Ethel’s tale isn’t very remarkable, I’ll admit.  I know nothing of her early years, and her adult years were relatively run-of-the-mill.  It’s Ethel’s later years, however, her geriatric years, where she showed her true colors, her strength in the face of illness, her generosity, her patience, and her sensitivity.
 
In 1996, after completing my residency in small animal internal medicine at Colorado State University, I accepted a position as chief of staff and hospital director of VetSmart Pet Hospital and Health Center in Columbia, Maryland.  VetSmart was a corporate chain of veterinary hospitals, and every VetSmart hospital was located adjacent to a PetSmart store. 

PetSmart was active in promoting pet adoption, and the Columbia store had a popular and well-maintained adoption center inside.  Our hospital had an agreement with PetSmart: if any of the cats or dogs that were up for adoption were to become ill, VetSmart would take care of these pets, at a discounted price.

One insanely hectic afternoon, one of my technicians caught me as I was zipping in and out of the exam rooms, and told me that one of the
PetSmart adoption cats was in a cage in our ward, to be examined after I finished
seeing our scheduled appointments. 

Several hours later, after all the dust from a busy day had settled, and all of the clients had gone home, I peeked around the corner into the ward, and there she was:  A pudgy little mackerel tabby, somewhere between the age of 10 and 12 (according to the adoption center), with tiny feet, a short tail, and a left ear with a ragged edge.  As boring and undistinguished looking as any cat I’d ever seen.  With runny eyes and a snotty nose, to boot.

I put her on the exam table and gave her a complete physical.  Nothing Earth-shattering to report – just an upper respiratory infection.  Exhausted after a long day, I leaned back to relax for a minute before returning her to her cage.  Before I knew it, this congested little kitty was pawing her way onto my chest, and then settling in for a major session of flesh-kneading, face-rubbing, and head butting.  I was smitten.  

“What’s this cat’s name?” I asked my technician.  “They don’t have any name listed for her”, I was told.  Hmmm.  For a sweet pudgy little old lady cat, I figured “Ethel” was as good a name as any.  And so she was newly christened: Ethel. 

Ethel’s recovery was swift, but I confess to being a little slow when it came to declaring her “recovered”, to avoid returning her to the adoption center.  I inquired as to how long she had been up for adoption.  “Over a month”, I was told.  It seems that the kittens were flying out of the adoption center, but nobody had shown any interest in a nondescript mature cat. Well, after hearing that, it was settled: Ethel would soon be joining Gigi, my sweet geriatric longhaired tortie, as the newest addition to my household.

Ethel blended into the household seamlessly.  She readily accepted Gigi (although Gigi wasn’t too thrilled with the arrangement, at first).  While never bosom buddies, Gigi and Ethel ate side-by-side, and even slept on the same bed (though at opposite ends). 

In 1998, I was invited to join the ASPCA as their vice president of animal health.  Excited at the thought of returning to my hometown (New York City), I accepted the position, and packed up my belongings, including my two most precious feline possessions, and off we went to the Big Apple. 

Things remained stable, kitty-wise for a few years.  Gigi, aged 15 at this point, was on a special diet for mild chronic renal failure, and was doing well.  Her kidney disease was stable, but she was feeling the effects of old age, gradually getting thinner and sleeping about 20 hours a day.  On December 31st, 2001, I left my apartment at 10:00 p.m. to attend a small New Year’s Eve cocktail party.  When I returned about five hours later, I discovered that Gigi had passed away in her sleep, peacefully in her bed, at the age of 18 years, 2 months.  Ethel was now the queen of the castle.  But not for long.

As I continued to work at the ASPCA, one of my duties was to oversee the medical care of some of the cruelty cases that we were presented with.  One morning during my hospital rounds, I encountered in our Intensive Care Unit a tiny kitten that had been scalded with hot water.  On intravenous fluids and swathed in burn cream, she looked completely helpless.  I told Sadie, the head ICU nurse, that if this little kitten pulled through, I would take her home and make sure she lived a pampered, stress-free life forever after.  Needless to say, the feisty little kitten whom I dubbed “Crispy” (um, a black sense of humor is one way we cope with the cruelty cases) survived her ordeal (although her ears and tail, all badly burned, did not).  Ethel was about to acquire a playmate.

Baby Crispy was a total maniac when she got home. Crispy’s entire existence was focused on play.  Play play play.  Nap. Eat. Play play play. But Crispy’s maniacal side brought out a side in Ethel that I had never seen.  Ethel handled Crispy with aplomb, reacting to Crispy’s insanity with a gentle firmness that, to the average observer, might be considered “maternal” in nature.  With Ethel being a senior citizen, however, I suppose this transcended “maternal”.  This was “grandmaternal”. 

When the ill-mannered Crispy grabbed her favorite toy and goaded Ethel to play, a seemingly disinterested Ethel knew not to indulge Crispy immediately, teaching Crispy to ask nicely and be patient, before caving in and playing for a little while.

Crispy hung onto Grandma’s coattails, learning the rules of life, such as how to eat slowly and politely. If Crispy got a little out of hand, one swift but gentle swat with Ethel’s tiny little foot spoke volumes.  In no time, Crispy grew into a well-mannered young lady.  (A bit of a diva, but that’s my fault, not Ethel’s).The age disparity between Ethel and her new roommate brought out Ethel’s hitherto untapped grandmotherly instincts, and it was this role as Grandma that defined the last years of Ethel’s life.

Illness is a fact of life, and Grandma Ethel’s geriatric years were not without their medical ups and downs.  Like most senior cats, Ethel developed chronic renal failure.  Thankfully, her case was mild, and she readily accepted the restricted protein diets that are an important part of the therapy, and Ethel remained symptom-free.  She later developed hyperthyroidism, and after months of struggling to find innovative ways of medicating her (when Ethel says she’s not taking any more pills, the issue is settled), one dose of radioactive iodine cured her thyroid condition. 

In early 2003, just a few weeks after my hospital, Manhattan Cat Specialists, opened, I noticed Ethel was having some trouble navigating my studio apartment.  She seemed tentative on the steps leading up to the sleeping loft, and she wasn’t spending as much time nibbling at the food bowl as before.  I examined her eyes and was disheartened to discover that Ethel was suffering from age-related retinal degeneration, leading to a gradual but steady loss of vision.  In just a few weeks, it was apparent that she was nearly totally blind.  I had already observed that her hearing had been slipping as well. Ethel’s gradual drift into a world of darkness and silence took its toll, and unable to negotiate the steps to the loft and the two little steps to the litter box in the bathroom, Ethel’s condition began to deteriorate.  Obligated to devote enormous amounts of time to my new practice, I was unable to provide Ethel with the attention she required at home.  Grandma Ethel required round-the-clock nursing care.  Very conveniently, I had just built the nursing home!  So, in March 2003, Ethel joined our staff as official mascot and permanent resident.  Exam Room 1, our smaller exam room, became her home.  With her bed, food bowl, and litter box all within a few inches of each other, Ethel couldn’t be happier.

Ethel thrived in our new hospital.  Determined to make up for the weight loss she experienced over the past two or three months, we encouraged Ethel to eat as much as she wanted, as often as she wanted.  She quickly hit 4 lbs, then 5 lbs.  In a few months, she was back up to her ideal weight, 6 ½ lbs.  Perhaps we were a little too enthusiastic in our pampering, as she hit 7 lbs, and then hovered around 8 lbs for a few weeks.  Once again, she resembled the pudgy little old lady I first encountered years before.

Ethel learned the layout of Exam Room 1 very quickly.  Soon, she began to venture out, quickly learning where the waiting room was, much to the delight of our clients who were easily charmed by Ethel’s good nature.  We set up a bed in the waiting room, and Ethel made that her new residence during the day.  Now visible to passersby on the street, Ethel quickly acquired a fan club, receiving all visitors (mostly neighborhood children, with parents in tow) with warmth and grace.

Around this time, Ethel developed a weird irritation in her left eye.  Despite constant monitoring and medication, the eye did not respond to any therapy and began to bulge and become painful.  Even though it was already a sightless eye, it needed to be removed.  Ethel’s surgery went well.  After removing her eye, I was curious as to the cause of the irritation, and elected to have a pathologist examine the specimen.  The diagnosis: lymphosarcoma, a malignant cancer.  The prognosis was gloomy.  Recurrence was likely, according to the pathologist. 

In July 2003, our receptionist Joshua came in to work holding a scared, dirty little gray tabby kitten.  Cowering under a car in the middle of a busy Manhattan street, Joshua managed to corral the little fella and whisk him into our hospital.  With both eyes badly infected, this little guy was a bit of a mess.  However, a bath, some antibiotic ointment, and lots of TLC solved his problems pretty quickly, and before long, he was escaping from his cage and darting up and down our hospital corridors as if he owned the place.  Eager to find a playmate for my cat Crispy I decided to give this kitten, now dubbed “Crunchy” a home.

Bad move.

Crispy and Crunchy were like oil and water.  Despite Crispy’s clear signals that she did not want to be bothered, Crunchy made a sport out of tormenting her at every opportunity.  He would not let her sleep in peace.  He would bother her while she groomed. He would pounce on her while she ate.  He even would pester her while she was in the litter box!  Whenever Crispy tried to set some rules, Crunchy would violate them.  Crispy was miserable, and fled to the highest points in the apartment, growling at the mere sight of him. Crunchy was frustrated, wanting to play, seeking a partner in crime, but not possessing any manners about it.  I had no choice but to bring Crunchy back to our hospital.

Remembering Ethel’s positive influence on Crispy, I decided to introduce the two of them, in the hopes that Grandma Ethel would teach rude grandson Crunchy some manners.  Apparently Ethel sensed that Crunchy needed some guidance, and she immediately took him under her wing.  Crunchy, having to fend for himself on the harsh streets of New York City without his mother, seemed to welcome the grandmotherly attention.

However, any time Crunchy began to reveal his tormenting tendencies, a swift smack (and when he really deserved it, a quick nip) from Ethel, and Crunchy backed off and chilled out.  Crunchy was becoming a star pupil in Ethel’s charm school.

Crunchy’s transformation was soon to be tested.  Christophe and Ellen Franzgrote, clients of mine whose beloved cat Annie succumbed to intestinal cancer a few months prior, were taken with Crunchy’s handsome face and feisty disposition, and were looking for a companion for their cat Lucy, now lonesome after the death of her housemate.  Warned of my experience with Crunchy, but aware of his recent stint at Ethel’s charm academy, the Franzgrotes cautiously brought Crunchy home.

In just 48 hours, Lucy and Crunchy were inseparable: sleeping together, grooming each other, eating together and wrestling for hours. Ethel’s patient yet firm manner with Crunchy taught him the manners necessary for his smooth integration into a household in which a resident cat already held court.   The results were clear: before Ethel = thug; after Ethel = angel.

Ethel settled into her routine here at our hospital.  Everyone looked after her, cleaning her feeding her, cleaning her litter box, and letting her be the Grand Dame of the hospital.

A few months later, a woman came into our hospital with a young male cat, asking if we could take him.  Apparently, she had four other cats, and simply couldn’t care for a fifth.  We told her that we were a small hospital and didn’t have the capacity or resources to serve as a shelter.  However, we could make some recommendations.  While searching for our list of humane societies and rescue groups, we couldn’t help but notice how friendly, handsome, mellow and good-natured this cat was.  Let’s face it: I’m a softee.  I caved in, and agreed to take him in, knowing that one of our clients would surely fall in love with him and agree to adopt him.   Thus, “Petey” joined the MCS family.

Little did we know what an absolute joy Petey would turn out to be.  A big teddy bear, with giant feet and a giant heart to match, Petey was the perfect hospital cat, saying hello to every client, and to every cat that crossed his path.  He drank water from the faucet and leaped after flies like a gazelle.  Of all his wonderful traits, the one that endeared him to our hospital was his kind and gentle manner with which he treated Ethel. 

Petey liked to sleep in a bed near the reception desk, while Ethel slept in her own bed, in Exam Room 1.  Once in a while, however, Ethel would be stricken with a desire to roam around the hospital, and would delight in discovering a new bed, which she quickly commandeered.  One day, while wandering aimlessly around the hospital, Ethel discovered Petey’s bed.  This time, however, Petey was in it, sleeping soundly.  Ethel was undeterred.  As we stealthily watched from across the room, Ethel squirmed and tunneled her way into the bed, along side Petey.  Awakened by the commotion, Petey seemed bewildered.  Yet he did not hiss.  He didn’t growl.  He didn’t fight.  He didn’t flee.  He simply moved over, gave her a little space, put his arm around her, and peacefully drifted back to sleep.  While Ethel never seemed to mind mentoring the kittens, I think she missed having an adult cat around.

As the months passed, Ethel had her ups and downs, health-wise.  The cancer that caused her to lose her eye never did recur.  However, every few weeks, she would have a few days where she would stop eating her usual diet, and we’d offer her a veritable smorgasbord of cat food (and people food) in an attempt to jump-start her appetite.  Blood tests were invariably normal,
and physical exams were unremarkable. Half the time, we had to resort to force-feeding, much to her annoyance, until, without explanation, she would resume eating.  She usually wouldn’t gain back the weight that she’d lose during these episodes, but she’d maintain her new, lighter weight for a few weeks, until the next inexplicable episode.  In June and July 2004, these episodes became a bit more frequent, yet she stubbornly pulled through every time. Having weathered more ominous health situations (hyperthyroidism, renal disease, blindness, cancer of the eye), we came to regard these episodes as more of a nuisance than anything else.

In the last week of August, however, Ethel’s appetite declined significantly, and our usual nursing care was having no effect.  On the fifth or sixth morning, Ethel looked awful.  The floor of Exam Room 1 was spotted everywhere with fetid diarrhea, and Ethel was lying in her litter box, weak and unresponsive.  After bathing and hydrating her, we monitored her throughout the day.  That night, I took her home, expecting her to pass away.  Always the fighter, Ethel made it through the night, and briefly looked a bit stronger the next day, however, it was clear that she wasn’t going to pull through this episode.  No longer able to control her bladder and bowels, and unable to stand without assistance, our dear Ethel was miserable.  Although she was very weak, she violently resisted force feeding, mustering all of her strength to defend herself against the feeding syringe.

Enough.

After nearly two decades of a charmed life, it was time to help Ethel leave the world peacefully and with some dignity.  And so, after wrapping up a busy Saturday, on September 4th, my technician Hiromi and I gently put Ethel to sleep, in her favorite bed. 

As she passed away, a little piece of my heart went along with her.  Although we all knew it was coming, my staff took the news pretty hard.   Our morning receptionist, Joshua, took the news particularly hard, as tending to Ethel was a big part of his daily morning routine.

Life continues at Manhattan Cat Specialists pretty much as usual.  We continue to make the sick cats feel better, and help the healthy ones stay that way.  Time heals all wounds, and in time, we’ll feel Ethel’s loss less and less.  I’m sure if won’t be too long before the planets align just right, and the perfect cat appears at our hospital, uninvited, most likely.  If it turned out to be a pudgy little female mackerel tabby, well, you certainly won’t hear any complaints from me.

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