What does her nose know? Michele made an interesting comment last week as we began walking in the hospital. “Misty’s going to be smelling a whole lot of new scents that will be strange for her but if you stay calm, she’ll stay calm...”: (see September 13, 2012). When I reflected on how Misty reacted with some patients in her first visit to the Palliative Care Unit, seeming to understand things about them that I was not picking up, I decided to do some digging... and I found some pretty interesting information. I’ve included some references at the end of this article in case you want to do some extra reading yourselves:
First of all, in one study “ordinary household dogs”, with a few weeks of training, were able to distinguish lung cancer and breast cancer from healthy controls in samples of patients’ exhaled breath. In another study, researchers found that dogs could identify lung cancer in exhaled breath samples, even when those samples were confounded with breath from patients with Chronic Obstructive Pulmonary Disease, tobacco and food odours. One group of researchers reviewed studies suggesting dogs can detect bladder and prostrate cancers by sniffing urine samples, as well as melanoma in skin and ovarian cancer in a frozen tumour sample. All these findings have led to work on an “electronic nose” but, dog respecters and lovers alike, undoubtedly will be quite satisfied to know that “dogs still appear to be ahead in the race and seem to have sniffed their way to the front of the line.”
So what is Misty detecting that is beyond my puny human capability? In addition to cleaning/disinfecting agents (hmm... perhaps she’s not so familiar with these from our home...), there’s the pharmaceuticals, what comes off of or out of humans in the hospital, including pheromones, those chemical substances produced from our more primitive animal selves-- and it seems she could be detecting cancers, even though she may not be able to comprehend the significance of those particular scents. Having said that , however, when our cherished elder Golden Retriever, Quincey, developed lymphoma this year, Misty stayed by him, choosing to sleep beside him downstairs when he was too weak to make it up to my room at night. Perhaps she could detect his tumours. Or maybe it was his suffering. It could’ve been both. Whatever she was picking up, Misty took very compassionate and attentive care of both Quincey and me up until he left his body. ..
“NO! NO! NO!... N-NO DOG! NO DOG!” We had been met in the hallway by, I assume, the mother and brother of a man we’d visited last week. During that visit, he was very drowsy but his wife had a lovely interaction with Misty and asked us to make sure we came back. Now we stood outside his room as Mom and Brother showered Misty with hugs, “What-a-beautiful-dog”s and Misty responded with happy wagging and welcoming eye contact. When Brother bent over to meet Misty at her height, she licked his face. He surprised the humans, but not Misty I’m guessing, by holding the flap of her ear in his hands and kissing it...such an outpouring of affection, warmth, sorrow, need, from this family as they confronted the hovering loss of their loved one.
When Michele, Misty and I entered the man’s room, however, he responded with alarm. “NO! NO!”
“Okay, don’t worry, we’ll leave,” I said softly as we began to back away from his bed.
“Dear, it’s Misty. The Therapy Dog! You remember her, don’t you?” His mother clearly wished for her son to feel the comfort Misty could bring him.
“NO!” He shook his head and tried to sit up in the bed.
Michele’s voice was very soothing. “Not tonight. That’s fine. We’ll see you another time.”
Mother shrugged as we backed into the hallway and once again encountered Brother. Once again he bent over to hug Misty. Once again she wagged and licked and took care of him. A short while later we moved on.
Back to the Party Scene. A few weeks earlier, when Michele and I were visiting with Michele’s sweet little dog, Jasmine, the cubicle of this man was stuffed with visitors and laughing and high jinx. On that evening, the man had a happy meeting with Jasmine. Last week, when we came by with Misty, there were no visitors. The man sat glumly in bed, showing no interest in Misty or us. Now that the throng had returned Himself sat up in bed with a big grin on his swollen face. He was happy to be the butt of their shenanigans and ready to feed Misty some snacks. His swings from sullen to party-hearty clearly depended on the absence or presence of his family. After clowning for a bit and teasing Misty with snacks (I couldn’t tell if this was a performance or whether neurologically he couldn’t operate his hands properly – no matter – he got a rise out of his audience, intended or not, and that was reward enough for him), he snapped open a magazine. We were dismissed. “OHHHHHHH!!!” his family razzed him as we left the room. We were props in his play and that was just fine with all of us.
Return to the corridor. Make notes. Sanitize hands. Next stop. Brother had passed us in the hall once again. He murmured something about not following us, “Honest” and he hastily left us behind, appearing embarrassed. We had no opportunity to reassure him that we didn’t care if he needed more Misty Time. Misty would’ve communicated that herself, given the opportunity.
We came to the door of the young man we couldn’t see last week because he’d had a treatment and was too groggy. Again, his door was closed. Another treatment. Another opportunity for paw to greet hand missed. Hopefully next week we’ll have better luck connecting with him.
As we navigated the corridors, we often encountered nurses who smiled and hugged Misty, each waiting for those retriever kisses. So many had stories of their own dogs who slept at home while their humans padded along the hospital’s hallways.
The Empress of Cheerios awaited. She was looking less regal, more wan now – although still mentally sharp. “Misty! Oh, you’ve come back, have you?” Greeting Misty seemed to drain her somewhat. She looked over to cabinet, searching in vain for Cheerios to feed her caregiver.
“Would you like to give Misty some of these snacks? They’re pumpkin and cranberry.”
Before I’d produced the tidbits, Misty was trying to wiggle between the siderails to get closer to the Empress. Michele was way ahead of me, deducing how to lower the railing – a trick she’d never had to learn with Jasmine, whose sweetness was compacted into a small frame that could be lifted on patients’ beds. With the railing down, Misty placed her front paws on the bed beside the Empress. I looked to Michele for guidance and she said, “It’s okay as long as her paws don’t touch the person’s skin because the skin could be broken.” Misty seemed to have figured that out herself as she wedged her top half between the outstretched arm and torso of the Empress, crunching the treats.
Misty’s tail was saying, “Oh yes, they were quite satisfactory” – but her eyes were saying “More please? Pretty please? With sugar on it?” Misty does not “smile” in that anthropomorphic way some dogs do. I’ve always wondered if dogs who can offer a humanesque smile get more treats... What do you think? Do you have a dog who smiles? Does that lucky pooch get fed more treats? Does your smiling Rover weigh a bit more than a dog who doesn’t smile? Let me know. Send me your smiley stories here in the Comments section, please... Let me know if I’ve been overly harsh in my assessment!
The Empress’ smile was waning. She was tired. Misty pulled herself off the bed. I pulled up the siderail and promised we’d return. I said to Michele that this was the first time the Empress hadn’t mentioned her desire to go home.
Another woman in the room had requested a visit from the Therapy Dog. Misty and I went to her bedside. “Hi. Did you want to see the Therapy Dog?”
I raised my voice a little, trying to aim the loudness into her ear but not to the other occupants of the room. “DID YOU WANT TO SEE THE THERAPY DOG?”
“OH! YES! IS THAT THE DOG?”
“YES. HER NAME IS MISTY.”
“OKAY. I’VE SEEN HER. THANKS VERY MUCH.”
Michele and I exchanged glances and stifled our giggles until we were outside the room.
The oxygen canula was off his face, lying loosely on his chest. The man who seemed so anguished during Misty’s visit last week now had hooded, unfocussed eyes. He was short of breath, clearly needing the oxygen. Fortunately, a nurse came into the cubicle, attracted initially by Misty. The oxygen delivery was restored and the nurse left so she wouldn’t distract Misty from her primary focus: the man struggling to breathe in the bed. I leaned over him and said, “Misty is back to see you. Do you remember Misty the Therapy Dog?”
Misty pushed her nose into his bluish hand. For a moment, the man’s eyes opened slightly wider and he said, “Oh, Misty... Misty... Misty... Misty... Misty...” He began to move his head back and forth and for a moment he looked like he was trying to pull himself onto his side as he had done last week. Then his body slackened and his eyes began to close. It was just way too much exertion for his pronounced exhaustion. Curiously, Misty started backing away. Why was she doing that? What was she sensing? What did she understanding that I did not understand? And so it was in this place of such tender yet profound, shared heartbeats. He seemed to be retreating to a less external place. I cupped my hands around his cool fingers and paused for a few moments to wish him a peaceful journey.
Michele was a little teary so we stopped for a few moments in the corridor.
The sign beside the door read, “This is Laura’s Room”. Since the door was pulled almost closed I was concerned that Laura’s condition had slipped from last week. Well. Concern was not required. Not at all. After knocking on the door, we three entered to find Laura dressed in pretty funky street clothes, certainly not PJs, sitting on the side of the bed, chatting animatedly with her visitors... until she saw Misty. “OH! Look who’s here!” Misty pranced in and set about licking and wagging and generally adding her medicine to the medicine of Laura’s visitors. It was tonic-like. Laura was vibrant and beautiful. Then she announced to her guests, “I’ve known this dog since she was a puppy.” Nobody skipped a beat. The chattering and laughter continued. One of the guests produced a photo of her Golden Retriever looking everso “kewl” in shades and a hat. The talk turned to dogs and Laura never had her hands off Misty and Misty never ceased her licking and wagging – especially when those pumpkin-cranberry goodies were produced once again.
It was a lovely finale to our visit, but one further happy event awaited. When we returned to the nurses’ station to sign out, with great flourish and ceremony, Michele bestowed on Misty and I our final certificate of completion – we had “made it” – a fully certified Therapy Dog and Handler. Michele’s arms were covered in goose bumps, so genuine and meaningful was this moment. And I was so completely proud of my West Prince girl. Upon reflection, however, I realized that Misty and I would now begin visiting without Michele... we had been successfully “launched”.
Life change often ushers in poignancy... as was the case with this change. We could’ve asked Michele to continue visiting with us for a time. We still can make that request. Certainly her support would be welcomed. But this is Misty’s Journey. It’s a time of exquisite inquiry. Misty will continue to love her patients. I will continue to tell you about it.
McCulloch, Michael, et al. “Diagnostic Accuracy of Canine Scent Detection in Early- and Late-Stage Lung and Breast Cancers” Integrative Cancer Therapies. (March 2006) vol. 5, no. 1, 30-39.
 Ehmann, R., et al. “Canine scent detection in the diagnosis of lung cancer: revisiting a puzzling phenomenon” European Respiratory Journal (March 1, 2012) vol. 39, no. 3, 669-676.
 Moser, Emily. McCulloch, Michael. “Canine scent detection of human cancers: A review of methods and accuracy.” Journal of Veterinary Behavior. (May 2010) vol. 5, issue 3, 145-152.
 McCulloch, Michael, et al. “Lung cancer detection by canine scent: will there be a lab in the lab? ED.” European Respiratory Journal (2012), vol. 39, no. 3, 511-512.