Our first day in Nain was as exciting and eventful as expected. The Chinook team arrived mid-morning and spent most of the day setting up our makeshift clinic in the local fire hall. Once the clinic was completed, the team was anxious to begin seeing the owners and pets who had been long awaiting our arrival. There is no veterinary care available to the community of Nain. The closest veterinarian is Dr. Becky Inkpen, a flight away in Goose Bay. Often, medical conditions are treated via phone, and there is no real opportunity for routine care. Thus, our team saw many dogs and cats that first evening for medical appointments – everything from simple vaccine updates to more complex illnesses.
The most memorable patient that I saw that evening was Max, a striking eight-year-old yellow Labrador. Max’s owners brought him and Pixie (their spunky Chihuahua) to the fire hall to see us. Over the past few months, Max had been developing a growth in the right side of his mouth. Dr. Becky had spoken with the owners via phone and sent antibiotics in hopes that the problem was an abscess or tooth infection. However, this treatment had resulted in little improvement, and by the time Max came to us, the mass had grown so much that his lower jaw had become misaligned. Max’s mouth was obviously painful to touch and his associated lymph nodes were enlarged. This combination of signs pointed to a serious cancer within Max’s mouth.
As so many labs do, this sweet boy seemed to endure his suffering with a steady grace that I could only hope to emulate. Drs. Heather Gunn-McQuillin and Peter Foley had a serious discussion with Max’s family about the likelihood that Max had a cancer and also had no reasonable chance of cure, especially in these remote conditions. While this sad news was delivered, Max seemed entirely unconcerned about the state of his mouth and continued to wag his tail at the mention of his name.
At this point in his disease, Max’s quality of life appeared to be fair. His appetite and attitude had not yet been thwarted by the painful tumor. In more settled areas, this kind of disease can be handled by providing palliative care until quality of life declines such that humane euthanasia is chosen. Unfortunately, due to the remote conditions in Nain, humane euthanasia is not possible most of the time. In order to prevent Max’s inevitably approaching anguish, his family asked our veterinarians to put Max to sleep while the Chinook Project was in town.
Non-veterinarians often surmise that putting animals to sleep must be the most burdensome aspect of the occupation. While euthanasia is by no means a cheerful subject, the ability to end suffering and maintain dignity the dignity of our animal friends is truly a privilege. The idea that without veterinary access, loving companions like Max would suffer unnecessarily is a greater burden to consider. I have participated in many euthanasias during my short time in the veterinary arena. However, I had not really confronted the fact or the implications of the fact that in some places – like Max’s remote community — this is not a possibility.
After spending the last few days with their faithful family member, Max’s owners invited Drs. Gunn-McQuillin and Foley, Paul Fenton, Nain animal wellness coordinator, and myself to their home to put Max to sleep. “At home euthanasia” is another occurrence that was unique to our circumstances in the remote community. Although some veterinarians in the south are able to offer this service, it is often impossible in busy practices; and pets have to spend their final moments with their families outside the comfort of their own homes. In this situation, though, Max was able to spend his last moments in his familiar living room surrounded by his family.
Max’s story is packed with lessons. It demonstrates the harsh reality that in remote areas, even death can be a challenge. While this may seem somewhat disheartening, Max’s supremely positive attitude was encouraging. So often animals have taught me to be a better human. And, in his death, Max reminded me how to accept circumstances with joy and focus on what is most important. To the very end, Max spent his energy loving his family. And his pure love was returned by them. The love that Max showed for his family and the devotion they had for him is truly inspiring. True love is choosing the best for one another. In their most difficult decision, Max’s family certainly demonstrated this. They loved their pet enough to choose the best for him – no matter how difficult and painful that decision was for them. In choosing to prevent Max’s future suffering, they put Max and his well being first. Max and his family reminded me what real love is. They will not be forgotten.
Liz Byers, AVC 2017, traveled to Nain in 2016 as one of the student participants on the Chinook Project. As part of the experience, the students craft various pieces of reflective writing. This is one of Liz’s pieces.