June 7

June 7.

It was a day, as they say. 

I got back home from Montauk at around 1:00 p.m. Just in time for a phone consultation from the oncologist who will provide Julie’s radiation treatment.

The news was, well, a lot to digest. 

There are two main options for Julie, as far as radiation goes. 

1. Palliative radiation. Just as the name suggests, this is a conservative treatment, focused on trying to improve Julie’s quality of life. It would consist of one treatment per week for four weeks, and could begin as soon as this week or next. Negative side effects are possible, but quite unlikely. The treatments cost about $5000. 

The average survival time is three months. 

2) Stereotactic radiation. Again, as the name suggests, this treatment is more aggressive, giving her larger doses in a more concentrated period of time — a treatment a day for three straight days. A CT scan is required before treatment can begin, which delays the procedure for a week or so. Negative side effects are not likely, but they are more likely than with palliative care. The CT scan itself costs about $2500, and the radiation is $8000. 

The average survival time is three months.

“Why is that?” I ask. “It seems counterintuitive, no? I would expect that stereotactic radiation would have the possibility for much better results, and the risk of more side effects.” 

“It stands to reason that you are correct,” the oncologist says. “But the data just has not shown that to be case. We see an average survival time of three months. Six months is possible, but would be considered a good outcome.”

“What is the reasonable best-case scenario?”

“If she responds well, we can give her another round of radiation in six months. Studies have shown cats surviving up to a year after diagnosis. But those are outliers.” 

As a pet owner, there’s something unseemly about choosing the cheaper option for treatment. Especially for me and Julie — I started a blog about her, for Christ’s sake! I would spend whatever is needed. I’m sure there is a limit somewhere, but it’s hard for me conceptualize what that would be. We are fortunate that we can afford it. Many people don’t have these options at all when their cat gets sick. 

But I believe in data. There is, apparently, no correlation between more aggressive treatment and a better outcome. If there were, I would choose the stereotactic option — but there isn’t. 

I’ve accepted that Julie only has a few weeks or months left. I am determined to make them the best weeks or months they can be. 

The CT scan sounds stressful and requires an extra trip. The three-days-in-a-row procedure would gird us both. The side effects worry me; it’s possible that the radiation could effectively kill her tongue. (Pardon my way of paraphrasing what the oncologist told me more artfully.) And it would not begin for at least two weeks. I’m panicked already about the amount of time wasted between today’s date and her diagnosis on May 11. Tragic little has been done for Julie in these last 27 days. 

I call Angela to ask her opinion. She’s a doctor. Maybe there’s something I am missing? 

“I think the palliative care makes more sense,” she says. “You want her to be comfortable. The stereotactic care sounds like it will be tough. The CT scan will require her to be under anesthesia. That has its own complications.” 

I didn’t realize that. Good thing there’s a doctor in the family! 

Palliative care, it is. 

These phone calls are exhausting. It’s 2 p.m., and my day has consisted of a three-hour drive from Long Island (in which Waze curiously took me through the Midtown and Holland Tunnels, and thus, through midtown Manhattan), but I’m gassed. Of course, my day isn’t done, and neither is Julie’s. We have a 3 p.m. appointment at the oncologist to see how she’s doing and do some more tests; I can barely keep track with the tests these days, but I know one is a urinalysis. After that, we have a 4:30 appointment with a pet groomer. Here goes! 

To the oncologist we go. Julie assumes her seat, shotgun, in her carrier. She’s gotten far too used to this routine over the last month. 

As soon as we hit the road, I realize we are very low on gas. I guess I was focused on getting Angela home as fast as possible, and didn’t notice the gas tank was lower than I thought. Can I make the round trip to the oncologist, the groomer, and back to home with the gas I have? Probably, but might be close. I can make it and get gas tomorrow morning en route to work. Do I really want to subject Julie to pulling over and getting gas? Of course, if I don’t, I will spend this ride panicking as I drive her there, one more stressor I do not need, worried that somehow the two of us will end up stranded on the side of the road as she misses her appointment. 

Lord, the things I stress out about these days. 

After a comical amount of wavering and overanalysis — I stop for gas. 

I live in New Jersey, a state which, if you were not aware, does not permit pumping one’s own gas. Every gas station is full-service. I pull up and roll my window down.

“What you want?” the attendant says.

“Twenty-five, regular.” 

He looks down at Julie for a second, then steps back to the pump. A new shared experience. Perhaps that is how I should view these things now — a chance to spend a little more time together. 

From there, to the oncologist again, where she passes whatever tests she get with flying colors. She’s cleared for radiation, but we still don’t have an appointment for that set up yet. I’m prepared for that simple step to consume an agonizing amount of time. 

And from there, to the highlight of the day — the groomer. 

I called ahead to make sure they knew the situation. 

“What’s your dog’s name?” they asked. 

“She's a cat. Julie.”

“Oh, okay. We don’t get many cats here.”

“She usually grooms herself, of course. But she has a medical condition now, and she can't really clean herself like she used to. Shave her pubic area, please, and from there, just use your discretion. Do whatever you think will make her most comfortable.” 

Yes, I asked the groomer to give my cat a Brazilian. 

“Does she have any medical conditions? This can be stressful for a cat, so if she has a heart condition, we need to be aware in case something happens.”

“She will be fine. Is that really that important?”

“So no medical conditions?”

I pause. “She has cancer.”

And here goes the conversation I don’t want to have. She apologizes to me several times, and I nod. 

I arrive and place Julie, in her carrier, on the counter. The groomer smiles. She’s been looking forward to this.

And in she goes! The groomer put a hilarious transparent dome-thing on Julie’s head. She looked like an astronaut. Then she’s put on a leash on the table so she can’t escape. From there, a hilarious and, to Julie, humiliating display, before a small crowd of bemused onlookers. I snapped pictures as the groomer stood Julie on her back legs to trim her belly fur, combed her, and wiped her down. Maybe it was just me, but Julie seemed to make eye contact me for a few minutes. She looked pissed. 

“I’ll just charge you for a nail trim,” the groomer said. The fee comes to $10.44. I give her a twenty and tell her to keep the change. 

Best twenty bucks I ever spent. Julie looks adorable with her shaved underside, and she seems frisky. Maybe it worked. Maybe she’s more comfortable now, absent a morass of fur she can no longer clean. And it doesn’t take her long to get over her anger; soon as I get on the couch after dinner, she’s back in my lap.