The Paradox of Care
doing right by and good for our animal companions
(this article was previously published in my Medium site)
Watching with sadness, my wife and I witnessed the decline and eventual death of the members of our four-legged family.
First the Teensy cat, one of two kittens who had survived an apartment fire in New York City, who died of liver failure in Fall 2014, just 12 years old.
Then Magnus, adopted by my wife as a young, terribly abused puppy, died in Fall of 2018, 14 years old.
Then his younger sister, Amica, adopted from a litter who had survived Huricane Katrina, also 14 years old, died in Spring of 2020.
And then in Spring 2022, Teensy’s sister, the Sassy cat, who had surprisingly outlived all the rest, died aged 19 years old.
All four of these beloved pets were fortunate to be adopted by my wife (and then later by me). She saw to it that they all received excellent medical care. In Sassy’s case, there were significant complications from the fire. She was on daily doses of antibiotics for years. Her tail went necrotic in stages, and eventually half of it fell off.
The abuse Magnus suffered required a lot of work and attention. I was the first man he came to trust, later on in his life. For years, Amica was deathly afraid of bodies of water, and would shiver and shudder when it rained. Quite a sight to see, with a 100+ pound Black Lab & Catahoula Leopard Dog mix.
They got regular checkups, boarded only with well-vetted kennels, ate high-quality foods (including marrow bones for the dogs). The cats had the run of the place, and later once I’d moved in with Andi, got to go out with me in the fenced-in yard of the place we rented. The dogs got lots of exercise, playing in the wooded yard in New York, taking long walks with me here in Milwaukee, and regular trips to dog parks in both places. Andi and I both devoted love and attention to them, and they did to each other, forming a hybrid canine-feline pack.
One can always look back and say “I could have done more,” or specifically “I should have done this thing,” for any given pet, or for that matter for any person one develops a relationship with (more about that in a bit). But for the most part, we did right by our four-leggeds. We deliberately and lovingly, day after day, year after year, ensured that they got excellent care.
And that’s where the paradox of care comes in.
What Is The Paradox of Care?
The first time I realized the dynamic I’ve come to identify as the paradox of care was the final week of Teensy’s dying. She had been in and out of our vet’s office weekly for several months. She would go off the food she and Sassy shared, and we would switch it up with a different kind and flavor of food. This went in waves, where she’d lose weight and energy, we’d find something else she could be enticed into eating, she’d regain a bit and do all right for a while, and then lose her appetite again. She spent a lot of time just cuddling and sleeping with us, her sister, and the dogs. And then she started getting jaundiced. That was close to the end.
The vets tried a lot of measures, but Teensy was in continual decline. Eventually, it reached the point where the options were
a last-ditch attempt to save her by boarding her in an emergency clinic in Albany,
bringing her home to slip into death into our apartment, in the midst of her pack,
having the vet put her to sleep with both of us there in the office.
Prospects for improvement even with extraordinary interventions were pretty poor. If she went up to Albany, it was much more likely that Teensy’s last days and hours would be lived out mostly alone, and that she would die at best surrounded by strangers.
If we weren’t concerned about the pain Teensy likely was in as her liver and then kidneys failed, we might have chosen to bring her home. Instead, I held her in my arms, and we petted and talked to her, as the vet injected the two doses of sedative into her, and she died in our embrace. That was hard on me (I’m tearing up as I write this nearly a decade later) and much harder on Andi, who had raised the two sisters since she adopted those kittens.
Sometime during all of that, the vet said something like:
It’s a shame. Some people take such good care of their animals, and that usually extends their life way beyond what they’d normally live. And then other things get them. Cancer for some. Or their organs just wear out. Infections as their immune systems run down.
And that’s precisely it. The paradox of care, or at least one main part of it.
If you love your pets, and you understand these sorts of matters (some who do love their pets don’t), you take good care of them. Perhaps even the best care you can give them. You make sure they eat good healthy food, which often costs a good bit. You take them to the vet for regular checkups and when they get sick or injured. You shell out for medicine and you give it to them as they need it. You make sure that they have love, affection, enjoyment, “enrichment” as they call it today. You try to keep them safe.
If you do that, there’s no guarantee they’ll necessarily live into old age, since all sorts of things might cut their lives short, despite all your care and concern. But odds are good that they will live a lot longer. At least long enough for their bodies to inevitably wear out and run down, often before their spirits do. It’s precisely your care that brings them — and you — to that juncture.
So paradoxically, the very care you’ve devoted to them, to keep them from certain sorts of harm, to help them flourish in their lives, is a major factor in them being subjected to, and in the end succumbing to, other things that cause harm, pain, suffering, to those beloved animal companions.
Of course, you still can — and should—continue to care for them until the very end of their lives. Not only is that a duty you have taken upon yourself. Such care is also a vital and tangible dimension of love and affection you feel towards the aging animals. It is how that general affect takes real, determinate shape each day.
Quandaries of Care — And A Needed Affirmation
The paradox of care seems a bit like a catch-22. It is not one of those general cases where there are two options, both of which ultimately lead to unsatisfactory ends. It’s not simply damned if you do, damned if you don’t. Instead the very provision of good care intended to prolong life and prevent suffering leads — most likely — to later situations where the cared-for animal will suffer for other reasons, from other conditions, for which the best you can do is continue to provide care which can ease the end of their life, but not save it, except for a little while longer.
Given this dynamic, it’s easy to envision — or to experience — people who are genuinely caring ending up feeling a sense of helplessness, dismay, and deep sadness when confronted by the mortality of their beloved animal companions. Decisions about ongoing or declining quality of life, what measures ordinary or extraordinary to consider, and what the wishes of the one being cared for are difficult enough with human beings, who at some point can communicate the levels of pain and discomfort they are in, what they feel is wrong with their body, and what their wishes are. In the case of animals, we have to determine much of this as best as we can, and make the decisions for them.
Many people feel conflicted about these decisions as they find themselves having to make them, often without particularly helpful guidance or even input from veterinary professionals. They may also feel guilty or demoralized — in addition to the grief they naturally experience — after their animal dies on their own or is euthanized. Might they not have tried a different course of treatment? Was it too soon, or too late? If you do care, it is easy to second-guess yourself in these sorts of situations.
I’ll leave off here just by writing something I’ve had to say to myself and to others who found themselves dealing with this paradox of care. Care and the motives and feelings that accompany, produce, and follow upon it — like the love, concern, and affection you feel — remain good things even if in the end they can’t stave off suffering and death.
The inevitable limitations of something good don’t alter it from being good to something bad, or even erode that goodness into something neutral. Though it is past, though the animal after its death can no longer experience it, the good you did still remains such. And even if in retrospect, it wasn’t the best that you could possibly have chosen or done, that doesn’t at all nullify the positive good that you did commit to and try to achieve for your animal companion.