Miraculous Maisie

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As a child, Jill McIlraith wanted to be a vet (or a policewoman) but settled for being a human doctor instead – and has never regretted it although animals continue to be pivotal to her life.

Miraculous Maisie

In the realm of angels and miracles, a schnoodle is an unlikely heroine.

But making grief bearable, helping a 68 year old lady fall in love again and bringing a family together is all in a day’s work for Maisie, a schnauzer-poodle bundle of cuddles and energy.

A few colleagues tease me (others just think it slightly odd) that I remember the names of my patients’ dogs and cats more often than I do their children’s. Asking about their pets has become part of the therapeutic bond I share as a general practitioner with many of my patients. Many, of course, are not animal people and we then move onto other areas of mutual interest on which to build the foundation of continuity and confidence essential for successful doctor-patient interactions.

But talking about other touch-stones of Kiwi life such as rugby and favourite Super 12 teams, politician’s eccentricities and changing the flag and the weather just doesn’t arouse the same warmth that sharing pet stories does.

In medicine, you have to take joy where you find it: you need good days to balance out those when you tell someone they have cancer, or that they are not going to get their knee or hip replacement because they don’t meet the local DHB’s threshold.

So I revel in those occasions when a patient pulls out a photo of their dogs or cat – their face lights up, their voice lifts and their spirits soar, all of which is much more successful at lessening their ills than my pharmacopeia.

Pets are a focus for their caring and provide a consistency to daily life against which we can weigh the uncertainty of being sick or just getting older. Some patients have brought their dogs to our practice to be introduced, to the slight disapproval of some staff that think dogs shouldn’t darken the doors of a medical centre.

But what doggy patients and I both know, deep down in our souls, is that dogs are often more important to healing than the tests I order, examinations I do or pills I hand out. They know that it is huge source of comfort to stroke a dog’s head and feel a cat purr and don’t care that science has backed this up as lowered blood pressure and heart rate.

Maisie epitomizes this. When her owner, Glenna (I use her name with her consent), lost her husband to cancer, she was devastated –the house was empty and cold and she found herself staying late at work to avoid going home. Her family, although all close by, were busy with their own lives. Days were long and lonely and her world contracted around her.

Talking about grief and coping strategies, I suggested that she consider getting a dog. Above my desk is a favourite photo of my daughter with Archie and Boris, our Cairn terriers, all three looking alert and ready to tackle the world. The picture is often a talking point for patients – children, especially, want to know the dogs’ names and whether they are naughty.

I talked to Glenna about how dogs put the world into perspective and are an antidote to angst and sadness; how they take us out of ourselves and reconnect us with the world. She was dubious but said she would talk to her family about it.

She had never been a dog person, so it was a shock when a small black bundle of soft fur and liveliness arrived and she was instantly smitten.

“I thought I was too old to fall in love with a puppy, but she has been like a miracle. To have this little breathing creature greet me each day the way she does – rolling over on her back with all four paws in the air – before cuddling up, has been just the most wonderful thing.”

“She has filled the house with energy, life and love. It has been a journey of discovery that has taken me by surprise. I share my ups and downs with her and talk to her all the time.’’

Glenna says that she would never have anticipated that she could fall so hopelessly in love with a dog.

“I always thought people who were nutty about their dogs were slightly odd. But now I get it – you can become besotted with a dog. I can see how they become a central part of one’s life. Maisie has been life changing. She has been a guardian angel to me.”

And Glenna says that Maisie has been wonderful for her whole family and has brought them closer together. Doggie members of her family shared her upbringing, offering advice about where Maisie should sleep, how to toilet train her and how to get the balance right between loving her so much, and not letting her become the boss.

It has also had a direct therapeutic benefit for Glenna: she exercises more, as Maisie doesn’t care if it is sunny or if the southerly is howling through Dunedin’s hills. She is always thrilled and ready to go walking and to fill each day with delightful exuberance.

Many of my patients know that I like animals and have a menagerie including pet goats and an elderly ewe called Lambchops, who shall never be asked to fulfill her named destiny. Most also know that I continue to love them even when the human-animal interface is challenged, as happened when my horse Larry bucked me off and broke my pelvis and five vertebrae.

Larry has now been retired from being ridden – declared too unpredictable by the local horse whisperer after nine months of attempted rehabilitation. But he remains part of the family, living up to his name by happily chomping his way through knee-high grass as a paddock mate to Harriet. He still has a place in my heart.

Animals are often an integral part of patients’ stories and all the odd things that happen. I am often astounded at how complex ordinary lives can be and how animals are interwoven into our narratives.

One patient recounted to me all the dogs she had had, remembering all their names and quirks as she has loved and lost them, like steps on the ladder of life of her long life.

Animals impact directly on the well-being of many of us – what can be sadder than having to say goodbye to a dog who has loved you unconditionally for years and doesn’t understand that frailty has meant that a rest home now beckons? Or the urgency felt by one elderly lady who insisted on leaving hospital as soon as possible because she was worried her cat was lonely?

Ripples from such sadness can manifest in a myriad of ways from depression to chest pain, just as the joy of loving a pet can mitigate such symptoms. Another of my patients has a tiny Chihuahua, Teddy, who is so small he sits comfortably in one hand. But he has been enough of a force to counterbalance her significant congenital medical problems and a very dysfunctional family. Teddy, of course, is oblivious to his pivotal role he plays in this young woman’s life.

A patient recently told me her favourite story of how dogs came to play such an important part in the lives of humans: When Adam and Eve were kicked out of the Garden of Eden and the gap between Heaven and Earth grew wider and wider, at the last moment a dog leapt across the chasm. This was so humans would know the benefits of unconditional love and the joy that everyday dogs bring to everyday lives.

As doctors, we try to help patients interpret what is happening to them and be there on their journeys. Sometimes we underestimate the impact of advice we offer and not all my well-meaning suggestions to patients have been as successful as Maisie.

It is the only time I have suggested a patient consider getting a dog – usually I would be wary of asking anyone to make such a commitment and am very against live animals as presents. But the bond that has formed between Glenna and Maisie has been more successful at helping her cope with life and loss than anything else I have done.

Maisie, of course, is blissfully unaware that she is a heroine – she is too busy doing her doggy thing of living and loving in the present.

John Berger, in A Fortunate Man, his famous essay about being a country doctor, stresses that a vital element of being a good doctor is the ability to identify with patients, to form a fraternal bond (1). What patients often need, is not more medicine or hospital, but “more doctor” – it is the personal interaction and connectedness that is integral to the healing process.

For some patients what may be most beneficial for them is “more dog”. What could be more miraculous than a gift as small as a five kilogram schnoodle that keeps on healing?

 

(1) John Berger: A Fortunate Man. Penguin Press, 1981.

 

– Jill McIlraith

Born in South Africa with an original career as a newspaper journalist during the tumultuous 1970’s in Johannesburg and Cape Town, Jill has now lived in Dunedin for nearly 30 years. She works as a general practitioner at Aurora Health Centre in South Dunedin and sexual health doctor at the Southern DHB. When not at work, she still dabbles in writing and enjoys her animals, including four dogs, gardening, reading and watching science fiction movies with her neurologist husband.