The Mechanics of Giving Care

Ladu pressed against me, his small body shaking. I murmured, “It’s okay, Kitten. I know. I know,” as we both took in deep, shuddering breaths. Flecks of chicken floated to the ground, caught in my curls, the slight hairs on his belly, clinging to the tip of one of his enormous, triangular ears, ground into my cosy pants.

“You did it!” I whisper-exclaimed, rubbing his back and chest, kissing his velvety forehead, the furrows rippling against my lips. Our racing hearts slowed in tandem as the electricity in the room fizzled away, like the fading afterimage of a lightening bolt. After a few more moments of nuzzling, Ladu’s trembling stopped. “I love you, sweetie,” I said. “It’s only because I love you.”

A few days earlier, Ladu had been diagnosed with an ulcer. Like many cats, he had shown no signs of pain until he suddenly began vomiting and defecating blood, the latter as dark and tarry as freshly laid asphalt. We had begun a regimen of bland food and medicine, but on this morning, Ladu had stopped taking his pills.

I had held out the little canned food meatball with an antibiotic center hidden inside, and he had delicately sniffed it, nostrils flaring slightly, before turning away. When I put it on the ground before him, he nibbled the outside and left behind the tablet. Ultimately, I had to medicate Ladu by holding him tight, prying his mouth open, slipping the pill inside, holding his muzzle closed, and stroking his throat, begging him to swallow.  With the first few attempts, I found the pill in the corner of his mouth, dissolving like a bitter sugar cube. He eventually swallowed the sodden lump with an audible click, as if a door had been closed. 

When Adrian returned from his business trip two days later, I was exhausted.

At this point, the process of medicating Ladu twice a day had become an enormous source of stress. It was like the sun, boiling and roiling and rotating. Every twelve hours, we would cringe, Ladu doing his best to resist the unsavory medications and me doing my best to coax him. Most often, this medicinal dawning and eventide was accompanied by a ceremony of my tears and streamers of his saliva.

“It’s getting harder and harder to get him to take his medicine,” I confided to Adrian on the night of his return. “I hate having to pill him. He is losing trust in me when I offer him food, too.”

It was true. At dinnertime, he would scamper into the kitchen with Reko, indicating that he was hungry, but when I put a bowl of food in front of him, he would look at it, eyes bright with anxiety, and then at me. Finally, I would offer some to Reko, who would gamely eat it. Only then would Ladu commence dining.

“The Royal Food Taster,” I would say laughingly, as Reko licked his lips, but inside, my own stomach was boiling and roiling.

The next night, Adrian came home with doctor-approved turkey slices. “These will get him to eat,” he said optimistically.

With great determination, I rolled a piece of turkey around Ladu’s antibiotic. I could feel the drumroll of my blood pulsing in my neck. I held out a piece to Reko, who gobbled it up, his tail sliding back and forth over the ground.  I held out the turkey roll to Ladu. He sniffed it, licked it with the tip of his tongue … and turned away.

My disappointment and confusion were like an anvil falling on me. I felt crushed. “I guess I am going to have to pill him again,” I said, my voice morose.

“Would it be okay if I tried?” Adrian ventured.

I weighed the pros and cons. Adrian was the one the boys went to for treats. If anyone could get Ladu to take the turkey roll, it would be Adrian. Plus, I could still pill him at this point if needed, even though it was awful for both of us. On the other hand, if Ladu started to distrust Adrian, we would be at an impasse. 

I looked at Ladu. He was ravenous and thin, watching us with those eyes, shiny as polished mahogany, the scent of the turkey twitching his nose.

I stepped back and Adrian held out a piece of turkey saying, as he did every night at Treat Time, “Reko.” Reko sat and gently took his piece. “Ladu.” Adrian turned to Ladu, who gobbled down his piece with the antibiotic.

“Wait!” I said. “He is also supposed to take an antacid.” I handed Adrian a chip of medicine and he went through the routine again, and again Ladu took the roll unhesitatingly.

I slumped against the counter, relieved and uneasy. “Thank you, Adrian. You have no idea what this means. Thank you.” Then,“Why did he take it from you and not from me?”

Everything I had thought was wrong. I had thought Ladu could smell the pill and that was why he wasn’t taking it. Or maybe he had been too nauseated. After all, I had offered the turkey to Reko first, which had before always prompted Ladu to eat. Since it hadn’t this time, it was reasonable to think he didn’t have an appetite.

“Well,” Adrian responded. “I wrapped it up in a ball.”

“I did the same,” I insisted.

“I offered it to Reko first,” Adrian suggested. “Like I do every night when I treat them.”

“I did the same,” I could sense that Adrian wasn’t understanding my question, in large part because I couldn’t understand it, either. I couldn’t sort out my feelings about this incident, so I began to analyze it out loud. “Why would he take it from you and not me? Since the beginning, I have been tending to, medicating, and feeding him. You just made it seem so easy. It hasn’t been easy. It’s been messy and agonizing and sleepless. Is it that I paved the way doing the hard work and then you simply walked down the road I built? Why can I not walk down that road, too?”

Adrian looked at me somberly. After a moment he said, “I appreciate everything you have done.”

That wasn’t it, either. I was still trying to figure out why I felt as though a dark cloak had fallen over me, blocking out the light and fresh air. But somehow the words I was saying made Adrian feel he had to say thank you. I wasn’t looking for credit; I wasn’t resentful. I was just confused

And then, I couldn’t speak anymore. 

In my head, however, I mounted a StairMaster, climbing the same steps over and over, each one leading me to understanding. As I marched, I thought about my interactions with Ladu over the past few days. I also read veterinary recommendations and personal anecdotes about medicating techniques. I escalated in place all night, even as I slept.

When I woke up, I walked into the kitchen and said, “Adrian, I think I understand what happened: because I was forcing Ladu to take pills when he was really really sick, he feels apprehensive now when I try to feed or medicate him. Because you started medicating him after he began healing, he still associates them as treats from you.”

Adrian nodded, the steam from his coffee fogging his spectacles. 

I continued. “I didn’t do anything wrong. I took care of him the best I could, but he was very ill. It’s like the canned chicken: he won’t eat it now because he vomited so many times after we gave it to him. It didn’t didn’t cause the vomiting — the ulcer did — but for him, that briny chicken is unpalatable now.”

Adrian stared at me. “Yes, of course that is what it is. Of course you didn’t do anything wrong, Saraswati.”

“You already knew that?” I asked in astonishment. “I had to figure it out! I kept thinking about what I must have done wrong because how could Ladu not trust me after all of my care? He feels better because of it, right?” 

“But that isn’t how he sees it,” Adrian said. “He doesn’t know that it is medicine let alone that it has been helping him. But, he trusts your caresses and kisses and nurturing — he returns to you over and over again for that affection. He trusts you.”

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Over this past year, since I discovered that I am autistic, I have reflected on so many events in my life, recognizing the attributes that had previously gone unnoticed or misunderstood. Examples of my concrete thinking, echolalia, stimming, and rigidity provide context for my failed relationships and my inherent “otherness” (an otherness I, incidentally, celebrate and revere).

Despite the efforts of my black-and-white thinking, I have learned that single autistic traits are not neatly and directly linked to single circumstances, the way a tugboat pulls a barge over the water. I have also learned that individual circumstances are not independent of each other. They are connected, rolling and receding like waves on a beach. My autism and my life experiences are most akin to the complicated ecosystem found in coral reefs, multitudes of species interacting with each other, the sun, and the sea.

For example, when I reflect upon the last two weeks at The Chand Bungalow, I see many, many ways in which my autism influenced how I handled Ladu’s diagnosis and subsequent care:

1). I fell out of my routine. I love my routine. It has been carefully crafted over several decades. It incorporates my special interests; assists me with some of my interoception challenges, since my meals and bathroom breaks are scheduled; and helps me with my executive function, as my many alarms encourage me to switch from one task to another .

I have watched Adrian complete his projects and still monitor Ladu. I don’t know how to do that. I became singular-minded and rigid, unable to leave Ladu’s sight for longer than a minute or two. Taking care of Ladu became my one and only task. I didn’t think to have groceries delivered or to bake bread for easy lunches. Instead, I opened one can of pea soup for each meal and gnawed on frozen, soggy berries when I ran out of fresh fruit.

2). My affective empathy overwhelmed me. I didn’t just sense Ladu’s discomfort; I felt it. I knew when he wanted to be touched and when he was too nauseous or painful to even listen to me talk. I knew when he wanted to be wrapped up with his giraffe-print blanket into a little kitten burrito and when he wanted to be on top of the covers, with nothing restricting his movements, fresh air circulating him.

Affective empathy is a wondrous magic. It helped me be a strong and capable caregiver. Like an essential oil, it is pure, powerful, and lingering. That potency needs to be handled with kindness and patience. I had harshly self-chastised for the stress and guilt I felt over Ladu’s distress. I could have instead taken time to meditate or journal or dance … all while maintaining my Ladu-watching mode.

3). My cognitive empathy underwhelmed me. As powerful as my affective empathy is, my ability to see from another’s perspective is a struggle. I could feel Ladu’s misery when I pilled him, but I couldn’t understand why he wouldn’t simply take the medication when it was wrapped in a piece of food. It was like a math formula to me:

Misery = Forced Pilling ∴ Misery = Quickly Swallowing Pill in Meatball

Because Ladu wasn’t learning this calculation, I felt that I had failed him. This began a cycle of self-loathing and self-criticism.

I couldn’t see that the formula really was:

Misery = Pain + Nausea + Hunger + Yucky Tasting Medicine

4). My perseveration deepened as I tried to figure out where I went wrong. Sometimes this replaying and analyzing helps me process, as it did when I climbed that mental StairMaster to figure out why Ladu wasn’t taking medication from me. Sometimes, however, the recapitulation can transform into a fixation. I believe this is what happened when Adrian was out of town. I spent the twelve hours between pilling Ladu preoccupied with pilling Ladu. I wasn’t finding a solution or an awareness; I was simply ruminating over the last dose and dreading the next one. At that point, it was as though I was sitting on a stationary bicycle and expecting to ride across the country.

5)). Alexithymia and wobbly oral communication skills created a misunderstanding between Adrian and me. I was not able to identify why I felt uneasy when Ladu took medication from Adrian and not from me. I then tried to express that confusion in conversation, which for me is like painting a fraction of a cityscape — maybe just the sky or part of a building — and expecting the viewer to recognize the location. This misrepresentation made it seem as though I was begrudging my husband his success. This could not have been further from the truth. In this situation, it was resolved, but in most of my relationships, these miscommunications have lead to abrupt dissolution.

6). I began to worry that Ladu didn’t know that I love him with all of my heart. Over the past forty years, I have been told on more than one occasion that I am cold, emotionless, detached, and disconnected. Many people have tried to “fix” me before cutting me off, sharply slicing me out of their lives as if I were mold growing on a block of cheddar cheese. They felt that I do not know how to love. Does Ladu feel that way? I wondered.

But, even as I type this, Ladu is curled in my lap, purring. He puts one paw on the keyboard and tilts his head back to gaze at me, as if to cajole me to focus my attention entirely on him. He rubs his face against my chest and I kiss him.

This exercise has been productive, I think. I have learned much about myself and my process. I have information to reference when I start to feel stuck, tight, troubled.

I took the clock apart to find out what makes it tick. I have examined the mechanisms, the gears, the springs, the weights, the bell, the pendulum. Now, I carefully put it back together and close the beveled glass cabinet over the clock face. This moment is for me to sit with Ladu and Reko, love and sunshine swaddling us together, timeless and true.

 

 

© 2018 Saraswati Chand

 

 

Credits:
Cat images — https://emojipedia.org/cat-face/

 

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