Monday, May 4, 2009

Frank & Mabel: a love story

It was a typical day for me when I made the appointment. Mabel, an elderly woman living in an apartment in the suburbs, was very worried about her 15 year old cat named Frank. He'd been healthy most of his life, but over the past two weeks, he had become lethargic, eaten very little, and was drooling a lot. She was concerned that he might have a rotten tooth that was bothering him. I suspected otherwise. I had seen hundreds of cases like this.

Cats are a rare combination of predator and prey animal in one body. When they become sick or injured in the wild or on the streets, displaying illness or weakness openly is the equivalent to wearing a bull’s-eye during hunting season. Domesticated indoor cats haven’t gotten the evolutionary message that it’s safe to whine and whimper the way humans do when we don’t feel well. As a result, when their owners finally observe that their feline companions are a bit “off,” they often either discount it or just watch them for a while to see if they’ll bounce back soon. This becomes more concerning when cats get into their teen years. They are prime candidates for kidney insufficiency and, later, failure, hyperthyroidism, diabetes, and cancer, among others.

So after giving me a detailed description of Frank’s unusual behavior by phone, Mabel asked me to come to her house to give him a thorough physical examination. She requested that I pay special attention to his teeth. I emotionally prepared myself to console and give careful advice to a very concerned, compassionate old lady whose only living companion was a cat. I would talk to her about death, letting go, and most likely schedule another appointment in a day or two to humanely put Frank to sleep.

By then, I’d been a house call veterinarian for a decade. I spent eight years and a minor fortune getting my degree. I worked at many hospitals, apprenticing under various doctors before becoming one myself. That experience was fun and interesting, full of exciting growth and learning. My job was simply what was in front of me.

I barely lasted a year in a busy practice after graduation. I was well paid considering the profession’s usual slim salaries. I was respected, and had found one of the best associate positions available to me at the time. I hated it. It felt like an endless, miserable assembly line to me. Everything moved so quickly that I didn’t feel connected to my clients or patients at all. Most of the animals were terrified, the staff felt disrespected and could barely make a living, and the clients, after sitting for up to an hour in the waiting room, felt rushed by the veterinarians and then overcharged. Nobody seemed happy there to me. A friend of mine, who had graduated a few years earlier than I, confessed that his closest classmates all hated their jobs. It was a depressing realization after a life-long, arduous struggle to become a veterinarian. One colleague said that she’d rather be doing anything else, though I recall that she hadn’t been treated very well by the owner of the practice where she worked.

By the time my contract expired the following year, I resigned and immediately started my own business treating cats and dogs in their own homes. The contrast was dramatic; no sterile rooms, no office politics, and no frantic rush -- just a relaxed visit in a family’s living room or kitchen. I didn’t have twenty to thirty animals to treat per day; typically just five or six. I didn’t rush through an appointment in 15 to 20 minutes; I took the time that was necessary to get to know the animals and their owners in the comfort of their homes, as well as attending to the medical or behavioral issue at hand. And most importantly, pets were no longer in a hysterical state of fight or flight. While some may have been slightly upset or concerned, most didn’t behave as if their lives were at stake. Many were absolutely thrilled that someone had come just to see them!

I entered the apartment dwelling where Mabel lived. She was well into her seventies and had lost her husband some months earlier. Frank had belonged to both of them and was the last living connection to her beloved. Except for her feline friend, she lived alone.

I knew I had grossly underestimated Frank’s condition as soon as I walked through the door. He lay on a sofa in a contracted upright position, intentionally frozen in place to minimize the suffering. His jaw rested heavily on the fabric and his forehead looked as if it would sink into the couch. There was a steady stream of saliva coming from his mouth, and based on the layers of towels covering the furniture, it was evident that he had been living like this for some time now. I winced in empathy.

Frank was a typical teenaged cat suffering from kidney failure. He was nothing but skin and bones, and most of his muscle had been metabolized by his own body to fulfill nutrient requirements. His eyes were sunken, showing signs of severe dehydration. His case was quite advanced based on the ulcers throughout his mouth; thus, the drooling.

As I was directed to a chair next to the sofa, Mabel did something that very few of my clients had ever done. It made me smile! She approached her companion and said, “Frank, this is Dr. Rennings.” I was stunned. I have always viewed animals as equals. Equal and different, just like people. The more they are talked to and interacted with in this manner, the more refined their behavior becomes, and the more well adjusted they feel living in an alien world. It is alien to them; some more than others, depending on their environment. Talking to them also greatly improves their self-esteem and understanding of our, at times, seemingly bizarre behavior.

Frank casually looked up at me from his internally fixed state like a waking zombie. He stared me right in the eyes and seemed to say, “Nice to meet you. You’re different.” I get that a lot! I’ve studied animal behavior and their culture my whole life. I trained and showed dogs throughout my childhood and adolescence and instructed classes as a teenager. I engrossed myself in the methods of the most gifted “horse whisperers” for over a decade, culminating into a beautiful experience of communion with my four-legged partners. I had bred and raised two foals with this approach and could point and send them over a jump from the ground like a well trained dog. I could lead them by holding a few hairs from their mane or forelock, and ride them without a saddle or bridle in an arena. They responded to the slightest touch from my hands or legs and changed directions to follow the focal point where I was looking and the resulting curve of my body. Later, I became intrigued with the idea of training cats and used many of the same tools that I’d learned from the pack and the herd. My two rescued friends, Simon and Sam taught me their delicate language and subtle intricacies of the feline world. They both ride in a car without a carrier, come enthusiastically when they’re called, go for long hikes in the woods, and sit politely waiting for their food at meal time. I used to take Simon into stores, to friends’ houses, on errands, and once had him sit and stay with a leash and collar attached to a picnic table outside a restaurant while I picked up dinner. He calmly waited while I watched him through a window, knowing he’d get a treat when I came back.

With this background and many years of veterinary house call experience, and with an insatiable passion for the fine art of animal communication, including apprenticeships, classes and certification, I’d developed an ability to read animals very quickly and accurately. Sometimes I could hear them conversing with me, just like chatting with a friend. I heard Frank that day as clear as a bell. He was used to being heard, acknowledged and honored; just not with guests.

I was very concerned about Mabel. Frank couldn’t hold on much longer and then she’d be all alone. I told her that we could run blood-work to determine the exact nature of his illness but that at this point, the answer would be an academic one. He was dying and the cause was a moot point as far as he was concerned. I explained that I could hold him down and frighten him by taking his blood, charge her a lot of money for the service, and then wait a day to get the results back. But the outcome would be the same; he needed to be put to sleep. And soon.

In their hearts, most clients know the right thing to do. But they are often deeply conflicted by the intensity of their feelings for their pets. They just can’t bear the thought of losing their best friend and, typically, their only source of unconditional love. It usually takes some time for people to come to terms with the idea and be at peace with it.

Mabel had more to lose than most of the people that I’ve cared for as a veterinarian. She had every right to fight and say, “Please, just give me a few more days with him.” That’s a common response to the suggestion that one’s dog or cat is ready to die. She was extraordinary in every way, though. As I talked, I could tell that in spite of her loneliness and the relationship she had with a very special cat, I didn’t need to handle her with kid gloves. She was emotionally mature and mentally acute. I read her like I read animals. I asked, “You knew this was coming, didn’t you?” She nodded. She didn’t want him to suffer. I asked her if she wanted to wait 24 hours and spend some quality time with him before she said goodbye. “No,” she replied after a few moments of calm consideration. “If he’s in pain, I don’t want him to wait any longer.” I was surprised and relieved.

We made plans to have Frank’s body cremated, took care of paperwork and I drew up a hefty sedative to take him down to a surgical plane of anesthesia before I gave the second shot of barbiturate. It was all going so smoothly.

Then things became complicated. I came back to address Frank and he told me very clearly and authoritatively that he wasn’t going anywhere.


He felt responsible for Mabel’s well-being and he loved her unfathomably. “She’s alone,” he explained. “I can’t leave her.” Mabel was fussing in the kitchen, looking for her checkbook.

“Frank, your body is failing. It’s time to go.”


So this was the difficult negotiation that I had to handle. It’s usually the other way around.

“What if I find someone to be with her, Frank?”

“Yes,” he decided. “That’s a good idea.”

Mabel was completely unaware of the tense dialog going on in her living room. I found her writing a check with terribly shaky hands. She was trying to be brave but, inside, she was crumbling. Frank was right.

“Is there anyone that you can call to be with you while we do this? You really shouldn’t be alone,” I offered gently.

She pondered this for a moment. Why, yes. There was the lady who had referred me to her and she lived right upstairs. Mabel phoned her and she was happy to come right down. Providence! The Good Samaritan arrived in just a few minutes and gave Mabel a big hug. They seemed to be close friends. Okay, we’re on, I thought to myself.

So while they talked, I conferred with Frank again.

“So it’s all set, Frank. You can go.”



This time he explained that the kindly neighbor would help Mabel out in the short term, until the “job” was done and then she’d be alone again.

“Okay. Hmm…”

I joined Mabel and her friend and delicately asked if there was a family member who could stay with her after Frank was gone. Yes, she did have a daughter that lived a short distance away. But she didn’t want to bother her. She lived such a busy life.

“This is a big event, Mabel. Could you just ask her?”

She dialed the number with trembling fingers. Luckily, there was an answer on the other end and Mabel began speaking and crying at the same time. Her daughter rose to the occasion and said she drive right over.


Once more, I came face to face with Frank. He’d been the rock all the way through.

“So, Frank, is everything okay now? Can we proceed?”

He sat in what appeared to be a meditative state. He was weighing everything and watching Mabel with his eyes and his heart. He lingered there for some long time.

Without another word, Frank raised his weak, frail body from the sofa that had been his throne. He hadn’t moved an inch save his head to communicate with me the entire time I was there, which was the better part of an hour. He hopped down to the floor, walked over to the chair I had sat in, and with more grace and dignity than I thought possible of his tired, bony frame, he jumped into the seat. Beside it lay my box of supplies and the powerful sedative that I’d drawn up in a syringe for him.

“Okay, Carin. It’s time.”

Home Veterinary Service
Carin Rennings, DVM
* Holistic & Conventional Medicine
* Behavioral Therapy
* Serving Howard County
(410) 461-9969


  1. WOW!!!!!!!!!!! Carin this is great!!!! I am glad you have found an place to write... looks good and keep it up!!! Hugs Marni

  2. The tears flowed, not just for Frank and Mabel, but also for me and for the cats and dogs early in my life that I was too immature to understand. There is great sweetness here as you non-judgmentally construct a heart-centered situation in which characters interact from deep places. How wonderfully filling! Great blog, Carin! I want more. - Brian

  3. Wow, what a sharp turn this story took. Very touching. It brought back to majestic, dignified final hours of my Heidi's near 12 year life. And you've inspired me to write about it for my blog.

    I am now ready for my next female German Shepherd. We haven't found her yet, but we will soon and I am pleased that you will be Brigita's godmother.

    Keep writing, doc. Al

  4. I just reconnected with "Mabel's" neighbor. They both read the story and were moved. I'd always wanted to go back and share what had happened with "Frank" that day and it finally happened. Funny how things work out that way.