My Inspiration - Zara
Dogs are our link to Paradise. They don’t know evil or jealousy or discontent. To sit with a dog on a hillside on a glorious afternoon is to be back in Eden, where doing nothing was not boring- it was peace.
Milan Kundera
Zara is my most loving and adorable dog. Now, “What has a dog got to do with cancer?” you might ask.
I have noticed how comfortable Zara is with people. By observing Zara and interacting with her, I have learnt qualities and fundamental values that we as doctors and caregivers need to adopt in order to give quality attention to terminally ill cancer patients. We all possess these qualities and values but the key is to be mindful of them and to practice them in our daily living. Initially this may be difficult but with practice it will become second nature.
All the stories in this book latch on to some of Zara’s traits.
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These are the valuable attributes Zara taught me.
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Focus
Zara has a favourite red ball. When it is time to play with it, nothing distracts her because her focus on her red ball is so intense. I have learnt that each of my patients deserves such focused attention when I am with them.
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Patience
It is a well-known fact that dogs are always eager for their food. Zara is no different. On one occasion however, I had dished out her food and before I could give it to her, my phone rang. I placed her food on the table and attended to the phone. After that I had my own breakfast and wandered into the serenity of my little balcony garden. I suddenly realised Zara was not with me. I found her patiently waiting by the table, neither whimpering nor barking. Her behaviour gave me cause to ponder and I learnt an important lesson as a doctor. For this most important item – food, Zara was willing to wait. On a long day at the clinic, or at home, giving focused attention to the ill requires much patience. When patients wait in hospital lobbies/ waiting rooms to see doctors, they uncomplainingly wait as long as it takes. Yet when the doctors finally see them, how much time do the doctors give them? Or are they merely impatient to complete seeing the patients? This is indeed something to ponder on.
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Perception of time
Despite her patience, Zara has such a keen sense of time that I call her “the alarm clock”. At the yoga class that I attend, when the instructor goes beyond the one hour of the class, Zara begins to make sounds. I reflect that in the medical practice many of us fail to realize how long the patients wait for us. Zara has taught me to give utmost importance to time, - mine and that of others.
Communication
Zara communicates with me with the sounds that she makes and I have learnt to understand her language. The tone of her bark denotes what she wants me to do. If her ball is under the sofa and she cannot get it out, her bark sounds pleading. If there is someone at the door, the urgency of her bark varies, depending on whether it is a friend or stranger. As doctors it is so important for us to communicate with patients on all levels so that we can provide quality care for their varying needs
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Listening
Listening is the basis of good communication. Dogs listen instinctively. It is uncanny how, while she is watching TV with me in the bedroom, Zara can hear that someone is at the door and runs to it. I do not have a doorbell, so when I check if there is anyone at the door, she has always been correct. This knack of hearing above the surrounding noise is a quality that clinicians should develop. They should listen carefully for the clues that emerge from the surrounding chatter and the words used by the patient or family members, that raise the red flag for underlying issues.
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Empathy
Silence is a factor of listening. On days when I am not in a mood to play with Zara, she understands. At these times she is quiet and always by my side. This is her way of empathising. Sometimes with our patients we do not have to say much. They may just want us to understand their sadness.
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Unconditional love
Those who have dogs will understand what unconditional love means. Zara never reproaches me for leaving her alone at home while I am at work. Instead, she greets my return with joy and excitement. My faults are overlooked. This is a trait that we all can develop in interacting with patients. It includes being non-judgemental of them and giving them the benefit of doubt
Friendliness
Unconditional love makes it easier for us to be friendly. Zara, with her simple disposition, is extremely friendly with people. When one of my friends was going through a difficult time with her ill mother, she wanted to play with Zara because it reduced her anxiety. I saw how therapeutic Zara had become not only for me but others too. I realized that such therapy would also help my patients and so I encouraged them to spend time playing with and stroking their own pets to gain inner calm. We all need this inner calm.
Humour
Zara has a great sense of humour, and she has infected me with it. For example, she has a doggy toy which is designed like a bone. It is rather big and Zara is not a big dog. When I am sitting engrossed with my phone chatting, she deliberately distracts me by bringing it to me in her mouth. I have to burst out laughing as the toy covers her whole face and she looks ridiculous. Doctors do not have to be serious for patients to have confidence in them and laughter in the most serious situations is better than a silent, morose, clinic room. Therefore using humour frequently in the medical practice makes for a friendlier atmosphere all around.
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Treading with care
When Zara’s red ball sometimes gets in between electrical wires, she will stand nearby and make noises that indicate to me that she does not want to take her ball when it is among the wires. I did not train her to do this; she developed this sense of boundaries instinctively. In cases of terminal illness, boundaries are important. Doctors will face situations where they need to tread carefully and not overstep boundaries especially with regards to religious and cultural beliefs and personal histories.
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Inner sense
Zara has an inner sense that enables her to warn me of strangers at the door or to suss out that I am too tired to play, or to know that electrical wires are dangerous. We too have this inner sense but many of us may have not yet become aware of it or learnt to trust it when we treat our patients. Sometimes, the inner sense can override clinical opinions.
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Hope
Hope is what we all live by daily. Even animals do. Zara has this relentless hope that every morning while I prepare her breakfast, I will throw her red ball for her to catch. At the beginning I did not realize this until I noticed that she waited with tense expectancy. Similarly, if doctors are aligned with the thoughts of their patients they can anticipate that their patients hope for cure, to live long or if need be, to die in peace. As doctors we can help to allay their fears. It is important to engage with them. In cases where cure is possible, it is important to convey that message.
It is a man's sympathy with all creatures that truly makes him a man. Until he extends his circle of compassion to all living things, man himself will not find peace.
Albert Schweitzer
