy. Dad, I’m so sad…I’m so freakin’ sad.”
The words trailed off.
My head is throbbing,” Mary Catherine told me as she said her farewell to Sox in this sterile, yet imitate, six foot-by-six foot room.
“Goodbye, sweetheart,” she told Sox. “I love you!”
In seconds, I was alone with Sox—one-on-one, just as the day I brought her home. I lay next to her on the floor, rubbing her head.
Dammit, this hurt! Sox knew it, that inner sense.
“I love you,” I told Sox repeatedly in a soft voice as I held her close. “It’s ok, just let go, let go, Daddy loves you…”
Moments later without notice, Sox suddenly stood up for one last time. She licked my face, then turned in three tight circles in defiance to death, licked my face again to say goodbye, then lay down, never to get up again.
It was time.
The attending doctor entered the room with two syringes, one to relax Sox, taking all pain away; the other to let her go. With Sox’s in my lap, her head resting on my right knee, the first injection was administered. Slowly, Sox leaned her head back toward me and appeared to smile, as if to say her pain was gone. With the second injection, the doctor told me to keep talking to Sox.
“Hearing is the last thing to go,” the doctor said.
I told Sox again how much we loved her, how much she was a part of our family, that we would never forget her. I hugged her tightly. She was at peace.
The doctor then put a stethoscope to Sox’s heart, and softly uttered two words I will never forget.
Greg O'Brien's latest book, "On Pluto: Inside the Mind of Alzheimer's," has won the 2015 Beverly Hills International Book Award for Medicine, the 2015 International Book Award for Health, and is an Eric Hoffer International Book Award finalist, as well as a finalist for USA Best Book Awards. O'Brien also is the subject of the short film, "A Place Called Pluto," directed by award-winning filmmaker Steve James, online at livingwithalz.org. NPR's "All Things Considered" is running a series about O'Brien's journey, online at npr.org/series/389781574/inside-alzheimers, and PBS/NOVA takes a trip to Pluto in its groundbreaking Alzheimer's documentary on April 6. For more information go to: OnPluto.org. O'Brien serves on the Alzheimer's Association Advisory Group for Early Onset Alzheimer's, and is a patient advocate for the Cure Alzheimer's Fund of Boston and the distinguished Washington, DC based UsAgainstAlzheimer's.