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By Christopher Goodwin, MD

I love dogs. Just not in my exam room when my patient has a very nasty wound and the only thing worse looking and worse smelling than the wound is the dog.

It was 1999, in the Pacific Northwest. I was working in a fledgling inner city clinic serving the uninsured and homeless that was started by a self-described “hippie chick” whose defense of the underserved was militant.

We refused care to no one.

So on a cold winter morning, when a guy and his dog came up from one of the homeless camps saying something was wrong with his ankle, but wouldn’t let anyone touch him unless the dog stayed at his side — the dog stayed at his side.

He looked twenty years older than the frightened child peaking out from the sunken eyes, wool skull-cap pulled low, sucked-in skin at the temples and jaw line betraying the emaciation otherwise hidden by multiple layers of clothes. There was the odor of unwashed body, campfire smoke, urine and stale fruity alcohol on his breath. But the dog was worse: black lab shepherd mix, bald spots, oozing sores and crusts, covered with dirt matted down with what looked like blood and grease, smelling like rotting animal.

“He rolled in a deer carcass on the way in, Doc. Sorry.”

His ankle wound was bad. He had passed out drunk after shooting up, and a hot ember from his campfire had jumped into his unlaced boot. This was maybe a week ago. He couldn’t remember. A burn hole in a filthy sock and a piece of charcoal in his boot told the story. The burn involved the entire outer aspect of his ankle. It had 3rd degree appearance of dirty candle wax, and a deeper ulcer centrally was collapsing with necrotic debris, maybe down to the bone.

“If you don’t go to the hospital, you’re going to loose that foot.”

“I don’t have anyone to take care of him,” he said, looking down at his dog. “And he takes care of me. He’s never let me down. Everyone else has. Nope. Cant do it.” So he limped out the door, bandaged in futility, with a handful of antibiotics, a few protein shakes, new socks, dog at his side.

No return visit.

A few weeks later, I went with a team from clinic on what we called ‘river walks’. We’d take some basic supplies and go to homeless camps along the Spokane River. It was a bright sunny, brutally cold day. It was getting late. We were about to turn back when we spotted them — guy and his dog, at a campfire, sitting side by side on an abandoned minivan bench seat. We persuaded him to let us check his ankle. Miraculously no worse, but definitely not better. Redressed it and gave him some more antibiotics, protein shakes, and another pair of new socks. He invited me to squeeze in with them on the end of bench. Next to the dog.

We sat for a moment silent.

The slow deep hush of the river,

breeze whispering through tall Douglas Firs and Lodgepole Pines,

late afternoon winter sun casting long shadows. Beautiful…

But this dog stunk.

There we were — the three of us crammed onto a 2-passenger bench seat in the woods, half a mile from the nearest road. Maybe if I offered to take care of his dog, he’d go to the hospital. I looked at the dog. The dog looked at me. I was certain that dog was looking at me, daring me to explain to my wife what I was about to do. I answered him with my eyes, “Well first thing, you need a bath.”

“I could do that,” his eyes said.

“You have to know we already have 5 kids, an underweight, nervous standard poodle who wont eat around other dogs; an overweight dachshund, who will tell you he’s starving while eating everything — “

The dog kept looking at me. This was becoming an intense telepathic conversation. “ — and a duck who slaps around the house in a diaper while bullying the dachshund; 3 chickens; and a horse….”

“So?” the dog shrugged.

“Dogs don’t shrug!”

“What was that?” the guy asked from the other end of the bench. Apparently our conversation had become audible. I got up and turned to him “Look. You’re going to loose this foot. If you’ll come back to clinic, I’ll take your dog home so you can go to the hospital and — “

He interrupted me and looked me right in the eye, “Doc — you’d do that? You’d take care of my dog? He doesn’t like many people. Usually bites ’em. “
(Now he tells me?)

“He doesn’t even growl at you. Kinda like you know each other already.”

(Yeah, we were just getting to know each other when you interrupted.)

“You’d take care of him for me?”

“Yeah… Yeah, we’ll work something out.”

I hesitated. And he saw it. But he covered for me there by the river.

“No Doc, you don’t need to do that. Maybe I’ll come by clinic in a couple days. No promise. Hey, you know, I might head home to Chicago, go to my moms — she’ll watch the dog, then I’ll go to a hospital. Might even go to rehab, get clean.”

He never came back to the clinic. Never saw him again.

For a long time after that, I wondered if he lost his foot or if he was even still alive. I couldn’t handle the inconvenience of taking care of a dog? A nasty smelling, dirty, dog to save a foot, maybe a life? I wish I could say I know I would make a different decision today.

About 6 months later, we got a postcard at the clinic. Chicago skyline.

“Hey. Made it to Chicago. Staying with mom. Went to hospital. Went to rehab. Got a job. Because you cared about my dog, you cared about me. Still have my foot. Still have my dog. Thanks.”

You never know — I thought that dog was the problem.

Turns out, he was the answer.

Fall 2019 Story Slam — Experiencing the Unexpected

Stories from Temple’s Narrative Medicine Program

Led by Pulitzer Prize-winning journalist Michael Vitez…

Lewis Katz School of Medicine at Temple University

Written by

Lewis Katz School of Medicine at Temple University. Exceptional students, clinicians and researchers with zeal for education, research and patient care.

Stories from Temple’s Narrative Medicine Program

Led by Pulitzer Prize-winning journalist Michael Vitez, Temple’s Narrative Medicine Program focuses on the human side of medicine through a celebration of and emphasis on stories and storytelling.

Lewis Katz School of Medicine at Temple University

Written by

Lewis Katz School of Medicine at Temple University. Exceptional students, clinicians and researchers with zeal for education, research and patient care.

Stories from Temple’s Narrative Medicine Program

Led by Pulitzer Prize-winning journalist Michael Vitez, Temple’s Narrative Medicine Program focuses on the human side of medicine through a celebration of and emphasis on stories and storytelling.

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