Buddy Breathe

Sarah is at home this time. She goes back and forth from the In-Patient Care Center (ICC) at San Diego Hospice, to her home in Vista, where she receives hospice home care. She has a regular volunteer as part of her hospice care team, but she makes a special request to the volunteer department for a different volunteer to come visit her. She wants to see Baxter again.

Sarah is an aspiring young artist who is married to Karl, a musician. Baxter meets them both many months earlier, in the ICC, when Sarah’s condition and pain become intolerable. When Baxter visits her for the very first time, she holds out her arms before I can ask if she wants Baxter next to her in bed. I pick him up from his wagon and place him inside her cupped arms. It’s a perfect fit. He becomes hers as she tilts her head to meet his; he kisses her. I can tell she wants more of him as their eyes almost touch. Their gaze is penetrating and soothing. And, it is this moment that enables Karl to take a deep breath. It’s really more of an audible sigh of relief. In his sigh, I imagine these words: Thank you for bringing Baxter. He makes Sarah come alive.

Then, Nurse Michelle enters. "Hey Sarah, I want to know if your pain level is any better now that you’re with Baxter, our hospice angel."

She responds with something almost incredulous. “Baxter took my pain from a level 8 to ZERO!

We each marvel at her response. Our heads nod back and forth, our breathing slows down, and the soft hues in the room reflect the elevated mood that Baxter brings to everyone.

Months later, I receive a call from Sabrina of the volunteer department. "Hello Melissa. Do you remember Sarah Joseph?"

"Of course I do."

"She is requesting that Baxter come visit her. Do you think you and Dennis could take him there?"

"Yes, we’d be honored. What is her address?"

Sabrina proceeds to give me the pertinent information.

On Monday, I phone Sarah and Karl’s home to see when and what time is appropriate for her to see Baxter. "Since Karl is at work most of the day, could you possibly come in the late morning after my hospice nurse leaves. You can come any day this week."

"Okay, we’ll be there around 11 on Thursday."

"Melissa, thank you. I’m very excited to see Baxter again."

"We’re looking forward to being with you, too. I’ll be sure to tell Baxter."

For someone who is dying, excitement is a treasured emotion that portends there is a future. In this situation, Sarah has something to look forward to, a healing time with Baxter. From past experience with him, she knows he will bring joy and comfort to her life. He will be a respite from any pain, anxiety, or loneliness.

I attempt to imagine what Sarah will look like now. It’s been months since we’ve seen her. It is VERY unusual for us to visit anyone in his or her home. Our responsibility as volunteers is typically relegated to visits with Baxter in the ICC. However, when someone makes a special request to see Baxter, he almost miraculously appears.

At this time in Baxter’s life, though, he’s having difficulty breathing. I call Dr. Hackett, his veterinarian, to see if a dog can be on oxygen, like most hospice patients we visit.

"Yes, dogs can take oxygen. I could write you a prescription for a small tank from a home health care supply. First, though, is there any way you can get a hospice nurse to do a test run to see if Baxter tolerates the tubing in his nostrils." He such a good boy that I imagine he’ll do just fine.

So, Baxter, Dennis and I make a special visit to the ICC. I grab one of my favorite nurses and tell her about my earlier conversation with Baxie’s vet. In silence, she takes my arm that translates into follow me.

We go into this little supply room with her. She sets up the oxygen tank with the tubing and puts it in Baxie’s nostrils. Michelle turns it on low and Baxter seems to “get off.” His breathing is easier. I start laughing uncontrollably. "Look at us. We’re all cramped in this tiny room with a dog, in a little red wagon, high on oxygen."

I’m amazed that he responds so quickly to this. I’m jumping up and down, hugging Michelle. I believe I’ve found a solution to what is becoming a chronic problem for Baxter. Without this oxygen, I don’t think he can continue as a viable therapy dog, as a hospice volunteer. I tap into every possible resource to not only ensure that he’s in a place where he can help others but, more importantly, that he has quality of life. With Michelle’s willingness to put rules aside, I hit the jackpot. Yea!

"Michelle, how can I thank you enough for this?"

My tears say it all. I reach out to her and hug her. She hugs me back and I can hear her sobs. She loves Baxter, too.

Later, I phone Dr. Hackett, get the prescription, and sign off on a rolling cart, oxygen bottles, and tubing. I’m in business and Baxter is, too. Now, we can comfortably go visit Sarah and other patients in the ICC. I no longer am going to feel anxious about Baxter’s inability, all of a sudden, to breathe with ease. He can continue to be immensely therapeutic for hospice patients, like Sarah. In addition, he himself becomes more of a “hospice” dog, struggling with end of life circumstances.

Thursday arrives. We make our way to Vista. We’re right on time. Dennis carries Baxter up three flights of stairs. I take his blanket, food, water, and oxygen. Just like Sarah, Baxter is getting closer and closer to the end. The oxygen is just one of the signs that the moments are more and more precious.

The door is slightly open. There’s Sarah, all made up, surrounded by her artwork, which consists of mermaids, made from abalone shells, floating in the sea.

"Hello Sarah."

She smiles. She’s enveloped in pink. Pink sheets, pink nail polish, pink lipstick, pink pillows, and a pink outfit covered in a pink blanket. She’s all woman, radiating femininity.

"Wow, Sarah, you look beautiful."

"Th…ank….y…ou. Sorry, I’m having trouble breathing."

She has her hand on her chest as if she pushes hard enough there will be more air inside to grasp and give away.

"I see your oxygen machine over there and the tubing stretched out on the floor."

With continued effort she responds. "Yea, I know. I’m supposed to be using that, but it just makes me feel closer to the end."

"Well, perhaps you notice the new addition to Baxter’s world. He’s on oxygen, too. Like you, he has to catch his breath. Look, if I put Baxter’s tubing in his nostrils and hook him up, will you then put on your oxygen, too?"

Sarah’s pink lips open wide. She nods her head.

"Would you like to be in your bed or on the sofa? Either way, I can place Baxter next to you and you can both breathe together. You can buddy breathe like in scuba diving when one person runs out of oxygen and has to share."

Sarah seems to like the fact that she and Baxter are in a similar place in life. She’s not alone. Neither can walk. Sarah needs a wheelchair and Baxter needs his wagon. And, neither can breathe well without oxygen.

Ironically, in many ways, they are on parallel paths. She creates underwater goddesses and he is a divine-like spirit. Neither Dennis nor I can top that identification. Their congruity at this moment is completely uncanny.

I watch in amazement as Baxter and Sarah bond again on a deeper level. I hold my chest, feel my breath, and want to reach inside, too. My breath is hard to find only because I’m struggling holding back my tears. It is this moment that encapsulates the meaning of life. It’s another magical moment with Baxter.

And, now, for the moment, it is Baxter and Sarah who share their life, their breath. And, I, standing in the background, watch what I deem to be one of the highlights of my life.