Category: Human Spirit

Cleansing

Joanne Dragun, M.D.

Last evening Jacksonville, Florida opened its beaches. Couples and families piled into jeeps with surf boards and bikes and raced out of my neighborhood (just 5 miles from the beach) at 4:30. Crowds jostled toward the surf at 5 PM on the dot as if they had just escaped from prison. There was a collective sigh of relief, not always hidden by a face mask,  but the exuberance and joy was evident everywhere. It isn’t even warm enough to surf or jump in the waves but people wanted a cleansing for themselves not just door knobs. Its been a month of fear, frustration, lack of schooling and loss of income and as children played in the sand, couples walked hand in hand, surfers tried to keep a distance, the sense of community said “Enough!” Many think, “If I get Covid so be it. I will take the risk that there may not be a ventilator for me.” The farther along we are with the management (there is no treatment yet) we realize ventilators are often not the answer. My responsible comment is to say, “Please stay home until its safe as to not overwhelm the system”.

The stay at home orders and shutting down of all elective surgeries and medical care resulted in hospitals now half full. Everyone is waiting for the surge, terrified of what happened in population- dense New York. It will not happen everywhere, but an outbreak in South Dakota shutting down a meat plant, demonstrates how infectious this disease is and insidious. A football player who never left the house gets infected but an ICU nurse with inadequate PPE does not. It seems so random. We do however, need to have a sense of caution. We also need to stop hiding in fear. In 5 days we will know if the Jacksonville experiment was safe or a disaster.

So how will we proceed ? I like to take a page from our patients. They are some of the most vulnerable yet they behave as if there is no risk. After all, the real threat is a cancer they are managing and treating. They do not have the energy to battle everything or the luxury of staying home. They show up everyday and teach us how to handle a crisis.

We all have friends and family with cancer who for years have walked boldly out the door to face the unknown, maybe with a scarf on the head, a badge of courage over the porta cath, a bag of knitting or work laptop for time in the chemo chair. They are not afraid. They come for toxic, scary, debilitating therapy and say, “Bring it on!” Cancer is also an unseen demon that took up residence in them without warning. No Clorox or Lysol can make them immune. They cannot wash their hands of it. If they hunker down at home in fear and sadness, they miss their chance for improvement or cure. And so they show up again and again. Our patients teach us about self care and recovery. Although some of us have not been exposed to this virus,  they are a reminder that we have been exposed to courageousness, fearlessness, determination, even fierceness. These are contagious too.

These brave individuals give us hope. They teach us that the real cleansing we all need is refreshing our minds. This fear will not be sprayed or wiped away. Cleansing our thoughts of worry and fear is therapeutic. Open the doors and windows and let the fresh air circulate to reduce the virus and “wash” the air.  Shut off the TV which is stealing our comfort and peace- the “news” is a threat we have allowed into our homes and is like a virus itself. Open your environment to a new way of thinking. Read a good book, dance to music, take a course on line, write a journal, tend a garden, do yoga, spend time in the sun which seems to kill this virus (thank goodness). Recovery on every level from this pandemic will take much more than testing and tracing. It will be personal for each of us. It will require us to face the unknown just as my patients do everyday. Trust that you will leave your home and venture forth with deliberate bravery.

Cleansing your spirit is a first step.  Welcome in the joy of freedom with each breath and prepare yourself to go out and face a bright future. It will require a mask, social distancing, honoring our immunocompromised and elders to keep them safe, washing our hands and not touching our faces, but you’ve got this down by now. Cleansing is a way of life. You are well prepared to take back our world!

 

THE RISING

Joanne Dragun, M.D.

We have all been instilled with amazing grace. We each have internal fortitude beyond what our thoughts can bring to awareness. Human history is defined by suffering, but it is our own personal pain and persecution that can seem so unbearable. There will be prayers passing over and Easter Resurrection this week and in each, the collective religions and universal humanity will offer up this new suffering in hopes of rebirth.

Now more than ever we must draw strength from the generations before us. Money, food, jobs, even health have been forever changed. Isn’t that true for the Jews protecting their firstborn in the passing over?  Jesus’ disciples being persecuted? More recently the grandfathers who went to the city dump to find shoes for their children in the great depression?  The parents who fought for years, not a few months, in WWII and the men and women who battled in Vietnam and mid-east? Weren’t there times when the pain and suffering was so great that the world as they knew it ended?

We are here today because they did not give up. We do not have all the answers- not for cancer- not for this virus and not for the economic challenge ahead. Neither did they. But every one of us can get up, reach out, pray, plan, and be strong for those to follow. A friend is sending videos of her new grandchild getting ready to crawl. She pushes back and forth in what looks like pushups with such anticipation and energy. She will get there, she will bring hope and light because she has a beautiful future.

In war, as my husband says, its not the country you fight for its the man beside you. So let us fight for each other. Let’s be strong together. While in this pandemic, governments can help, but no government has ever saved. For that we need higher power. We need to pray boldly and be unafraid. We must believe that this pain will Passover. We should believe in the Resurrection and for ourselves. Belief is necessary for the future and  no one has power over what you believe. We are in our own (literally) trenches. I believe the pain will pass. I believe the suffering will diminish. I believe that this pandemic and trials will define a generation and history will find we were resilient and strong. I believe if we pray as one voice we are heard. I believe you have within you every cell of compassion, hope, and strength to survive this and that we will each find our way to thrive again.

Your personal Resurrection is coming, just believe it. Jesus may have opened the way but His followers found hope, persevered and spread His teaching not for a generation but world wide for over 2000 years. This virus may be highly contagious but you have weapons against it- Belief is contagious, courage in battle is contagious, strength is contagious, laughing, positive attitude, joy, empathy,  and gratitude are all contagious. Let’s open our hearts to hope together.

Now put on a mask or scarf and go out for that walk, knowing that you are not alone. You are in a family and a community of believers.

God Bless you this Passover and Easter season. Have faith that we will all hug our loved ones soon.

 

Going viral

Joanne Dragun, M.D.

If the corona virus doesn’t make us sick, the hysteria will. Are you considering becoming a “prepper” or risk being left without toilet paper or God forbid chocolate? Well hang on because its becoming a bumpy ride.

There is no cure for the common cold and more people die from the flu so let’s get real here: community acquired diseases threaten life everyday, especially in people with significant advanced age and co-morbidities. The panic in China and the petri dish of the Diamond Princess served to escalate the craziness of an ailment that will remain with us and likely not have a ready cure or vaccine. We live with salmonella yet still dine out, we have a cold several times a year but still work, play and engage. These are just some examples of ubiquitous illnesses that we have learned to “deal with” and not over-manage.

If I knew there was a norovirus on a ship, I’d stay away. If a country had a plague-like environment with people dropping on the street, I would cancel my ticket. There are definitely times when a change in plan is necessary, but panic is not.

STOP TOUCHING YOUR FACE! You don’t get the virus through skin. Its when you touch something that has a virus droplet from a cough or sneeze then you transmit it to your nose or mouth. The virus enters thru the nose so turn away and distance from someone coughing. If you had a cold or flu, its always best not to go to work and infect others so same rules apply. Stay home. I would choose to not go to a hospital unless I became ill with fever and shortness of breath and then call ahead so no unsuspecting healthcare worker engages without proper precautions. If you are immuno-compromised or on chemo, stay away from crowds, family with cold or flu, wipe all hi-touch surfaces in your home with disinfectants or bleach, hydrate, don’t smoke or drink alcohol.

If it comes to your town, stay out of hospitals for elective procedures, be aware that confined areas: cruise ships, jail, nursing homes (so many similarities) infection spreads quickly. Travel bug now has a whole new meaning. Children (aka petri dishes) tolerate the virus better then parents and especially grandparents, but can be carriers so no visiting a frail grandma or the nursing home for now- Skype. Wash hands constantly and when you cannot, carry hand sanitizer and wipe your phone down too. Stop touching everything in public. Carry a paper towel for buttons, door handles, etc. then discard quickly. Shut off faucets in public with towel not the hand you just washed. I like to imagine my hands are covered in sticky candy so I touch things less and wipe them more.

You will get a cold, you may get the flu, you probably won’t get Covid 19, but be smart to stay well and grateful that the US health system, even during panic, will make every effort to rescue you. Focus on what is wonderful today and shut off the news. Take a walk in nature and breathe deeply to refresh. What drove people crazy in quarantine wasn’t lack of fast food or Starbucks. It was removal from social interaction. We can still virtual hug. Let’s help others where and when we can. That will have more impact on our lives than fear.

For updates: https://www.cdc.gov

Powerful forces

Joanne Dragun, M.D.

What passes as “news” can only leave us with one conclusion: no matter your wealth, power, business acumen or intelligence, no one is immune to outside forces. President, CEO, prince, icon, there is only so much we can control. Its a fallacy that’s life long: if we get an education we can control our career. If we exercise and eat well we can control our health and perhaps longevity. If we avoid toxins we can avoid cancer and heart disease. If we pay bills we can keep our house. If we don’t drive under the influence we can avoid jail. While there are positive effects of these behaviors, real control a fantasy.

Why the fatalist attitude doc? You are depressing us. My hope is to have you see that the real power is coming from within, not outside forces. Were you in control when you met your spouse, discovered a career you love, met a close friend, raised a husband, I mean child, came upon a place you love to visit, found that you have a hidden talent? No, most of this was serendipity. We read articles and search the web hoping we find just the right cure, a new discovery of magic that erases all woes (or wrinkles). Lets not be ridiculous.Its impossible.

So what’s the message? We only have control over our reactions- to the insult, the pain, the illness, the fun event, the loving gift- all of it. This is actually a great place to be. Instead of ping-ponging around and living a life confused, damaged, fearful or messy, get in the habit of watching your life like a bystander and decide for yourself if you will engage. It’s the reason we started the year with meditation. This practice, even a few minutes per day, helps us with that awareness.

There are decisions we get to make- will I accept treatment, where will I live during therapy, should my husband be in hospice, but decisions are not control. Relieve yourself of the burden and some days just control your breathing while the world tumbles around you. It can be very freeing. We should stop trying to control everyone and everything. Just go ahead and experience the relief of that concept even for just a few minutes. The outcome isn’t ours to decide. Our reaction is.

To the rescue

Joanne Dragun, M.D.

“Stayin’ alive. Stayin’ alive ah ha ha ha stayin’ alive.” the Bee Gees create a great tempo for the 30 compressions and two rescue breaths timing for the CPR class this week. The EMS instructor is coordinating our movements for success preparing for a challenge in any environment and the staff is gaining skills not just for the cancer clinic but for life. “Another one bites the dust” is another option for pacing but I think she is just kidding. The hands on instruction for this refresher happened to be timely this week in the clinic.

If you’ve never taken CPR or are rusty (2 years), I strongly recommend taking the time to train in basic life support. You have energy and are fearless, so you know if needed, that you would spring to action. We are all life- long learners and take classes for every skill, why not one that could save a life? I thought I’d take this opportunity to provide general guidance on emergency response because in the chaos of a moment, someone needs to keep a cool head and make good decisions. As dramatic as a heart attack or stroke to a sprained ankle, there are many ways we find ourselves accessing the healthcare system in an emergency and I hope this helps.

When to call 911: Examples are: A significant fall, head injury, uncontrolled bleeding, chest pain and shortness of breath, seizure, syncope (unconscious) drug overdose, drowning are appropriate for medical emergencies. The EMTs have medications and electronics to treat in the home quickly then have direct access to the ER upon arrival- no waiting. Always state the problem and your address quickly- that info is immediately sent to your nearest response team while you are giving the dispatcher further information.

Out patient centers (privately or hospital owned) are procedure oriented: minor surgeries, endoscopies, radiology, low risk catheterizations, minor orthopedic procedures, biopsies. Most are accredited with board certified physicians who also serve on hospital staffs. These are never used for emergencies. They are for procedures with appointments. For significant emergencies, hospital is best where all equipment and specialties are readily available.

Urgi-centers: Many of these “doc in the box” units are springing up, often affiliated with a hospital to move less critical care into the community. They serve as a family doc open 24 hrs. Think “I have a problem but don’t need an ER”. These are fine if you need stitches, have a sprain, flu symptoms and are under age 70, or other minor ailments. You may be triaged to a specialist (ortho, cardiac, cancer center) or told to call your family doctor once the issue is assessed or treated. These centers are not designed to provide every level of care and have no specialists other than ER physician on call. Further rescuing requires a fully staffed hospital.

I am pleased that healthcare is moving closer to you, just be aware that these units are not meant to replace more comprehensive care. You always have the right to head to your nearest ER or to call rescue. Again, everyone should take CPR, especially if you are caring for children, have a pool, live near water or live with someone who is at risk. (your local hospital and YMCA often have classes for the public). Be familiar with first aide emergency handbooks. Preparing is the best plan. If you read this blog, you are most likely the person in control in a crisis, so others will look to you. Be ready.

We care about each other and sometimes you have to actually take care of another and “live to see another day”. You can make a huge difference. With knowledge, your bravery can protect a loved one or even save a life.

Age

Joanne Dragun, M.D.1 Comment

What word should we use? Middle age, senior, super senior, old, older, young, youth? Often I hear people say, “Oh I am getting old” if they have an ache or pain. Everyone is horrified when the AARP invite comes, how did that happen? Medicare “wellness screening” starts at 65 and in the medical record they have to ask all sorts of probing questions such as, “Are you forgetful, do you fall, how is your memory” etc.etc. The checklist is all so insulting.

The very first doctor’s visit after 65 definitely causes us to take pause- oh I guess I am now a senior citizen! Ha! I don’t buy it. “It all goes down hill after 70 doc”. Well Abe shouldn’t tell that to the 112 year old youngster from Japan. He made the news this week as the oldest known man. Photos of Mr. Watanabe and his wife are adorable. The oldest living woman is also from Japan at 117! So Abe at 70 is only 2/3rds there and when he beats this cancer needs to make plans for a future. That is if he follows Mr. Watanabe’s recommendation and smiles everyday!

How to approach this creep to geriatrics? Perhaps we should choose to ignore it. There are many freedoms that come with ahem..aging. You can exercise today when you didn’t have time for it while raising kids. You bring wisdom into your life not available in middle age. You can learn to enjoy the simple, leaving behind the frenzy of overdoing everything. You become more aware that positive words should be spoken in every situation and avoid piling on the crazy (which will dissipate quickly if left alone). You can choose when to engage and have less ego about it.

Consider a new mind set- not “I am getting old” but “I choose to live full blast as long as possible.” Blow through the midlife and charge into aging not letting aches and pains define you. If you have a major illness, don’t allow it to steal your time. The next day, years, career, golf game, book in the queue isn’t promised.

So live that life at full speed. Don’t give into that misleading review of symptoms docs inflict on their questionnaire. Prepare but don’t abdicate. When the finish line is in sight that is soon enough to finally say, “Okay I am ready to break thru the ribbon. I didn’t slow down because of some concept of aging.” God didn’t put us here to rest- there is ample time for that. There are many in our families, our friends, and young veterans whose lives are cut short. They would be disappointed if we didn’t appreciate or we gave into a lesser life.

I strongly disagree with Dr. Zeke Emmanuel from Penn who helped craft Obama care and wants to stop all healthcare after 75. He says he wants to only live ’til then because you are “slower, less of a contributor” etc. What nonsense. We dishonor all those who didn’t get the chance to age or age well. Be strong everyday. Be fierce. Do not go gently. If you are lucky to hear the two minute whistle, then decide how those last hours are spent, but do not do less, be less, or give in, because a number defines you. You are are not old. You are lucky. And just maybe, you can also reach that 112 number with a smile on your face.

Hearts and roses

Joanne Dragun, M.D.

This week forget about the flu and viruses, political theater, climate and economy, even health and wellness. “Doc, what will occupy my attention? You want me to plan for Valentine’s day but I don’t even have a sweetheart”. But you do indeed so don’t disregard this important holiday. Its more critical to you than the super bowl was. By the way, my Grandfather’s name was Valentine so just maybe I inherited some insight.

Embrace the concept that our own special Valentines are everywhere, you just need awareness. In the cancer center, these life enhancers come in all shapes, sizes, relationships and species. Mr. Levin adopted a senior Labrador from the kennel. His wife recently passed from cancer and all his attention was devoted to her. Mr. Levin didn’t expect to get his own ticket here, with his new diagnosis of prostate cancer. Conversations are filled with this new love of his life, “Lady helps me get up in the morning. I think she is saving my life-just like I did hers”. Another patient, Mark has a significant other, his seven-year-old grandson. Mark’s cancer treatment is never center stage and the drama isn’t his illness. It’s making a life for Manuel whose mother is incarcerated. Last week Linda came to see me about her husband who is choosing hospice over more treatment. “Doc, we are believers and I know Tim will be in heaven with our baby son soon” she sobs. Down the hallway comes Amanda escorting her elderly mother whom she cannot leave alone. “Honey, am I sick?” she says. Amanda shakes her head ‘no’ and eyes tear as she keeps her own stage four cancer to herself so her mother won’t be concerned.

Valentines Day occurs every day with these signs of love and devotion. With awareness you will be so gratified to realize how much you are loved too. Wish others a happy valentine’s day, gift a candy heart, a flower, a hug, a phone call, offer a prayer. It doesn’t have to be a grand gesture and your kindness will open hearts to you. Remember those little “kid’s” cards? In my first grade class, we had to write one for all 98 (!) students. I didn’t want to send one to the boys who pulled my hair, yet receiving one from them was precious.

Give love and it will be returned. Be grateful for all the “significant others” in your life. You are a gift to them as well. Cancer and other illnesses are not unique in providing opportunities to demonstrate support, give attention, embrace a friend, restore a friendship, forgive a loved one. Open your heart to appreciate this celebration of love.

Happy Valentines Day. May love, friendship and devotion find you everyday.

The Greatest

Joanne Dragun, M.D.1 Comment

If you’ve visited a doctor’s office or ER, you may have been asked: “Why are you here today? What’s wrong with you?” (??)!! What a way to start a conversation!

Regardless the ailment, when you are seen in any medical office, you are handed paperwork to fill out listing all of your afflictions. This week I read through an orthopedic surgeon’s consult that, due to electronic medical records, was 13 pages long. It detailed everything about this patient, Mr. Pratt, from birth to present. Three small words near the end said, “No surgery needed”. What I found amazing is that in the report no where did it list anything that was right and good with this patient who unfortunately was diagnosed with prostate cancer in his bones.

The consult carefully crafted, didn’t say that up until this new pain, Mr. Pratt played golf, ran a business, was a terrific grandfather, married 50 years, volunteered at his church, looked after his also aging neighbors, had coached his son’s soccer team, taught his daughter to drive a stick shift, boogie boarded in the ocean with his grandson and thousands of other personal history items not found written anywhere in Mr. Pratt’s detailed report. But aren’t those the aspects of life that are really important? In the cancer center we analyze every minutia in records and films that is abnormal. Always looking for the dis-ease. Sure we are there to fix the abnormality but we can forget the good in the history, the real reasons Mr. Pratt is seeking care.

I recall the shock when Mohammad Ali described himself- such conceit, and pride. He made it his identity. Now so many years later, if you say “the greatest” the champ still comes to mind. There is nothing wrong with acknowledging our own strengths. Unfortunately, if you or a loved one are ill, all the focus shifts to the sickness. Everything else is forgotten until this one abnormal thing (such as cancer) is fixed.

May I suggest that you take a few minutes to define yourself? You have strength, wisdom and life experiences. Give yourself your own pat on the back everyday. Don’t let illness or injury define you. If you care for someone who is ill, then help to give them the dialogue. Remind them of how special and talented they are. Not just “I love you” but the why. That is the heart of the support. Don’t forget yourself. Look in the mirror everyday and remind yourself who you really are.

“Doc, I thought I was going to die. I was so scared”. Fear made the situation worse. Now with treatment, Mr. Pratt can get back to all that he loves and truly makes him great. Stronger in mind, body and spirit. He is able to face more challenges to come, not letting his identity be lost in the struggle.

This is what you deserve. Really seeing strengths behind the affliction. Then reaching out and helping you to reach within and gain control. Cancer physicians work feverishly to deliver the knockout punch to cancer. When we offer the hand to help our patients up from the mat- that is where the real healing resides.

Tell yourself everyday that you are the greatest. You deserve that identity too….because you are.

Just say “No thank you”

Joanne Dragun, M.D.6 Comments

First off, ‘no’ is not a four letter word. I recall the grades in Catholic elementary school. One was for obedience. There were many parents incredulous when their errant child came home with an ‘A” as they double checked the name on the report card. They’re often obstinate child seemed perfectly capable of following orders- just not at home! Anyone over fifty recalls when obedience to authority was valued and we feel guilty not complying with the norm. So, let me give you new permission. Saying ‘no’ is not defiant or selfish. In healthcare, decisions must conform with your own values, needs and vision for your life.

As a doc we say “treat” or “get tested” or often we just set you up for this craziness without asking. It’s a “trust me we know what’s best for you” mentality and you may be tempted to fall in line to get the coveted “A”. But treating cancer and all disease should come with life options, not just treatment options. Sure therapies have changed but more remarkably the decisions have too. Patients in the ’90’s would sometimes say, “Whatever you think, Doc”. Now they come with reams of web information. But here is what I find interesting: People are taking control of their therapy, not just with information but by bringing into the plan their own unique perspective and needs.

“Doc if I cannot be cured, I will not use our retirement savings for treatment. My wife has longevity in her family and could live another twenty years. I cannot leave her broke.” Mr. James has a point about consuming resources. Carlos has a great life here in the states and regularly sends money home to Honduras. “I can still work so if you could just help me survive as long as possible, it’s not for me but it’s good for my family”.

Even small issues are on the table: Sandra will not agree to a chemo that causes hair loss before her grandson’s wedding. “Its going to be the last time many of them see me so I have to look spectacular!” Elaine is a quilter and refuses the chemo that causes peripheral neuropathy with numbness in her fingers- she’ll accept the hormone therapy but that’s all. For the many patients I care for, it is not about whether they can survive and “do everything”. Often the decisions are about other aspects of life.

My best advice is very simple: If you or a loved one are diagnosed with an illness, listen to the “gold standard of care” from your physicians, do some research and then weigh the pros and cons of going all in vs no or less therapy.

A Doctor’s dictum is to “Do no harm”. I believe this includes encouraging the patients’ decisions, and avoid forcing our own skill and value system on them. Just because I can treat doesn’t mean that I should. Back up a pace, evaluate what is right for you.

If you have a doctor who is dogmatic “my way or the highway”, find someone who really sees you and accepts your role in the process. We don’t pay for your treatment. We don’t go home and care for your children, or help your parent, or spoon feed you grandmother. We don’t work your job and support your family. We are not attending your events when you want to feel well rather than sick with treatment. There is always risk to letting cancer grow, spread and take over your life. BUT there also is risk to saying ‘yes’ to everything.

Always speak up. Never be afraid. Find therapy that matches your own path and physicians who respect your part in the plan. When you are brave, find those who fight- fight- fight for you. When you are tired express that you are done. Live your own life always. Never be bullied even by well meaning doctors or relatives. You have the right to say ‘no’. Its not selfish its self-care. You will never ever be sorry when you are in control. We are all here for you, but only by choosing your own path can you have peace and your own unique wellness. Obedience to your own internal guide always deserves the “A”.

Puppies!

Joanne Dragun, M.D.

The Australian kangaroos and koala bears are capturing our imaginations as the wildfires roar. We feel heartbreak for their helplessness and grateful for the U.S. and international forces rescuing that beloved country.

Elaine arrives for therapy for lung cancer and tells of being moved by the tragedy. “Doc, I was feeling such a strong desire to do something. I wanted to help in some way. Then I realized I still have a power right here. At 78 I thought I was too old to get a new pet, but I got off the sofa, walked out the door. I went to the rescue shelter and adopted a puppy! I felt that he was waiting just for me. Oh my gosh, my husband was shocked when we came into the house, but “Barky” flew into his arms like he was finally home. Oh what joy I cannot tell you!”

Elaine already has her hands full but training a new puppy is a great distraction from her own drama. “I was putting away the Christmas decorations and he just tumbled through the mess and had a gay old time He is so comical we just laugh and laugh”. She tells how the puppy has bonded fiercely with her husband. “Barky doesn’t know that I have cancer, he just expects me to stop everything and pay attention to him. And I do! He doesn’t realize that my husband has Alzheimer’s disease and that sometimes he forgets we have a puppy”.

A new and exciting, fun-filled routine has captured their imaginations and filled their once sad and painful home with renewed life.. I ask to see a picture, but even better her husband is waiting with him in the car. We head to the parking lot and as I peep through the window, both are sound asleep with Barky snoozing on his belly. What a sight. This bundle of joy greets Elaine with wags, licks and adoration and my heart sings with happiness for them.

Elaine was inspired to open her heart and now their lives are changed magically. They are looking for a pet- friendly assisted living since her husband will need more care and she is in her own battle. What joy Barky will bring to others there as well. Who doesn’t fall in love with a furry, wiggly ball of happiness? Barky is a funny name because he is so busy giving attention and cuddles that I haven’t heard him yip once. I am thrilled for Elaine and her bravery in reaching out for renewal instead of giving into the drama of their situation. Both of their immune systems will be boosted by this tiny gift of goodness, and the several daily walks will enrich their togetherness and stamina.

Little puppy, you outshine all the medications, chemo and radiation we can offer. Love does that.