By Karen Fine, a veterinarian and the author of “The Other Family Doctor: A Veterinarian Explores What Animals Can Teach Us About Love, Life, and Mortality.”
Marula was an orange kitty, a purr machine with multiple birth defects, so he was the perfect cat to be a veterinarian’s companion. He purred against my belly when I was pregnant and, years later, he never missed story time, seeming to read the book from one side of me while my son sat on the other. “Did you know your cat is limping?” new visitors to my home often asked with alarm. I’d point out the cat’s shortened leg and funky paw and reassure them that, despite his awkward gait, he got around just fine.
Cats, I’ve often told clients, usually live long enough that when they leave us, it feels like the end of an era. And that was definitely true with Marula.
He was an old kitty when I noticed a lump on his leg that looked like a callus. The next day, it was bleeding and ulcerated, and I started him on antibiotics. The mass continued to grow by the day and continued bleeding off and on. Within a week, several more bumps had formed. A sample of cells sent to the lab confirmed a rare and aggressive cancer.
As a holistic veterinarian, I asked for advice from colleagues and mentors and treated my cat quickly with everything I could, using both Western medicine (corticosteroids) and Eastern medicine (Chinese herbs). The lumps got smaller, and although his energy was low (always a high-energy feline, he was finally acting his age), he seemed himself.
Until he didn’t.
It’s hard enough when loved ones die, but the ability — and necessity — to choose the moment of their death can feel overwhelming. Euthanasia, or assisted suicide, is rare (and often illegal) in human medicine, yet it is a common end to the lives of our companion animals, relieving suffering of a terminal condition. It’s very likely that if you have an animal, you’ll one day be faced with it. Many pet caretakers and veterinarians consider the ability to make the decision to relieve suffering through euthanasia to be a blessing. So why are we often so racked with not only sadness but also guilt when we look back at the moment we made it?
The word “euthanasia” comes from Greek, meaning “good death,” but deciding on that death is a huge responsibility. Each situation is unique, and there is no playbook to follow. It’s a formula for doubt and shame to sneak in and manipulate our emotions, especially after the fact. I’ve watched many clients rewrite the narrative of their animal’s death from “I made the best decisions I could at the time” to “If only I’d done this or made the decision earlier.” They feel they failed as a caretaker and family member. “If only I’d noticed sooner” becomes “I should have noticed sooner.”
For this, we can blame hindsight bias. In psychology, hindsight bias is a documented phenomenon that clouds our judgment about what we actually knew in the past and the extent to which an event could have been foreseen and avoided. When hindsight bias becomes entwined with guilt and grief, they can overwhelm our memory of a beloved animal friend.
It’s important to understand this bias and its effects. I’ve seen many people convince themselves that if they’d been better pet owners, they would have acted differently and there would have been a better outcome. The deaths of our animals hit us hard — often harder than we expect. “My parents died three weeks apart, but losing my dog was worse,” a client confided to me recently.
When my friend Dina thinks of her beloved cat Tigger, she sometimes feels guilty that she didn’t do enough for him at the end of his life. But I encourage her to remember that when Tigger couldn’t climb stairs, she and her husband slept on an air mattress in their living room for three months. She also made him shrimp smoothies in her blender. Our acts can seem inadequate to the depth of our love for our animals, especially when we are anticipating their loss.
Even in the worst-case scenario — if you really did hesitate for too long, despite knowing your pets were suffering, and your animal friends did not have the best possible end — that is not the whole of their story or yours. There is more to the narrative: How did you treat your animals when they were alive? Did you care for them, love them, cherish them?
“Remember that you made the best decisions you could with the information you had at the time,” I’ve often told my clients. When Marula’s condition declined, I had to take my own advice.
After about a month of low-energy but high-quality life, Marula suddenly slowed even further. I started him on a new medication, but I knew his cancer had most likely spread internally. The next morning, my beloved cat could barely move and seemed uncomfortable.
Clearly, it was time. My husband and I talked to our son, who decided to miss school and go with us for the ride to the clinic.
Later, I berated myself for waiting. Why didn’t I make the decision the night before? At that time, I had what I thought was a realistic hope that his condition might improve in the morning. Yet what if I hadn’t waited so long?
Death is a decision that cannot be undone, a button that can’t be unpressed. I didn’t want to cheat Marula or us of more quality time if it was at all possible. But looking back, I doubted myself and the decisions I made. I felt I had failed.
This is where an awareness of hindsight bias helped me — and can help anyone who has had to choose to end an animal’s life. When I look back now, I remind myself that I did my best to make difficult decisions while weighing love, hope and grief. It was unfair to judge myself and my actions as if I’d known the outcome in advance.
I also recognize that animals comprehend mortality in a way that we do not. Even if animals don’t choose their own time and die on their own (as we veterinarians say), they may have known that death was coming. And the circumstances, timing and manner of my friend’s death — even if imperfect — should not define his life.
Now when I remember our quirky, loving orange cat, feelings of guilt and shame still lurk, but they are lessening. I’m certain Marula knew he was beloved. And I know he loved us, too, with all his feline heart. I think of Marula with love and longing, and I hope to focus not on the way he died but on how he lived and all his magical, purr-filled, funky-pawed days.
On Pets, Moral Logic and Love/ March 19, 2023
When a Pet Dies, Helping Children Through the ‘Worst Day of Their Lives’/ June 8, 2017