Vol 30: What lies beneath
There was a time growing up in Nassau, and perhaps many places, when finding out someone had cancer was so rare that it was considered shocking. The island gossip mills churned for weeks on end with callous disregard and absolute bewilderment by the mere occurrence and in some cases friends of the newly diagnosed quietly shied away out of fear that it might be contagious.
Today, cancer in one form or another has touched nearly every family. The etiology for this exponential rise in cases is yet to be determined but scientists have theorized that poor diet and obesity may be contributing deleterious factors. Nonetheless, early detection and diagnoses, both then and now, fosters a greater chance of survival and quality of life for the patient.
Early this year, one of my patients shared the story of how his father discovered that he had cancer. Always smiling, his friends have described him as an eternal ray of sunshine so, for the sake of this report, we’ll refer to his father as Ray.
From an early age, Ray mastered multiple jobs and worked tirelessly at all of them to provide for his wife and two children. A devoted animal lover, one of his passions was breeding and training dogs so his heart was filled with happiness when a Belgian Shepherd dog (a breed similar to Dutch and German Shepherds) joined his family in 2013. From the moment he held him they were inseparable and their relationship was filled with unconditional love. He followed Ray everywhere, fell into a depression whenever they were apart and then jumped around ecstatically whenever he returned.
Then one day, a little over a year later while sleeping, Ray felt a sudden sharp pain in his right lower abdomen. It was intense enough that he got out of bed and, not wanting to disturb his wife, he made his way to the bathroom. Walking upright stretched his abdomen and subsequently intensified his pain so he hobbled around with his back marginally slumped. Fortunately after a short while the pain subsided so he went back to sleep.
Over the course of the next few weeks, his symptoms recurred but only at night. The pain became progressively worse and at some point so unbearable he had to sleep on his back for relief. He also noted during this time that his dog’s behavior changed. He began poking the area with his nose, laying his head on Ray’s stomach and constantly using his paw to lift up his shirt so that he could lick the area. It felt as if he was trying to smell something beneath his skin and because the dog that had become his constant companion repeated the action so often, Ray took it as a sign and made a doctor’s appointment.
His family physician examined him and expressed that everything seemed fine. When the pain persisted and his dog continued to lick the area, Ray went back to his doctor a month later. This time a CAT scan was performed but the results were assessed as normal by the radiologist, which coincided with his previous exam.
At this point, Ray felt strongly that something had to be wrong because the pain in his side was now mind numbingly severe. But, since it initially only occurred at night when lying down and his doctor had twice now assured him that he was okay, he decided to ignore his intuition. He was prepared to live with the pain and opted to alleviate his symptoms by taking over the counter pain medication, adjusting his sleeping habits, his diet and his mattress.
His usually calm dog, however, wasn’t willing to let this happen. He began jumping on the area and barking until one night Ray decided that he needed to see his doctor for one final consultation. He made an appointment and this time his doctor probed more deeply.
He noted that Ray had lost some weight recently but he hadn’t altered his diet or activity level to account for this weight loss. He also discovered that Ray was experiencing constipation on and off for several months and his abdominal pain was now frequently occurring even during the day. A colonoscopy was ordered. Approximately three weeks later, Ray was asked to come to the doctor’s office to discuss his test results in person. He was devastated to learn that he had stage 3 colorectal cancer and required immediate surgery to save his life.
Ray was admitted into the hospital later that evening and he spent almost one month there following surgery to remove his entire colon. When he returned home, his dog started to lick him again, but this time it wasn’t on his right side, it was along the incision that lined his stomach where his surgery was performed and he continued to do so until it healed.
Dogs have 300 million scent receptors in their nose in contrast to humans who only have around 6 million and their ability to analyze those smells is about 40 times greater than ours. In a 2015 study, dogs that were trained to detect diseases were successfully able to identify prostate cancer from urine samples with 99 percent accuracy, significantly higher than machine based odor analysis. Despite this, it’s incredibly rare for an untrained dog to detect diseases making this case all the more miraculous.
For four years following his surgery, Ray credited his dog with saving his life. They shared an indescribable love and closeness and the bond between the two was unbreakable. He continued to follow Ray around everywhere, content with being at his side and patiently waiting for him to rub his head and stomach.
Sadly, after years of remission with no symptoms, Ray’s cancer unexpectedly returned and this time it had metastasized to his liver. Ray died within days but inherently knowing that he’d exhausted all the borrowed time allowed and grateful for having been given the opportunity to do so.
The Bahamas Alliance for Animal Rights and Kindness (BAARK) was founded in 2009 after a young teenager wrote a letter to the editor of The Tribune newspaper. In it, he detailed how up to 50 animals a week, made up of strays and pets surrendered by their owners, were being euthanized at the canine control unit. Donors, moved by his words, sprang into action and now with a small but ever growing group of animal advocates and volunteers, they strive to reduce the number of stray animals roaming the streets through education projects and their spay/neuter program.
This week, another patient of mine donated a 26-foot custom designed mobile clinic to assist with their efforts. Controlling their population in this regard is the most humane solution to animals that haven’t been blessed with owners like Ray.
Ray’s son continues to provide care for the dog that saved his father’s life but this remarkable dog has never been quite the same. Not knowing if he’d done something to make his owner abandon him, he’s never exhibited the same sparkle in his eye and jumping excitement that he often did with Ray.
Once in a while, and more frequently as he ages, he’ll lay for hours next to the chair outside where Ray always sat, alone and unaware of why he hasn’t come home but perhaps hoping that someday all will be forgiven and they’ll be together once more
This is The KDK Report.
