by Christopher Hann | Photos by Andrew Lichtenstein '88
It's 11 o'clock in the morning on the first full day of summer and it's already hot—New-York-City-heat-wave hot—when Linda Koebner MA ’12 walks into the lobby of Montefiore Medical Center in the Bronx with her mixed-breed dog. Spirit’s short, thick fur is splotched with black, brown, white, and gray. Koebner has been told that he could be part Catahoula Cur (that would explain his eyes, which are practically cerulean). Koebner found Spirit six years ago as he was roaming a park in Louisiana, alone. “Starved enough to be eating pebbles,” Koebner says. “Looking miserable.”
She and Spirit, now healthy and plump, head to the palliative care unit on the seventh floor of the hospital. They’ve been coming here every two weeks since last December, when Koebner, a master’s candidate in the Health Advocacy Program, received permission to start the first pet therapy program in the history of Montefiore Medical Center. Spirit is wearing a red vest—complete with photo ID—that identifies him as a therapy dog, and his appearance on the unit brings instantaneous oohs and ahhs and smiles of recognition from the nurses on duty.
All the patients on palliative care are coping with serious, often terminal conditions. They are among the sickest of the sick. On this morning, as Koebner and Spirit enter their rooms, they lie in their beds, alone, tubes strung from their veins, surrounded not by doting wives and husbands and sons and daughters but by machines that beep and flash and hum.
Koebner and Spirit enter a room occupied by a lone elderly woman who is legally blind. Koebner moves the narrow table extended over the woman’s bed so that Spirit can introduce himself. The woman rolls on her side and, not without some difficulty, reaches her right arm down the side of the bed, her hand searching for the dog that has come to see her. “What color are you?” she says. “It’s okay, baby. It’s okay.”
Spirit delivers his care with an aplomb that could serve as standard protocol for all health care practitioners today, no matter their number of legs. He listens attentively. He never interrupts nor cuts his visits short. He nuzzles into your elbow. He lifts a paw (sometimes two) onto your chest. He licks your face. The woman’s hand finds Spirit’s head, his snout, his ears. He is only too happy to let her fondle him. By the time Koebner and Spirit bid their goodbyes and head for the door, the woman, now sitting up, has managed a smile. “Thank you for visiting me,” she says, an uplift newly evident in her voice. “It was nice visiting with you.”
In a very real way, Koebner has been preparing for this work her entire life. Growing up in the Riverdale section of the Bronx in the 1960s, her home was filled with a fairly traditional menagerie of domestic pets. That is to say, there were no chimpanzees. But as far back as she can remember, Koebner fantasized about having a pet chimp. Lo and behold, when she was 17 years old, her chimp prayers were answered. Koebner’s mother was a preschool teacher, and one day a mother arrived at pickup time holding an infant chimp, swaddled in a blanket.
Turns out the woman was Stephanie LaFarge, who was caring for the chimp in her Upper West Side brownstone as part of a novel experiment being conducted by Herbert Terrace, the renowned—and sometimes reviled—psychology professor in charge of Columbia University’s Primate Cognition Lab. (Terrace’s experiment with another chimpanzee, Nim Chimpsky, was the subject of the 2011 documentary Project Nim, in which both Terrace and LaFarge, who is now a staff psychologist for the American Society for the Prevention of Cruelty to Animals, figure prominently.) Koebner soon found herself babysitting for Bruno, one of the first chimpanzees to communicate using American Sign Language. On occasion, Bruno would spend the weekend at Koebner’s home in Riverdale.
Thus began a lifetime of working with animals. In ensuing years Koebner would conduct research on the nesting behavior of songbirds, the sex lives of cats, and vervet monkeys on the island of St. Kitts. Later, while pursuing a PhD in anthropology at Rutgers University, Koebner organized the transfer of nine chimpanzees from a shuttered laboratory in Tuxedo, New York, to a wildlife preserve in Loxahatchee, Florida. It was believed to be the first such rescue operation involving laboratory chimps. Years later, her empathy for lab chimps led Koebner to develop Chimp Haven Inc., near Shreveport, Louisiana, and serve for 10 years as its executive director. Recognized by the federal government, Chimp Haven evolved into a 200-acre retirement home for chimps that were no longer needed for scientific research, entertainment, or as pets.
“I believe so strongly in the human-animal bond and how healing these relationships can be for all species,” Koebner says. “I certainly have experienced this power in my own life and see it every time Spirit pays a visit in a nursing home or the hospital, or comforts a crying child.”
Comfort on Four Legs
The idea of animal-assisted therapy is not new, of course. By some accounts it dates to the late 18th century, to the York Retreat in England, a Quaker facility where an assortment of animals (including rabbits, seagulls, hawks, and poultry) were used in the treatment of mentally ill patients. More recently—say, over the past four decades—hospitals, nursing homes, and other institutions, even prisons, have incorporated animals in their therapy programs. The idea is to bring some measure of comfort to patients by allowing them to interact, even briefly, with an animal, typically a dog. Although the science on pet therapy is not universally accepted, studies have shown that patients who interact with animals experience lower blood pressure, reduced anxiety and depression, even lessened pain.
Dr. Rose Guilbe, who specializes in palliative care, has championed the pet therapy program at Montefiore. In Guilbe’s experience, Spirit’s impact on patients has been unambiguous. “Dogs bring another dimension,” she says. “You can see there’s something more to the patient than just being someone that you treat. It brings out a personality. They talk more. They express feelings they don’t say to us physicians.”
Koebner, too, sees the impact of pet therapy every time she leads Spirit onto the palliative care unit at Montefiore. She says one young patient told her that Spirit’s visit helped her take her mind off her pain. For another patient who’d been withdrawn with the hospital staff, a visit from Spirit conjured memories of growing up on a farm. “It gave the staff fresh context for understanding the patient,” Koebner says. With older patients especially, she says, “Spirit provides unconditional kindness and touch. Many patients have no visitors, and the hospital can be a lonely, frightening place where one can quickly lose any sense of the outside world. Spirit and I can provide that comfort to both the patient and the family.”
Guilbe says a visit from Spirit tends to relax patients, to give them a respite from their worries, even if only temporarily. “They are relieved. They’re happy. Their faces change,” she says. “They smile.”
Koebner returned to Riverdale in 2006 to care for her mother, who was in declining health. (Ruth Koebner died last October, just three months shy of her 100th birthday.) Once back in the Bronx, Koebner enrolled in a writing course at Sarah Lawrence. “One thing led to the next,” she says, and, some four decades after graduating from Hampshire College, Koebner enrolled in the Health Advocacy Program (she is scheduled to graduate in December). “It was time to apply the skills I learned in advocating for chimpanzees to humans,” she says.
Vicki Breitbart, the director of the Health Advocacy Program, says she sees in Koebner the embodiment of the health care advocate. “I think she is a very good example of bringing the compassion and humanity into a system that has really lost a lot of those values,” Breitbart says. “Linda’s project is a perfect example of attending to the whole person.”
The Health Advocacy Program at Sarah Lawrence, begun in 1980, remains the only such master’s level program in America. Graduation requires three internships of 200 hours apiece. Koebner completed all three of her internships at Montefiore—the first one in the department of customer service, whose director, Leslie Bank MA ’84, also graduated from the Health Advocacy Program. It was Bank who guided Koebner through the 10-month-long approval process for the pet therapy program. Bank had helped create a similar program at Greenwich Hospital in Connecticut, so she knew how it could benefit patients. “I’ve seen a dog get a kid walking again when nobody could get the kid out of bed,” she says.
Koebner would like to expand the pet therapy program to include more animals, more handlers, and more hospital units at Montefiore and elsewhere. She has also started bringing Spirit to Blythedale Children’s Hospital in Valhalla, New York (aided there by Patricia Stanley MA ’06, a member of the hospital’s board of trustees). For now, Koebner performs her work in pet therapy on a strictly voluntary basis. “I would love to expand these programs so more individuals can benefit,” she says.
Having completed their rounds at Montefiore, Koebner and Spirit are relaxing at a park a few blocks away, Koebner seated on a bench, Spirit stretched out nearby. Koebner is reflecting on the long process of getting her pet therapy program approved at Montefiore. With Leslie Bank’s help, she crafted a policy that would cover the rules and regulations under which she and Spirit would operate—how it would be decided which patients were visited by animals, how often dogs would need to have their paws washed, that sort of thing. The policy covered the theoretical and the practical, even the unthinkable: What happens if a dog decides to relieve himself while making his rounds?
Has it happened?
“No, thank goodness,” Koebner says. “We spend a lot of time in this park before we go into the hospital.”