Thursday, August 7, 2008

Cut The Rope?

A Dilemma:

I read a story a few years back about a two man climbing expedition in South America (Touching the Void) where one of the climbers is forced to make a terrible choice: His climbing partner had been badly injured at high altitude and they had to make a treacherous descent, essentially straight down the fall line off a sheer face, … in a storm, … through the night. To faciltate this, the uninjured climber lowerered his injured partner down the face, one rope length at a time. In the end, he has lowered partner over the edge of a cliff where he dangles perilously: On belay he is slowly loosing his purchase, about to be pulled off the face which will cause them both to plunge off the cliff. His choices? To hang on as long as he can and ultimately be swept over the precipice with his partner, or … to cut the rope, sacrificing his partner and saving himself. He cut the rope. Oh by the way, this is a true story, and his partner survived the fall.

when such a sutation is contrived in a novel I suppose it has a name. in reality, it could be referred to as a moral dilemma, but it is hard to see an ‘immoral’ choice here, just a very bad situation with two different outcomes, both of which are emotion laden. I am facing something similar, though the outcomes are not nearly so dramatic. Here is how my own little Andean tragedy plays out:

I went back to the Docs earlier this week for another 'evaluation'. The ENT guy is getting down to the bottom of his bag of tricks, he’s not real anxious at this time to do more surgery (me too by the way). In this instance, he's sort of the QB of my 'crack medical team' working to sort out this medical board game (seems like battleship to me, lots of torpedoes, not very many hits). So he thought another visit to the allergist for a follow up consult might be enlightening.

Last year I had the skin patch test where they expose you to lots of allergens to determine what if any allergies you have. I tested positive for Oak and Cat. Well, not so good there: We live in OAKville and our expansive spread does include a nice little patch of Oregon White Oak. I feel incredibly fortunate to have my own private forest. To be the temporary caretaker for a beautiful stand of living things that are much older than me is a responsibility I am pleased to shoulder. Trees have been a big part of my life, shoot of my family’s history and lifeblood. I am disinclined to kill these beautiful oaks to relieve my runny nose and raspy cough. It would be a fools errand anyway, trees know no political bounds and our piece of the earth is surrounded by more oaks.

We also have a Siamese half breed, or perhaps I should say we've been allowed to provide support to the Commisar of the Feline Directorate as he deems appropriate. Even though there is no Little Red Book I am intimately familiar with the Thoughts of Chairman Meow.





He's done a good job of insinuating himself into our lives. He’s quirky, irascible, has no social graces whatsoever but occasionally deigns to show us some affection in his moments of weakness. His personality would make him ‘hard to place’ if we had to get rid of him. For all his faults, we really like him. he lightens my days, gives me loving head buts when I come home from work, attacks my hand relentlessly as I try to fall asleep and usually comes to the bedroom window sometime to between midnight and 4:00am to ask me in his whiniest Siamese voice to get up and open the patio door so he can come inside and snuggle up. It is fair to ask ”what good is a cat?” We are not beset with disease carrying vermin, there are no other ‘practical’ benefits to having a cat, and having him around actually presents a number of 'downsides’ if you feel any sense of responsibility as a pet owner.

By now you can probably guess where I am going with this.

Last year, none of this seemed to be a problem. At that time the doc suggested that my reactions to these allergens were so slight that it did not make sense that they were the source of my troubles. Made sense to me because I had been enveloped in this funk for most of a year prior to the time we bought the spread and were adopted by the cat. Obviously, that was a relief. One does not relish the thought that the place you live or your quirky little side kick make you sick.

So imagine my surprise when I met with the Allergist yesterday and he gave me some assurance that I could expect dramatic improvements, 70% to 100% recovery in approximately 3 months ….. if I get rid of the cat. This was a stunning revelation, and I was literally at a loss for words, momentarily. But then we had a long conversation, I drilled him closely on all aspects of the situation and got his read. He clearly knows his stuff, he had reasoned answers for most of my predictable questions and he supplied much deeper technical knowledge than I could easily comprehend. We talked about other therapies and their likelihood of success. For him, it comes down to getting rid of the cat first. A very logical approach to solving a problem. But as I mentioned above, there is no ‘logical’ reason for having a cat as a pet, that’s particularly true in the case of our overbearing Chairman. And so in matters of cat ownership, logic does not necessarily trump emotion.

There were some points at which his knowledge could not adequately bridge the gap between cause and effect: Why did this ‘allergic’ reaction have such a sudden onset, in the late fall of 2007, 6 or 8 months before we moved into our house and came into contact with the cat? No explanation there. How can he come to such a different conclusion now? while this fellow is clearly an expert in his field , still, he’s an allergist who just happens to have a vey serious allergy to, you guessed it, Cats! I could never prove this but I suspect that his knowledge, his experiences, and his personal circumstances create a certain bias that leads him to a conclusion. When you are a hammer, every problem looks like a nail, and in this situation crabby little Chairman is the nail in the shadow of the hammer.

But he may be right (or not!). I do have a problem, and there is some as yet unknown cause. The only way to determine if the doc is right or not is to ‘remove the cat from the home environment’ to use his euphemistic terminology.

The thought that I could be back to the old me, teases my mind like the smell of a patisserie between Tintineac and Loudeac at dawn. But imagine the emotion
if we shipped Chairman off to the cat 'home' and I didn’t get any better. (Romeo and Juliet, with hairballs)

I had a troubling driving home (Mrs. C had ridden her bike home from work). In fact I lolled about in Olympia window shopping, until I realized that I was avoiding going home, avoiding sharing this bad news with her. I had told the Doc that I would hate to force my wife into choosing between me and the cat, I was half joking but I also didn’t want it to come down so clearly to that.

On the drive home I ‘replayed the tape’ from my Dr visit and I think I have sorted out the next steps we need to take to resolve this dilemma. After we talked it through Mrs C is generally in agreement so I got back in touch with the allergist to clarify a few things and to see if he was willing to re-administer the allergy test. If I’m going to ‘cut the rope’ on our little four legged field marshal I want to be absolutely sure that the test is appropriately administered and accurately interpreted. I know there is never any guarantee when it comes to medical procedures but big decisions need to be made with the best possible information. The Doc understood the gravity of the situation and agreed to re-administer the test week after next. Though he doesn't speak English I think Chairman understands i better than he lets on: he's been on his best behavior since we returned from our trip back east.

As ‘bad’ as this situation is, I keep coming back to the prospect of getting back to my old, ‘normal’ self. Imagine being able to go back into the gym and having a workout without a coughing attack or constantly blowing my nose (not a real big hit with the gym rat set). Or riding hard on the bike for a couple hours and not having to stop, gasping for air and digging into my bag for a bevy of inhalers and prescription pills. Simple little things that I used to take for granted now seem like such fantastic good fortune.

If you are a ‘cat person’ you can see this for the enormous, tragic, life changing drama that it is. If not, you’re probably rolling your eyes and thinking something like ‘get over it and get on with it!’ Oddly, I find myself stuck with a foot planted firmly in both camps. It’s real, it’s our cat and if we have to part ways I have no idea how we will find suitable digs for him, much less deal with the hole this would leave in our lives. On the other hand I’m in touch with others who are facing much more significant, real life and death situations which helps me put this whole business in some sort of perspective.

PS: After the briefest pause for consideration, Mrs. C said she would choose me over Chairman Meow, ….. if she had to.

2 comments:

  1. For what it is worth, here is what I would do in your situation.
    See a different doctor for a seperate test. If it comes out the same, find out what you can do to keep meow in your life without being in your nose. Extra cleaning? Not allowed on the furniture?
    I am pretty suspicious of the diagnosis though. It would be one thing if you just got the cat and it started to flare right away, but you've cleary had it long enough to grow attached without it hurting you sinuses.

    Keep in mind I am very biased since we just lost our cat though.

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  2. Um…yeah. I thought about that and still might do it.

    In order to get the Doc to agree with a retest I wrote out a note, (a letter really) detailing the issues as I see them. I mentioned the time gap you brought up and the seemingly dramatic difference in the interpretation a year on. I tried not to cast any aspersions on his methods or the work of the tech staff. I mentioned that when I had the test he never saw the results and the nurse was pretty casual about interpreting the spots on my arm. Casual might not be the best term, I got the impression that the results were sort of a ‘spotty’ positive but not the kind of results that would earn a two year ban for a rider from WADA. Not sure how to say this but she seemed a little more interested in me than in the test results.

    When I got a call back from the Docs office the woman I spoke to gave me the impression that my little 'situation' was perhaps becoming a minor cause celeb. It sounded like folks there picked up on the pathos and I suspect (I hope anyway) that this procedure is going to go down ‘by the book’.

    Depending on how it plays I may still seek a second opinion.

    As for what to do, the Doc understood that scratchy might not get the boot so he suggested in ascending order of severity:

    1. Keep the cat out of the bedroom.
    2. Keep the cat out of designated ‘cat free’ spaces in the house. Here I’m thinking my office.
    3. Keep the cat out of the house daytime (while we are at work) and maybe in the garage at night.
    4. Just have him be an ‘outside’ cat.
    5. And of course, finally “remove the cat from the living situation”.

    I really go back and forth on this. Right now I'm thinking screw that, this cat is lucky enough that he'll probably be squatting to leave a steamy pile of superiority on my grave and what's a runny nose in the cosmic scheme of things?

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