Love On Four Paws

This week Ellen and I withdrew from Love on 4 Paws, an organization we've been volunteering with for the last 15 months. We were taking our dog, Dylan, to hospitals to do animal assisted therapy, which mostly means visiting patients to cheer them up and give them a brief break from the tedium and stress of being in hospital. The organization is run with careful and constructive discipline by a woman called Suni and her team leaders and coaches. Before you start, the dog passes a "canine good citizen" test and is checked out to see how he reacts in various situations, such as having a lot of people milling round making noise. For the handlers, there's a lot more training in the hospital procedures and the legal requirements.

The first hospital you visit is Shriner's hospital for children (all the locations are in LA). Shriner's is a relatively easy environment to work in, but even so the first few visits were hard work: as well as looking after the dog and setting him up to interact with the patients, there are many hospital protocols to follow. Mostly they are to do with hygiene, such as washing your hands on entering a room, but there are others too. For example, you usually take a picture of the patient with the dog using a Polaroid camera. Occasionally, one picture doesn't come out well, and so you take another, and then you have to remember to hand them all to the patient, or destroy the extra ones, as taking the picture away would break the HIPAA confidentiality rules.

The big step comes when you move to Children's Hospital of LA. Whereas Shriner's is mostly orthopaedic and clinic patients, CHLA has many patients who are very sick with cancer or other serious illnesses. As well as making it a more highly charged environment emotionally, it means the protocols you have to follow are much stricter: no entering certain rooms where a patient is in isolation, wash hands on entry, wipe patient's hands, put an extra sheet on the bed before the dog gets up, wipe patient's hands afterwards, fold up the sheet from the corners inwards... At the end of the first few visits, we were totally wrung out. I also kept making mistakes such as leaving my bag of supplies behind in one patient's room after the visit, then having to try to figure out which room I had last visited to go back and get it. Over time, it got easier, though. In the middle of 2008, we also started visiting St John's, a hospital for adults. The visits are of a different sort there: you tend to spend longer with each patient and see fewer of them. Sometimes in CHLA, the visit is really just a quick snuggle with the dog, a picture, and move on.

With all the training that we as handlers do, there is no training for the dog. Over time, Dylan worked out what he was supposed to do, and for a while seemed to consider it his job. But in the last few weeks, he was getting more and more reluctant to do the visits and at the end was scarcely engaging with the patients. We had said from the start that if we thought he didn't want to do the visiting, we would stop. He seemed to telling us that he didn't want to be there any more, and after a visit to St John's last weekend, we made the decision to stop visiting and leave the organization.

I feel sad about this. It's easy to think that your work matters or that by giving to a charity or participating in a campaigning group that you are changing the world. It's a different thing when you have this direct personal involvement. I saw situations where having a visit from the dog got through to someone who was in distress and pain, and provided them with a moment of respite or happiness. When that happens for a child, it also often helps the parent, a moment of normality in a turbulent time. The medical staff sometimes benefit from a minute or two with dog as well. Even the man who runs the valet parking at one of the hospitals was always happy to see Dylan.

Dylan is quite a shy dog. When he decided he is your friend, he loves you wholeheartedly, but it takes a long time to get there. Other dogs I saw had a temperament that was better suited. Think of your archetypal golden retriever who loves everyone, for example. Calmness is another quality that works well, and that is something that Dylan has once the shyness is out of the way. I saw many skillful handlers too, who have some magic that creates just the right interaction between the dog and the patient.

I'll miss the friends I made in LO4P, and I'll remember the way that at CHLA we all ended by gathering in a ward that had a sun-trap glass roof, resting for a moment after the work we'd done, before setting off on the "dog parade", all the dogs and handlers leaving the ward together.