CJ Stops Dialysis and Enters a Hospice Facility is the turning point at which CJ moves from caring for people at the hospice to living there as a patient. After years of illness and dialysis, she chooses to stop treatment and enter hospice, describing the decision not as a wish to hasten death but as a refusal to prolong a life increasingly defined by pain and sickness. Toby witnesses the choice and its consequences from close beside her: first as her companion during the conversation with Fran, then as the dog who stays with CJ as her health declines and she dies.

Background and Decision

CJ’s announcement comes after periods in which she is away from the hospice for a week or two, though she always returns. Shortly after one such absence, she speaks with Fran at lunch. CJ is uneasy enough that Toby senses her fear and sits up alertly. She says a new guest may arrive as early as Monday; when Fran asks about the guest, CJ explains that it is herself. The reversal is immediate: the person who has been visiting and helping others is preparing to take a bed among them.

CJ tells Fran that many things are going wrong with her health and that her doctors scarcely know where to begin. She is exhausted by pain, sleeplessness, sickness, and the burden of taking forty pills a day. Gloria’s death has changed how CJ understands her remaining obligations: she says that, with Gloria gone, she no longer owes anyone anything. Her decision is not presented as sudden. CJ says she reached it long ago, had told her family at a reunion and said her goodbyes, and had put her affairs in order. She has also worked through the choice with her therapist for a year and a half, speaking about little else.

Stopping Dialysis

Fran urges CJ to discuss the decision further and suggests that she might see someone. CJ responds that her therapist has already been part of that process and that her doctors agree with her decision. She cannot know for certain that she will suffer another stroke, but the possibility frightens her, especially after watching Gloria. CJ fears losing control of her mind and becoming debilitated; she wants to determine the circumstances and timing of her decline rather than have treatment extend her life without regard to its quality.

The decisive fact comes plainly: CJ has stopped dialysis. She describes the change as freeing her from having to return for treatment, and says that her life has had its ups and downs but has been good and long. In her view, continued medical intervention would keep her artificially alive while a poor prognosis left the eventual outcome unchanged. She insists to Fran that “This isn’t suicide; it’s acceptance.” The distinction is central to how CJ explains the choice: she is not denying that death is coming, but asserting a limit on how far she wants treatment to postpone it. When she speaks, Toby senses that her fear has lifted. He nuzzles her hand, and she strokes him tenderly.

Entering Hospice and Toby’s Care

A few days later, CJ comes to the building to live. Toby can tell at once that she is more ill than before. He jumps onto her bed and stays close, shifting between her head and her feet, sometimes lying curled in a ball. Her new position in the hospice alters their daily relationship: CJ had moved through the rooms to visit patients, talk with them, and sometimes embrace them, while Toby followed at her heels. When she left at night, he would often remain with someone who needed company, allowing patients and family members to hold him. The dog’s work had been to offer comfort within other people’s suffering; now his attention gathers around CJ herself.

Toby’s presence is not simply exuberant companionship. He has learned to respond to the hospice’s vulnerable patients by being still. After once stepping on a man’s stomach and hearing his sharp cry, Toby understood that the people in the beds might be in pain and that play could hurt them. He could distinguish his own calm role from Duke’s rambunctiousness: Toby could lie quietly beside someone who was ill. That learned restraint shapes his care of CJ. He does not try to lift her spirits through play; he stays where she needs him, at her head or feet, and she continues to call him a good dog even as her voice grows weaker.

CJ’s Farewell and Death

While feeding Toby pieces of a ham-and-cheese sandwich Eddie has brought her, CJ tells him that she is going to leave him. She says that life has given her its good things and that she is weary of its hardships, especially what might come if she tried to prolong it. She wants to be with her husband, Trent, and regrets leaving her friends, naming Toby among them. She reassures him that he is loved and cared for, and describes the qualities in him that recall Molly’s gentleness and Max’s self-assurance. She asks him to tell her angel dogs that she is coming and to stay with her in her final moments so that she will not be afraid. Toby’s attention remains on the sandwich, but the scene makes clear that his companionship is part of CJ’s plan for facing death.

CJ dies on a cool, clear spring afternoon. Fran has been sitting with her all day, while Toby lies with his head on CJ’s chest and her hand loosely strokes his fur. When that hand stops moving, Toby looks toward Fran; she brings her chair closer and takes CJ’s slack hand. CJ gradually lets go of life and dies with one final breath. Fran embraces Toby and tells him he is a good dog. The choice to stop dialysis has thus led not to an abstract statement of independence but to a particular ending: CJ makes her decision known, enters the hospice, asks for the presence she trusts, and is accompanied by Fran and Toby as she dies.

Significance

The event brings together CJ’s insistence on control over her own dying and the hospice’s practice of care. Her decision follows long consideration, discussion with her therapist and doctors, and preparations for saying goodbye; it is also made in the knowledge that her body is increasingly ill. The narrative holds that agency alongside dependence rather than treating them as opposites: CJ chooses to stop dialysis, yet she wants friends and a familiar dog with her, and Toby’s quiet companionship becomes part of how she meets the end she has chosen.

Toby’s perspective also turns the hospice from a place where he serves other people into a place where he can remain with the person he has loved across lives. His understanding of being a good dog has grown from learning not to hurt patients to recognizing that stillness and presence matter when someone is dying. At CJ’s bedside, the service he has offered to strangers becomes intimate care for his own person. The event therefore marks both CJ’s passage into hospice and the completion of a bond expressed through staying: she asks Toby not to let her be afraid, and he is there when her hand falls still.