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October 2001 |
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Saturday 6 October We have been fretting about Lela all week. Mary noticed a week ago that she wasn't eating, and made an appointment for her to see Stuart the vet on Thursday. We have two elderly cats. Lela, the mother, is 17, and her daughter Rosie is 15. Neither of them has any teeth left, and Rosie has been completely blind for the past year or so. But Angora cats have a fairly short life expectancy (anything over 12 is above average), so they are not doing too badly. By Monday, Lela was not looking good at all. She still wouldn't eat, and she was getting so weak that she couldn't even jump up onto a chair. Mary was worried that Lela wouldn't survive until Thursday, so she made an emergency appointment for us to see Bill, one of the junior vets, on Monday afternoon. Unfortunately, Stuart wasn't available on Monday. Stuart is the senior vet, and he is a real sweetie. He is very kind and caring, good looking, with a great sense of humour, and he knows the cats inside out. He only has to look at them to know what's wrong with them, and it's entirely thanks to his expert treatment that they have both lived so long. Young Bill was nice enough, but he doesn't have the same expertise. He checked Lela over, listened to her heart, took her temperature, felt her kidneys, and admitted that he couldn't see what was wrong with her. He suggested doing a blood test on her, so that the results would be available when we brought her back to see Stuart on Thursday. Meantime, he gave her an antibiotic injection. He also suggested that we should leave Lela there overnight for what he called some more aggressive therapy, intravenous feeding or something like that. But I said No, we didn't want to subject her to that. Mary and I have often discussed this. We think that as the cats come towards the end of their lives, we should let nature take its course, and not inflict stresses of that sort on them. If they seem to be in terminal pain then we'll have them put down, and if they have diseases that can be treated at home then we'll do all that we can to keep them going. But we don't see any point in subjecting them to high-tech medicine just so that they survive a little bit longer. I always think of the verse that says "Thou shalt not kill; but need'st not strive Officiously to keep alive." We feel the same about our own lives. If ever either of us is suffering from a painful terminal illness then we would want to end it quickly rather than linger on in some dismal hospital environment for a few months longer. I don't know whether or not this is true, but I read somewhere that two thirds of all medical expenses in the US are incurred by patients in the final six months of their lives. The way I see it, the world would be a happier place if that money could be spent on the living rather than the dying. The injection may have done some good, because Lela was at any rate no worse by Thursday. I took her to see Stuart, and he said that the blood tests showed that Lela had some kind of kidney dysfunction, as elderly cats often do. He's so enthusiastic about his work that he can't stop talking about it. and he gave me a 20 minute lecture on how the failure of the kidneys leads to the build up of various toxins in the blood, and what can be done to remedy this. One thing he suggested was to put her on anabolic steroids to build up her wasted muscles. He prescribed some Nandoral tablets, and he mentioned that this was one of the banned substances that athletes like to take. He said that we would have no difficulty getting her to take these pills, because they taste very pleasant and sweet. "You may wonder how I know that," he said, flexing his arm muscles like a weightlifter. He looked impossibly cute doing that, because he is a skinny little fellow with hardly any biceps to speak of. It made me really want to hug him. He counted out 21 tablets, and said that if I came back asking for more in less than three weeks then he would be highly suspicious. That's a shame - I wouldn't mind going back to see him every week. Mary and I often wish that our own doctor was as charming and knowledgeable. We sometimes ask if we can sign on with Stuart, but unfortunately he doesn't take human patients. In fact, I do have to take Lela back to see Stuart on Monday, for another antibiotic injection. With luck, that and the steroids will keep her going for a while yet. Thinking about that quotation above, I looked up the poem that it comes from, by Arthur Clough. It's called "The latest decalogue", and it's his take on the Ten Commandments. You can find it in this excellent online verse collection.
Lela is still not doing too well. I took her back to see Stuart the vet today, and he suspects that she is suffering from pancreatitis. He reckons that he can treat that. The alternative is that her kidneys are packing up, which would mean that she hasn't long to live. After checking her over, he gave her an antibiotic injection. Then he said that she looked dehydrated and that she needed a subcutaneous injection of saline solution to rehydrate her. He looked at me and said "I don't want you to be alarmed, because this is going to look like something out of Tom and Jerry." He went out to the back office, and came back carrying an e-nor-mous syringe, almost as long as the cat and about two centimetres across, filled with saline solution. He said that Lela would not feel this any more than the little antibiotic injection he had just given her. After the initial skin prick there is no further sensation, according to him. Sure enough, when he took hold of Lela by the scruff of the neck and emptied this gigantic cylinder of liquid through the skin by her shoulder, she did not really seem to feel it. "Okay, that went in well enough," he said, "so let's try another." He refilled the syringe and emptied it into her other shoulder. But this was not quite so successful, because as he pumped the liquid in, it started to squirt out through the injection hole that he had just made in the other shoulder. Poor Lela was not enjoying this, but I couldn't help laughing at such an absurd sight. Lela is curled up on Mary's lap this evening, feeling a bit sorry for herself. Stuart is quite concerned about her, and has asked me to bring her back for a further blood test tomorrow. He reckons that this will enable him to tell whether the trouble is with the kidneys or the pancreas. He truly is a wonderful vet. I wish more than ever that our own doctor was anything like as competent.
The cats are Mary's really, not mine. I prefer dogs. But Mary has always had cats, and I have to admit I have become very attached to our two. I had to take Lela to the vet nearly every day last week. Mary would normally have come with me, but she is so allergic to all the varied smells in the vet's office and waiting room that she can't go there any more. Not that I'm complaining - it meant that I got to see Stuart the dishy vet on Monday, Tuesday, Wednesday and Friday. As the week went on, he was more and more confident that Lela's problem was a curable infection of the pancreas, and by Friday he reckoned that she was getting better and that he didn't need to see her any more. That's too bad. I no longer have the excuse to see Stuart every day. But at least we'll no longer have to be paying vet's bills all the time. And of course we're both very pleased that Lela is more like her old self again. For the past couple of days, she has been very cheerful and lively, and it looks as though she will be with us for some while yet. But Stuart did warn us that her kidneys are not functioning too well, and that any further illness could be her last. I tried to get a photo of Lela sitting on the sofa, but she kept jumping up and running away. This was the best that I could do.
You may perhaps be wondering about my sense of priorities, seeing how I have devoted the last three entries to the cat's health problems without mentioning Mary's. It's time to redress the balance. In the five months since Mary started taking the desensitising injections, there have been definite signs of progress. She can tolerate several foods that she was previously reacting to, and she is also noticeably less sensitive to some chemical smells like vehicle exhausts. Perfumes are still a problem, which limits our social life. The worst thing is still the central heating. I can't imagine what it is about this that causes such a violent reaction, but whenever the radiators get hot Mary gets an intense pain in the chest which lingers for about a day afterwards. The allergy consultant seems baffled by this. Fortunately we have had a very mild autumn so far, and the heating has barely come on at all. One of the problems faced by people with chronic fatigue syndrome and MCS (multiple chemical sensitivities) is that a lot of doctors think that these are purely psychological conditions and don't believe that they have any physical basis. But anyone who knows a CFS or MCS sufferer will have no doubt at all that these diseases must have physical causes, although these have yet to be understood by medical science. Unfortunately, many doctors seem to have the attitude that if you don't understand the illness then you blame the patient. However, it is also true that, as with any illness, a positive mental attitude is a big help towards recovery. I was very worried last month that Mary seemed to have a very negative attitude about her condition. Especially when she was suffering a severe reaction and feeling depressed, she was saying that she was never going to get better and that life held no future for her. I wanted to be able to help her to think more positively, but without in any way giving the impression that I thought her problems were all in the mind. I think that I came up with a clever way to handle this. I waited until a day when Mary was feeling a bit happier (because she had been able to eat rice again without getting a bad reaction), and I started to talk about China. The four-yearly International Congress of Mathematicians is due to take place next August in Beijing. Mary and I had a wonderful holiday in Beijing in 1997, and we were both looking forward to going there again next year. Mary speaks quite passable Mandarin, which came in very useful on that trip, and she wanted to have the opportunity to do that again. But it would be impossible for her to travel so far in her present condition, and we had agreed that I would have to go on my own. What I did last week was to mention very casually to Mary that I have been asked to be one of the five British delegates to the General Assembly of the International Mathematical Union, which takes place in Shanghai immediately before the Congress. So as well as staying for a couple of weeks in Beijing, I shall also have three days in Shanghai beforehand. Neither of us has ever been to Shanghai, although it's one of those places that we would both like to visit. Mary's first reaction to this news was to be very envious, of course. But as I hoped, it wasn't long before she started to think that if her present pace of recovery continues then she might just be able to come with me. Since then, she has been making a list of all the problems that she would face on the trip, and thinking of how she could overcome them. It has certainly given her something positive to aim for, and with luck we might actually be able to do it.
Plans for the new year are beginning to take shape—not the New Year as such, which will probably be a very quiet occasion for us, but the weeks that follow it. We are going to Gran Canaria in January, as we have done for the past two years. This time, we shall spend two weeks there. We shall not be stopping off in Málaga to visit Steve, Jo and Tommy, because they are no longer there. They have moved further west, and are renting a house near Aracena while they look for somewhere to purchase in that area. We hope to go and visit them during the Easter break. Our friend Lorraine is coming with us for the first week in Gran Canaria. She can't stay for the second week because there are examinations at the University and she is responsible for marking one of them. So am I, but I am less conscientious than Lorraine, and I shall keep the students waiting for their grades until after I return. I went to the travel agents yesterday to confirm the booking. We have booked Lorraine to stay for one week, and Mary and me for two weeks. But what we are actually planning is that Mary will probably stay there for the rest of the winter, to give her a chance to escape from all the allergens in our house and to convalesce in the clean warm surroundings of the Canary Isles. With luck, her immune system will have recovered enough to cope with conditions here when she comes back home next spring. At the travel agent's, I was surprised to find that I was the only customer in the shop. Perhaps it's true that people are nervous of flying in the current international situation. I can't imagine why: with the heightened security checks everywhere, flying now is probably much safer than it has ever been. But I quizzed the travel agent very carefully to make sure that we shall get a full refund if the tour operator or the airline go bust or cancel the trip any time between now and January. That gives me a tenuous reason for quoting something in an email that I received today. I'm not sure that this is in very good taste, but I rely on Bruce's comment, in his latest journal entry, that it has now become acceptable to make jokes about the events of 11 September. So here goes. The London Math Soc publishes English translations of a number of Russian mathematical journals. Each journal has an English editor who is responsible for ensuring that the translation is grammatically correct and idiomatic. A couple of years ago I appointed an American mathematician, I'll call him Harry, as English editor of one of these journals. (Yes, really! An American who writes correct grammatical English: they do exist.) The Russians are a bit dubious about this appointment. They have a caricature image of all Americans as brash and semi-literate. In fact, Harry is as quiet, cultured and literate as any European, despite living in Massachusetts. (Hallo, have I lost all my American readers by now?) He also speaks very good Russian. We thought that it would be a good idea to get him to visit Moscow so that the Russians could see for themselves what a good guy he is. We wrote to Harry offering to pay for him to go to Moscow some time soon. Unfortunately, there are some very good reasons that make it impossible for him to go. He sent an email today to explain this, and then added this at the end of the message:
Well I warned you that it wasn't in very good taste, but it made me laugh out loud when I read it.
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Arthur Hugh Clough
