A Day With DexterSeptember 18, 2019
Nathan Deaton has never walked a dog. Until today.
It’s a Tuesday afternoon in early July, and 10-year-old Nathan is staying on the eighth floor of Children’s Memorial Hermann, one day removed from a spinal cord surgery to aid with his cerebral palsy, a disorder that affects muscle tone and motor skills. Before the surgery, Nathan’s muscles were so tight that he couldn’t unfurl his hands. Now, a day later, he can lay his palms flat and sit up in new, looser positions than ever before.
And, his occupational therapist Magdalena Jungman tells him shortly after lunch, he could even wrap his hands around a dog leash for a walk through the hospital’s halls.
Dexter — who has no last name, though his hospital badge filled in the blanks for him, dubbing him Dexter Dexter — is a 2-and-a-half-year-old Labrador Golden Retriever mix who began working at the children’s hospital in February. Already he’s a star, earning greetings from staffers and patients alike whenever he strolls through the hallways with his handler, child life specialist Christy Lange.
Therapy dogs have become a familiar sight in hospitals over the last several years, as a growing body of research suggests that having dogs present in these places can have beneficial effects that stretch from reduced heart rate to lower perception of pain, thanks to raised levels of oxytocin that flood a person’s system when they look into a dog’s eyes. They come in and out, once a month, or perhaps more often, usually on the end of a leash led by a volunteer. But Dexter’s not a therapy dog; he’s a facility dog, which is to say that Dexter is to a therapy dog what a Swiss-Army knife is to a cork screw.
A therapy dog only needs to pass a basic obedience course. Dexter, who will turn 3 years old in October, has already spent more time in school than is required to earn an associate’s degree. As a result, he knows more than 50 commands, which enable him to do everything from pulling a child in a wagon and holding books to be read aloud, to demonstrating medical techniques, like pulling Band-Aids off dolls, or serving as a model for how to wear an anesthesia mask before a child’s surgery.
And he’s always listening for what Lange will ask him to do next, in one of her three distinct voices.
There’s her normal, daily tone that she uses at home or as she talks with her patients at children’s Memorial Hermann; the sweet coo she shifts into when she’s telling Dexter that he’s a very good, very handsome boy; and the goofy, pull-her-chin-in baritone she uses when she speaks on Dexter’s behalf.
That one’s the crowd pleaser.
Just before lunch, Lange sits alongside a patient bed on the hospital’s 10th floor, where Dexter is curled up in a nose-to-tail ball, luxuriating as 14-year-old Season Finley combs his fur in long, leisurely strokes.
“Do you like the bed, Dexter?” Season asks, her voice doting.
“Oh yes thank you so much Season for sharing the bed with me,” says Lange, 34, with her cartoonish, vaguely midwestern Dexter flare. “You know it’s my favorite.”
Season beams at the 52-pound ball of golden fur nestling deeper into the top sheet of her bed. She’s old enough to know the dog isn’t talking to her. But in this moment, eight days into a hospital stay after a horrendous car accident that left her bruised, contused and confused, she leans into the comfort of confiding in a four-legged friend.
And that is one of the key reasons Dexter is here each day, his employee badge pinned to his outfit, just like any given hospital staffer. Even if no one else wears a blue service-dog vest, or yawns so conspicuously in front of patients.
When Dexter came to the hospital earlier this year, he became Children’s Memorial Hermann Hospital first full-time Good Boy. But he’s not the first of his kind at the bustling Texas Medical Center. The child-life team at Texas Children’s, for instance, is home to a team of golden retrievers, with very similar job descriptions. But even as a glance around any airport lounge will illuminate the growing trend of deputizing dogs to assist in human work and comfort, dogs like Dexter are a rarity.
His very existence was planned by the folks in charge of the breeding program at Canine Companions for Independence, which has trained dogs like Dexter for more than 40 years. He is a Lab-Golden mix not by chance, but because that pairing is associated with obedience, adept retrieval and a desire to work his tail off. At 8 weeks old, he was sent to a trained puppy raiser, who housed him, potty-trained him, and taught him basic commands, until he reached 18 months — old enough to enter the intense service dog training, from which only 55 percent of these bred-for-it dogs will graduate.
There, as he boned up on ever-more challenging skills, Dexter’s trainers evaluated him to determine which of four career paths he was best suited for: a service dog, who assists someone with physical disabilities; a skilled companion, which is similar to a service dog, but serves someone who is either younger than 18 or has disabilities that require another human caretaker to facilitate the dog; a hearing dog; or a facility dog.
And here’s the thing about Dexter — he is beyond mellow. It’s like his internal clock is powered by molasses. When Lange tells him to sit, he will always sit. But there’s this long lingering pause between when she makes the command and he lowers his rear to the floor.
It almost looks like he’s challenging her, Dexter’s trainer Kate Incremona says. But of course he’s not. He just takes his time, something Incremona came to expect from Dexter over the six intense months she spent training him.
When Incremona found Lange’s application in the stack of candidates looking for a dog from Dexter’s graduating class, she knew for sure that Dexter and Lange could be a perfect pair. He is patient, and kind, and could probably withstand a child crying loudly or tugging his ear without batting one of his brown puppy eyes.
Dexter tests this theory daily. A couple hours after falling asleep at the foot of Season’s bed, Lange brings Dexter to the eighth floor to meet Nathan whose spinal cord surgery has given him more mobility. But these new sensations come with discomfort. And as Nathan’s mother, Aydee Deaton, and his occupational therapist, Jungman, work to help Nathan find a comfortable sitting position, his body twists and spasms, sending a shot of pain through him — followed by tears.
Dexter barely blinks. Just sidles up closer and licks Nathan’s hand.
“What did Nathan have, surgery wise?” Lange asks.
“Just on his back,” Aydee Deaton answers. “The RSD.”
“OK, so if Dexter touches him on his leg, that would be OK?” Lange asks.
A moment later, Dexter’s pink-tipped nose is resting just above Nathan’s knee. Jungman takes Nathan’s hand in hers and guides it toward Dexter’s ear, which he strokes with his open hand.
“Oh wow, Dexter, you have such a soft ear,” Aydee coos, as a smile spreads across her son’s face. It’s mirrored on her own face. Just one day earlier, Nathan would not have been able to pet a dog like this. And this hard-won progress feels sweet.
“What if,” Jungman suggests after a few moments, “we took Dexter for a walk?”
Holding a leash requires an open hand, a command Nathan’s nervous system has never been able to communicate to his limbs. But today is a new day for Nathan. So Jungman and Nathan’s father, Steven Deaton, whisk him into a wheelchair, and Lange loops a yellow-and-blue walking leash over Nathan’s wrist. Dexter has been specifically trained to walk alongside wheelchairs while letting the rider guide his speed, so he walks alongside Nathan as though they’ve been doing this together forever.
“This is the first time Nathan has ever walked a dog,” Aydee says, as Nathan and Dexter roll through the eighth-floor atrium, in search of a playroom. Her voice is hushed. Reverent. “This is all kinds of exciting.”
A dog sleeping on the end of a patient’s bed as she combs his fur, or walking slowly alongside a boy in a wheelchair and licking his arm, may seem like minor moments. They’re not.
“The kisses, specifically for Nathan, having the sensory piece of having those kisses from Dexter adds a lot for him in particular,” Lange whispers as she leads Dexter back to her office on the 10th floor, where she’ll input notes about the visit.
Typically, she discourages Dexter from licking patients. Some kids don’t like it. And germs are a real concern in a hospital setting. But for Nathan? The kind of sensory reactions that come from a puppy kiss, or petting the soft underside of Dexter’s ear actively work toward goals set forth in Nathan’s recovery.
In fact, every task Dexter undertakes is consciously assigned by Lange to work toward one of four goals that the child-life team works to meet: psychosocial, education, developmental or bereavement. Just about every patient — and many of their parents — would like to see Dexter on any given day. But when evaluating how to manage Dexter’s days, Lange considers who would benefit most, and which of these four goals Dexter can help a child work toward.
As Lange enters notes into her computer, Dexter plays with one of his favorite toys, a stuffed monster. And for just a moment, the dog that one of the patients’ mothers has affectionately dubbed “Mellow Yellow,” looks like a puppy, playing next to the heavy-duty vacuum cleaner that Lange has to keep on hand to suck up the blond tumbleweeds that form around Dexter’s preferred corners of the room.
Lange peels her eyes away from her computer screen. “Oh I love my monster,” she says in her full-throated Dexter voice.
“These are some of those moments I love. Staff will be like, ‘Oh he’s just sitting there. He’s just laying there.’ Like, ‘Oh, he looks so sad,’” she says. “But they don’t get to see these moments, when we come back up here and he’s in dog mode. They see him in working mode all the time. And I’m like, we’re the same. I’m not the same way when I’m in the office with my co-workers as I am when I’m outside of here.”
Dexter chomps on his monster, which squeaks in response, like he’s adding an exclamation point to his human’s little soliloquy. Lange smiles at him. They’ve only been paired together since February, but already their bond has grown so deep that they can communicate with subtle body language and the tone of Lange’s voice.
“You’re a good boy,” she says, dotingly. “So handsome.”
His tail, still nearly all day, gives a little thump against the carpet.
“But we’ve got more work to do,” she says. “Are you ready?” Her voice jumps an octave. “Are you ready Dexter? Let’s clean up our toys. It’s time for work.”
Down the hall, Michael Carrillo Chino is recovering from an invasive surgery that left his head wrapped in bandages. The 17-year-old is a day away from being discharged, and Lange wants to check in on him one last time, to talk whether he’s discussed this latest, most obvious surgery with his friends, so she can gauge his level of social support. Michael’s not always a talker. But she’s figured out that if she pops a football game into the Play Station set up in the children’s lounge, and sits Dexter next to him in a chair, the words start flowing, and she gets to see little slices of Michael’s life that he wouldn’t otherwise share in a hospital room one-on-one.
“We’re going to go see our friend Michael,” Lange tells Dexter.
Dexter takes a moment, before slowly standing back up with a long, wide-mouthed yawn. He’d been enjoying his afternoon break, but he knows he’s not here to play with his monster.
There are more patients to see. More beds to doze on. More hands to lick. And more chances to hear the one reward that keeps him focused on his goals, day in and day out. The words Lange lovingly whispers to him just now, as he sits back down, ready to lumber back into action.
“Oh, you’re such a good boy.”