Puppies and Rainbows

The past twelve months have been difficult on us all. No one was prepared for the pandemic the world has struggled to deal with. Staying at home, isolation, missing friends and family, substituting Zoom meetings for everything from class time, work from home, meetings, and even happy hour get togethers. As a hospice nurse, I am used to being independent and working out of my car, but COVID has made it so we rarely see one another, unless from a computer screen meeting or a rare joint visit.

It has now been twelve months of masking, decontamination routines at the back of my car, rushing into the shower once home before giving the “I’m home” kiss to my husband, and the hardest on us all, being unable to physically comfort the hospice members of our people who are dying. There were many times when I wanted to pen my thoughts, but the one consistent thing of 2020 was complete and utter exhaustion accompanied simply by an inability to muster the energy. Inequities, violence, intolerance of others, hate, the deaths of so many in healthcare as well as the community, the attack on science, and the need to adjust everything we do to protect others from COVID has made the year has feel like a century. Whoever knew there were morning and afternoon loungewear, aka pajamas? While there is light at the end of the tunnel with vaccinations getting into arms, pandemic fatigue has been a real thing for a long time. While adding work, sharing time with puppies continues to provide me my own therapy. Yin and yang, life and death; normal ends of the life cycle.
Being a midwife at the end of the life cycle has often been balanced here with welcoming new life. At times, I am fortunate to help bring puppies into the world and raise them, while simultaneously helping patients and families to manage all aspects of death and dying. Over the years, I have shared when we have had puppies, even when it makes more work
for me. So many have found the puppies help them smile, cope, and I even had messages years ago telling me seeing puppies daily was a reason not to complete suicide plans. They were even more helpful during this tumultuous twelve months when so many were staying at home trying to navigate a pandemic and political upheaval. Laughing at puppy antics and imagining being surrounded by them clearly made for a nice break for people. Sometimes though, in the background of happiness comes sadness. Life certainly is not always easy.

As time has gone on and I discuss end of life topics periodically, I have learned how people project their own fear of dying onto others, be it people or animals. I feel an obligation when sharing about our dogs publicly to also help navigate the times when something goes wrong. While so many share their lives with pets, we also share the common reality that almost all of us will outlive our animals. Talking about dying, death, and preparations doesn’t end with people.
When I remember JJ, her zest for puppies and life brings a smile, not tears. She thought puppies were the best from a very young age and no one could convince her she didn’t belong with them. Her last year had been intense while allowing so many to share the cancer diagnosis, treatment, and eventual death of a popular dog who provided virtual therapy for so many. JJ had been the perfect conduit over the years for sharing with others about death and dying, although at times, it made it much harder on me while we were dealing with JJ’s cancer. Now, whenever puppies arrive, I always think of JJ and her eager anticipation to see “her” new arrivals. Two months ago was the third anniversary of JJ’s last night with us and with a special group of nine puppies, nannied for their first eighteen days by the Super Nanny herself. JJ was tired, but clearly wanted a last moment with those puppies, including Ember, the sassy one in the pink collar. We all say that JJ shared some special secrets with those puppies. That last evening was just us; no sharing of the time with puppy fans, because I knew her time was short.  

That pink collar puppy grew up to be my next therapy dog, Ember. Her registered name matched her personality, Calhoun’s Get The Party Started. She also happily learned to take on the Super Nanny role and may be even more puppy obsessed than her great aunt.
The Year of the Pandemic has meant no therapy visits and it has been clear how much she has missed seeing people and spreading her joy and magical fibers with them. The belly rubs have become severely rationed by visitors over the many months, as we continue to wait for it to be safe to do therapy dog visits and therapy dog evaluations, as handlers have to be close to others. The one thing we could do was plan a litter of puppies and we wanted to keep one of Ember’s daughters. When we plan a litter of puppies, long before breeding, we usually have a long list of homes already screened. As sometimes happens with mother nature, three of the girls with those long lists came into heat at almost the same time. Because of the pandemic, we were home almost all of the time, so decided to sign up for some lack of sleep, knowing we would have two Labrador litters and Ember’s puppies all within a four week time frame. Get the party started, indeed.

Normally, we have uneventful arrivals of the puppies here. The first twelve arrived without a hitch, requiring time, patience, and a coffee-filled all-nighter. There were two weeks of puppy bonding and snuggling with wee ones before round two was upon us. In the meantime, during a break in the dark, a very special cloud appeared for a short period over the puppy yard. It’s not uncommon to have things in nature remind us of those who have died. For me, rainbows and dog clouds bring the smiles and “Hi, JJ!” thoughts to mind. 

I should have known the O.G. Super Nanny was up to something. Since JJ would walk hospice patients out of our inpatient facility after they died, when she died many of us would envision her role reversing to “walk in” people after they died. We knew by ultrasound and doppler that Rosie, our second lab mama, had at least nine puppies. She went into labor and had two boys before indicating to us she was having a problem with her labor and had to go into our vet team at Oregon State University. By the afternoon, we brought Rosie and three more puppies home.
Sometimes, things can go wrong in utero. I often comment how fortunate we have been over the years to only rarely have to deal with problems bringing puppies into the world. Five puppies didn't make it. There was no indication of problems, but in dogs, we don't do the multiple ultrasounds and fetal checks with advanced technology that can tell us when a baby isn’t developing properly. These puppies were at least one third the size of their healthy siblings. There wasn't anything obvious for our vet team to see what might have gone wrong. While I hated disappointing the puppy owners looking forward to bringing home one of these puppies, I was thankful to have a healthy, but tired, mom and five vigorous littles.

The next several days were a blur, between taking care of seventeen puppies, making sure I kept up on our schedule of puppy care needs, kept track of on a white board calendar, as well as my daily hospice work. Luckily, my husband was home full time and we simply needed to stay organized. A week later, we confirmed Ember was carrying 8-10 puppies, meaning December would be a really busy time. Besides going from house to house to see hospice patients and families, we were staying home, so managing our quickly growing circus was fairly easy. Time flew as Ember spent her time nannying the Littles whenever she could, swimming anytime she could get close to the pond, hunting for rodents while proudly displaying her mud coated head, nose and feet, all while her belly grew and grew. 

Ember went into labor during the morning, something that rarely happens here. I was thrilled to think I wouldn’t be going to work sleep deprived the next day. As Ember got to work nesting and digging in her whelping box, I received a text from a friend with the words “Hi, JJ. Must be puppy day” and a photo of a rainbow ending right at our house. I have so many photos of JJ with rainbows from her last two years of life and I send her a shout out any time I see a rainbow, which is often, especially here at home. I didn’t give it much thought as Mr. Red arrived about forty minutes later. Ember and Red spent time together as she rested and he nursed, receiving the important colostrum which gave him his mom’s protective antibodies. We have rules to follow when puppies arrive, specifically designed to make sure we are seeking veterinary attention when needed if labor stalls or isn’t progressing as we would expect. As time went on, it was clear something was off. We called the OSU team and headed out. There was no way for us or those watching the labor not to be even more nervous, given what had happened one month earlier with Rosie. And I thought of that rainbow. “Please, no more puppies for you, JJ, you have enough” was my silent plea as I sat with Ember while she continued her obviously ineffective contractions.

Because of COVID precautions, vet visits are done remotely. I handed off Ember to the team, while the chief resident asked me how many I had counted a few days earlier with the doppler. “At least nine” came my reply as she nodded in agreement looking at 
Ember’s very rounded and dropped belly. Ember is always happy seeing people, including vet staff, so off they went without a glance back and we returned home to wait. Shortly afterward we received an update. Some bad news, but a lot of good news as well. There was a puppy without a heartbeat blocking the way for the other eight, who were all in good shape on ultrasound. A c-section was needed and was done quickly. The relieving phone call came announcing five more boys and three girls, all healthy and nursing, and a mom who came through surgery without a hitch. By early evening, all were settled, and even while drowsy, Ember was attentive to her puppies in between naps as the anesthesia wore off. There was a collective sigh of relief as hundreds were able to see them all back on the camera. We have had so little loss over so many puppies caught here, I would be happy to have boring back for 2021 when it comes to puppies and the world we live in. 

Time went on and the lab puppies made their way into their new homes in the next few weeks. We definitely relied on the whiteboard calendars to keep track of daily tasks for each litter and their moms, along with a different color assigned to each group. It was chaotic at times, but fun, and my husband likes to point out I thrive with chaos and will make some just to be in my happy place. Ten years ago we had three litters at one time and had said emphatically we would never repeat that silliness. I guess ten years is long enough to forget how much work it really is, but we now agree with our smarter, younger selves on this topic. 

Once the labs left, Ember and her nine made us practically feel like empty nesters. We had a month ahead of us with fun and games, yet it seemed so quiet and lacking chaos. I spent most of that month sharing videos almost daily on JJ’s Facebook page, knowing the collective stress we were all going through in January. The puppy videos were shared around the world, often bringing slews of daily messages “I want a puppy.” I do know they helped so many take a few minutes out of a stressful day to smile and laugh. 

Meanwhile, I spent as much time with them as I could. Puppy therapy was helpful for me and I made sure to spend time continuing the enrichment and desensitization things we do with all puppies. It was common to hear the door open with a “Tracy, time to put your dolls away and go to sleep.” Goldie isn’t the only Fun Police in this household. People knew a girl would be staying and kept asking if I knew which one. By seven weeks I knew, but had decided to keep it quiet as I continued to watch and interact with the puppies as I worked on puppy placements for the families. 
While we didn’t get to do our usual Pile of Puppies visits I so enjoyed because of the pandemic, we did have a special event planned with the puppies. Just a few days before go-home, the puppies were a part of a surprise marriage proposal. Ember was certain all of the people had come to see her and she made the most of charming the people. It was such a joy filled day with some really wonderful people, a rare occurrence over the past year.  The puppies loved the attention and cuddles.

I talked with each puppy owner about which puppy would be going home just before the weekend, but as usual, I refrained from announcing which puppy would be staying with us. Friday morning before their vet visit, we noticed Mr. Red not feeling well. He had thrown up a few times, but when the vet checked him, nothing seemed out of the ordinary. He got an anti-nausea med and I let his owner know he would be staying a few more days so we could monitor him. He rallied and was feeling a little better, but I was concerned and had a bad feeling, a spidey sense that as a hospice nurse is not a good thing. I scrolled through hours of puppy cam footage and videos trying to pick up on any noticeable problems. With the exception of tiring out earlier than his siblings the previous few days, nothing seemed amiss. Mr. Red started to have difficulty with his breathing and I knew he needed to be seen in ED Saturday night. He was quiet and didn’t make a fuss, a concerning assessment in an 8-week-old puppy. My initial thought was an aspiration pneumonia after he had vomited the day before. I wanted to get treatment started ASAP and get him on the road to recovery. It was midnight before they could take him in to be seen and I settled in for an uncomfortable nap in the front seat. Two hours later, I received the update and I wasn’t prepared to hear his diagnosis. It was horrible and catastrophic. Baby Red had a congenital diaphragmatic hernia/tear (an opening in his diaphragm) with no air exchange on the left side, because his stomach was displacing that lung.

For a puppy so symptomatic, even if surgery was attempted, prognosis was poor and it was something too complex for anyone in the middle of the night to attempt. I didn’t need to think too long. I had just read about this condition a couple of weeks earlier along with a discussion of treatment possibilities in puppies and poor outcomes. He was having a difficult time and there really was no choice. I decided to wake up the owner I was going to place him with before we euthanized. I couldn’t in good conscience not alert her. It was one of the hardest conversations I have had to have, much less at 2 in the morning. When I got into the clinic to spend some time with him, it was mind boggling to see how fast he was declining. It didn’t take long to call them in. The perspective I have as not only a hospice nurse, but one who had to assist families to understand when their loved one was transferred to our inpatient hospice and was actively dying, was helpful in my disbelief. I simply didn’t want him working any longer as his body had betrayed him with this hidden birth defect we were unaware of. I had been distraught, but that calm of being present as life ends is second nature and took over as I nodded my readiness to the vet. It was fitting to be the one with him for his first and last breath. He was the sweetest boy and I had such high hopes for him, moving on to his new home. Goodbyes shouldn’t have to happen so early in life, but reality can be cruel at times. What I didn’t know that difficult night was that I would be facing this same thought just a few days later, except in my work life. 

Sleep well, little man. You were the bestest boy during your time here. Pink sister will heal hearts in the family you were destined for. Your nanny has you from here. Be sure to send a rainbow from time to time. 


  1. Thank you for helping me to better deal with dying. There has been a lot of it in my life, the past two years and a new perspective on it helps me to work through the pain. Also, thank you for all the joy your pups bring!

    1. I am so sorry to hear. When we have multiple deaths, it really compounds grief. I am glad we can lighten the mood from time to time.

  2. When I was in nursing school on hospice lecture day, a very wise colleague commented that many people think the greatest honor in medicine is to bring life into the world. She commented that helping someone leave this world with dignity and grace was an equally worthy honor. Not many balance the two the way you do Tracy. You have answered and balanced two similar but vastly different callings beautifully. Keep up the inspiring work!

  3. As a occupational therapy assistant, we rarely encounter death. If one works in skilled nursing or long term care long enough, we see the eventual wave rise and crash with the winter holidays. Nothing prepared me and my co workers for the summer of 2020. 7 patients in a span of 2 weeks. All COVID deaths. Telling patients we loved them because they had no family but us, getting the news that some one had been put on hospice and then was dead 3 hours later. It was a shock to the system I will always remember and try to learn from. Thank you for sharing Mr. Red's story. 2020 brought more unexpected death to our door with the loss of my twin sister's 3rd guide dog from hermangiosarcoma. This blog post about Mr. Red mirrored what she had to go through. The grief is still there and I simply listen as she continues to navigate her grief. I tell her its still ok to cry, to sob, to be angry, etc. Grief is different for everyone and the best gift we can give someone grieving is our patience. I know I'm writing a novel but I just wanted to say thank you; for your work in hospice, the puppies, the stories and the care.

    1. Thank you for that. Grieving is absolutely different for everyone and I worry about the toll that COVID has taken on our healthcare team members. As you said, those who may not have had much exposure certainly has had death thrust in front of them in this past year. I am so sorry about your sister's guide dog. Losing a partner like that is just so hard.

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  4. Thank you for this beautiful, heartfelt, and enlightening story! Your words have a way of giving comfort even as you describe such scary and sad situations. As a Hospice Nurse, I’m sure you bring the same comfort and peace to your patients and their families, just as your puppy videos have done for me.

  5. I went back and re-read this after reading the new one about the infant who was surrounded by love during a short few hours of life. Besides doing the valiant work of accompanying at the end of life, you also - somehow - find the strength to teach us about it. The stories about Mr. Red and this baby show just how important your work is, and how hard it can be at times like this. We like to think that sweet little boy puppies and very small babies with their little hands wound around mom's finger just shouldn't leave so soon. But sometimes, they do.

    1. Thank you! These cases have definitely had me taking time to re-center and fill my cup back up.


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