Introduction Pransky, my soon-to-be ten-year-old dog, is lying on the living room couch, her body filling it end to end, for though she is not a big dog, she is double- jointed, which means that her hips lay out flat. If I weren't typing this I'd be stretched out next to her because I'm tired, too, as I often am on Tuesday afternoons. Every other day of the week, Pransky is a carefree country dog who operates by instinct, roaming the meadow around our house. But Tuesday mornings we spend time at the county nursing home, going door-to-door dispensing canine companionship and good cheer. Working at the nursing home requires us to pay attention--Pransky to me, to her surroundings, and to the people she is meeting, and me to her, to our surroundings, and to the people we are meeting. After three years you'd think we would have gotten tougher or more robust, but that's never happened and probably never will. When I first considered training Pransky to be a therapy dog she was in her late adolescence. Dog years being what they are, she is now about the same age as most of the people in the nursing home. Even so, the words "work" and "walk" still get her to her feet in a unit of time that is less than a second. Is she better at her job, more empathetic, now that she, too, is of a certain age? I doubt it. I doubt it because I don't think she could be more empathetic. As foreign as the nursing home environment was to both of us when we first started visiting County, it was a little less so to me, since my first job was at a medical school in a teaching hospital where I sometimes went on rounds. I was in my late twenties, with a newly minted doctorate, hired to teach ethics to second-year students. This should tell you all you need to know about how seriously that place took the ethical part of medical education: at that age I had about as much experience with the complicated ethical dilemmas of sick people and their families as the second-years in my class had treating sick people and dealing with those ethical dilemmas, which is to say, basically, none. Still, reality was not our mandate. We were supposed to consider what might happen "if," and then think through the best "then." The one thing you need to know about modern philosophy is that the operative word in the previous sentence is "best." The first thing we had to do in that class was figure out what it meant. Was it what the person in the bed said she wanted, what the doctor wanted, what the hospital's risk manager wanted, what the church (whatever church it was) wanted, what the husband wanted, what the other doctor wanted, what the wife wanted, what the parents wanted, what the partner wanted, what the children wanted? Sorting out what was best was, to say the least, challenging. For guidance, we read works by Kant and Aristotle and Bentham that were harder to get through than the textbooks on human anatomy and organic chemistry, and, for my students, who were itching to get into the clinic, largely beside the point. While I didn't think for a minute that an abstract principle, like Kant's categorical imperative, say, was actually going to lead to the right decision on whether or not to give a new heart to a homeless man, it seemed like a reasonable idea, in a place where right answers were often not as black- and-white as they might appear, to inject some of these notions into the future doctors' heads. If ideas like these could become part of their mental landscape, then in the future, confronted with that homeless man, they might see the terrain with greater definition. Historically, when people looked for guidance on how to conduct their lives, they turned to philosophy or religion or both. That's less true now, as formal religious affiliations drop away and academic philosophy becomes more and more arcane. It's not that people are less inclined to examine their lives or to seek wisdom, it's just that they are more likely to look for it in other places: in support groups, on radio call-in shows, from life coaches, on the Internet, in books, or, in my case, inadvertently, with my dog, in a nursing home. When Pransky and I started working at County, I expected to learn things--how could I not?--though what those things would be I had no clue. I assumed I'd learn something about old people, and about the thera- peutic value of animals in a medical setting, and about myself in that setting, which was alien and not a little scary. What I found myself learning quickly sorted itself into a template that anyone with a Catholic education, especially--which would not include me--would recognize as the seven virtues: love, hope, faith, prudence, justice, fortitude, restraint. It should be said that the Catholics didn't have a corner on virtue, in general, or on these seven in particular; they just happened to enumerate and, in a sense, popularize them, so when we think of virtue, we tend to think in sevens. But well before Catholic theologians codified their list, Greek philosophers, most notably Plato and Aristotle, offered advice as to the traits and behaviors that should be cultivated in order to live a good, productive, meaningful life, a life with and for others. It was to Plato's original four-- courage, wisdom, justice, and restraint--that, centuries later, Saint Augustine added love, hope, and faith--what are commonly called "the theological virtues." These, he believed, both came from God and delivered one to God and, ultimately, to a place in heaven. In our own time, for most people, love and hope and even faith, if you think of it as loyalty and consistency, are unmoored from visions of an afterlife. Still, the virtues remain as guides not only to good conduct but to our better--and possibly happier, more harmonious, most humane--selves. Happiness, as it happened, was the dominant emotion for both Pransky and me when we were at the nursing home, strange as that sounds, and strange as it was. I didn't go there to be happy any more than I did to learn about hope or fortitude, or to think about courage and faith, but that's what happened. You could say I was lucky, and, in fact, by landing at County, I was lucky. County happens to be blessed with tremendous leadership, a devoted staff, and a larger community that embraces rather than isolates it. I wouldn't presume that it is comparable to any other nursing home. But I do believe that in settings like nursing homes, as well as hospitals and hospices and any other place where life is in the balance, we get to essentials, which is what the virtues are. More than luck was at work, too. My dog was at work, and she brought to it a lightness and easiness that seemed to expand outward and encompass almost everyone she encountered. We often talk about "getting out of our comfort zone," but rarely about entering someone else's. Pransky made that possible. With her by my side, and sometimes in the lead, I was able to be a better, more responsive, less reticent version of myself. One day a man I didn't know was sitting idly by himself in the nursing home hall. He was wearing a badly tied hospital johnny that exposed part of his back, and nothing else. It was rare for people at County not to be dressed in street clothes, but it wasn't his attire that caught my attention. The man was jaundiced and almost as yellow as the liquid running through the tube that started under his hospital gown and ended in a bag on the side of his wheelchair. That, and he had no legs. This was not Joe, another double amputee who became one of our regulars and will appear in these pages, but someone I'd never seen before and never saw again. If I had been alone, I might have nodded in his direction and kept going, because that man represented most of the things that scared me about nursing homes: debilitating illness, a lack of privacy, bodily fluids. But I was not alone, and my partner veered in his direction, which meant that I had no choice but to go over and talk to him. What a nice guy! We talked dogs (he had two Yorkies at home), sports (he was a Steelers fan), and dogs some more. I was in his comfort zone, and Pransky's, and then, ultimately, mine. It was, in the scheme of things, a small thing, but small things add up. My mommy would like your doggie," a youngish woman with developmental disabilities said to me the first time we met her at County. "My doggie would like your mommy," I said. "Where does she live?" "In heaven," she said. "Oh," I said. "Pransky has a lot of friends in heaven." And after what was by then a year at County, it was true. A certain amount of death is inevitable in a nursing home. This is where the virtues can be helpful. They point us at what's important and valuable in life. They can offer perspective and frames of reference, and if a dog is in the frame, all the better. As I was working on this book, and friends asked me what it was about, I would say "right living and dogs" or "moral philosophy and dogs" or "old people and dogs." Eventually I realized that every one of those descriptions was wrong. I was saying "dogs," plural, when it was actually about one singular, faithful, charitable, loving, and sometimes prudent dog. That dog has risen from her slumber and is standing behind me now, showing great hope, restraint, and fortitude as she waits for me to stop typing and go for a walk. Excerpted from A Dog Walks into a Nursing Home: Lessons in the Good Life from an Unlikely Teacher by Sue Halpern All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.
