Maladies Part 1 / 2 : All the Pills in the World

By Rachel Doboga

“No pills for what I feel. This is crazy!” – Neko Case, “I wish I was the moon tonight”

I have medicines to protect me from anxiety, depression, even nightmares, but there’s no medicine for sadness and fear. I could have really used a pill for those emotions after my diagnosis and over the years of my battle with ALS. I especially could have used them in September. The entire month was hell.

As I always say, when you haven’t heard from me in a while, something is wrong. Well, in this case, nearly everything is very, very wrong. In early September, a tumor the size of a golf ball appeared on my dog Malka’s ribs overnight. Literally. It was a shock to say the least. My very kind in-laws paid for testing. We found out it was very aggressive cancer. By the time we put her to sleep, the tumor was the size of a softball.

Malka died a horrible, painful, LOUD death. I still think I hear her moaning in pain in the night. If I didn’t wake Evan fast enough or it was too soon for another round of painkillers (it always was towards the end), she would start barking in pain. I was especially hypervigilant when she took to hiding across the house in the closet in Evan’s office. That’s where she used to hide from fireworks, which were pretty much her only fear. She was a fierce protector. It was so painful to witness that. It was like she thought she could hide from the suffering. It was hell being so helpless.

Malka was the best dog in the world, and I don’t just say that because she was my dog. She was perfect. No temperament or behavior problems. Totally healthy her whole life. She was so sweet and at the same time, very protective of me. She actually saved my life twice.

Even towards the end, despite her pain, she guarded the bedroom door while I napped, as if she could do anything if a bad guy showed up. Still, she couldn’t break the habit of protecting me. No guarding on her final day though. We kept her busy catching her beloved fried shrimp tails and even a few whole fried shrimp in the morning. That’s the last thing she ever did. Then came the pills.

Evan took such good care of her, especially when it got bad. He was her hospice vet. No one could have done any better by her. He barely slept because Malka needed so much in her last days, and she was so scared to be alone. I’m having trouble using the past tense. Everything with her will forever be past tense.

I kept having nightmares she died without me, but my wonderful husband was absolutely committed to getting Malka in the bedroom so I could be a part of her final moments. Following the advice of Melissa, the best vet and the best best friend in the world, we sedated Malka very heavily with three painkillers before the arrival of the vet who delivered Malka from the agony caused by that evil enormous tumor. She fell asleep in a patch of sunshine in the living room, content because at last, she had all the painkillers she could want. I will always remember Evan saying, “We’ll get her in here even if we have to carry her.” In the end, that’s what they had to do. They used the stretcher the vet brought to carry her away after she passed.

My generous parents and sister paid for in-home euthanasia. Malka needed so much help getting in and out of the car in the weeks before her death, and she was so tender to the touch by the end, if we tried to get her to the vet she would have spent her last moments in agony and terror. I’m grateful to them for saving her from that and giving her a degree of peace.

Melissa told me that the word “euthanasia” translates to “dying well” or “a good death.” I kept repeating that to myself as the vet who would put Malka to sleep arrived. The vet was very compassionate and good at explaining everything she was doing. There was no rush, and she was very respectful of our privacy. I read Malka a story I wrote about heaven (see below).

My caregiver stayed in the room to wipe my tears so I could type my last words to Malka (“what a good dog” and “I love you”). I was able to use my own voice so she would recognize me because I recorded some phrases before I lost the ability to speak five years ago. I used my own voice a few days before her death to tell her she’s a good girl, and Evan said she looked up. That meant the world to me. My caregiver even cleaned up the puddle of urine where Malka lost control as she passed so Evan and I could cry together. It truly was a good death, just like Melissa said.

Here’s the story I wrote for and read to Malka –

Dearest Malka, you’re going somewhere very special where you’ll be young and healthy forever. It is a meadow with tall beautiful flowers where it’s always summer, and it’s surrounded by big trees so you can cool down in the shade after you have been sunbathing too long. You will have pizza crusts and fried shrimp tails for every meal. There are plenty of elk for you to chase, and we will all be together before you know it.

* I can’t post comments or reply to them, but I can read them and I love them. Keep writing.

If you have fond memories of Rachel as a teacher in her life before ALS, or if a post on this blog has ever moved you, please consider making a contribution to Rachel’s out of pocket caregiving fees, medical expenses not covered by insurance, and transportation costs through Friends of Rachel. From your PayPal account you can donate to

2 thoughts on “Maladies Part 1 / 2 : All the Pills in the World

  1. Hannah says:

    I’m so sorry for this devastating loss, Rachel. I too, have a loyal pup who guards me on my worst days and snuggles with me on the better days. To love deeply is to open ourselves up to great pain. It sounds like Malka had the absolute best you guys could do under the circumstances. Sending love.


  2. Sue says:

    I know how hard it is to say good bye to your furry family member. You and Evan are very strong to let Malka go, it is so hard to make that decision but now she is free from pain. I wish I could give you a big hug…


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