Tails of Love for the Dying: Memories of Hospice Patients and Their Beloved Pets

By Karen Pico RN

In Tails of Love for the Dying, Karen Pico, RN describes stories of her hospice patients, their struggles at the end of life, and how their relationships with their pets add depth and quality to their end of life experiences.

This book shows how human compassion and understanding can bring healing even at the end of life. Pets hold an important role in the lives of these patients, and often show unique ways of expressing their love and devotion.

Pico brings out the joy, sadness, and love of these pets by expressing their stories in a way that can be enjoyed by everyone.

• Language: English
• Publisher: Balboa Press
• Release date: Feb 7, 2017
• ISBN: 9781504373982

Karen Pico RN

Karen Pico has been a Registered Nurse for 18 years and has worked in various nursing environments. She has received her training from Indian River State College and her Baccalaureate degree in Healthcare Administration from University of Phoenix. Hospice nursing has been her calling and many of her nursing years have been in this challenging area of nursing. Pico is also an animal behaviorist, with a certification in dog training from Animal Behavior College, and has a unique connection with animals of all kinds, enabling her to understand their imbalances and behavior issues. Her understanding of human and animal psychology has allowed her to bring her two loves together in the writing of this book. Pico lives in Rockledge, Florida with her husband, Rick, her teenage son, Bennett, the dog, the cat, and the bird.

Book preview

She Said Come

I was just a puppy when I met my human mom.

I was out on the lawn with my littermates.

Our eyes connected, and she sat on the ground.

And she patted the spot beside her.

We all looked at her, but nobody moved.

Then she said, Come,

And so, I went.

We never looked back from that day on.

We lived in the moment each day.

Wherever she went, I went along

To the park or the store or the lake.

We went everywhere together then.

She said, Come,

And so, I went.

We would play out by the lake.

She would run, and I would chase.

She would laugh and throw the ball

Over and over for me to catch.

Life was the best a dog could have.

She said, Come,

And so, I went

She grew tired more every day.

The playtimes began to dwindle,

But we would walk and talk to neighbors.

Her laugh and theirs would mingle.

I enjoyed the time with friends as well.

But she said, Come,

And so, I went.

After a while she would go away.

I wondered why she would leave me.

She would take me to a neighbor’s house.

I loved him, but it did not appease me.

She would return, smelling of chemicals and sickness.

She said, Come,

And so, I went.

I sat beside her on the couch all day

When she was no longer able to go out.

The neighbor would walk me and throw my ball,

But I just wanted to be with her.

I would run back inside to nestle in.

She said, Come,

And so, I went.

Friends would come, and nurses would help.

And I could tell something was very wrong.

Her daughter was by her side more now,

Crying and holding us both.

Her pain was calling out to me for healing.

She said, Come,

And so, I went.

A terrible day came when she said no more.

I lay on her bed and waited.

As she took her last few breaths, I kissed her face.

Her life force soon abated.

I looked around hopelessly when at last she was gone.

Her daughter slowly picked me up.

With tears, my friend held me close

And snuggled me to her chest.

And then with a tiny, saddened voice,

She said, Come, and so, I went.

Chapter 1

Meeting Meg

I carefully wove my SUV through the little lakeside park of small mobile homes and travel trailers and approached the tiny home of my new patient. She had just been admitted to hospice care for symptom management of end-stage cancer. The cancer had started in her breast five years earlier. After she had been in treatment for three years, the cancer went into remission, but it returned after only a year. This time it was found in her liver, lungs, and bones. To make matters worse, tumors had recently been found in her abdomen as well. She was only fifty-six years old and tired of feeling sick from chemotherapy and radiation.

The day her physician told her about the tumors in her abdomen, he also told her that the other sites were not responding to treatment. That was when she decided to stop all aggressive treatment and live the rest of her life on her own terms.

As I listened to the admission nurse’s report that morning, I thought about the challenges ahead of us and said a prayer for strength—for both of us.

This day was sunny and clear. Early spring in Florida has always been heaven to me. The little mobile home park was situated beside a beautiful lake surrounded by small docks with little Adirondack chairs and umbrellas set up here and there.

Most of the residences had tiny gardens with lawn decorations of various forms ranging from colorful gnomes to pink flamingos or little waving flags. It was quiet and peaceful there. I wished I could sit all day and enjoy the view and the gentle breezes playing across the lake and tickling the grass. One of the wonderful things about Florida is how people on limited incomes can still surround themselves with beauty and live happy lives in simplicity. The year-round mild weather makes it attractive for people who have retired.

I considered how fortunate I was to be able to do this work. It is my heart’s work. I am free to travel around in the allure of Florida and visit people who become my friends. I have the privilege of sharing the difficulties, pain, and vulnerabilities that illness brings and provide comfort, peace, and love from my soul. I can’t imagine anything more fulfilling in life.

As I parked my SUV and approached the front door of my new patient’s home, I heard a high-pitched barking. Small dog, I thought. I was happy to realize a pet would be part of this experience. As I waited, I heard an annoyed voice from inside trying to shush the dog celebrating the arrival of a friend.

I find such pleasure in animals. Pets are amazing healers, and some are better at it than others. Just the comfort of having a friend in a time of need is often healing by itself, and pets have a way of taking our minds off our troubles and placing them into a more creative state, the state of love. It is in this creative state where healing begins, and by healing, I mean the potential for a mind-body connection that can make anything possible. That includes physical healing miracles, psychological reconciliation, and even spiritual return to peace. I have seen these things happen many times right before my eyes.

The door to the tiny trailer opened. A wiggling, chubby Jack Russell terrier greeted me by jumping up and down happily. I couldn’t help laughing at the way he lifted his lips, showing his teeth in a way that looked suspiciously like a grin. This little dog had figured out a way to show his joy in a very human way! "Look at him smiling! He is so cute! I turned my attention to Megan. I am Karen, your nurse," I said. Megan stood back a distance, not looking amused.

You can call me Meg, she said in a gruff voice that belied her pretty, feminine appearance. She was a petite woman with short, dark blonde hair styled in a comely fashion. Come sit down. Just answering the door makes me tired. That’s Prince. He’s always been a grinner. I don’t know how he learned it, but he’s always done it.

I could sense no joy in her and felt as if she was reluctant to let me in at all. She spoke in a bland, monotone voice. She didn’t make eye contact with me, and I felt her cold displeasure as she stepped back inside, allowing the door to close on me before I could catch it. Her face seemed to be stuck in a sour frown that made me feel instantly sober. I put my playful spirit aside and focused on how she must be feeling about her situation.

I looked around the interior of her miniscule home. It was a small travel trailer that had been augmented with a carport. The carport had then been modified to become interior living space, and it was this area that I was standing in. She had transformed it into a living room that contained her couch, a chair, an end table, and a television on a stand. Crafty decorations hung on the walls, and feminine touches of silk flowers in vases were scattered around the room.

Thank you, Meg. I’ll sit next to you where I can take your vital signs and listen to your heart and lungs. As I sat next to her on the small couch, Prince jumped up and squeezed in between us. He wasn’t grinning anymore, but he looked from Meg to me, touched my hand with his nose, and then turned to begin sniffing around Meg’s belly. He loudly snuffled at one place on her abdomen. He then put his paw on the spot on her flat belly where he had been sniffing and expectantly looked directly at me.

I had heard of dogs being able to pinpoint areas of concern in people. Some seem to know when a seizure will happen or a diabetic crisis and even the scent of cancer. Dogs’ senses are much more acute than humans’. This often makes them great companions and service animals for people with medical conditions that cause limitations or disabilities. Some animals have a natural talent for knowing a person is in danger.

I remembered a story of a man who credited his dog with saving his life by repeatedly telling him about a spot on his chest by sniffing, scratching, and even biting at it. He had gone to his physician several times about it only to be told there was nothing there. Finally, through his insistence, further testing found the area to be cancerous. I realized Prince must be one of these intuitive beings who can sense when something is not right.

Thank you, Prince, I said. Good dog. He curled up next to Meg as I continued to make my assessment of her condition.

Meg and I sat and talked for more than an hour as I did some paperwork and developed a plan of care for her. During our conversation I learned some interesting things, one of which was that she had a strong aversion to taking medication. You can order medications if you want, she stated matter-of-factly, but I probably won’t take them.

I can understand your feelings about medication, I said. I feel the same way. I’ll make you a promise. When I see you struggling with a symptom, I can make some suggestions about options that may help, and you can choose how you want to be treated. Sometimes how we feel at the beginning of the process changes when symptoms become intolerable. I’ll always be honest with you and let you know what is happening to you, okay?

Okay, she replied. This is just so difficult to think about. I can’t believe that what they tell me is actually happening. Everything in me keeps saying it’s just a mistake. It can’t be real. Then she grew very quiet. As I watched the emotions play across her face and her furrowed brow deepen, I realized that she was feeling extreme anger. The vibration was palpable in the room. Her pretty face was etched in bitterness. I could see a tear trying unsuccessfully to gain access to her lower eyelashes.

At times like those, I sometimes feel the need to … well, run! But the compassionate part of me stays, and instead of running, I call on my protective angels to wrap me in the comfort of light and love. I hold on to the love in my heart to do this work in a way that benefits my clients without taking on the sadness, anger, distress, and desperation that often go along with it. I could not possibly help others through this transitional time of their lives if I were not completely stable and loving. I would be in emotional upheaval every time I lost a patient. I choose to love from a healthy heart. So I said a little prayer and dove right into the abyss of her pain.

Tell me what angers you most about your experience with cancer, I offered, knowing I had just opened Pandora’s box.

The previously subdued tears began to find their way to her lashes and slide from her eyes. They were not tears of sadness but more like those of immensely strong hatred, and she was having trouble containing the outburst of emotion that lurked just beyond the edge of her control.

"This is just so senseless! I am young, fun-loving and have friends. I mind my own business, and I’ve never hurt anyone. I have a daughter who is still young and needs guidance. I just don’t know why this had to happen to me. I’ve been taking classes, and for the first time in my life, I’ve been making straight A’s. And I’ve been looking forward to starting a new career and making my own way in life.

I spent most of my life taking care of everyone else in a relationship that held me back from my dreams. Now when I can do whatever I want, they tell me I’m dying! It isn’t fair, and I can’t accept it. I don’t want you here, and I don’t want to do any of this!

Prince looked up at her, hearing the rise in her voice. He offered a little kiss on her chin, and she pushed him away.

I see, I said. And I did. I have been in these awkward moments many times. People say things in fear and grief that may be taken personally or cause bad feelings in others. I have learned many things from working with hospice patients and their families, and one of those things is that none of their experience has anything to do with me. I may be the one who opens the door to vent the anger, frustration, or pain, and that is my honor and privilege. I do my best not to judge people for their feelings of grief, for every perspective is worthy of validation.

It takes great courage to face death, look it in the eye, and accept it. Most people cannot do that and must turn away in denial. Every emotion and fear is valid, and I have not yet found a right or wrong way to be prepared for the end of a life. Whatever choice we make to cope with the idea of death, our bodies instinctively know what to do, and the outcome always remains the same.

I hear you, Meg, I said. I know how difficult this is for you and all my patients. I’ll leave you now and let you relax. I can come next week and stay only for the time it takes to check on you. I am here for you to talk to if you need, but I’ll never force you to do or feel anything you are not ready for.

My eyes kept going to a picture on her end table. Once again, I looked at it. Jesus looked back at me from the gilded frame. This typical-looking Jesus portrayed a somewhat western-looking dude with long, light brown hair and a faraway glimmer in his blue eyes as if he could look right through you. I have often wondered how we came up with that version of Jesus. I am sure he must have looked like most Jews of is day with short hair and a darker complexion.

My mind went back in time to a large picture of Jesus I had in my room as a little girl. It hung on the wall directly facing my bed. I was a little afraid of that picture because the eyes followed me everywhere, confirming my father’s mantra that Jesus could see everything I did. Isn’t it funny how many thoughts can go through your mind in a flash when you look at a picture? A smile came to my face, one that Meg must have seen.

She said, Do you like my picture of Billy Ray Cyrus?

I looked at her in momentary confusion and then back at the picture with a little more interest that time. Amazingly, the picture of Jesus looked very much like the country music singer and actor. I laughed out loud, and she chuckled along with me.

The relief from the sadness and anger was so strong that we couldn’t stop laughing until we had tears rolling down our faces. When we were quiet again, she said, I’m not that into Jesus or anything, but a friend of mine gave me that to make me feel better. And normally, I would have thrown it out, but it makes me laugh when I look at it, so I keep it out. Prince danced around us on the couch, happy that we were laughing and no longer feeling sad and angry. I scratched his ears.

How about you and I go outside for a minute, I said to Prince. He jumped down and started doing spins and jumping up and down. Is it okay, Meg?

Sure, it will save me a trip outside. Thanks, she replied.

When we came back inside, Prince jumped back up on the couch and nestled in beside Meg, and I gathered my things to leave. Meg said, So will I see you again next month, or how does all of this work?

I replied, "No, Meg,