tag:blogger.com,1999:blog-46675166297457314392024-03-19T01:47:11.748-07:00Diary of a Real-Life Veterinariankrista magnifico, DVMhttp://www.blogger.com/profile/15133566329579911573noreply@blogger.comBlogger856125tag:blogger.com,1999:blog-4667516629745731439.post-38975888721779694262024-03-02T08:07:00.000-08:002024-03-02T08:07:39.277-08:00The Advice I Wish I Had Been Given. New Grads in Veterinary Medicine<p> </p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgXprufeCojFRV0aAF04Rfr9OLuQZWnUhftgBkIwEY5MWM6chGYQHISzjv66hhV0oKyIcUhWoLs3OCkzqoCeNR468GKa2Q5vqfb000cvylQetD34Y3BsxLdyInKciAhrByYoSFcCzu2HZZdI4pKnSKbtpeK5u65W0riZpEnoIIazv1CRiQJMpgEj4sAsJE/s332/logo.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="243" data-original-width="332" height="234" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgXprufeCojFRV0aAF04Rfr9OLuQZWnUhftgBkIwEY5MWM6chGYQHISzjv66hhV0oKyIcUhWoLs3OCkzqoCeNR468GKa2Q5vqfb000cvylQetD34Y3BsxLdyInKciAhrByYoSFcCzu2HZZdI4pKnSKbtpeK5u65W0riZpEnoIIazv1CRiQJMpgEj4sAsJE/s320/logo.jpg" width="320" /></a></div><br /><p></p><p class="MsoNormal">We are at an unprecedented time in veterinary medicine.
Never before has the demand for veterinary care been so great, and never before
has the availability of veterinarians to take care of animals been so thin. It
is very important for new grads to understand this. We are also at a place
where the ethics and intentions behind every decision being made within vetmed
has serious long-term consequences. Never before have you had to start making
life changing, and life influencing decisions so soon out of the gate. <o:p></o:p></p>
<p class="MsoNormal">No one from the other side is going to tell you this. They
won’t tell you because they need you and they need you to remain new enough to
be green and naive. No good, strong, lasting meaningful relationship starts
with this as the premise. <o:p></o:p></p>
<p class="MsoNormal">When I graduated from VT I was looking primarily for two
things; mentorship and long term stability where the fruits of my labors would
reward me with a piece of the pie that I had helped establish. It took me a few
months, and a few practices, to find this place, but once I did, I stayed. What
I didn’t recognize as truly important was the people that I shared my
professional life with. I had been too self-absorbed in trying to become a
great practitioner to understand the importance of a place of belonging. When
all else was turning into a catastrophe soup (and yes, these days are ahead
regardless of where you go), I had a group of people who supported, cared for
and saved me.<o:p></o:p></p>
<p class="MsoNormal">I have always been a veterinarian. From my earliest thoughts
and actions, I was meant to be a part of this profession. I suspect most of us
are this way. I was all passion, some training, and dedication in limitless
bundles. What I learned is that patients come and go, your place in their lives,
(albeit incredibly important) is also transient. What is not transient, what
grows and motivates, and moves you into <i>legendary</i>, is the impact you
have on those around you. What has defined legacies of the veterinarians before
you, (and perhaps the veterinarians who helped get you here), is the other
stuff vet med brings to your life.<o:p></o:p></p>
<p class="MsoNormal">Your perfect place is out there. It will grow with you,
evolve because of you and be better because you are a part of it. Finding that
place out of the gate will take some self-introspection, some questions you may
not be able to answer fully yet, and courage. <o:p></o:p></p>
<p class="MsoNormal">Here are some of the insider employer secrets; <o:p></o:p></p>
<p class="MsoListParagraphCxSpFirst" style="mso-list: l0 level1 lfo1; text-indent: -.25in;"><!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]-->If it is all about the money you will leave
vetmed heartbroken/bankrupt. There are sharks among us who are here because of
the money. VC’s are circling and capturing veterinarians in record numbers. You
are a cog in their money-making machine. You can justify a small, transient
existence among them, but you will sacrifice something along the way you will
regret. Money does that. There are limitless lucrative possibilities here, but
know who’s terms you are making them upon.<o:p></o:p></p>
<p class="MsoListParagraphCxSpMiddle" style="mso-list: l0 level1 lfo1; text-indent: -.25in;"><!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]-->A contract always benefits the house. Don’t sign
anything. You don’t have to, and it doesn’t protect you outside of a short
period of time. Everything in life is negotiable. <span style="mso-spacerun: yes;"> </span>No one has any business influencing your heart
and soul. Walk away. You need to learn this lesson early. It is ok to say no.
You have a voice and a responsibility to yourself, your patients, and clients (occasionally).
A non-compete, and/or gag-order are hard NO’s IMO for me. Period. <o:p></o:p></p>
<p class="MsoListParagraphCxSpMiddle" style="mso-list: l0 level1 lfo1; text-indent: -.25in;"><!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]-->Never sell yourself short. We are all growing
and learning and there is beauty and strength in this.<o:p></o:p></p>
<p class="MsoListParagraphCxSpMiddle" style="mso-list: l0 level1 lfo1; text-indent: -.25in;"><!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]-->Promise yourself you will be honest from minute
one day one. You can admit to anything and be ok. I promise that.<o:p></o:p></p>
<p class="MsoListParagraphCxSpMiddle" style="mso-list: l0 level1 lfo1; text-indent: -.25in;"><!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]-->Always remind yourself of your <b>WHY. </b>Know
WHY you are here and never stray. You know what it took to get here, and never
abandon that person. <o:p></o:p></p>
<p class="MsoListParagraphCxSpMiddle" style="mso-list: l0 level1 lfo1; text-indent: -.25in;"><!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]-->Have fun every single day. Nothing is more
valuable than joy. (Purpose is a close second).<o:p></o:p></p>
<p class="MsoListParagraphCxSpLast" style="mso-list: l0 level1 lfo1; text-indent: -.25in;"><!--[if !supportLists]--><span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]-->Remember that mentoring is so much more than
medicine. It is also mentoring for success in every avenue that makes you YOU.<o:p></o:p></p>
<p class="MsoNormal">If you truly find an advocate, they care about you without
caring about how it benefits them. Vetmed was founded on this. <o:p></o:p></p>
<p class="MsoNormal">If any part of this resonates with you, or if you want to
learn more about how we practice you can find me anytime at my email, or our
social media sites. <a href="mailto:kmagnifico12@gmail.com">kmagnifico12@gmail.com</a>
or Jarrettsville Veterinary Center, Jarrettsville Maryland. New grads, interns,
wanderers, curiosity seekers, surgery exposure, or good-deed-doers are always
welcome. We have housing, no contracts, no emergency calls, zero tolerance, and
hard-won cases that heal every bad day in great abundance. We never practice
economic euthanasia and we never break hearts, hope, or good intentions.<o:p></o:p></p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhttBEB7io6NObmin3dAYYXitcAKnMkbHk48MoGxFLVSwWxo66qmc3kWRXLwkyUT2X7tOgWLi66OAsy6Vp_BroDI7PpNLzokIt7j_QcjohUiucLaXZEPAAEesXHBe9fJ0a2EiIshcoTUwjVyqo5ou1VJwdDQo19VWU-mKXkntmPdAM1Kg9pmL7uB-oJ2wM/s2016/IMG_5137.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1512" data-original-width="2016" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhttBEB7io6NObmin3dAYYXitcAKnMkbHk48MoGxFLVSwWxo66qmc3kWRXLwkyUT2X7tOgWLi66OAsy6Vp_BroDI7PpNLzokIt7j_QcjohUiucLaXZEPAAEesXHBe9fJ0a2EiIshcoTUwjVyqo5ou1VJwdDQo19VWU-mKXkntmPdAM1Kg9pmL7uB-oJ2wM/w400-h300/IMG_5137.jpg" width="400" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Jarrettsville Veterinary Center</td></tr></tbody></table><br /><p class="MsoNormal">more on us here; Jarrettsville Veterinary Center <a href="https://www.facebook.com/JarrettsvilleVet/">Facebook</a></p><p class="MsoNormal">Jarrettsville Veterinary website, <a href="https://jarrettsvillevet.com/">here</a></p>krista magnifico, DVMhttp://www.blogger.com/profile/15133566329579911573noreply@blogger.com0tag:blogger.com,1999:blog-4667516629745731439.post-90709526433781144322024-03-01T09:50:00.000-08:002024-03-01T12:10:18.903-08:00Reflection's In The Sea Glass<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiXHMl5oQZFmddEK6EGv7CQr10dx2UTx8g3DH6FGpw2CDLRdhXVAWjHnprCbegdSmkaGm5YnN7TBiFfXXfpSwty_C-LdqeawVCNp92zeTm7GahE199NgVzTuhlnfxVxp6r_8Mkqo-crnoOPjU4DdrWcz5Gw03zGZMDa6AUz0Ml-GyFafd-9-GGZCpNX5OQ/s2856/IMG_4316.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2856" data-original-width="2142" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiXHMl5oQZFmddEK6EGv7CQr10dx2UTx8g3DH6FGpw2CDLRdhXVAWjHnprCbegdSmkaGm5YnN7TBiFfXXfpSwty_C-LdqeawVCNp92zeTm7GahE199NgVzTuhlnfxVxp6r_8Mkqo-crnoOPjU4DdrWcz5Gw03zGZMDa6AUz0Ml-GyFafd-9-GGZCpNX5OQ/s320/IMG_4316.jpg" width="240" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Morning writing time with Birdie</td></tr></tbody></table><p>The sunshine beaming in my windows delivers just enough warmth to remind me that Spring is right around the corner. I am at home in Southern Pa., close to the Maryland border. It is the last week of February. The tail end of Winter's quiet. The peaceful transition from snowy, sleepy, slumber to the bright burgeoning of the colorful explosion of Spring life. There are a few birds congregating outside my window at the feeder I fill daily. They sing songs of cheerful excitement, catching up on free pickings as if prepping the internal organs for the demand ahead that perpetuating a new generation demands. They skip quickly from the evergreen branches to the feeder weary of a hawk that stands guard above. Even she has an internal clock that ticks and gnaws for the fledglings she must soon create and cultivate. The grass on our lawn sprawls widely on each side with its cropped-tight, still silver-grey veiled surface. Below its feet lies a vibrant spring-greenery hidden safely by the frozen ground soaking up this sunshine while gathering momentum for the weeks that lay just ahead. These are the days between the seasons. The days I run to a warmer place, for just a few days, to avoid the clutches of the Winter doldrums that living in the north forces us to endure.</p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEixvsAIpvG5RwoOsDX1iHjclw3vIGsP0w9HygREKuRxrFyfdwYMkQHbCN6RayrKQB-AvVmrVSA9FBarRL3qUQZnh9GR4aFR13UMd2t2LLZSkJuNJ0DHvcoQW1rjI1x7Gl0e0K9lRiWEYTViq3O-TUcH1RRhMZklIaaDCu0qPyXp7sM3GSivz8k5Y6H7Yq8/s640/IMG_2847.HEIC" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="480" data-original-width="640" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEixvsAIpvG5RwoOsDX1iHjclw3vIGsP0w9HygREKuRxrFyfdwYMkQHbCN6RayrKQB-AvVmrVSA9FBarRL3qUQZnh9GR4aFR13UMd2t2LLZSkJuNJ0DHvcoQW1rjI1x7Gl0e0K9lRiWEYTViq3O-TUcH1RRhMZklIaaDCu0qPyXp7sM3GSivz8k5Y6H7Yq8/s320/IMG_2847.HEIC" width="320" /></a></div><div class="separator" style="clear: both; text-align: center;"><br /></div><p>We arrived home very late last night after a long day of travel from abroad. The five of us; my husband Joe, sister Diedra, and her two boys; Cody and Anthony, went on our second end-of-February trip together to Grand Bahama Island. Grand Bahama Island is a small speck of land, (or <i>atoll</i> as Joe would correct me), that lies just off of the southern tip of Florida. Grand Bahama is replete with sand skirts and coral outcroppings yet oddly quiet all day everyday that the cruise ships aren't berthed to her. Grand Bahama is close, but the travel to and from isn't ever easy, nor, effortlessly quick. The total air time amounted to a scant 3 hours, but our travel time encompassed more than 16. We all got up early to leave our villa by 8 am. Packing took up most of the night before. After a week at the beach our rooms looked like a teenage summer away with clothes, snacks, wrappers, billowing attempts to air dry bathing suits and a cascade of make-shift dive gear strewn between two adjoining rooms. We had booked the rooms with a shared door to allow for the adults to awaken early and the boys to sleep in as per their preferred daybreak sunlight avoidance preferences. </p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhRcmlykkZ77MKv0ul50qidwIKnJJ1DNeVPPB4H7fSuyI8crFjGkUwHfHhFiWJA_j3AzJj-wAn_cLZ96xri2O5GhOUzTtccB9tWr1Uyssmgsp4rt5VDHt8MylmuiG976a2fxEAY8jSHY1sJ42d0V2B0_uKIXYhVFGxURpdUv6lAp1dOtIkBfueXPK2PSqY/s2856/IMG_4291.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="2856" data-original-width="2142" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhRcmlykkZ77MKv0ul50qidwIKnJJ1DNeVPPB4H7fSuyI8crFjGkUwHfHhFiWJA_j3AzJj-wAn_cLZ96xri2O5GhOUzTtccB9tWr1Uyssmgsp4rt5VDHt8MylmuiG976a2fxEAY8jSHY1sJ42d0V2B0_uKIXYhVFGxURpdUv6lAp1dOtIkBfueXPK2PSqY/s320/IMG_4291.jpg" width="240" /></a></div><br /><p>Seven days of expeditions upon sand and we were left with a massive collection of seashells and sea glass to discern/decide, divvy up and divide. Suitcases were repurposed to stow coral encrusted fans and sea-bitten detritus home. The yearly challenge to jettison the unvalued in exchange for the newly found, albeit decades old treasures the sea coughed up for us. We travel here, for this bounty. It is inevitably always the most enjoyable moments of our time there.</p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEivxLkj1z-anwRkGGQInZrUnbzx47QAFPYv-hD8mOJ9l4PvTGfSL_gqIgZz4ATkkelp2telKS8gBSQieFV5U1u0D15A9ZHTE0JWiu8awfxjUQdlLn9gOT6HiS-pDSokSD7-GydBYNrwOrL1MbF03JchGn-cI2VnQypFcqUgDWVyd4BApm-HnfwELYmon3Q/s2016/IMG_4447.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="2016" data-original-width="1512" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEivxLkj1z-anwRkGGQInZrUnbzx47QAFPYv-hD8mOJ9l4PvTGfSL_gqIgZz4ATkkelp2telKS8gBSQieFV5U1u0D15A9ZHTE0JWiu8awfxjUQdlLn9gOT6HiS-pDSokSD7-GydBYNrwOrL1MbF03JchGn-cI2VnQypFcqUgDWVyd4BApm-HnfwELYmon3Q/w240-h320/IMG_4447.jpg" width="240" /></a></div><br /><p>The adult section of this entourage wakes up for each sunrise, makes our own percolator coffee, (which we make room for in the packing process to also include our preferred variety of oat milk and miniature grater for fresh cinnamon and nutmeg), always packing enough for the allotted days abroad. Every morning is the same. Up for sunrise, fresh hot cup of coffee in hand, open door to beach to pepper the unmarked sand with our foot prints. We never have to share the beach, or wish another human a "good morning" greeting. We are always alone, and, always plotting the rest of our day ahead. We may have a resident feline with us, and, we welcome their company with great enthusiasm. There are always four or five resident cats here. They appear early in the morning looking for a kind hand of affection, or late in the afternoon seeking a hand-out from the snack hut patrons. They are always young, in early stages of pregnancy, and always bearing the shaved back-ends from over aggressive grooming to keep the fleas at bay. We stop behind the tiki hut bar to make sure the food we scavenged from the previous day, and left before we went to bed, has been taken by the stray dogs that live in the woods behind the abandoned (due to lack of business), HR trailer. Everyday is a copy of the one before; wake, sunrise, grind beans, brew coffee, grate cinnamon and nutmeg, sip, stroll, plan. After the coffee is emptied we dress to go for a run, or to bike to the beach. We always pack a mesh bag to stow whatever treasures we find. </p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgj6X0VFWuJwXwU7f_DSD_oHK00vqF5L5oTc0elJHm6lVRrQ8B6VIm4nvNLtdRQi7Hi8tWD34Aq5BIFZ_x-9sPBsLzVZcCAWXLbBXYnKkDXfAZSlRQ6aJqTPAR_47syvyqeij6woAmn_AXS6ZGb1iPIOfHw90zSrZhl-X-h7fVGKeBF0QYOJPj0abmIigg/s1280/IMG_2747.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="960" data-original-width="1280" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgj6X0VFWuJwXwU7f_DSD_oHK00vqF5L5oTc0elJHm6lVRrQ8B6VIm4nvNLtdRQi7Hi8tWD34Aq5BIFZ_x-9sPBsLzVZcCAWXLbBXYnKkDXfAZSlRQ6aJqTPAR_47syvyqeij6woAmn_AXS6ZGb1iPIOfHw90zSrZhl-X-h7fVGKeBF0QYOJPj0abmIigg/s320/IMG_2747.jpg" width="320" /></a></div><br /><p>The resort is a gated beach of rambling pastel colored villas scattered across a massive, mostly forgotten, landscape. This place has a long history of chances, intentions, allure, and lost dreams. There are miles and miles of empty beaches. Running along them are paved roads with overgrown, unkempt, planted palm trees, lamp posts (most missing their globes), stop signs, traffic directives, and gutted electric boxes, sewer plates and four buildings. Ten skeletons of homes remain standing. All strewn about the 600 acres of land that stretches from one shore to the other. It is so mind boggling how so much could be built, at such great expense, and have so little to last to show for it. There is an infrastructure of cut canals, golf course, club house and one single home about 80% complete surrounded by nothing. A cemetery of dreams built by a wealth of intentions that fell so tragically hard it is impossible to believe. We wander these roads, these beaches and we reflect on how immense a mistake this was. A billion dollar debacle 4 decades old. These beaches are awash with glass, ceramics and parts of machinery almost unrecognizable. Whole train engines are buried under sand with piston pock marks left as their only identifiable feature. Over 10 years I have collected suitcases of these beaches lore. Many still bear the names of the developers initials, or the resorts names. Some are almost 100 years old. There are so many stories washing up here and I collect them with a curiosity that compels. This is what beaches beckon to me for. A stroll and a collection of trinkets some man made and others sea borne. All with a story unto themselves. They are my treasure, but they began as someone else's dreams.</p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg1BZxeYkxF61I2fNbx1U3Ao1ncoXJ48ifFnBKiyNcvMjStfwsI3wCTEJEtWLY-o5pfEtEgTrszHdu9lV2uveTHXCCz9XzFQcF7Bk_A_tF2QlKcx_eGIrrQArb-9-IwGOmLuLT9QHwQ35igtJmMG3Q0S8od-fG4_eBgT_5o0KSdsxhdYeu9uzQh0WrVyw4/s2016/IMG_4304.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="2016" data-original-width="1512" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg1BZxeYkxF61I2fNbx1U3Ao1ncoXJ48ifFnBKiyNcvMjStfwsI3wCTEJEtWLY-o5pfEtEgTrszHdu9lV2uveTHXCCz9XzFQcF7Bk_A_tF2QlKcx_eGIrrQArb-9-IwGOmLuLT9QHwQ35igtJmMG3Q0S8od-fG4_eBgT_5o0KSdsxhdYeu9uzQh0WrVyw4/s320/IMG_4304.jpg" width="240" /></a></div><br /><div class="separator" style="clear: both; text-align: center;"><br /></div><p>The point is that I travel far away to rummage through the decades old of castaways of lost, shattered hopes, and massive work efforts gone debunk. Curiously, (and let's be honest <i>concerningly</i>), I am not sure what I am building, or, if any of it will stand the test of time? Maybe all of my efforts will be left to fall into the sea only to be washed up to find some curious fingers in 2074? Perhaps this is all just fodder for reflective pondering of the hopes of one person among the tides of challenges that is inevitably a lifetime of intentions and a hope of longevity? Maybe all of this hard work, exhaustive effort that leads me to run away to far away islands is all futility in the end? Maybe even the biggest dreams, with the loftiest of intentions will end up as trinkets with soft edges, barely recognizable from the original pieces of remains the sea spills over and over onto the shores of harsh, inescapable mortality.</p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh4XZT1WZwrYn2r5JK8qTWK8WQtO9Ofvm05V3xSGvQ7yyeHlkaMIN6ckB1IEA2mC02nauwLKcHp-FriIGjwO8xv5zKsUVjbHFaw2k_ci8sx1xlbNVmUc6Yc0sygB72ijj6Gt3sGOUujwXO0mCwZ8VuEB2Dd5BZXU2lGmVhbe-ro3k37BxlpBVRXAh2Qk0Y/s1280/IMG_4319%20(1).jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1280" data-original-width="960" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh4XZT1WZwrYn2r5JK8qTWK8WQtO9Ofvm05V3xSGvQ7yyeHlkaMIN6ckB1IEA2mC02nauwLKcHp-FriIGjwO8xv5zKsUVjbHFaw2k_ci8sx1xlbNVmUc6Yc0sygB72ijj6Gt3sGOUujwXO0mCwZ8VuEB2Dd5BZXU2lGmVhbe-ro3k37BxlpBVRXAh2Qk0Y/s320/IMG_4319%20(1).jpg" width="240" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Jack Tarr, or jt</td></tr></tbody></table><p>With each return home I am so grateful to be back in my own bed. I am so fortunate to have healthy cats who aren't licking/chewing/scratching to the point of balding on their bellies and backsides. Struggling to have another litter to support whilst scrounging for scraps from the tourists at the tiki bar. In the Bahamas there is an odd twist of fate. The dogs are largely roaming vermin and the cats are more likely to find a kind hand of offerings. Few dogs have a place within the home. A little more so are tied to a pole in the yard, but, the vast majority roam the side streets and stores flea infested, trailing pot-bellied worm gravid bellies and sad bleak faces of indifference based compassion. These souls break me. A constant reminder of how fortunate we are in this country in the vast places I live and frequent. Spaying and neutering is an inconceivable concept there. A way to deny freedom versus protect the high mortality that life on the streets presents. </p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi3vcAY0kC-hgZjC-cU4TDQRdWzh8M0zw8NaR0eX8DKaVUSBUb-uS6QFTJGQri6rGEJqoOcGcZSmY8VfxKo1zRX1TlfhwZk5a437BxrKyYKkJUbVi1z0J02qvyPWQbBa1C5Gvwo7z230RvtDW6l3zbNw0L1FEpdfl3wz_2THEnDr-O2PztQ55D3IVGR1aw/s1428/IMG_4288.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1428" data-original-width="1072" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi3vcAY0kC-hgZjC-cU4TDQRdWzh8M0zw8NaR0eX8DKaVUSBUb-uS6QFTJGQri6rGEJqoOcGcZSmY8VfxKo1zRX1TlfhwZk5a437BxrKyYKkJUbVi1z0J02qvyPWQbBa1C5Gvwo7z230RvtDW6l3zbNw0L1FEpdfl3wz_2THEnDr-O2PztQ55D3IVGR1aw/s320/IMG_4288.jpg" width="240" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">One of the resident cats staking claim to the sunny spot on the bed</td></tr></tbody></table><br /><p>As we arrived on the island a storm erupting above us. We landed in turbulent cross winds that jarred the small plane like dice on a craps table. There were audible outbursts of muffled screams from the passengers caught off guard. We were relieved to have landed safely, but the adventure of reaching our destination was still laying ahead. Our efforts to secure our rental car in the torrential down pour left us soaked through within seconds. The ride from the airport was a constant reminder to "STAY LEFT" while traversing unmarked streets with absent signage. Had it not been for our phone maps we would have never made it outside of the airport parking lot. The downpours left us navigating overflowing unlit streets to find detours from the one road that headed to our end of the island. One 20 foot detour off of the main strip led us to a mixed litter of bobbing puppies and a pack of their parents intent on reminding us that we were not welcome here. Diedra and I decided we would rather risk drowning in the street puddle than traversing this motley angry gang. There was a heated argument on whether we could even safely turn around without running over a straggling starving puppy. </p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjlP_bDwBMGXwkOXJFJFINtziSiigs6fdJVjMm_lYn-JAMhQDyelNt8uT25SU1f1C3zuHhEh3YnYjNIS7L1Hwsw5SG4B-DPrE4eUq_7HNdZ3q_VRH9bFY824s8lHXslq5ZVTWRBfFwA58CaSzQLALiAV8OGnifjcnPrRRM699_wkREX6vOPPgzWJFVvyhY/s1280/IMG_2859.HEIC" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1280" data-original-width="960" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjlP_bDwBMGXwkOXJFJFINtziSiigs6fdJVjMm_lYn-JAMhQDyelNt8uT25SU1f1C3zuHhEh3YnYjNIS7L1Hwsw5SG4B-DPrE4eUq_7HNdZ3q_VRH9bFY824s8lHXslq5ZVTWRBfFwA58CaSzQLALiAV8OGnifjcnPrRRM699_wkREX6vOPPgzWJFVvyhY/s320/IMG_2859.HEIC" width="240" /></a></div><br /><p>Life is like that in this part of the world. While blessed with beaches they are poor with interventional actions for the other inhabitants of the paradise isle. </p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg_7UhbpZHHSbfkkclN3qur8Gqq-0SRMxFEwrq8OPuz75nPT9aSsR-nnQ5rAHm1f047Z8w0DoTU5iRVsKOs9PBsZsIgxHiUShzkJtqjSu3lduamEDOcvsULVnDDnHem49m0ezCF_Vepbhfw79QYKV__R6vAlBQ9GC1rKW1yDg2duyIeaEx-eOJFtP68lUk/s1280/IMG_2770%20(1).jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1280" data-original-width="960" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg_7UhbpZHHSbfkkclN3qur8Gqq-0SRMxFEwrq8OPuz75nPT9aSsR-nnQ5rAHm1f047Z8w0DoTU5iRVsKOs9PBsZsIgxHiUShzkJtqjSu3lduamEDOcvsULVnDDnHem49m0ezCF_Vepbhfw79QYKV__R6vAlBQ9GC1rKW1yDg2duyIeaEx-eOJFtP68lUk/s320/IMG_2770%20(1).jpg" width="240" /></a></div><br /><p>As the off-mainland veterinary colleges sprout up in record numbers in adjacent islands the standard of living for the cats and dogs in their neighborhood improves markedly as they begin to receive out reach support for the vet students training purposes. Ask any vet school student from these institutions how many are brought home each year and the numbers will speak for themselves. Why are so many colleges being built? Two reasons; there is a desperate shortage of veterinarians, and, they are highly, (much easier to get accredited and more lucrative than the human doctor factories), profitable. Kids will go into astounding, unrecoverable debt to go to vet school. We are hounds to a bone with blind oblivion to the consequences.</p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgFkxk64SRAky5JeDLmNtlhduaL1KXM6cQs4441Y23RddWxMcOZud_aebdh1vzncF9nbcsDdx6es_zbWGbKb3z-xkS2HtmOmFQeQ7m2YGVM9ioea2tuOrgs38uoejzS-jkFjrTmYXcd-wqkCc_7z0drhiKHpqXbChM-2YieqCdxELFIQiztwey1hG7eBI8/s1280/IMG_2828%20(2).HEIC" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1280" data-original-width="960" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgFkxk64SRAky5JeDLmNtlhduaL1KXM6cQs4441Y23RddWxMcOZud_aebdh1vzncF9nbcsDdx6es_zbWGbKb3z-xkS2HtmOmFQeQ7m2YGVM9ioea2tuOrgs38uoejzS-jkFjrTmYXcd-wqkCc_7z0drhiKHpqXbChM-2YieqCdxELFIQiztwey1hG7eBI8/s320/IMG_2828%20(2).HEIC" width="240" /></a></div><br /><p>My vacation time was spent unplugged. I intentionally kept my cellular roaming capability off. If I don't begin to take time off I will pay for it in blood pressure statins and botox. The reality of my professional life is that I am not feeling my cup as full anymore. Too many tiny holes in the mainframe to allow a full tank. I repeatedly ask myself if this is more than exhaustion? Perhaps a bit of lacking in the enthusiasm department when the gauge reads within the eligibility for retirement age. </p><p><br /></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhQe8UQKjlD0ohoi-Sumrt8007i-_c2L-3LjdvrIl9GBWhaCBgBi3MKDl9imvifC1yg_QB1DyKjlUmzOicYEnlvxzngG-Wtb4nDnND9EWknO-gzuil_a4Rd1Pqg9sHzEmuZ4lr7cKOlpX2G8-tjKsCOnOH5ZsK6nI4NzwTbzg0F5zhciYKSiqQt93aqbHI/s2856/IMG_4300.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="2856" data-original-width="2142" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhQe8UQKjlD0ohoi-Sumrt8007i-_c2L-3LjdvrIl9GBWhaCBgBi3MKDl9imvifC1yg_QB1DyKjlUmzOicYEnlvxzngG-Wtb4nDnND9EWknO-gzuil_a4Rd1Pqg9sHzEmuZ4lr7cKOlpX2G8-tjKsCOnOH5ZsK6nI4NzwTbzg0F5zhciYKSiqQt93aqbHI/s320/IMG_4300.jpg" width="240" /></a></div><br /><p>There are benchmarks that mark your life. The calendar being our primary measuring tool. Mine is in the place where most of my peers have paid for the kids colleges and weddings and now find themselves free from allowances to dependents. I am at the place we never believed we would actually find; debt-free. My last loan to the 20 year purchase agreement for the clinic is due in under 60 days. How did that happen? How did the sun actually circumscribe the heavens enough times to reach the maturity date on that loan? Two decades ago, as a brand new graduate veterinarian that number was so mammoth in its zero's that I just assumed I would expire before it did. Who works this long in one place? </p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj4HbZ-ZjIVc8CAgOEiQi3g5OIjzNGCQWDjO8GaD5LanA25ZH_MeDwlOFyTAeRPVnGsz2r6ctFXyPsvjA0DTkrLGbknSjp5agwWrMICXywljBHwSseoQF0NinYL3Bswc2SFTvis7X4pUrsOG9QoHru03SfkX9uuomWG-1fZt65S0-ied1mqAnA51pqtfmQ/s2016/IMG_5137.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1512" data-original-width="2016" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj4HbZ-ZjIVc8CAgOEiQi3g5OIjzNGCQWDjO8GaD5LanA25ZH_MeDwlOFyTAeRPVnGsz2r6ctFXyPsvjA0DTkrLGbknSjp5agwWrMICXywljBHwSseoQF0NinYL3Bswc2SFTvis7X4pUrsOG9QoHru03SfkX9uuomWG-1fZt65S0-ied1mqAnA51pqtfmQ/s320/IMG_5137.jpg" width="320" /></a></div><br /><p><br /></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhgEkZwsr3hiWHYgQMYK7hF2Hp0hvthRGEYyUAN1TRmBPMWYeDCQyv4-eQZ4ZwUdAMZBDYIBI9hWzMC6ar4TWZnl-x1uL-xb0BCtaN7J757YfS70ZbXd51IQyVrDsC770PTCU3MXVnk_ZWfvb8NYubBWiecKgs7cc__2dkHDJv5UTmMRkViDxhMmXnMu2c/s332/logo.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="243" data-original-width="332" height="146" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhgEkZwsr3hiWHYgQMYK7hF2Hp0hvthRGEYyUAN1TRmBPMWYeDCQyv4-eQZ4ZwUdAMZBDYIBI9hWzMC6ar4TWZnl-x1uL-xb0BCtaN7J757YfS70ZbXd51IQyVrDsC770PTCU3MXVnk_ZWfvb8NYubBWiecKgs7cc__2dkHDJv5UTmMRkViDxhMmXnMu2c/w200-h146/logo.jpg" width="200" /></a></div><br /><p>What I didn't realize was that as that sun was doing its donuts around my best of intentions a village was being built. Passionate efforts day after day, week after week, for years on end got me to this place. Intentions manifested into a lifetime of stories that involved wet noses and wags. There is a proud assertion of power that comes from standing on the top of the mountain you created. A sense of accomplishment to assuage your aches. A quiet sense of reflection for the lives you made stronger, happier, more inclined to nap than have to fret about the litter you cannot support. The choices you had the luxury of deciding. The knowledge that yours are free from the streets, the unmet pleas for empathy, and the heart songs of the moments of the life you got to share. For every dream a veterinarian ponders there is this life I paid for in hopes and got reimbursed for in reflections I don't want to escape from. I am so lucky,, maybe even as lucky as these pets I call my kids.</p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiM78Rq5WOz3Oiy8KElSSTpH15QU54gEm4ObfhLjWoNR4D5u0uKeuu7fojwQ5Dwj3oUn9xa_ukJc3JXA58YKXmMsME3MpNkjZUT_a6E68-h7xs1Fv-STgoFz7yLKl99f6wo7Zp9LNGiLTmYJT_-lyVqzNjW2A8rWRDYU0ANFpQuO-2bY2sCJbJcdWU5flc/s2856/IMG_3304.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="2142" data-original-width="2856" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiM78Rq5WOz3Oiy8KElSSTpH15QU54gEm4ObfhLjWoNR4D5u0uKeuu7fojwQ5Dwj3oUn9xa_ukJc3JXA58YKXmMsME3MpNkjZUT_a6E68-h7xs1Fv-STgoFz7yLKl99f6wo7Zp9LNGiLTmYJT_-lyVqzNjW2A8rWRDYU0ANFpQuO-2bY2sCJbJcdWU5flc/s320/IMG_3304.jpg" width="320" /></a></div><br /><p>I remember that first day of vet school so vividly. My starched white jacket, my green nametag, that symbol of the snake and the cross, so ancient Roman impressive in its unpronounceable title, and me,,, wondering how I had gotten here after so much determination and grit, and an interminable 4 years ahead to try to keep that determination burning despite the challenges I knew I would face. Twenty years after graduation I have done vet school 5 times over. Who stays this long at anything, and why? To put those numbers into perspective I joined vet school after a ten year stint at sea. My second career is twice as long as my first, granted I adore this one and found great challenge in even attempting to like the first (no dogs or cats, or anything even remotely feminine at sea).</p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjnasELroyz2pT29gudV11t2Cr9fosZKQfCCLZcNZpcImlvHSHFk5rpdLOLV4XlxaQGIyyjGAfvz6uUYECNcMCsBitJbLPQeF614TttK4dY-jU2Sfj6_2cb682jJm2QlZPA7KpUPQg-icPZb2XVTCcDtu-yQUKnqHpUESJm0Q1jSLp1qSqbVZ1F7ijXoXc/s1544/IMG_3277.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1544" data-original-width="1158" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjnasELroyz2pT29gudV11t2Cr9fosZKQfCCLZcNZpcImlvHSHFk5rpdLOLV4XlxaQGIyyjGAfvz6uUYECNcMCsBitJbLPQeF614TttK4dY-jU2Sfj6_2cb682jJm2QlZPA7KpUPQg-icPZb2XVTCcDtu-yQUKnqHpUESJm0Q1jSLp1qSqbVZ1F7ijXoXc/s320/IMG_3277.jpg" width="240" /></a></div><br /><p>I can travel to get away from myself, but I always find out that I am happier with what I have built than what I want to get away from. That's the only kind of reflection that I should make time for at this point. Isn't it?</p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjznOhhL8FZCS16uWDfsRrjPGDdEc6OWa31rlPz32zE0CB17JTcIrPAvV2lYqVzVBAYxWzJ3EoGF6jzu8vnTlEjZ7ccUZJ1-I5vQYrtASwb9NIG_JK_EkMHC6LkQo9RrdYr35YvbTPQ8S6-_vrrOolIcWbOs4WCixCc0QMMfo-YQeYJcrSp97CeV5Vc8M8/s1280/IMG_4293.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="960" data-original-width="1280" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjznOhhL8FZCS16uWDfsRrjPGDdEc6OWa31rlPz32zE0CB17JTcIrPAvV2lYqVzVBAYxWzJ3EoGF6jzu8vnTlEjZ7ccUZJ1-I5vQYrtASwb9NIG_JK_EkMHC6LkQo9RrdYr35YvbTPQ8S6-_vrrOolIcWbOs4WCixCc0QMMfo-YQeYJcrSp97CeV5Vc8M8/s320/IMG_4293.jpg" width="320" /></a></div><br /><p>Maybe all of this effort will only amount to a cascade of colors with softened edges and hazy opacities. Maybe everything with even the best of intentions ends of rolling itself up on the shores of another lifetime as either detirtus or treasure? Maybe its only a matter of being the eye of the beholder and not wanting anything more than gratitude for the adventure given to us all?</p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEie4Nyq6ootLr8z8dCBdUAyDVoa2u3Ter_y-jym3mNP_87hgLx_xeC2XWPf5r2GGHLLoZXr6i0FwCDpxLekVRhALb76yJm7z7IfuMMhqCsh1G_dZOCyi5_SFnDTuFMCSATKSuiL_wKE1XFkrVHwH7CgvNLUYis6P0GNtZABeCgfq7ITrahgevtKklOS3xk/s2016/IMG_5818.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="2016" data-original-width="1512" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEie4Nyq6ootLr8z8dCBdUAyDVoa2u3Ter_y-jym3mNP_87hgLx_xeC2XWPf5r2GGHLLoZXr6i0FwCDpxLekVRhALb76yJm7z7IfuMMhqCsh1G_dZOCyi5_SFnDTuFMCSATKSuiL_wKE1XFkrVHwH7CgvNLUYis6P0GNtZABeCgfq7ITrahgevtKklOS3xk/s320/IMG_5818.jpg" width="240" /></a></div><br /><div class="separator" style="clear: both; text-align: center;"><br /></div><p>For any of you interested in the history of this resort here goes. Enjoy,, I loved running down this rabbit hole. Finding the back story behind these fragments found in the tidal vomitus.</p><p><a href="https://www.grandbahamamuseum.org/exhibits/history-of-grand-bahama-and-freeport/butlins-west-end-debacle">Butlin's West End Grand Bahama Island Debacle, care of the Grand Bahama Island Museum</a></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEicz-kjkn3_BYsUDZbUlbxwDS4N2_Twow2ZeS_LtMdNmOBQEVMe1sytuttkZnMF9WWxb39LKGQRdR3HyzsCzaqnR_4m5k8jFwiNT85UZ1XT71eWz9eNxofT2gA1nvZrXbMUDi2LNYzfE5boRqHHcJaEDiKzR1kxVzb0qi0NHNq2bT-jboxEah1Q3WMmG6A/s640/IMG_4320%20(2).jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="640" data-original-width="480" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEicz-kjkn3_BYsUDZbUlbxwDS4N2_Twow2ZeS_LtMdNmOBQEVMe1sytuttkZnMF9WWxb39LKGQRdR3HyzsCzaqnR_4m5k8jFwiNT85UZ1XT71eWz9eNxofT2gA1nvZrXbMUDi2LNYzfE5boRqHHcJaEDiKzR1kxVzb0qi0NHNq2bT-jboxEah1Q3WMmG6A/s320/IMG_4320%20(2).jpg" width="240" /></a></div><br /><p><a href="https://www.butlins.com/">Butlin's current resort options here</a></p><p>Jack Tar Village Grand Bahama West End <a href="https://en.wikipedia.org/wiki/West_End,_Bahamas">here</a></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiatRKG5m54mV2Kq8XN2IOXcSxJcVXuv5LYvUBfIJeE1-1Dzr0XiTgNLhwEGsogEPd7ZH1bSfyGUThTY6xwXiG8hndZAg5wG0AiNwe4Ft74g-YqYcJ6hOqOd10W47LO5CSi3bLH5nsGE4ziWkvy_pBoVxUFkNv5Q6IHvztrHb_3PPXvRA7kXX94-WPXLnE/s640/jack%20tar.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="366" data-original-width="640" height="183" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiatRKG5m54mV2Kq8XN2IOXcSxJcVXuv5LYvUBfIJeE1-1Dzr0XiTgNLhwEGsogEPd7ZH1bSfyGUThTY6xwXiG8hndZAg5wG0AiNwe4Ft74g-YqYcJ6hOqOd10W47LO5CSi3bLH5nsGE4ziWkvy_pBoVxUFkNv5Q6IHvztrHb_3PPXvRA7kXX94-WPXLnE/s320/jack%20tar.jpg" width="320" /></a></div><br /><p><br /></p><p><br /></p>krista magnifico, DVMhttp://www.blogger.com/profile/15133566329579911573noreply@blogger.com0tag:blogger.com,1999:blog-4667516629745731439.post-67431331144963747222024-02-04T10:41:00.000-08:002024-02-04T16:57:33.165-08:00I AM NOT AN E.R. The Story Of Sophie. Baclofen Toxicity<p>It has been a week since I last flossed. It seems like a confessional to the internal self to seek a
pardon, and once again, promise to do better. It seems I seek a peaceful acceptance of all of my
inadequacies within my inabilities too often.</p><p class="MsoNormal"><o:p></o:p></p>
<p class="MsoNormal">This week was exactly like this… a series of internal
confessions with a humble begging for forgiveness to a self that doesn’t take
disappointment, or failure, easily.<o:p></o:p></p>
<p class="MsoNormal">This day, this Wednesday evening, within this moment, was about Mollie, Genie, Maxi, Taylor, and Sophie. They were all in some degree of desperate dying. Each patient was supported by at least two technicians, all wondering the same thing as I; how could so many
catastrophes happen at once?, and, which one would start to crash/die on us
first?</p><p class="MsoNormal"><o:p></o:p></p>
<p class="MsoNormal">“We are not an E.R.” I hear myself produce these words almost
daily these days. I am not sure why I even try to explain, or, perhaps more realistically,
excuse myself. For every 100 times I recommend to a client that they transfer to the ER, 1 actually
consents and goes. People just don’t/can’t/won't/refuse to go. For some of these cases they
have already tried to get in. They have called, been directed to sign in via the
online portal, and been notified that there is a 10 to 24 hour waiting period. People who
are desperately worried for their pet’s life are not going to wait 10 hours.
So, they drive to us. Many just show up. Arrive unannounced. Crash a party and
hope that the door is open and the staff is welcoming. Depending on the degree
of the emergency they <i>may</i> have called us. <i>May</i> have spoken to our Charge
Tech to plea their case, which gets parlayed to a vet, and almost always given
permission to “come up, be patient, and we will do our best.” I try
with each case to set the stage for the reality that we are “not an ER” and may
have to transfer them to one should it be in the best interest of the patient
to do so. I know that even with this preface, this CYA blanket statement, that
I invite the chaos, and hence, I internally beg for forgiveness yet again when
I get myself too deep in the shit pile.</p><p class="MsoNormal"><o:p></o:p></p>
<p class="MsoNormal">At 7 pm I was standing, circling and losing my
mind amid the evenings vetmed emergency offerings I had unintentionally invited
to my own misery party. I looked into the surgery room. On the table to the
left was an 8-month-old puppy. I’ll call her Sophie. She was intubated, on
oxygen, and poorly to absently responsive. Under her head sat a bucket of vomit
with specks of white pills. To the right of her was Taylor. A five-month-old
tabby with fluid in his chest. He was sleeping in a clear plastic box full of life saving, life giving super saturated 100% oxygen. He was happy
and loving his time with us, thanks to the oxygen. Just outside the doors to
the surgery in a little stainless-steel cage sat Mollie. She was barely visible behind her cluttered cage door with its two fluid pumps, iv fluid bags, (also two),
and a clipboard holding checklist of her too numerous medications. You couldn't see her adorable face with its white fluff mane that surrounded her blunted nose and omni present wide mouthed grin framed within the haloed plastic e-collar. She
was sitting up on her front feet but straining and posturing her back legs. She
had spent the last week like this. Trying in vain to push out a stone that was
lodged so deep down her urethra it was only permitting a drop of urine at a
time to pass. In the cage beneath Mollie was Genie. A sweet, slow, aged Dobie who
had been vomiting for four days. She came in as a mystery ailment and she
remained the same until the next day when the 4-year-old in her family confessed
to feeding her a whole box of chewy milk-bones. She was in critical condition
and not able to move, except for the vomiting that just spilled out of her
mouth as she lacked the strength to pick up her head. Skip a few feet to the
left and there was Tigger. I.v. catheter running saline into his veins in the hopes
we could flush out the grit in his bladder and dodge the need to place a urinary
catheter. He had arrived 3 days earlier just about to block. We mounted the
most aggressive defensive plan we could to spare him a urinary catheter and his
mom the price tag it came with.</p><p class="MsoNormal"><o:p></o:p></p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiFdQdosDjfh90lB8VE3R_FkMhMM4_De6k0zFdmChmK6DsNgeSre6VPl42sW1r7_lIzMxvqDBm8Ls5etY3Zpktfc_vPRC4jpjNdNl8Ol0fcTyhXASIFFl0ldRUrl7Obs9BIiPZS2XQz3Bsh8KoYZzu_cwBrn3NPIhXwt4MzIhnZ7OXglBmtN_W_MTMjzaw/s1280/IMG_4856.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1280" data-original-width="960" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiFdQdosDjfh90lB8VE3R_FkMhMM4_De6k0zFdmChmK6DsNgeSre6VPl42sW1r7_lIzMxvqDBm8Ls5etY3Zpktfc_vPRC4jpjNdNl8Ol0fcTyhXASIFFl0ldRUrl7Obs9BIiPZS2XQz3Bsh8KoYZzu_cwBrn3NPIhXwt4MzIhnZ7OXglBmtN_W_MTMjzaw/w300-h400/IMG_4856.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Gastric lavage</td></tr></tbody></table><br /><div>Within these moments time stands still. I have to suspend it. It is the only way I
can muster all of the senses to attention to compute the vulnerabilities and re-assign staff
to guard the weak points. I know, I know deep in the seat of my gut, that at
least 2, maybe even four of these guys are going to die in front of me. Probably
in the next few minutes to hours. “I am not an E.R.” I remind only myself this
time.<p></p><p class="MsoNormal"><o:p></o:p></p>
<p class="MsoNormal">This is one of the best examples I can give of where vetmed
is now. We have burnt so many people they don’t trust, or don’t want to be sent
to an ER. For all of the many reasons the ER’s have gotten themselves in the
predicament our clients see them as, it doesn’t change the reality that
accidents, illnesses and yes, even death comes to find us. <o:p></o:p></p>
<p class="MsoNormal">I see my husband for about 15 minutes daily. 15 minutes when
I get home, typically around 9 pm, starving and exhausted. He has a meal
waiting, typically two hours old, as I never get my ETA correct. I do not
recollect any of the meals from the last week. Only that I inhaled them, and
that the portions were too large. We go to bed with me feeling like a bloated corpse,
and him angry that I cannot ever say “no.” He reminds me of my limitations and
the power of “NO.” I remind him that there are few options in these scenarios that I can live with.
I remind him that I am reminded that if I don’t help, I don’t know if anyone else will. If martyrdom was a pageant, I
could have a crown to sit upon. Think I am being foolish? Well, lets talk about
each of these cases in a little more detail. Wonder why I don’t floss? Well, I don’t
do anything in this state. I fall asleep as soon as I hit my bed. Surrendering to the exhaustion like the coma that claims me. I repeat this
Monday-Tuesday-Wednesday and Thursday. I fall off to sleep worried for the
patients I saw. Fearful for those I failed, and afraid for those I will see. I
cannot say “No” to these either. They find me in my dreams. Even here, as I try to rest I see them. I worry and react for them. I send them treatments, and apologies. A figment of a life preserver even here, when they aren’t near me. </p><p class="MsoNormal"><o:p></o:p></p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh6GfL4retypkdiBJF0yU0ThyR0NF5_zebr4MqPyjbcTHboWAcDa68OVwFwJqg_r7Hwg68WUU1HiD3iXuZfyjDzujom_4IJJ4MIZlcftsh18Zi7G53ZOuWHDFa_dKUbI9xIqgWWBOZAEFTBSsY8cx6tyah7XI4j0V7svpVCwY4sZxnOynYIRWtYLIYMzXs/s4032/IMG_8645.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="4032" data-original-width="3024" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh6GfL4retypkdiBJF0yU0ThyR0NF5_zebr4MqPyjbcTHboWAcDa68OVwFwJqg_r7Hwg68WUU1HiD3iXuZfyjDzujom_4IJJ4MIZlcftsh18Zi7G53ZOuWHDFa_dKUbI9xIqgWWBOZAEFTBSsY8cx6tyah7XI4j0V7svpVCwY4sZxnOynYIRWtYLIYMzXs/w300-h400/IMG_8645.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">The routine day</td></tr></tbody></table><br /></div><div>On the night before a dog arrived with much the same scenario; "ER has a 10 hour wait. Patient is bleeding everywhere from a dog fight." We explain to the caller that we will do our best to help, but, if sedation or anesthesia is needed they will have to head to the ER. When they arrived it was after 6 pm. I was told that he was "bleeding everywhere" so I rushed in to see him. There was blood splatter on every wall in the exam room. He had been there for less than 5 minutes. The wounds to his left ear were so significant that I was not able to fully assess whether ear needed reconstructive surgery. The ear was not being held up at a normal (or symmetrical) angle on head. There were about a dozen (maybe more) wounds to the top of his head that included both puncture wounds and lacerations. Some appeared to have pocketing and underlying muscle damage. Again too bloody and painful to assess. Wounds appeared to go over to right ear, base of ear and included the neck. As with all wounds of this severity he was too painful to assess fully without pain meds and sedation, and most probably required general anesthesia. I advised them to go to ER. When I mentioned the ER the owner became volatile. She shouted and became angered. She would not to go to ER! she yelled, so I offered analgesics and antibiotics as initial treatment option but again warned that wounds may need clean up to check for degree of soft damage, and tissue damage. I told the owner I was also concerned about pain, bleeding, and high infection rates with dog bite wounds. Owner declined again to go to the ER, and take any medications. The owner went on to say that "this dog had cancer and she would not wait 10 hours at ER to be told he doesn't need anything." I attempted to diffuse her and offered pain management and antibiotics again. She stated that I was being rude. The owner got up, took her dog by the neck and began to leave exam room. She kept yelling, repeating that I was rude, and she was not going to ER. As she was leaving I told her to not return to us, nor treat staff this way. When I said this she turned around and charged at me with a hand in my face and the words "I'm going to beat your face." </div><div><br /></div><div>That's what advising someone to go to the ER can get you. She was served with banning papers from the Sherriff the next day. Yet another gem to add to my Wednesday fiasco.</div><div><br /></div><div><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh5UAUdQoJ2pdnLQfIKUzEvn0F53B5ZEa8-U0UHuEmyG7o0BdZtSmbsWjUK7GZaX128LgSbn0Rsy5GlRy5r7_h4zevxOJtKWURztJm51ZBvEQB22F0bFaWl1DFovOmA0ZCdh1GLYfMdSB_VaQ3HpqYkZnVsAQ7Csjng-B6JZLzGhcxwnj9zb68CnsWhKbU/s2856/IMG_3304.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2142" data-original-width="2856" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh5UAUdQoJ2pdnLQfIKUzEvn0F53B5ZEa8-U0UHuEmyG7o0BdZtSmbsWjUK7GZaX128LgSbn0Rsy5GlRy5r7_h4zevxOJtKWURztJm51ZBvEQB22F0bFaWl1DFovOmA0ZCdh1GLYfMdSB_VaQ3HpqYkZnVsAQ7Csjng-B6JZLzGhcxwnj9zb68CnsWhKbU/w400-h300/IMG_3304.jpg" width="400" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">My Storm,, his happy place.</td></tr></tbody></table><br /><div>Sophie is 8 months old. She is a wire-haired terrier just
fostered and adopted by an older couple who adore her. For all of the mischievousness
of a terrier, (vets tongue-in-cheek refer to them as “terrorists”). They find
her antics, her strong opinions, and fierce compulsions, adorable. (I can relate,
my parents felt the same about theirs. I grew up with 5 generations of Jack Russell
Terrorists. They killed our cats. They killed any small thing that scurried). Sophie has a boxy face, tan highlights to a brown face and inquisitive soft intelligent
eyes. Her ears stand with a little bow at the tips and she is formidable in a
compact package of taught muscles and youthful velvet softness. Sophie was
carried into the clinic in her mom’s arms as she burst in the front doors like
a hurricane. I was alerted to their arrival by my receptionist who quickly came
rushing into the treatment area yelling, “EMERGENCY! WE HAVE AN EMERGENCY!” arms
flailing above as if waving down a passing car. I walked to the front and her
sobbing mom attempted to pass over her lifeless puppy to me and asked myself, “why does this place feel like a firehouse on some days?” </div><p class="MsoNormal"><o:p></o:p></p>
<p class="MsoNormal">It is exactly in this moment that I have to decide. I do not
extend my arms. I do not rush to offer some act of heroism in a crucible of mercy. I have to make that
split second decision as to who I am and who I want to be remembered as. It is
in this second that your marrow matters. It is here that your consequences, your
good deeds, your ethos, and every second of every tid-bit of training finds you.
Your actions here will haunt you. I know this. This is the place where some
vets will offer “humane euthanasia” while others will offer extremis estimates for a
chance, and many will take a bad situation and make it hopeless. (To be honest I
never quite know if I ever pick the right offering of an answer. More on this
with Genie’s story to follow). What I wanted to do was ask her to remain there.
Put her on a pause, holding her rag-like puppy and make a quick physical exam
assessment and,,, punt. HARD. I did not want to be responsible for her. I did
not want to be responsible for a hysterical mom feeling guilty about an
accident I have seen so many times before. I did not want this dying puppy. I didn’t
want any of the <i>hers</i> in front of me asking for help. Now I know this sounds cold
and cruel, but the reality was that I had just finished a long morning of over
booked surgeries. I had come in early, after getting home very late, to try to
cram in all of the things that I had scheduled. There was not enough room for
them, never mind the falling deaths from the skies. I know this. I know I am supposed to say "NO!" I looked at her puppy, I looked
at her, the words slipped out softly, “I am not an ER.” I knew we didn’t have
the manpower, the time, nor the facility to help a puppy in this state to the
degree she needed. Sophie was purple, barely responsive and I was pretty sure she
was dying in her moms arms, if not already dead, and would die on her way to
the ER. I clumsily said as much. Mom begged me to “try” and I am a sucker for
that word. It is my verbal kryptonite. No other word compels me. Mom was hysterical.
Mom was not safe to drive. Mom was not going to make it to the ER with Sophie alive. <o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg3pF9BoSdqLwhQ1DHlEscFsuu6XlqbILSV9UEHuvFshMV_ZMtLKtLgW3ZfW2fjHiylqcDzm7qrUDBrWCn1jpsSMBflTTr3EZQnsTrTG9akzqn17SdAkeFQanLTHSJ_bAgCpbM1JACCpcCRN2J1ZbUK-nSW6D2hANUnsitSqnu1ZKjh6SPp2J5Fn7Whvq0/s640/IMG_4860.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="640" data-original-width="480" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg3pF9BoSdqLwhQ1DHlEscFsuu6XlqbILSV9UEHuvFshMV_ZMtLKtLgW3ZfW2fjHiylqcDzm7qrUDBrWCn1jpsSMBflTTr3EZQnsTrTG9akzqn17SdAkeFQanLTHSJ_bAgCpbM1JACCpcCRN2J1ZbUK-nSW6D2hANUnsitSqnu1ZKjh6SPp2J5Fn7Whvq0/w300-h400/IMG_4860.jpg" width="300" /></a></div><br /><p></p>
<p class="MsoNormal">Sophie was in such a terrible state that I knew she had a
very narrow window. I took her in my arms and we headed into the treatment area. Over the next few minutes the story
of Sophie’s predicament unfolded. Her parents had left her at home for a few
hours. When they came back she ran to greet them, same as always. Within a few
minutes she had vomited and then they found the chewed up pill bottle. Scattered
around the bottle were large white aspirin-powdered pills. Baclofen. The label
was so chewed up that we had to use the pills and pharmacy information to
identify them. The bottle was filled for a 30 count. 13 remained. As the
technician called Pet Poison I debated her degree of consciousness and whether she
was awake enough to induce vomiting. She was not. Sophie had dried bloody,
thick, taffy-like saliva and vomit in her mouth. I tried to clear it. It was a sticky-spiderweb
goo that left your hands incapable. Sophie was placed on the x-ray table. She
had a huge distended stomach full of,,,, well, seemingly dog food and pills. We
whisked her to the surgery table, quickly intubated her and provided oxygen to
her purple lips and tongue. She was slipping into a coma. Four people, two of
them veterinarians, swarmed around her tiny new body. We placed a stomach tube.
We lavaged the stomach contents in a desperate effort to remove as much pill-peppered-ingesta
from her stomach as we could. The clear plastic tube sucked out tan kibble speckled
with white powdery-pieces of pills. She gagged once, whimpered once, and lay
lifeless for the rest of it. I gave her intermittent breaths of oxygen and told
her that I was sorry. I told her she was loved and I watched the staff so
desperate to help and so foreign in this act of emergency procedures. Sophie gathered a crowd and I barked orders to try to turn a tide I knew we were all
likely to drown within. I called the hospital manager down. I told her to call
all of the rest of my evening appointments and tell them we were swamped with
emergencies. “Offer to reschedule, (knowing this never works), and ask them to
be patient if they don’t want to. Go in all of the exam rooms, (I knew all 7
were filled with people waiting for us), and tell them the same.” I put her on
the reception desk and pulled the last two techs to the back treatment area.
For three doctors we had 8 technicians scurrying. We also had 17 patients in
our building, 7 wanted to crash and expire if you blinked. <o:p></o:p></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgJXednCS9AY7vZjPkQMU9BtZknYNJJ0swaNdU3rrxZujTJaKO1e3iv8uBmKAVlO8jQNb7i5xa3d3VKLLq_ccYSOvgm5BhZU2S1vsKJXbrblAzKfxbiP913jKNaIrliMRbWay6WFqVdaUZfdmwpEYLxiplzEY7xTGAbB6rDwuddxBRT0QwPSbpJ29GW-fc/s1280/IMG_4847.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1280" data-original-width="960" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgJXednCS9AY7vZjPkQMU9BtZknYNJJ0swaNdU3rrxZujTJaKO1e3iv8uBmKAVlO8jQNb7i5xa3d3VKLLq_ccYSOvgm5BhZU2S1vsKJXbrblAzKfxbiP913jKNaIrliMRbWay6WFqVdaUZfdmwpEYLxiplzEY7xTGAbB6rDwuddxBRT0QwPSbpJ29GW-fc/w300-h400/IMG_4847.jpg" width="300" /></a></div><br /><p class="MsoNormal">I got on the phone with a veterinarian from the Pet Poison Helpline. He
was slow spoken, jovial, and the calmness on his side of the line was re-assuring
and yet vexingly annoying. “Baclofen is a common toxicity. Have you had one
before?” There it came again, “No, I am not an ER.” ‘Don’t kill the messenger’
and ‘be nice.’ I said to myself. He is here to help me. (Does he know that I have
7 other animals trying to die around me?).</p><p class="MsoNormal"><o:p></o:p></p>
<p class="MsoNormal">“Baclofen is a muscle relaxant,” (yeah, I can see that). “It
has a very narrow index of safety in dogs” (Like 1 pill? How about 17?). “Unfortunately,
(never want to hear a sentence start with this), most dogs, <i>if</i> they survive,
(never want to hear this either), need supportive care for 72 hours to up to 6
days. Many need to go on a ventilator.” (Crap, who has a ventilator? Only the veterinary
teaching hospitals, I thought). I kept
going. We kept lavaging, hoping, and telling her that I loved her with a gentle
pat to her head. I stroked her ears in between her oxygen bag compressions. If
she was going to slip away it would not be without my whole heart and soul going
with her.<o:p></o:p></p><p class="MsoNormal">Over the next hour we tried fluids and desperate attempts to
stabilize. She was the last patient to leave the hospital that night. I called the local
ER to refer. “No,” they had not had this toxicity either. “No,” they didn’t have
a ventilator, but, “Yes” UPenn vet hospital does. They had sent a patient last
week. Estimate given for this was $18,000 to $30,000. OMG Crap.</p><p class="MsoNormal"><o:p></o:p></p>
<p class="MsoNormal">I look back on Sophie and I want to cry. I want to be upset
about how many times pets get into things we think that they are smart enough
to avoid. I want to put up billboards to say, “NO! crate training is not
punishment. It is the safest place for your pets to be.” My pups are 4 years
old. They are my children. My most beloved. They are also raccoons in
autographed collars. They will get into everything if I turn my head for a
second. They are trouble. I know that. They are crated when I am at work. They
are in a cage at the clinic. They are in a crate in the bedroom when we go out
the door. I don’t care if it is 5 minutes or 5 hours. They have been raised
this way. Every pill bottle in this house is double locked. A bottle in a
closed drawer. Never, ever is it out. Have you ever shaken a pill bottle next
to a pet toy? It’s all the same inviting tune. <o:p></o:p></p>
<p class="MsoNormal">In a sea of crashing waves, tumultuous and treacherous, I
will never forget Sophie’s face. I will never forget that yellow pill bottle
with its perfectly intact child-resistant white top, labeled as such. Tattooed with
its cursory; “push-down and turn” orange letters. Shrapnel-ed bottle, completely
missing any recognizable bottom, or rounded edges. The label chewed, swallowed
and obliterated in casual terrorist fashion. <o:p></o:p></p>
<p class="MsoNormal">Sophie was sent to the ER at 830 pm. She was transferred
without her breathing tube. She coded overnight. She never regained
consciousness. <o:p></o:p></p>
<p class="MsoNormal">I hope that she heard me. I hope that she knew she was
always adored. I hope that she forgives as much as I hope I can forgive myself.
Maybe I could have/should have used warmer water in her lavage? Maybe I should
have done it just one more time?<o:p></o:p></p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjSPFLAzbJxWyd9JQMSpiZouQmT8DCEIp50BTKM5TTws_5nJzd-qR81rNCTS7tNJgxtm-yLRbLp2R0czrOPdrtkBoLI8-aZCKB_t3Fzg5QSCElpiFCzSDMmn5Ju3bJcIR3UkX3-sXYnX3hZrs6ksK15_JSVOthJgKzP5T-EZMvrsxXSJa_XlwIqWgsuu6Y/s640/IMG_3698.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="640" data-original-width="480" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjSPFLAzbJxWyd9JQMSpiZouQmT8DCEIp50BTKM5TTws_5nJzd-qR81rNCTS7tNJgxtm-yLRbLp2R0czrOPdrtkBoLI8-aZCKB_t3Fzg5QSCElpiFCzSDMmn5Ju3bJcIR3UkX3-sXYnX3hZrs6ksK15_JSVOthJgKzP5T-EZMvrsxXSJa_XlwIqWgsuu6Y/w300-h400/IMG_3698.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">My Raffles,, on our daily "dog" walk</td></tr></tbody></table><br /><p class="MsoNormal">Maybe forgiveness holds as much power as intentions? Maybe
peaceful acceptance maintains the balance?</p><p class="MsoNormal"><o:p></o:p></p>
<p class="MsoNormal">Maybe the other 6 will survive. Maybe I am an ER, if only in
sheep’s clothing?<o:p></o:p></p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhS-2tnAzBRnW4HYf0saALgqHvh_zKIrmSJ5H88reuWnqmDsSZKFjPQ5I-7T0v9Sx65-NHrP-6Di2HcbFRBKDpEPE8i5BH8z-wMAdejibJbYBRNjm94B-m1AE4f7fAjHzO674ByRdnhxAgJqTHTBk6hva_7wcO2R8wbYL8K0OLJA9ls7qUn2QKModkPfnU/s1428/IMG_3700.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1428" data-original-width="1072" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhS-2tnAzBRnW4HYf0saALgqHvh_zKIrmSJ5H88reuWnqmDsSZKFjPQ5I-7T0v9Sx65-NHrP-6Di2HcbFRBKDpEPE8i5BH8z-wMAdejibJbYBRNjm94B-m1AE4f7fAjHzO674ByRdnhxAgJqTHTBk6hva_7wcO2R8wbYL8K0OLJA9ls7qUn2QKModkPfnU/w300-h400/IMG_3700.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">My Frippie and Storm</td></tr></tbody></table><br /><p class="MsoNormal"><br /></p></div>krista magnifico, DVMhttp://www.blogger.com/profile/15133566329579911573noreply@blogger.com1tag:blogger.com,1999:blog-4667516629745731439.post-18945557203700889972024-01-27T11:40:00.000-08:002024-01-27T11:40:27.056-08:00The Dilemma. What do you do when you don't think it's time to euthanize?<p> </p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh_icsvjJwtNNBWAVrJCLgIUNpX0NrLOIZj9Yi6ncNYmJozz1dQIv6T5KJn7eFGHYM5NdJTKEZnEouaxEzDhm9qcC8Dt0rhr7Jp8s5R16vWQC37TXkYgZrDoI9cXvyv98uQeBAZj_eleyvb0NUjv2O-TTCRGrppWHsnrWpV9Sle3BHHxFWQL82WL7p-fn8/s2856/IMG_3340.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="2856" data-original-width="2142" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh_icsvjJwtNNBWAVrJCLgIUNpX0NrLOIZj9Yi6ncNYmJozz1dQIv6T5KJn7eFGHYM5NdJTKEZnEouaxEzDhm9qcC8Dt0rhr7Jp8s5R16vWQC37TXkYgZrDoI9cXvyv98uQeBAZj_eleyvb0NUjv2O-TTCRGrppWHsnrWpV9Sle3BHHxFWQL82WL7p-fn8/s320/IMG_3340.jpg" width="240" /></a></div><br /><p></p><p class="MsoNormal">There was still a tag attached. <o:p></o:p></p>
<p class="MsoNormal">That’s what I remember most vividly. There was still a big
cardboard tag, the kind that keeps you from being able to fit the merchandise in your pocket
as a theft deterrent device, still attached to the obviously brand new toy she held so proudly in her mouth. It was the kind of tag that allows it to be hung on
a rack for easy display whilst also providing the descriptor that announces the
features of the toy that your pup might find most exciting and enjoyable. The
colorful cardboard backing to allow plastic ties to prop up mouthpiece rope
from the stuffed animal body and prohibit easy pilfering. That tag was hanging
out of one side of her mouth as she clung to the beloved toy that dangled from the other. Toy and tag in tandem swinging from one end of her while the other wagged tail so hard it
made her bony hips hula. <o:p></o:p></p>
<p class="MsoNormal">Her name was so endearing it made me stop to smile. Her
name, a blossom in springtime, a flower in the glimmer of an eye, the baby of a
movie star who wanted to be cool and still maintain cute. I’ll call her Honey.
She was bright-eyed, exuberant, bubbly, bounding and exploding with joy to be
around people. She is the lab pup every Labrador-lover dreamt of. She is pure
love and kisses in your face the minute she gets close enough to steal your cheek
unguarded. She is the reason I became a veterinarian. She is the reason every
pet loving person grieves for decades when they lose their beloved pet. She is
perfect. BUT, she is also old. 11 years old to be exact. She has not been to the vet in
many years and her very dapperly dressed dad is sitting quietly in his designer
loafers without laces, cross-legged in pressed, creased herringbone tweed
pants. Where Honey is outgoing and energetic, he is stoic and reserved. <o:p></o:p></p>
<p class="MsoNormal">There is a foot of snow on the ground outside and every inch
of landscape is slush and snow. I look at his buff-tan-kidskin leather loafers
and wonder how he got from his car to our exam room on this yacht shoes missing
soles. I look for an assistant who must have carried him in, knowing Honey
wouldn’t have permitted an easy passage and yet he shows no sign of snow or
wet. <o:p></o:p></p>
<p class="MsoNormal">I sit on the floor next to Honey and she cuddles up in my lap immediately. </p><p class="MsoNormal">I am here in this room with them both, on the floor embracing Honey and delivering the hardest conversation I ever have to be present for.</p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEicRuXdprpbZcTrLafLbthzwzKGNROUrmEnsvkUMo3IqW595ShsysGTnUa6RQeHodzF8eb84MDlSGz1iUe3OGezQ1kMchtTKEkMYPCw9axsTtH2xsJfDWQJGzlzQIZEWUnodTfDbvjTLpcJ_DPwVTJxNlDRPX_UPLUtpe9L9i5Nu53y39qd2BK27HYPAo0/s2016/IMG_9488.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2016" data-original-width="1512" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEicRuXdprpbZcTrLafLbthzwzKGNROUrmEnsvkUMo3IqW595ShsysGTnUa6RQeHodzF8eb84MDlSGz1iUe3OGezQ1kMchtTKEkMYPCw9axsTtH2xsJfDWQJGzlzQIZEWUnodTfDbvjTLpcJ_DPwVTJxNlDRPX_UPLUtpe9L9i5Nu53y39qd2BK27HYPAo0/s320/IMG_9488.jpg" width="240" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">This is Biscuit.. she reminds me of Honey.<br />I adore this girl,, and she knows it</td></tr></tbody></table><br /><div><br /></div>
<p class="MsoNormal">I look at Honeys overdressed dad and say, “I’m sorry but the
veterinarian doesn’t feel right about this.” He is quiet, his eyes narrowing
and his composure tightening. He is waiting for me to dig in, and I see him returning
the favor. <o:p></o:p></p><p class="MsoNormal">You see Honey is here, brand new toy in tow, wagging, happy and excited to be with us, to be euthanized. Her dad is here, holding her tight on a short leash, stoic, reserved and yet determined to make this a one way trip for her.</p>
<p class="MsoNormal">I go on to say; “We have a terrible problem with burnout,
suicide and mental health. I do not force anyone to do anything they don’t feel
right about.” I let the words fall around him hoping they landed softly enough
to allow a crack in the façade to let the light in just a little bit?<o:p></o:p></p>
<p class="MsoNormal">I waited. I stroked Honey’s head and whispered a mental “I
love you,” knowing I would likely never see her again.<o:p></o:p></p>
<p class="MsoNormal">These are the moments of the days of my veterinary life I
despise. The moments that remind me to be brave and stay true to my heart,,
even if I am alone in this. <o:p></o:p></p>
<p class="MsoNormal">I was the fourth person to enter this room with Honey today.
The first had been our vet tech who had placed both in the Comfort Room as his
appointment with Honey had been scheduled as a “QOL” exam, short for <i>quality
of life</i>. We do not book euthanasia appointments with out a veterinarians
prior consent. This is not a slaughterhouse. You do not drop off to pick up
remains later. We are a family who loves pets as our own family. We take this request
as a discussion and a decision not lightly agreed upon. If pets are truly property
there is no conscious of grief to surrender yourself to. But we all know pets
are so much more than this to all of us. We know that they are our truest
friend. Our most adoring confidant, our reason for early wake-ups and long
walks. When everything else in life seems questionable and unreliable your pets
will remind you they are your constant. We don’t need much more than the belonging
they inherently give us.<o:p></o:p></p>
<p class="MsoNormal">The technician came back to the treatment area to report
that Honey was walking well, seemed happy as a lark, was carrying a toy to show
us how delighted she was to have it, and that she was deeply concerned that Honey looked
A-OK. She couldn’t imagine what kind of <i>quality </i>her dad was in search
of. Honey had bounced up to her, thrust her toy in her face, dropped it to the ground
and planted a big wet kiss on her face. The technician was smitten with Honey. <o:p></o:p></p>
<p class="MsoNormal">The second person to enter the Comfort Room was the
veterinarian. In less than a minute Honey had given her the same welcome, and
after a brief exam it seemed that Honey had aging back legs and might benefit
from an analgesic and NSAID. The veterinarian also offered to run some routine
diagnostics and see if we could provide some options to help improve her quality
and spare her life. A discussion ensued about cost, benefit, possible side
effects, and after a few moments Honeys dad said, “the family has decided. We
are ready to put her down.” It hit like a blow. The veterinarian countered. “Would
you consider surrendering her?” He nodded, she left and the office manager
entered.<o:p></o:p></p>
<p class="MsoNormal">In the bowels of the hospital the staff gathered to hear
what the veterinarian recalled. “He’s going to sign Honey over to us. Call
Heidi, see if she will come down and meet Honey.” We started to make plans to find
Honey a new home, and we started to draft a list of diagnostics to run to make
sure we knew what Honey had going on inside. The techs were excited, bustling
and congratulating each other on their interventional good deed. There was a
levity that spread, it was hope packaged in healing hands and warm hearts. It
is the lifeblood that feeds the marrow of a place like this. It is the small miracles
that fill our long days with purpose and stories and the passing of intentions
into matters that build our souls and fill our sails. For a place like our
veterinary clinic it is the small wins to help make the inevitable tragedies
more palatable. <o:p></o:p></p>
<p class="MsoNormal">A few minutes later the office manager came into the treatment
area. We all knew by her quiet entrance that the news was bad. “He won’t surrender
her.” The girls begged for a “why!?” She replied; “He doesn’t want her to be with anyone
else.” <o:p></o:p></p>
<p class="MsoNormal">None of us could accept it. They all argued with how the
hopes had been dashed so quickly. Had she asked the wrong question? Had it been
lost on him in translation between a vet and a manager? Should we send the vet
back in? <o:p></o:p></p>
<p class="MsoNormal">The girls suggested alternatives to save her life, spare her from being disposed of so coldly and unconscionably, ..<o:p></o:p></p>
<p class="MsoNormal">“Can’t we just say we euthanized her? He doesn’t want to be
with her anyway?” The first option they threw out.<o:p></o:p></p>
<p class="MsoNormal">“What if we only give a little bit of the solution?” Like adding a splash of water to the euthanasia solution might dilute it to the place where it wasn't effective.<o:p></o:p></p><p class="MsoNormal">Desperate pleas for a desperate place. </p>
<p class="MsoNormal">There were no answers left to offer. We only had one choice
left.<o:p></o:p></p><p class="MsoNormal">Honey's dad wasn't going to let her have any other option than the one he walked into our door deciding she deserved. These places, these cases, these are the ones that kill you. For some of us, literally and completely. They destroy lives that care and our ability to care again.</p>
<p class="MsoNormal">I looked at the other veterinarian. She looked back at me.
We both didn’t want to be the other persons answer. The mirror of responsibility
to the staff who always had their hearts on their sleeves and worked so hard to
just be a kind heart to a pet in need. We didn’t want to put the other in a
place of heart-wrenching decision making. <o:p></o:p></p>
<p class="MsoNormal">“I can’t do it,” she said. “I just can’t.”<o:p></o:p></p>
<p class="MsoNormal">I looked at the office manager. “He is not going to
surrender her.”<o:p></o:p></p><p class="MsoNormal">That left me. Alone, and with a Honey of a problem to reconcile alone. </p>
<p class="MsoNormal">I walked into the room with Honey. The fourth person she
brought her new toy to. The fourth person she was as excited as the first. I
sat on the floor, she flopped, toy in tow bouncing with its cardboard tag alongside
her tongue into my lap. <o:p></o:p></p>
<p class="MsoNormal">I whispered silently to her longing eyes of love, “I love
you.” </p>
<p class="MsoNormal">Honey is not alone. She has me rooting for her. Alone in a
quest to remind her father, her family, whoever, that there has to be compassion,
even in times of mercy, and we have to remember how precious each day is and
fight for our chance at seeing tomorrow with love, hope, and kindness in our
hearts.<o:p></o:p></p>
<p class="MsoNormal">Honeys dad tried to argue our stance. He made phone calls,
he stood fast in his decision. When I cam back into the room some minutes later
I handed him two bottles of analgesic hope and a paper that said Honeys
treatments had been on the house. I added that I hoped it help her feel better
and that we were here if we could help her again. <o:p></o:p></p>
<p class="MsoNormal">I extended an olive branch of defiance. I stood by my staff
who would have been balling and questioning my cruelty had I chosen Honeys <span style="mso-spacerun: yes;"> </span>family’s side. I stood by being kind when it wasn’t
the right thing for me to do for her family. I stand here now not knowing if it
was the right thing for Honey, and why I should be asking about it being
anything other than that.<o:p></o:p></p><p class="MsoNormal">Here's more on Honey's case;</p><p class="MsoNormal"><br /></p><div class="separator" style="clear: both; text-align: center;"><iframe allowfullscreen="" class="BLOG_video_class" height="266" src="https://www.youtube.com/embed/olshtFc4gvM" width="320" youtube-src-id="olshtFc4gvM"></iframe></div><br /><p class="MsoNormal">..and so the question remains? What would you do?</p><div class="separator" style="clear: both; text-align: center;"><br /></div><br /><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhokTiTWNEHg1PjNC5uRzeAexMzL8uak21KOMoxbIhSRR6uCa917-wywcSiT2X8e-_L-SPuUdXugEEUXkqKtfWSDh4jjagUuMnx_AlDV2vqgWk3RXwCEVMlspgL0Jy9ziEY3Cu4q52e0rf4AYC3w_66SFA5GAT1Olae32GkDtSclue7MLiHnoQzsrlc32E/s2856/IMG_3320.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2856" data-original-width="2142" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhokTiTWNEHg1PjNC5uRzeAexMzL8uak21KOMoxbIhSRR6uCa917-wywcSiT2X8e-_L-SPuUdXugEEUXkqKtfWSDh4jjagUuMnx_AlDV2vqgWk3RXwCEVMlspgL0Jy9ziEY3Cu4q52e0rf4AYC3w_66SFA5GAT1Olae32GkDtSclue7MLiHnoQzsrlc32E/w300-h400/IMG_3320.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">My pup Storm. Rescued from NC after his family left him at the shelter</td></tr></tbody></table><br /><div class="separator" style="clear: both; text-align: center;"><br /></div><br />krista magnifico, DVMhttp://www.blogger.com/profile/15133566329579911573noreply@blogger.com0tag:blogger.com,1999:blog-4667516629745731439.post-63175779106494257062024-01-06T18:03:00.000-08:002024-01-13T08:15:02.889-08:00The Blocked Cat. The Approach To Get Out Alive. Part Two<p>Cats with a urinary blockage always need to be addressed as an emergency. Unless you have experience with this condition before almost all of these patients arrive at the clinic as an emergency. Most commonly they have been blocked for some period of time and this leads to a higher likelihood of either bladder rupture or toxic changes to the heart. </p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh10d44ZE9GlwIm84fXPdA8tODZABX5hjXrjNx5rLkIx_NIrn5VkvsUStk7AUTBeUyL_27kqcmWDsq0CGWu7xJfV-zaX0w-iderffgkl2Uy3BGnpDfbXg5w7exk0uvBi4aDXTVMzn2jZZrK-NA4PexlIhUR676AxZSrm-YmKG9_kzi34ysFAbv5X-Y4Mag/s2856/IMG_2047.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2856" data-original-width="2142" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh10d44ZE9GlwIm84fXPdA8tODZABX5hjXrjNx5rLkIx_NIrn5VkvsUStk7AUTBeUyL_27kqcmWDsq0CGWu7xJfV-zaX0w-iderffgkl2Uy3BGnpDfbXg5w7exk0uvBi4aDXTVMzn2jZZrK-NA4PexlIhUR676AxZSrm-YmKG9_kzi34ysFAbv5X-Y4Mag/w300-h400/IMG_2047.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Beau. Blocked three times. $8,000 for two ER trips, <br />then he found us. Third block and a PU surgery; $1500 on a payment plan.</td></tr></tbody></table><br /><p>I have to recommend that you go immediately to a vet if you suspect that your cat has a urinary blockage. I also have to caution that most clinics either refer to the local ER, or, charge a hefty price to treat this. </p><p>Please go back to the first blog in this series now (go <a href="https://kmdvm.blogspot.com/2024/01/blocked-cat-uo-introduction-what-does.html">here</a>) if you haven't read it already. The first chapter will define what a urinary obstructed cat looks like. </p><p>The singular goal of this is to get your cat out alive. If you are like most of us you live in financial constraints and your cat is a vital, beloved member of your family. The profession knows this, and the profession has profited greatly because of it. We know you love your cat, and we know your cat is going to die from this, soon, if you don't cough up the admission fee for us to treat it. It's the culture of the American way. Make as much money as you can from wherever you can. Ask yourself how you are a part of the problem and then ask yourself what you are doing about it. Sure, I am disappointed in my profession for killing so many treatable pets, but, this is the world we all decided to emulate. Every rich person has profited from the misfortune of another. Medicine should be the neutral, sacred territory. It isn't. </p><p>Here is my professional advice, as a veterinarian of 20 years, on getting your cat out alive when they have a urinary obstruction (aka a blocked cat). </p><p>Tips; </p><p></p><ul style="text-align: left;"><li>be nice</li><li>be honest</li><li>be insistent</li><li>be ready to challenge every interaction</li><li>never lose hope</li><li>never walk away without knowing that the only advocate in your pets life is you</li><li>be willing to surrender your cat if it means it might save their life. </li><li>ask for help from everyone. Build an Army around your cause and then help pay it forward. If you find a way to get out alive pay that forward to someone else. The current practice of blocked cats in almost every ER setting is so expensive it is forcing most of these cats to either suffer or be euthanized. There are only these two options. Why is it that we allow these cats to go home and die a horrific death of suffering? or shame you into paying for something that has such an incredible mark up we lose the ability to heal? </li></ul><div>If your cat is demonstrating any of the clinical signs listed in the first blog on this (see <a href="https://kmdvm.blogspot.com/2024/01/blocked-cat-uo-introduction-what-does.html">here</a>) then you must bring them to a veterinarian. </div><div><br /></div><div><b>Start with the exam.</b> Blocked Y/N if YES, then ask for a written copy of the exam findings. Immediately. If the staff or vet declines, ask them to give a verbal description using the form provided below. Do not leave your cat without this. You should always have a copy, or have documented a detailed list of what has been done for your cat and what you have consented to. This is very important to help manage your cAts care and the expense associated with it. A blocked cat should be diagnosed by physical examination alone. The cat will often have a painful bladder that is hard, large and unable to be expressed (able to produce urine). If you sign anything ask for a copy of it immediately.</div><div><br /></div><div>From the initial examination an estimate is given for the expected, or recommended, treatment plan. Here is the first place that negotiations should begin. Here is the first place where I recommend that clients challenge the options being presented. </div><div><br /></div><div><b>Next; </b></div><div><b>Is the estimate is affordable? IF YES, </b>(your cat is blocked) and the estimate/deposit required is affordable walk away. Sign paperwork, get a copy, and walk away. Your cat is in good hands, and the safest place they can be. The veterinary clinics are set up to provide top tier medicine and provide appropriate treatments for the worst case scenario. The problem is that most people cannot afford this, and, in almost all cases you are charged for worst case scenario treatment even though most cases do not require them to be successful. The veterinary clinic benefits greatly by being prepared to treat your cat as the worst case scenario outlier even though most are not. No client should have to pay for Gold Standard care if the case does not need it. Further, if you cannot afford the first estimate you should be permitted to be given the treatment plan tailored to your cats needs at a price you can afford to get the best possible outcome. THIS IS NOT BASED ON THE AMOUNT OF TIME YOU CAN AFFORD, BUT THE CARE YOUR CAT NEEDS. I recommend that your cat stay on iv fluids and with a urinary catheter in place for a minimum of 3 days. Your cat should stay in their care until urine runs clear. Your cat decides the length of stay,, not the hospital. They should do the following; full blood work. ECG, abdominal radiographs, do ultrasound, do urine culture and sensitivity. Provide analgesics, appropriate urinary diet, appetite stimulant, stress free housing. The cost of this at a specialty hospital with ER has been reported as $6,000 up. Reminder; your cat has a chance of re-blocking. I.e. you and your cat may be back here again, soon. Budget accordingly. </div><div><br /></div><div><b>IF NO;</b></div><div>If the estimate is not affordable; <b>No</b>? Everything from here is based on budget and time. The house decides your cats prognosis based on your budget. The smaller the budget the less ideal the care. Why do they get to decide that?</div><div> </div><div><br /></div><div><br /></div><div>If blocked and you cannot afford the estimate; ask for all of the diagnostics to be declined before cutting the in hospital time. If the hospital will not do this ask to see the manager. Ask for the reason in writing. Do not leave with out this. There is this incorrect notion that vetcare is a one way street. We tell you what to do, and how much it is going to cost and you either pay or you hit the road. It is not the case. Veterinarians can decline to treat, but they are expected to give you a place to go for care. You can decline line items. You can ask for written prescriptions to fill elsewhere, and NO they cannot charge you for this. You can decline all diagnostics and ask for your cat to be unblocked. You can even decline pain medications, although I strongly disagree with this. Unblocking your cat, providing fluids (even in the case of a fluids kit you bring home to provide SQ fluids at home) is an option. Taking your cat home after they have placed an iv catheter and a urinary catheter is your right. In cases where the cost of care is so high I recommend that you tell the vet that you are transferring your cat to another clinic and they they be transferred with BOTH the urinary and i.v. catheter in place. I know of many (in fact I know of only 1 case where this was provided). In all other cases the specialty practice pulled BOTH catheters and then sent the cat to me. I had to replace both and this was detrimental to both the patient and the client. IF you paid for these you own them. Remind the practice this after you pay. (See form below).</div><div><br /></div><div>If you cannot afford anything ask for a cystocentesis to remove as much urine as possible, go home find a general practitioner who will help. Call every rescue, shelter, veterinarian, put out a social media plea. Start a fund raising campaign. Offer to surrender your cat. Any person who refuses to surrender their cat appears more interested in ownership then compassion and the life of their pet. </div><div><br /></div><div><$500; exam, comatose cats can be catheterized without sedation or analgesia. Take a video of how your cat presents to the ER. Ask if sedation is needed? If not it should be removed from your invoice. place urinary catheter ask if you can go home with sq fluids kit and urinary catheter in place. The act of placing a catheter is traumatic to the urethra that is already not functional. Placing and then removing before the tissue has healed is problematic, if not further worsening the cats prognosis.</div><div><br /></div><div>Decision Tree;</div><div>blocked -> Yes, AND I can afford the suggested treatment plan., sign forms, get copy, go home. See you in a few days. (Warning patients can re-block in days to weeks).</div><div><br /></div><div>Blocked-> Yes, BUT I cannot afford first treatment option provided; I would like to decline all diagnostics to have a urinary catheter and iv catheter placed, and at least 3 days of both with in hospital care.</div><div><br /></div><div>Blocked-> Yes, not enough money for multiple days iv fluids and urinary catheter treatment, then place both and take home. Find a vet who will help at an affordable price. Give this directive in writing. If your vet pulls the catheters after providing written or verbal directive see your State Veterinary Board and file a complaint. </div><p></p><p>Blocked-> Yes, cannot afford urinary catheter or iv catheter, decompress bladder (place a needle in the bladder and remove as much urine as possible. This will buy you a few hours to find a vet who can help. (Find me in Jarrettsville Maryland, or Denton County Animal ER in Denton Texas).</p><p><a href="https://kmdvm.blogspot.com/2024/01/consent-to-care-for-blocked-cat-pet.html">Pet Parent Consent For Care Form here.</a></p><p>If you know of someone who provides affordable, transparent care for blocked cats I want to hear about it. Email me at krista@pawbly.com</p>krista magnifico, DVMhttp://www.blogger.com/profile/15133566329579911573noreply@blogger.com0tag:blogger.com,1999:blog-4667516629745731439.post-74847460736075022122024-01-06T17:49:00.000-08:002024-01-06T18:02:47.323-08:00Consent to Care for a Blocked Cat. Pet Parents Edition.<p> I, ________________________________________, authorize care for my cat __________________ to relieve his urinary obstruction in the most affordable means necessary to provide him immediate relief. I authorize pain management be given to him in any and all options possible including a written prescription that I can fill elsewhere. I understand that this may include declining best care practices and recommendations in an effort to help manage funds to allow him the best chance at cure/survival based on unknown future factors that might influence his healing and prognosis. </p><p>I request all medical findings be provided as they are done and before other treatments are provided.</p><p>I request that if a catheter is placed (intravenous or urinary) that I be notified and offered the option to decline either, or any, be removed so that I might be able to transfer my cats care elsewhere. </p><p>I understand that my cat has a very serious, potentially life threatening condition and that by declining treatments, and treatment options I may be worsening their prognosis. </p><p>I understand that my cat has options for care. I request that decisions be made with my consent and with all options for care, and subsequent treatments in an open, up front, transparent manner. I request that more than one option be provided at each discussion.</p><p>I understand that euthanasia is my option at anytime. I understand that declining this as a case of economic euthanasia as a treatment option is also at my discretion.</p><p>I understand that denying care based on this document might be considered judgement, prejudice and impact my cats life. I understand that I am responsible for paying for his care and consenting with honesty and integrity is both parties right and responsibility.</p><p>I request the name of the veterinarian caring for my cat at all times to include transferring care should they no longer be on duty. I request this in writing at each transference of my cats care while he is here.</p><p>I request the name of the entity, or responsible party employing this veterinarian. I request this in writing at the time that I sign to consent of care for my pet.</p><p>I understand that my behavior is my responsibility. I will remain courteous and available for questions and discussions about my cats care.</p><p>I understand that the most important part of my cats treatment plan is to relieve the obstruction and provide fluids. I request that fluids be offered in anyway possible to allow me to care for my cat. I request the ability to take home an fluid bag to include the appropriate iv tubing and needles. If you cannot provide this I request a written script to purchase it elsewhere to include my veterinarians office, or an online provider (including Chewy.com).</p><p>If I cannot afford to hospitalize my cat based on the written provided estimate given to me, and signed by me then I request he have a cystocentesis to remove as much urine as possible so that he can be transferred to another provider. I understand that this is not without potential adverse consequences and I have consented to these with an understanding that my cat might die from any and all procedures and any and all treatments. </p><p>I am asking for assistance in providing the best chance possible to my cat surviving this disease with the limited funds I have.</p><p>If possible I will relinquish ownership of my cat to get him the care he needs to survive.</p><p>I am grateful for your time, your medical skills, and your compassion as we try to save our cats life.</p><p>Sincerely, __________________________________________ (write and sign your name)</p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgz8h_bZG5jKiVEioxngPr7Uxj8Cj-clSbFk-0qitU2CViXlWWcbrMk30TvirUmwjNtdpeD5JCnioHWthTuu6MQvcmBRSeQKBp50EJGyRs4LA34HHLxfAb1h54no3zeFqjfnpk4AFowaJxI16NYQwFp4Y_NTNzbkqDC8y7ZBWa2SdakctgObbHwbw908Us/s2016/IMG_7481.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1512" data-original-width="2016" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgz8h_bZG5jKiVEioxngPr7Uxj8Cj-clSbFk-0qitU2CViXlWWcbrMk30TvirUmwjNtdpeD5JCnioHWthTuu6MQvcmBRSeQKBp50EJGyRs4LA34HHLxfAb1h54no3zeFqjfnpk4AFowaJxI16NYQwFp4Y_NTNzbkqDC8y7ZBWa2SdakctgObbHwbw908Us/w400-h300/IMG_7481.jpg" width="400" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Raffles and Birdie</td></tr></tbody></table><br /><p>Please note this is a guide. I am not a lawyer, and I do not provide legal advice. </p><p>For all of the documents veterinarians give to pet parents requesting signatures to authorize care it is time that pet parents start to advocate for their pets and find a way to get them out alive. All of those of us practicing medicine with our patients at the epicenter of care already practice this way. We already offer any and every option to keep these family members with their families.</p>krista magnifico, DVMhttp://www.blogger.com/profile/15133566329579911573noreply@blogger.com0tag:blogger.com,1999:blog-4667516629745731439.post-20782742453748722162024-01-01T10:31:00.000-08:002024-01-06T10:29:43.443-08:00Blocked Cat. UO. The Introduction. What Does A Blocked Cat Look Like? Part One of the Series for Feline Parents<p><b><span style="font-size: medium;">The blocked cat</span></b>. </p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEidsyDlF94EVuJJBwA6AEWhPhTSGxTzkzrU6q560GTRXLo_lwxx4xIOLqG0WDNySz-1sBdFuUYDeMLYTTm99NUtVBpjJYV9O6WDvlzKds0v_IQC7PMUnmc4EIoSf4OrUgEHPAyDysNcfcQRDrTiXJgFmst4dH_JoJtzyUYxjU7flTdlMaRf06DQC51t3ds/s2016/72412288485__A6A94204-1F4E-46CD-917B-75D3066B47EE.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1512" data-original-width="2016" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEidsyDlF94EVuJJBwA6AEWhPhTSGxTzkzrU6q560GTRXLo_lwxx4xIOLqG0WDNySz-1sBdFuUYDeMLYTTm99NUtVBpjJYV9O6WDvlzKds0v_IQC7PMUnmc4EIoSf4OrUgEHPAyDysNcfcQRDrTiXJgFmst4dH_JoJtzyUYxjU7flTdlMaRf06DQC51t3ds/w400-h300/72412288485__A6A94204-1F4E-46CD-917B-75D3066B47EE.jpg" width="400" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Beau. Blocked again, $8K in, his story is so typical, <br />and could have been another tragic ending.</td></tr></tbody></table><br /><p>Blocked cats are my lifelong veterinary mission. They are the place that veterinary medicine can offer the most impactful life changing care and they are also the single place we have the most alarming, dismissal statistics in actually doing it. </p><p>The vital care needed for these cats is my passionate determined purpose. It is my hope to shed more light on this condition while inspiring others to offer more help with any, and every, degree of compromise needed so that we can relieve the suffering to save every blocked cat possible. I am proposing bold, ambitious, aggressive words of advice because of all of the many veterinary medical issues I am faced with in my day to day life there is no single other disease that has a higher prognosis to save ratio, while also escalating the cost of care so exorbitantly and unjustifiably that it has become cost prohibitive to allow most pet parents to provide it. When we allow the cost to exceed the ability to provide any degree of care the profession, the whole of the profession should be held accountable and culpable. The fact that we know most people cannot afford the ideal emergency care for this condition should be a wake up call for change. It shouldn't have to come from the outcry of the pet parents we have failed. It should come from inside the heart of our own code of ethics. With all of the miracles of modern veterinary medicine the blocked cat is both a product of our inability to educate on the appropriate care for cats before, during and after their UO, and, the profession denying every possible life saving treatment possible because we know you don't have another options to save your cat. Veterinarians, and the profession at large also knows that you cannot find affordable transparent pricing easily, if at all. We know you need us, and we know people adore their cats. We know how to take advantage of an emergency and the emotional turmoil this holds. We have profited from the intersection of emotional adoration, medical critical care, and no place for pet parents to find compassionate curative refuge. Further we have abandoned our compassion, empathy, responsibility and culpability in the process. If we are going to deny any modicum of meaningful interventional care it is time the veterinarians oath, the consequences and the challenging of what part veterinarians play in prolonging the suffering from UO's be challenged. When we offer no viable options we take responsibility for the cruelty that neglect carries.</p><p>I am here to challenge every single obstacle, empower and educate every single cat parent, and save every blocked cat I can. I am here to build a village so powerful it becomes an Army of causation for change. If the profession cannot provide affordable, transparent, compassionate care to these cats in the most dire need that is actually meaningful it is time to shift the paradigm of care based decisions back into the pet parents hands. Until the increasingly growing corporately owned monopoly releases the exorbitantly excessive costs that grip the access to pet care, and, the overseeing laws for pets being provided a higher elevation in status other than "property" are challenged there is only this, a public empowerment to permit great latitude for diversity of care based on the outcry of challenging the current Ivory Tower Gold Standard practices meant to benefit profits. The idea that we only offer what is both most profitable, albeit under the guise of ideal patient outcomes, is unrealistic and unethical. It is time to allow the conversation for ideal pet care to be shifted to an open two sided conversation. It is time to put patient options for ideal, or even viable, outcomes above all else.</p><p>This is the first part on a series of articles on this subject. This article will provide a basic overview of the condition, the clinical signs and the approach I recommend for every pet parent in the predicament of finding care for their blocked cat. The other articles will describe how to best customize your cats care to your abilities and preferences. They will also provide guidance for after care and help in addressing the likelihood of re-blocking.</p><p>Future articles will also provide a client based decision tree to help make the best decisions possible for their cat in real-time and with a team based approach to finding the best answers for you and your cat. Please follow on Pawbly.com for more help. There are also many amazing Facebook groups dedicated to this condition to help. If it takes an Army I will provide the troops and the battle plan. Never give up. Never lose hope. You are not alone and you are not helpless. Please also recognize that your voice, your pets story, these need to be heard and shared. If you find someone who won't offer options let the world know. If you find someone who will sit down with you and discuss any and every option to keep your cat alive and on the medical path to getting treatment to help them live a longer, happier life, please share this at Pawbly.com in the storylines section. It is time for all cat parents to become a part of the Army for change and care.</p><p>We are going to start here; educating, inspiring, empowering and reminding all of us that with compassion and hope anything is possible.</p><p><b><span style="font-size: medium;">Urinary Obstruction, i.e. UO, or, <i>blockage</i> (or a "blocked cat" refers to the inability to pass urine out of your bladder</span></b>, usually because the spigot is clogged. I describe it to clients as this;<i> think of the bladder like a balloon. Think about someone tying off your balloon and then having to pee.</i> In the beginning cats will go to the litter box frequently to try to empty the bladder. Over time the knot of the balloon gets tighter and the bladder gets larger, harder, more painful. While this is happening the toxins in the bladder become systemic to the body. The cats will often vocalize, (the loud, excruciating crying that sounds like a scream), is your cats way of saying "HELP ME!," In most cases this turns into a stupor and immobility, (lethargy that progresses to inability or unwillingness to move), because toxic doses of potassium are surging through the slowing heart, until it stops, OR, the patient dies after the bladder ruptures inside the abdomen. </p><p>What a blocked cat looks like;</p><p></p><ul style="text-align: left;"><li>frequent trips to the litter box</li><li>meowing, crying, vocalizing in the litter box</li><li>producing small amounts of urine more frequently</li><li>licking at the area of the anus, prepuce, under the tail area</li><li>not eating well</li><li>not playful, happy, or calm</li><li>agitated, not their normal self</li><li>pawing at the litter in the box more aggressively, or frequently</li><li>urinating outside of the box</li><li>the urine looks bloody, or cloudy, blood spots on the tile floor, or bathtub</li><li>angry if you touch or pet the belly area</li><li>indoor, male, young cats are most common for UO</li></ul><div>If your cat is doing any of these please go to the vet, or ER immediately. Waiting will worsen your cats chance of survival and make the cost of care more expensive.</div><p></p><p>Urinary blockage, (UO), happens primarily to young male cats (2-7 years old), who are indoor and being fed dry food, (usually poor quality dry food). They were previously otherwise happy, healthy, vibrant adoring cats. There is a horrific irony that the most vulnerable are often the youngest and the most beloved. The hidden joys in a home where the love of a cat who purrs you to sleep every night defines your ability to face a world outside your door that is too often unkind and unwilling to help.</p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgAoOVF1SeP6Js2SPY5PEorAWncaGw0hVaIj9bYrf70DmawpMAB0hlFg3usq8MgMipetxdyE_s-C0p_Imad-7gM1Tx2yF2mRkcQT4EZ3alCnCRcD1FQ0IcazeY4XiiabrlsYQx5-oK1bl0tV6zCf6i-XJeVkaKzeXNrGsLDZ08ZiBp6cgzLL5oQs4bpegw/s2016/72615768259__BDD458B0-A1EC-475B-ADA5-46DA67E7C6E1.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgAoOVF1SeP6Js2SPY5PEorAWncaGw0hVaIj9bYrf70DmawpMAB0hlFg3usq8MgMipetxdyE_s-C0p_Imad-7gM1Tx2yF2mRkcQT4EZ3alCnCRcD1FQ0IcazeY4XiiabrlsYQx5-oK1bl0tV6zCf6i-XJeVkaKzeXNrGsLDZ08ZiBp6cgzLL5oQs4bpegw/w300-h400/72615768259__BDD458B0-A1EC-475B-ADA5-46DA67E7C6E1.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Cash</td></tr></tbody></table><p>It is my hope that veterinarians, and the veterinary medical community, start focusing on what we can do, regardless of cost, regardless of ideal standards of care, and let pet parents find help for a very treatable condition. It is also my hope that sharing successful stories, highlighting that these cats often have bumps in the road initially, but they can, and overwhelmingly do, go on to live long healthy lives. There is hope where there is compassion. </p><p>Focus on this. I know that your cat is suffering from this disease, but I also know that these cats look like death when they arrive, and go back to living long healthy lives the majority of the time after they are treated. </p><p>These patients are so young, and this is (almost always) treatable! Your cat and this issue are not uncommon. I hear about cases like yours all the time.</p><p>Here's where my Blocked Cat plan shifts the decision making, and optimal treatment options back to the pet parent for the best chances at saving these cats lives.</p><p>There is a storyline section where all of this can be added. My hope is to find a way to help everyone in your predicament. And I cannot possibly do every cat and every pu surgery.</p><p>So let’s start with the immediate. </p><p></p><ol style="text-align: left;"><li>Diagnosis. Your cat needs this. A vet is needed. cost of exam $_____. This is a disease made by a physical exam, not thousands of dollars of diagnostics. Period.</li><li>Unblock costs this $____. You should ask for a detailed, exact list, of how this was done. It should be given to you in writing. (Insider secret; in some cases no anesthetic is needed, or given why do you have to pay for it? Keep a copy of everything you sign). </li><li>Get every piece of your cats veterinary findings in real time. For example, as soon as your cat is examined you should be given, or write down all of the physical exam findings. </li><li>If number 2 is not feasible, decompress by cystocentesis. Buy time by removing urine. Cost __. Get to a veterinarian who will help you affordably ASAP! You have (maybe) 12 hours.</li><li>Fluid therapy for 3 days. Maybe more. I treat until urine is clear and patient is acting normally again. </li><li>If you cannot afford in hospital stay ask to bring your cat home with the urinary and iv catheter in place. Go to your vets office with these. They are often much more affordable than the ER, although not 24/7. If they will not keep your cat ask about having one of their technicians help you? These cats can be safely and effectively treated as an outpatient. They should wear an ecollar 24/7 to protect these catheters. Replacing the urinary catheter might cost you over $1,000.</li></ol><div>If you cannot get these I recommend that you challenge every line item, impose upon every obstacle and call every local veterinarian, speak out on every social media platform and read the next series of my blocked cat blogs and YouTube videos. </div><div><p>Your cat needs to be diagnosed, unblocked, and get i.v. fluids. Immediately! This is our most important minimum. The very bare basics. Now I have been a vet for a long time. I don't care how this happens, where it happens, or who gets paid for this. I want your cat to survive. We are talking about survival. We are talking about putting the patient above all else. </p><p>Then your cat needs adequate time with the treatment plan for it to matter. In many cases people cannot afford the recommended number of hospital days the veterinary hospital is recommending. What happens next is almost as awful as remaining blocked, what happens next is the hospital decides length of stat based on available funds. WHAT SHOULD HAPPEN IS THE CLIENT AND HOSPITAL AGREE ON A PLAN THAT PROVIDES THE BEST CHANCE AT RESOLUTION BASED ON AVAILABLE RESOURCES. The hospital should be willing to compromise their financial gain by what the patient needs. There should be a plan that allows the adequate urinary and fluid catheters and decline the diagnostics that are advisable but not mandatory. These cats need three things more than anything else; </p><p>1. urinary unblocking via indwelling urinary catheter</p><p>2. intravenous fluids to correct azotemia and electrolyte imbalances</p><p>3 time with both of the above..</p><p>If every person in the cats healthcare service plan was dedicated to getting these highly treatable cats the care they needed this blog, this whole movement for change wouldn't be needed. It wouldn't gain any traction, and it would be just another vet story in the mist. Instead my clinic phone rings every day with people in the most desperate place to find help. </p><p>My point is that I don’t give up. I hope you don’t either. I will help but we have to figure this out for cats everywhere. In a profession that utilizes the tag line that "every case is unique and every treatment plan tailored" why aren't we allowing the pet parent to dictate the terms of the treatment plan so that an acceptable chance of cure is the only objective? To make this happen both parties have to agree that the only meaningful outcome is providing care to the best of all parties ability. Every cost, every line item on the invoice, and every out of the box option is acceptable and on the table. Consent for deviation of standard of care is provided and the patients life is above all else. For modern vetmed this will require stockholders to give up revenues to put the patients first. This is the war. Here is where the Army needs to be building their foundation and footing. Here is where the challenges are going to be fought. Here is where an insiders tips are lifesaving tools to keep at the ready.</p><p>If you are a cat parent please ask your vet how they manage these cases. If they tell you that they refer them to the ER ask the ER for an estimate for this before it happens to you so that you can be prepared for it. If the cost is too excessive find a general practitioner who is willing to help your cat in house. Ask what this estimate is. Be prepared before the emergency happens. Share your findings at pawbly.com, or leave a comment below. We are always looking to highlight practices, and practitioners, who offer help and don't discriminate based on financial ability.</p></div><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgfINDpEmS8Mut0qv5Yib3Vo0ESjZAsi4PGlgtOxtIxZ48HzitrY2uNOq9LM3DBUijsMtguY803ZPSs2bQFy3iyw6ao218ZZjLkI4Jzd49leDg145ez95kWM9Yf0bvlJ-wIxJT8THqAqFy1QcSMImfksCzPPFyV1nNbCWGVLK1vA-Cl1YSvSPqeFHT0Ljk/s2856/IMG_2413.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2856" data-original-width="2142" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgfINDpEmS8Mut0qv5Yib3Vo0ESjZAsi4PGlgtOxtIxZ48HzitrY2uNOq9LM3DBUijsMtguY803ZPSs2bQFy3iyw6ao218ZZjLkI4Jzd49leDg145ez95kWM9Yf0bvlJ-wIxJT8THqAqFy1QcSMImfksCzPPFyV1nNbCWGVLK1vA-Cl1YSvSPqeFHT0Ljk/w300-h400/IMG_2413.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Robert</td></tr></tbody></table><br /><div><br /></div><div>I expect that these words, these tabs of advice, the backward driven decision tree of care to help you get your cat out alive in the minefield of highly profitable, almost absent empathy, for a young cat with their whole healthy long life ahead of them will be met with anger, accusation and venom by the colleagues of my profession who have euthanized before compromising what "ideal care looks like." Bring it on. It's time to put the patients above all else again. It's time to save every blocked cat we can.</div><div><br /></div><div>There are other articles on this subject. Please follow along. Please utilize all of the resources I share. Please also become a part of this Army. Share your successes. Share your stories. Share the providers who cared enough to offer options outside of the first treatment plan they propose. Share the voices to build a village focused on the lives that so many of us consider our family.</div><p>I have been practicing veterinary medicine for almost 20 years. In 20 years I think I have treated hundreds of blocked cats. I have lost 2. I have never denied care based on cost. I have never recommended that euthanasia be chosen for this condition. I have learned how to do a PU surgery because I had to. I have been stressed, anxious, and afraid for my patients lives, but I have never given up on them. I will never give up on them. The profession of veterinary medicine owes these cats much more than we are providing them now. </p><p>Krista</p><p>What can you do right now? What should your immediate take-away?</p><p></p><ul style="text-align: left;"><li>You need to keep your cat on a good diet (I recommend a high quality canned food)</li><li>You need to keep your cat happy, engaged, active, and think about their environment and how you can enrich it everyday</li><li>You need to ask your vet how they would manage it if your cat blocked today? Would they refer you? What would that cost, and what would happen if you couldn't afford it? If they can't help you in a way that is meaningful to your cat getting out alive find another vet who can, and will. NOW.</li></ul><p></p><p><br /></p><p>See all of my blocked cat videos on my <a href="https://www.youtube.com/channel/UCq7z_qtov_Al1dEEfjZt8iQ">YouTube channel here</a>;</p><p>Follow me on my veterinary clinic homepage, <a href="https://jarrettsvillevet.com/">Jarrettsville Veterinary Center, here.</a></p><p><a href="https://www.facebook.com/JarrettsvilleVet">Jarrettsville Veterinary Center Facebook page here.</a></p><p>Ask me for help for free here; <a href="http://Pawbly.com">Pawbly.com</a></p><p>Disclaimer,, because you know this is the world we live in; I am not an internal medicine specialist, nor an emergency medicine specialist, nor a surgeon. I live, work, love, reside and chose to work in the trenches over every day general practice. I live in the place that the veterinarians before me made the most honorable yet humble profession in the world. I came here to save the lives that need me, and the rest of us, not become the wealthiest, nor the most exclusive. While I understand there are many others in this profession that will challenge my motives, and their own, I will say without hesitation that you are either here to serve your patients or get out of the way of all of the rest of us intent on just this. It is not about you, or even your perception of what "compassionate care" is. </p>krista magnifico, DVMhttp://www.blogger.com/profile/15133566329579911573noreply@blogger.com0tag:blogger.com,1999:blog-4667516629745731439.post-34959849516012965632023-12-31T16:48:00.000-08:002023-12-31T16:48:48.657-08:00To Harry, The Best Cat Ever.<p> "Harry was the best cat ever."</p><p>We ended the day, today, the last day of the year, on this.</p><p>Harry was a 16 year old debonair, distinguished, dark tabby dying from kidney failure, and all of the myriad of afflictions it brings with it. Kidney failure brings you a cascade of collaterals. You are hungry, but too nauseous to eat. You are frail, but still want to try to jump up on the counter because in your kitty brain you are still a total badass, yet unable to gain any air. You are thirsty, drain the water bowl dry, pee out the buckets in piles voluminous and dehydrating, only to walk to the water bowl again, and again, to have the thirst never quenched and the march to the box never cease. You become tired from the anguish of your starving muscles from the anemia in your bones inability to replenish the red blood cells that let your muscles do your bidding. You fail in tiny stumbles until there is no wind left in the sails. Harry, well, Harry was the husbands cat, and the husband was in the car, to distraught to come inside to share in the goodbye.</p><p>Today was the last day I will be a veterinarian in 2023. Do I remember my fist day of 2023? No, but I will always remember today.</p><p>"Harry was the best cat I have ever had. I am 88 years old, and Harry was it." </p><p>Harry's mom was short, quiet, smiling, gentle and full of pleasantries of gratitude that he was here with all of us, and loved. She held him for a moment, bent over to whisper that "you are the best cat ever," then kissed his forehead, and gave him a solid scratch under his chin. Harry was curled up, too tired to be afraid of the vets office. We stood nearby waiting for them to have their last moments together. Harry's mom wasn't remorseful about the days he didn't have left. When Harry was sleeping she looked at us and smiled. There weren't tears, nor fretful second guesses of hesitation. She said thank you to every staff member and left us with a laugh to replace the tears with her wisdom brought perspective. She told us how she had been coming to JVC for over 30 years. She told me that she first walked into JVC as a veterinary sales rep. She met Dr Wilson and knew immediately that this was the only vet clinic she would bring her pets to. She said that over all of these years this place was still full of love, and hope and kindness.</p><p>We shared stories about how Harry had found them, how they had found each other, and how much they all loved each other. </p><p>Today was December 31st, walk-in appointments were from 1-3, an Harry was the caboose on the end of the year. The last patient I saw. The last person I shared the day with over the lifetime of a loved family member they would grieve and miss for years to come.</p><p>I had decided to open for Christmas eve, and New Years eve for the clients whose pets wouldn't make it the 12 hours ER wait, or the 24 hour closed day pause. For the patients like Harry. To be there on their last day is as meaningful, or maybe more so, on their last than it is on their first. The honor of being able to say goodbye to someone so loved they mark our life with stories that give our purpose placement. That was Harry.</p><p>As we all toast a glass to a year ahead I take a few moments to feel the weight and the gratitude that sharing little piece's of our most beloved companions brings. How can we walk forward with anticipation and joy if we don't remember what the past has brought us, or taken away. There is never a full cup without the vessels promise of empty and the chance to fill the cup again and start another day with the memories that made us who we are and how lucky we are to have been here. </p><p>I set out to be a veterinarian all those many years ago to be a part of these stories. The happy ones, the sad ones, but most importantly the ones that remind us who we are when we put our whole selves out there to live every moment of the life we are given.</p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj3joktnlVJPhP5L54jF_5CE2_hgbtJJfgH8jpAL7dDYK3B5xXETavqL1pPb1soqtUvJjVR5Xl6UVUuQrbeeg6QLGMwcvenrX3NYZX5Z2HqYkmJ9exd5QnIGH4MzAArhr792AlbDgBu268WUf_vFJtTij7EKk-bUg4mPAnqjMtn-3bUsmSpYgADsnMRKfc/s2016/IMG_2279.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj3joktnlVJPhP5L54jF_5CE2_hgbtJJfgH8jpAL7dDYK3B5xXETavqL1pPb1soqtUvJjVR5Xl6UVUuQrbeeg6QLGMwcvenrX3NYZX5Z2HqYkmJ9exd5QnIGH4MzAArhr792AlbDgBu268WUf_vFJtTij7EKk-bUg4mPAnqjMtn-3bUsmSpYgADsnMRKfc/w300-h400/IMG_2279.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Rex, adopted 24 hours ago from a local shelter by one of our technicians.<br />The face of second chances and a better year ahead.<br />For Auld Lang Syne</td></tr></tbody></table><br /><p>Here's to you Harry, and your parents, thank you for being a part of every day that I get to live the best job ever. </p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjhxaY7J4VjZi3pbP8m9muaUeIriNGN2b4GK9RRHLsC14A0IUIsMdAgcLVMzqI0M1K2FfAidrjblVYCUlk9Mglv7v-vcV8oB_QafUjmvCp_1HdIXs_DNRpKlujdGG-iMtA0zg2Kc2XwaNH8J8B6ETXSt8R9JrkboL4ttxDgJveMiDxB45MberhJmqjluRc/s2016/IMG_1346.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjhxaY7J4VjZi3pbP8m9muaUeIriNGN2b4GK9RRHLsC14A0IUIsMdAgcLVMzqI0M1K2FfAidrjblVYCUlk9Mglv7v-vcV8oB_QafUjmvCp_1HdIXs_DNRpKlujdGG-iMtA0zg2Kc2XwaNH8J8B6ETXSt8R9JrkboL4ttxDgJveMiDxB45MberhJmqjluRc/w300-h400/IMG_1346.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Raffles, my adventurous one</td></tr></tbody></table><br /><p><br /></p>krista magnifico, DVMhttp://www.blogger.com/profile/15133566329579911573noreply@blogger.com0tag:blogger.com,1999:blog-4667516629745731439.post-4851713877446253702023-12-17T13:31:00.000-08:002023-12-17T13:31:35.433-08:00How Did We Get Here? The intersection of veterinary medicines needs and the professions gains.<p><span style="font-family: inherit;">I have tried to hold on, to not lose faith. I know I am not alone</span><span style="font-family: inherit;">. I used to believe, heck, know emphatically, that every veterinarian came into this profession with the same common goal. We all came here because we loved animals in such a </span>compulsory<span style="font-family: inherit;"> way that we would endure decades of schooling to help them in whatever capacity we could. We were pragmatic in knowing we could not always bend fate by sheer hopeful will, nor cure where disease had overtaken, but every so often some little wet nose would be saved by the hard work of our hands and the training of our mind. Vetmed was about this for all of us. Wealth from collecting and consolidating, or, fragmenting and focusing, well that was for the other white coats and their heart transplants and cancer ports. We vets were a humble, gritty, salt of the earth bunch. Quiet, yet trustworthy. Never a white coat spared for vanities sake. We were smelly, dirty, and proud of the badges of barn dust and species feathers we pinned in our caps. We boasted about having to be very skilled to fix a patient who didn't speak their ailments. We helped every patient who came our way. Each and every one of them, owned, beloved, lost, frail, unnamed, or otherwise was seen our duty, and our reputation on the line if we didn't at least try. We fostered compassion with every act of empathy. We were never too busy to be a beacon of hope in a world of cruelty. We were old souls that passed on our pearls of the profession from our weathered hands and thrifty resourcefulness to</span> fresh faces of the next generations<span style="font-family: inherit;">. We stood for the common man and their house pets inherent nucleus of the families whole. I set out to go to vet school to be this person. I bought my practice to perpetuate this long sought after lifestyle. I came into vetmed with all of this as our collective credo. The torch of quiet kindness f</span>or the sake of all the souls of the world we live within mad<span style="font-family: inherit;">e vetmed the most honorable profession of them all. Without exception we were all cut, fashioned, and trained from this. </span></p><p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiRdFf8Ue9VefDjJXxvnLLm-3XDNU8wxSK0ypVaz-uS2vxAvhw1ogbsFtlWRQRY_Tj25EZ-S08hnf3K4V0f8mSAzHukPVhwHxOju-SV_8g5AaZzc-BJtRIBMTMeubAsTnET-hFAbfVlg616MYoMxoKGt9tdPYp2XImbgNa7jE8ib5xiMRuTVkxVVJMELeQ/s2856/IMG_0304%20(1).jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2856" data-original-width="2142" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiRdFf8Ue9VefDjJXxvnLLm-3XDNU8wxSK0ypVaz-uS2vxAvhw1ogbsFtlWRQRY_Tj25EZ-S08hnf3K4V0f8mSAzHukPVhwHxOju-SV_8g5AaZzc-BJtRIBMTMeubAsTnET-hFAbfVlg616MYoMxoKGt9tdPYp2XImbgNa7jE8ib5xiMRuTVkxVVJMELeQ/w300-h400/IMG_0304%20(1).jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Raffles. My Beloved kitty</td></tr></tbody></table><span style="font-family: inherit;"><br /></span></p><p><span style="font-family: inherit;">I used to believe all veterinarians came here for this. The preservation of purpose. Perhaps we still graduate as this fledgling of hope and goodness, but, somewhere along the way the elevation of the status to pets being the glue and marrow of our all too complicated lives became so valuable it was extort-able, things changed. These voiceless, beloved to the point of needed beyond replacement value pets became fodder for greed. At some point it became permissible and acceptable to go to vet school at a price point the market could not support. With the incurring hundred of thousands of dollars of vet school debt, the corporate take over of the practices and the limitless, unregulated increasingly escalating cost of care, the professions barrage of whispered reminders that we are worth the six figures we command, the idea of being the one who cares for all as the oath we all took got lost. The profits soared, the costs climbed and the divide between the </span><i style="font-family: inherit;">cans</i><span style="font-family: inherit;"> and the </span><i style="font-family: inherit;">cannots</i><span style="font-family: inherit;"> grew in never before seen numbers. It became acceptable to place blame. It became permissible to deny care. It became excusable to turn the most needy away as we lacked the time, the willingness, and the empathy for them to make it worth our while. I don't know when that first denial to help because it was no longer profitable to even try happened, but it is now a systemic plague that has killed millions. We are part of this even if we can justify to myriad of reasons why. There is a shortage of veterinarians, and a squabble of people throwing obscene amounts of money at them, making it feasible by charging exorbitant amounts of money to feed the machine, and perpetuate the profession. We were once the place where all are welcome, all are cared for, and now we are the profession of the wealthy, or good luck finding help among the masses in the same boat as you are. I am going to tell all of those nameless, overlooked, dismissed and forgotten, broken hearted pet parents who have met the face of economic driven pet care that they are right. It is now very much about the money. If you are a person who loves their pets as family, spends most of your day insuring that your pets are comfortable and happy beyond the ability to provide the same for yourself than you have either learned this lesson, or will soon. If you are a pet parent who will need to hear the estimate for the cost of your pets care, and then have to negotiate for a higher credit limit to provide it, let's say you do not have $6,000 on hand for a 2 am ER visit, then you need to begin to plan for the ugly that lies ahead. Most vet professionals would insert a strong recommendation to get pet insurance. I will not. While I realize that the future of healthcare for your pet is not foreseeable to most, it is helpful to have some kind of financial plan. The hitch here is that you will not have access to this at 2 am when the deposit is required. You have to have an emergency fund of at least $2,000 and you have to be prepared before that fateful night happens, and you need to have insurance.</span></p><p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgvgSUhHvc3CTq0CNC-BsLXXOiWTU3r0Z-0nZD2pGGz6nbih4aOxcLlXEdSi5ohZZPCQB5aRr4_EIFKu_rXkK2Zsb-dOC8VU4S1rqIQKKLSUzFQWRHiSKG6DI7D5PuKxtjFXrZM316EKk0YyZqTYZ6wMZxA-gM7yAixn-OuJOlmAqpCaFyAgl1JUqGwGbk/s2856/IMG_0319.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2856" data-original-width="2142" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgvgSUhHvc3CTq0CNC-BsLXXOiWTU3r0Z-0nZD2pGGz6nbih4aOxcLlXEdSi5ohZZPCQB5aRr4_EIFKu_rXkK2Zsb-dOC8VU4S1rqIQKKLSUzFQWRHiSKG6DI7D5PuKxtjFXrZM316EKk0YyZqTYZ6wMZxA-gM7yAixn-OuJOlmAqpCaFyAgl1JUqGwGbk/w300-h400/IMG_0319.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">My Storm and Frippie.</td></tr></tbody></table><br /><span style="font-family: inherit;"><br /></span></p><p>I came into vetmed when every patient was given options to make them feel better. I came here when "tincture of time" and a pennies on the dollar analgesic plan was the norm. I came here at a time when vetmed didn't have access to the diagnostics, the specialists, or the corporate ownership and we saved more lives in spite of them. I came here when every pet parent was given equal access to our time, our talents and our unquestionable integrity. While it wasn't perfect, it served the patients with equal concern for their family. It came with generous hope, and unmitigated compassion. It was a time when euthanasia was only offered to spare an untreatable pet a suffering death. When equipment was purchased to save lives not bolster share holder dividends and entice/dazzle new talent acquisitions. We paid at point of sale, and never conceived of buying by marketing and passing the purchase price to clients in packages tied to services they couldn't opt out of. We were independent, privately owned, and working for the community who knew us by more than our credentialled monograms. We were faithful, devoted, and supportive of each other in a home-town baked-apple-pie way. I came here to pass the torch my predecessors granted me. Somewhere along the way we all decided we liked stuff, nest eggs, and the chasing of wealth more than the ability to be kind to all. We, the huge collective chasing the American Dream, we, all bought into this. We are all going to be reminded of it every time a life lies in the balance. What would you do if you were in our shoes? How many times do people tell me that they couldn't do my job because they would want to save them all? Where does the ability to chase the American Dream, profit upon the fruits of your labors, and the quest to get as much as you can meet the empathy needed to save the companions we call our lifes joy?</p><p><br /></p>krista magnifico, DVMhttp://www.blogger.com/profile/15133566329579911573noreply@blogger.com0tag:blogger.com,1999:blog-4667516629745731439.post-6027619792379117722023-12-03T15:32:00.000-08:002023-12-03T15:32:09.324-08:00What Your Pet Wants For Christmas<p>In the heart of Macy's department store for the month of December rests a large red Santa's mailbox. It is nestled between the racks of clothes, flanked by flocked evergreen trees, and it is always easy to find as it is the center of the crowd in the middle of the first floor. I visit it each year as a reminder of how magical this time of year is to the little kids in all of us. The front mail door swings open with its traditional metal hinge melody so often it sounds like part of the caroling. Children, of every size, from every corner of the world, congregate here to mail their present list to Santa. Although I have never slipped an envelope into its red belly, I stop and watch as the other kids do. For each time that door is pulled open and the mouth of the North Pole is summoned to answer a request, I wish for that kid to know that the magic is always here. Not in a store, but in the hope of a wish put to paper. The feeling of anticipation that whatever you ask for might be provided. If you take pause, and allow yourself to be the witness to another's joyful excitement you will quickly be reminded about how sweet the gesture of writing a list and sending it to make-believe-land is. You can stand as an onlooker to this little spot of letters, wishes, dreams, and love and just lose the rest of the bustling patrons elbowing by. I always wonder what those letters hold. How many are asking for a toy, a doll, a childhood keepsake to mark the year in the timeline of a life that grows up. How many are for such basic wishes that no child should ever have to ask for. Food, clothing, a home to feel safe in. How many hold wishes like mine always did; a pony, a puppy, a bunny. Something alive for me to cuddle and keep safe. Some little life to love and be needed for.</p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj6xdgUJsMT8XFCIxqbydT9RJOHHSHudp8vXCgNRQdXgQkfJ5N1rUa73ozb7_6CfK58eo0DtGyxYDp5gaf3jfZFcUhJuxDbzfmfn5JA5kMgjUqLYgbtXG_5Z3bVv1JplgkeZ6VS0_P3ZvB9wuDybEazdW4G0uJ_FwO9ljXwwVdVjmTjDRoOweiHomPg95Y/s2016/IMG_0078%20(1).jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1512" data-original-width="2016" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj6xdgUJsMT8XFCIxqbydT9RJOHHSHudp8vXCgNRQdXgQkfJ5N1rUa73ozb7_6CfK58eo0DtGyxYDp5gaf3jfZFcUhJuxDbzfmfn5JA5kMgjUqLYgbtXG_5Z3bVv1JplgkeZ6VS0_P3ZvB9wuDybEazdW4G0uJ_FwO9ljXwwVdVjmTjDRoOweiHomPg95Y/w400-h300/IMG_0078%20(1).jpg" width="400" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">How do you do a thoracocentesis?<br />One of our rescue kittens getting treated by my team. <br />Giggles are always on the schedule.</td></tr></tbody></table><br /><p>These days my life revolves around the little lives my home calls its heart. I have 5 cats, and two dogs, and I will admit with 100% honesty that I spend every day asking myself if I have fulfilled all of the items that they would have penned in their letter to Santa. They always have the basic needs of a cat or dog at their toes. The basic is food and water, a warm place to sleep every night, but the wishes meant for Santa's ears, they are the items that I ask myself if I am providing.</p><p>So I thought that this year I will share what I think my pets would ask for, should Santa remind them that their <i>Nice</i> days outnumber the <i>Naughty</i>.</p><p>Wren is the cat I call my beloved. She is the first one I go looking for at bedtime if she isn't already purring at the top of my pillow. She is aging, and less finicky. Less likely to call out in alarm when she hasn't gotten her way. She lets the kittens plow past her and grumps with the expiration of an old soul who hasn't got time for shenanigans anymore. She is wise, adored and Queen. She bows to no one, and puts up with even less. This year we got her a heating mat that has 10 settings, (she prefers 3), and we set it for 12 hours. She also likes her water changed daily. We keep a glass by the bed, and she prefers options even in this. It is more likely that she will drink from my overnight water glass, a tiptoe at a time to scoop it from the glass to her tongue. Even in this we share everything. (I know not to drink past bedtime). She prefers fresh plants in winter. It's too cold to go out for a green nibble. Reminding the housekeeping staff to bow to her as they pass. </p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgPfPHL3x2Ff-sv6XOtZ6uOt-Zli0R-Vuj5jFn6uypgRW-5DNWNjhuQnBSadjSlYrWyaMJlSP8tupbwwGPkLaF2T3_x9kbqkAUH67W3HN4Kfi0VBgY5REf_1gO0m3Lb3Z9NHCSwC8fMTLFffVRlP1SLALms0_zliFiscy4Wkx7oGmJApupSCecev4ibxw8/s2856/IMG_0605.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2856" data-original-width="2142" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgPfPHL3x2Ff-sv6XOtZ6uOt-Zli0R-Vuj5jFn6uypgRW-5DNWNjhuQnBSadjSlYrWyaMJlSP8tupbwwGPkLaF2T3_x9kbqkAUH67W3HN4Kfi0VBgY5REf_1gO0m3Lb3Z9NHCSwC8fMTLFffVRlP1SLALms0_zliFiscy4Wkx7oGmJApupSCecev4ibxw8/w300-h400/IMG_0605.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Wren</td></tr></tbody></table><br /><p>She has a window sill of her own. Packed with a bed and blankets. A perch to see the sunrise, and then set, and monitor the critters of her kingdom. For cats, every single one of them, this perception that they are the apex predator, the indisputable badass of their kingdom, is paramount. Every cat needs to feel they are free to make choices. Free to have opinions, and able to execute commands at whim. Finding your place in your own home when you are their servant is the key to an equitable, honest, and amicable life. Your cat always needs to feel that they are in charge, and this will not be threatened. It is part of the reason that there is a critical mass threshold for multi-cat homes. That one extra cat too many that tilts the apple cart and leads to marking territory, cat fights, and stress in the multi-cat home. She is the constant comfort for all of my days. The one who purrs when she sees me. Takes delight in me just being near. She is the epitome of why we all sacrifice so much for the pets we call family. </p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhq2Pshrmvc5VmVoPc_hF_k5pyYDK50qG80lwy6-OksZ7tHM4zeWgG7O08KFufa-lQJ0dvd5FTcWPqjuW0tfh1RwKDNT-luEt7V-AFd8XHOIQ1Fe0rdzmIxLP3fjs7tJbjB0KzLVpp6xk_4Gu9t12rwvEtQtWwYrO9_-k79F5VlVQjCHyApLMi-4bWhwrE/s2505/IMG_0609.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2505" data-original-width="1593" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhq2Pshrmvc5VmVoPc_hF_k5pyYDK50qG80lwy6-OksZ7tHM4zeWgG7O08KFufa-lQJ0dvd5FTcWPqjuW0tfh1RwKDNT-luEt7V-AFd8XHOIQ1Fe0rdzmIxLP3fjs7tJbjB0KzLVpp6xk_4Gu9t12rwvEtQtWwYrO9_-k79F5VlVQjCHyApLMi-4bWhwrE/w254-h400/IMG_0609.jpg" width="254" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Birdie</td></tr></tbody></table><br /><p>My two rabies quarantine kittens; Raffles (short for the state bird of Pennsylvania; the Ruffed Grouse), and Birdie, (the state bird of New York; the Eastern Bluebird), are wild, crazy, pure kitten energy rambunctious. These days my husband is retired. The two kittens follow him like ducklings, always underfoot. They grew up with the puppies, Frippie and Storm, and seemed to imprint on them as much as us humans, so they follow the dogs in and out for the am pee and the before bed bathroom. Unlike the dogs who stay wherever we are, they decide if it's time to come, or go, and beckon their wishes with long drawn out meows fit for drama soap operas of the B-rated variety. My husband stands near the door and opens it slowly for the kittens to come and go, based on which side of the door they scream from. He will stand their like a doorman and say, "I do this all day," with a prideful subservience only a parent could admit to. Their new favorite fancy is feathers. My dear friend Kim gave us a handful of her peacocks plumage and they have systematically disemboweled each frond. The confetti of a killer spread across the living room floor. Life for a kitten is easier, as long as it is quiet, safe and has ample food. They make the simplest things fun. You just need to remember their energy threshold requires they come in pairs.</p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjqUb7LEnr7Y5Q_wPRxUCSJucvu_DeB9RigzRpb2cpLXRyaol0ei_9tnTp8R2gz7wBHS3X1XZUnwo1Xv2CMm4B1FMxEC71YQLS3WlSZjW80kwDSDnae_WIi7E5-CFbfrO5Aj0_OMucTMQPM9iIMF-4KN176fxpXxxLfbg3N6Y2lW_0T2GgN1ZncvwVdJKg/s2856/IMG_0304%20(2).jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2856" data-original-width="2142" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjqUb7LEnr7Y5Q_wPRxUCSJucvu_DeB9RigzRpb2cpLXRyaol0ei_9tnTp8R2gz7wBHS3X1XZUnwo1Xv2CMm4B1FMxEC71YQLS3WlSZjW80kwDSDnae_WIi7E5-CFbfrO5Aj0_OMucTMQPM9iIMF-4KN176fxpXxxLfbg3N6Y2lW_0T2GgN1ZncvwVdJKg/w300-h400/IMG_0304%20(2).jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Raffles</td></tr></tbody></table><br /><p>The dogs; Fripp and Storm. Two peas in the pod who could not exist without each other, even though they are so different. There is a firm two dog rule in this house. Two dogs to keep each other company. Two to play so hard during the day that they sleep well enough through the night, so their already exhausted mom can go to sleep as soon as she gets home from work. This couldn't work if they didn't have each other. Their Christmas list to Santa would very likely include a wish for the other. They are this couple. They would only ask for more time. More time together to go on long walks. Walks where they lead and decide which trail to follow. Time to find that ever elusive squirrel and finally make peace with the pursuit. More steak dinners. Fewer vacations for their parents that involve planes or trains. The kind of vacations we take with cars allow them to go, therefore they prefer these. They are family and they expect every family vacation will include them. They are greeted every morning by a whisper of a "hello" that allows them to jump on the bed and curl up on our pillows. They insist that bedtime follow the same principles. Every day begins and ends with a bed in the bedroom and a wish for a peaceful night of dreaming about the adventures of tomorrow. These house fellows of ours never want for more than time together. It is the most sincere wish for Santa anyone of us could ever desire.</p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiM6T-EHVn4mwLk2j5poiBjAC4tzmOfDvc5vBXmnQP3zaLVhjLa4isEaK1Ri9Rr4NgmhdqEOmAv1QHbPEbUTdkMBA72TNAMvt_a_6frVERR2SAS-TmIzruK4up_oPmKB2CM0iOy4hjQ-n4rByUu3t4dAzJsLP4Ofz0rzz6_EaX7_9OBoPyzkDYHiopju_0/s2856/IMG_0319.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2856" data-original-width="2142" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiM6T-EHVn4mwLk2j5poiBjAC4tzmOfDvc5vBXmnQP3zaLVhjLa4isEaK1Ri9Rr4NgmhdqEOmAv1QHbPEbUTdkMBA72TNAMvt_a_6frVERR2SAS-TmIzruK4up_oPmKB2CM0iOy4hjQ-n4rByUu3t4dAzJsLP4Ofz0rzz6_EaX7_9OBoPyzkDYHiopju_0/w300-h400/IMG_0319.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Storm and Frippie</td></tr></tbody></table><br /><p>Here's to wishing all of you a very Merry Christmas and a holiday season where all of your time is loved and treasured with the family you call yours.</p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh9WDn-K9HqaBjw8M85WVoMy5yWx60mX-NTsUkRTN7cwfUdkSa_f3KdaagbCyEq2p_yAjDWFikTAdPWX7lIDwcrFJBV5akOGqn2mwuQnYKqPornYwCYKFR8gtb1UoPcMAh05zdxy1yvkpbfnAx5bHeoW16cOFKAVemZI9BoQArug2DpD21nUgGzQAaZUgA/s1633/IMG_0956.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1633" data-original-width="1217" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh9WDn-K9HqaBjw8M85WVoMy5yWx60mX-NTsUkRTN7cwfUdkSa_f3KdaagbCyEq2p_yAjDWFikTAdPWX7lIDwcrFJBV5akOGqn2mwuQnYKqPornYwCYKFR8gtb1UoPcMAh05zdxy1yvkpbfnAx5bHeoW16cOFKAVemZI9BoQArug2DpD21nUgGzQAaZUgA/w298-h400/IMG_0956.jpg" width="298" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Pets With Santa 2023</td></tr></tbody></table><br /><p>If you need some hints on what your pet might want this Christmas, think about these;</p><p>- a place to call home. So many pets die in shelters, and so many others still live in horrific conditions breeding the puppies of the internet sales ads.</p><p>- a person to remind them that they are loved. We all deserve this.</p><p>- the gentle acknowledgement that they are the most beloved being in the world.</p><p>- a warm place to sleep.</p><p>- a collar (dog only) AND a microchip that says "you are mine" (and the appropriate contact information).</p><p>- a place of their own. We all need a place that is exclusively ours. A bed, a perch, a cage, a corner, a space.. a bathtub and a vanity (if you are me).</p><p>- current vaccines for the appropriate place you live. Nothing, no one, not one living being should die from a preventable disease. Watching a pet die from parvovirus, rabies, a pyometra, the list is exhaustive, the mental pain, and the enduring heartbreak these bring, is avoidable. Why are we still begging for this?</p><p>- spayed, neutered, and putting the life of your pet above all else. (Breeding them puts their lives at risk, and we already have too many unwanted pets in the world).</p><p>- a walk everyday that is just for you, (I am talking to your dog, but, I know lots of cats who love being outside safely. Maybe consider a walk with them too). We don't walk a dog to go from point A to point B, we walk them so they can get out, stretch their legs, employ their nose to investigate a world of scents we can only imagine. Let your dog do the walking, just be the chaperone.</p><p>- a catnip station, toys, water fountain and feathers. How about indoor cat grass year around. What does your cat love to get their claws into? Do you think your cat feels like they are a guest in their own home, or do they think that you are?</p><p>- photos on the wall, the mantel, the wallet, all of the places where terms of endearment lie. Doesn't everyone have their screensaver set to their pet?</p><p>- cats need lots of choices for litterboxes. If you have four floors in your home, and your cat has access to each of them a litter box on each is a sign that they are welcome. Also, choices are important. What if your cat is afraid to get in the box with the lid, or can't quite manage to jump on the top to gain access? Think about your cat aging, and struggling with the joints? Who wants to debate a painful poo?</p><p>- dogs come in every shape, size, and demeanor. Some are highly social others just want mom and dad, and don't need anyone else. Maybe a gift of learning to allow others to have value is a way to ensure that your pet has options outside of you and your life. Dogs are just like people. Aren't we each our own individuals?</p><p>- remind your pets that they are the most important part of everyday. Say "good morning!" Say "I love you!" Or, say, "you are the most beautiful girl in the world!" it doesn't matter what you tell them, but acknowledge them every time you see them. There will never be another life who loves you so devotingly. </p><p>Spend some time thinking about how lucky you are to have your pets. How lucky are we to have each other. </p><p>Happy holidays to all of us who love the pets we devote our lives to.</p><p>I want to hear about your pets list to Santa. What would they wish for?</p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhiyHwICEWxbwR3MUPQL82aNwekhZdrIxtpmvNqxCZ5tkZOT3naqDYRvGthmLyI3Pv4rjUYQrSTiUX8_2jP_G9j-FbZ614m_n7SxOhVQ0y5_tzYZDR1sTQXWyCisSv9EYVC26dIpgqsdxA2cq3dRmVzQKpACfgbT7GuyjSC-7lo4ZxvaTT0dlIcPN1gLT0/s2856/IMG_0851.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2856" data-original-width="2142" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhiyHwICEWxbwR3MUPQL82aNwekhZdrIxtpmvNqxCZ5tkZOT3naqDYRvGthmLyI3Pv4rjUYQrSTiUX8_2jP_G9j-FbZ614m_n7SxOhVQ0y5_tzYZDR1sTQXWyCisSv9EYVC26dIpgqsdxA2cq3dRmVzQKpACfgbT7GuyjSC-7lo4ZxvaTT0dlIcPN1gLT0/w300-h400/IMG_0851.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Cheeto,, another broken kitten who needs us..<br />He will have half of his tail amputated tomorrow.<br />He came to us with multiple injuries,, and his story continues.<br />He is loved and he reminds us of our purpose.</td></tr></tbody></table><br /><p><br /></p>krista magnifico, DVMhttp://www.blogger.com/profile/15133566329579911573noreply@blogger.com0tag:blogger.com,1999:blog-4667516629745731439.post-68304800105439086662023-11-28T06:24:00.000-08:002023-11-28T06:24:51.457-08:00My Christmas Wish<p><span face="Arial, Helvetica, sans-serif" style="background-color: white; color: #222222;">Some people are just building a body of work. The getting up day after day to repeat the same tasks for the same boss. Punching the same clock. A small cog in a bigger wheel that they cannot identify their own importance, or the meaning of it, within. Day, after day. Weeks on end, until at some point you realize that the novel within you lacks a central character you can relate to, or, even root for. There is that someday where you realize that there is more behind you than in front, and you are at the intersection of <i><b>what's left to do</b></i>, vs., <i><b>what is left that you want to do</b></i>?</span></p><p><span face="Arial, Helvetica, sans-serif" style="background-color: white; color: #222222;">Others are just trying to find work. Find someplace to pay the bills and disregard the purpose, the passion, the place of belonging that maybe a job can bring. </span></p><p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgbEh4AcuH1FEnygrYZb5x5lksgr58giTwl2D6kevsltbzQbV37qfpwtcTXGVtcP8wfKQZQrlaEOWczk05ojXDV759M6cj0jzzhnJVDLsgOCk1IntuZYZoi3C-R1sNVXRY2NALYyK82SC60I5AJ1QtWjPc90Q2un1f9ncSymkRgRUIhOIOZI1uFz9rl_6U/s2016/IMG_1985.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgbEh4AcuH1FEnygrYZb5x5lksgr58giTwl2D6kevsltbzQbV37qfpwtcTXGVtcP8wfKQZQrlaEOWczk05ojXDV759M6cj0jzzhnJVDLsgOCk1IntuZYZoi3C-R1sNVXRY2NALYyK82SC60I5AJ1QtWjPc90Q2un1f9ncSymkRgRUIhOIOZI1uFz9rl_6U/w300-h400/IMG_1985.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Sadie. <br />The most influential patient of my veterinary career.</td></tr></tbody></table><span style="background-color: white; color: #222222;"><br /></span></p><p><span style="background-color: white; color: #222222;">Then there’s me; plodding along trying to build an empire. Filling my days with little wet-nosed lives that have already given so much. Filling my life with the people of Jarrettsville Vet who share this passion and purpose and expanding upon them, so that it touches everybody in our community from its core. I am also trying to convince the rest of my profession to feel the power and the addiction in the purpose we all came here seeking. Ask yourself if you became the Ebenezer when not so long ago you just wanted to help the Tiny Tim?</span></p><p><span face="Arial, Helvetica, sans-serif" style="background-color: white; color: #222222;">Every year at this time my husband asks me what I want for Christmas. I'm 5 decades into this passage, and I can say with 100% honesty that it's not wishing or wanting <i>more</i>. I simply feel so grateful and lucky for what I already have. Right here and now, this is it. I worked my whole life to get <i>here</i>. I am not waiting until retirement to live. Or go out and live. It's within everyday already. As far as the season of giving,, well, I just tell him; I don't want one more thing, that is a <i>thing.</i> Nothing. Not one smidgen of a particle of an article that was intended to be gifted. Not one more thing </span><span style="background-color: white; color: #222222;">to dust, to pass on, to leave behind, or, wonder how much of a carbon footprint it carries?</span></p><p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgkWipq2kALGfan6jcIzN_lW8YfV2VM9Yyj86KZJOuVEDOEghun5QnQyBSEldXP_84YT1Eijn6zbdekkJIHdfia-OHXWyowq4JZ49B1y9qy1FZ_HQWR5zk6NDy88THBY5UyqrHIW-g9GgqmqcUi_PkOfcsrGM7797CJs53MgRRceObJti0c9_eJD31LWls/s720/image.JPEG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="600" data-original-width="720" height="334" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgkWipq2kALGfan6jcIzN_lW8YfV2VM9Yyj86KZJOuVEDOEghun5QnQyBSEldXP_84YT1Eijn6zbdekkJIHdfia-OHXWyowq4JZ49B1y9qy1FZ_HQWR5zk6NDy88THBY5UyqrHIW-g9GgqmqcUi_PkOfcsrGM7797CJs53MgRRceObJti0c9_eJD31LWls/w400-h334/image.JPEG" width="400" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">The wealth of love</td></tr></tbody></table><br /><span style="background-color: white; color: #222222;"><br /></span></p><p><span style="background-color: white;"><span face="Arial, Helvetica, sans-serif" style="color: #222222;">This year the wish is to pay everything forward. All of the intangible things that spread peace, joy and kindness. Veterinarians, the whole lot of us in vetmed, forget, overlook, under appreciate how impactful and meaningful the power of kindness and compassion is. These don't cost any of us anything. </span></span><span style="background-color: white; color: #222222;">These change lives exponentially. They hold more power than our diagnostics, injections, and medications. </span><span style="background-color: white; color: #222222;">These save more lives than all of the tools in our medicine locker do. </span></p><p><span style="background-color: white;"><span face="Arial, Helvetica, sans-serif" style="color: #222222;">Now, I am not a person who lives in a tiny, shabby, debilitated make-shift hut. I have not come to the place where I shun all belongings. Meditate in a trance-like chant to find a higher inner awareness seeking permission elsewhere. I have traveled the world and seen far too many families suffering in poverty, corruption, greed and desperation. Living in a home constructed out of piled wooden shipping crates. Or, an assemblages of tarps. Rooms partitioned by shower curtains. Dirt floors, no provisions to allow for windows utilizing a portable camping stove with its assigned two pots forced to feed 5 or more mouths. Homes that wouldn't pass for junk are required to be the shelter for the heart of its inhabitants. I have heat, insulation, cable tv, food in the fridge, a pool, and the happiest, spoiled, blissfully unaware pets. There are rugs underfoot. Artwork on every wall. Bins of rotating holiday decor to embellish the upholstered furniture. It is a rich life. There is excess here. I admit it, and I am eternally grateful. For as long as it might last. Wealth, all of it, in all of its many forms, is fleeting and fragile. Wealth that is tangible, liquid, asset-based, is transient.</span></span></p><p><span style="background-color: white;"><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiPirYA8ghbU59C0FcS0WqfiiWynGwcbg0KSOd-aKJiZGAd8el_Hcbuo2SPZLcfPNG6UDPwirQ0UNnUykObfq-sUPro4bTacVTSOzzbTxFlEkztdkmR_5_xsx2MVFK1kgmLz22uNlI9dM0auu1ioiskpkMzQIc0wVeBfeyDye84H5MUSO0IE2ePrjvEAqU/s2856/IMG_0677.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2856" data-original-width="2142" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiPirYA8ghbU59C0FcS0WqfiiWynGwcbg0KSOd-aKJiZGAd8el_Hcbuo2SPZLcfPNG6UDPwirQ0UNnUykObfq-sUPro4bTacVTSOzzbTxFlEkztdkmR_5_xsx2MVFK1kgmLz22uNlI9dM0auu1ioiskpkMzQIc0wVeBfeyDye84H5MUSO0IE2ePrjvEAqU/w300-h400/IMG_0677.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">River, who is as excited to see me as I am her.<br />She, and her mom, are some of my dearest friends.</td></tr></tbody></table><br /><span face="Arial, Helvetica, sans-serif" style="color: #222222;"><br /></span></span></p><p><span style="background-color: white;"><span face="Arial, Helvetica, sans-serif" style="color: #222222;">Yesterday on the NYC subway a middle aged heavily sweat-shirted man broadcasted that this year he was asking for generosity. He had lost family in the 911 massacre. He had served in the Army. He was suffering from PTSD, on the streets, and begging for food. A man next to him </span></span><span style="background-color: white; color: #222222;">quietly and shyly </span><span style="background-color: white; color: #222222;">handed him a burger-sized, wax paper wrapped sandwich. "My wife made this for me. I hope it helps." That simple, impromptu, two second exchange made everyone on the train smile. It was accepted with gratitude and a firm handshake of "thank-you Man." The train stopped not one second later and we all got off feeling like a little bit of the holiday season happened with all of us to witness. </span></p><p><span face="Arial, Helvetica, sans-serif" style="background-color: white; color: #222222;">That is my wish. Pass on a small act of kindness. Avoid the door-busters. The stocking stuffers. The swag, and the stuff, and the things. Take great joy in what is already around you. The life you have built. The people you share it with. Think about how rich you already are. Want for nothing more than the possibility of this being all there is left to do and still being the most blessed person you could ever be. </span></p><p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEig2SxuzQh3KoH4r40yBIFTcem6eSbF54w8mclvIYiDGbsH6DuViNWGC18E2ZRVnLfnEhyphenhyphenUGxSOU25RAKt73si1ugwKLjRJBNxDWqLyXsXei1nWfA02lxGIf0RmQyrS1qTxT0XtpgGhlrvzRw_vGbEBSuI_VKbkI8bMl9tCdzFDAre4wK1gvFSwn0ljZD0/s1544/IMG_0672.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1544" data-original-width="1158" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEig2SxuzQh3KoH4r40yBIFTcem6eSbF54w8mclvIYiDGbsH6DuViNWGC18E2ZRVnLfnEhyphenhyphenUGxSOU25RAKt73si1ugwKLjRJBNxDWqLyXsXei1nWfA02lxGIf0RmQyrS1qTxT0XtpgGhlrvzRw_vGbEBSuI_VKbkI8bMl9tCdzFDAre4wK1gvFSwn0ljZD0/w300-h400/IMG_0672.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Autumn and I stealing a snuggle and a kiss with Otis.<br />He was at the clinic for his first puppy visit.<br />How many others do this on routine appointments? Why not?</td></tr></tbody></table><br /><span face="Arial, Helvetica, sans-serif" style="background-color: white; color: #222222;"><br /></span></p><p><span face="Arial, Helvetica, sans-serif" style="background-color: white; color: #222222;">This year I hope that I can refuse all the gifts. My hope is that I can convince others that there is nothing more to accumulate. I want nothing other than paying it forward. Is it possible to keep paying it forward until there is no one left who still can't recognize the treasures underfoot. I hope that they still give of themselves to enrich someone else's life and that they feel that the gesture pays back 10 fold over in return. Wealth in the truest form of pandemic proportions.</span></p><p><span face="Arial, Helvetica, sans-serif" style="background-color: white; color: #222222;">This year, as one fades into a new, Jarrettsville Vet is going to take on a new challenge. We are going to empower ourselves, every staff member, to find that sense of financial freedom and the independence it brings so that maybe by the time they all hit the same number of tree rings that I have they feel just satiated gratitude irrespective of Santa denoting you naughty or nice. You never have freedom unless you have this. It doesn't have to be millions. It only has to be enough to keep you from making choices based on the influence of need. It is why I feel so strongly that the debt we carry denies us the ethical integrity to put our patients first in every decision we make.</span></p><p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjVxHRrZk7kVamfwugX2dQHGXR2NKhoumHaw5U9T390EU4ZjBKUfPwL0JUjE0hCSs9TyRHcaPHABxWtcc5ATduXQHK4J5pe986idh6bYro7gA46ndtKOxRjL9LjbUN53HVQ29gMvSygx60_mhFvwYvcBCGUPsqCfe-i5asxsajSV0pBzB-pkt3bLigYmC0/s2856/IMG_0652.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2856" data-original-width="2142" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjVxHRrZk7kVamfwugX2dQHGXR2NKhoumHaw5U9T390EU4ZjBKUfPwL0JUjE0hCSs9TyRHcaPHABxWtcc5ATduXQHK4J5pe986idh6bYro7gA46ndtKOxRjL9LjbUN53HVQ29gMvSygx60_mhFvwYvcBCGUPsqCfe-i5asxsajSV0pBzB-pkt3bLigYmC0/w300-h400/IMG_0652.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Sadie. Captivated by the temptation of another treat.</td></tr></tbody></table><span style="background-color: white; color: #222222;"><br /></span></p><p><span style="background-color: white; color: #222222;">Nothing matters more than having the freedom to make your own choices. The sense of being healthy enough to pick your own path. Even if no one else wants to emulate or follow. The passion of your purpose to make other lives better, and the financial freedom to never feel you have to sacrifice any of these to etch out your own survival. Veterinarians forget that they hold such power. The power to bend lives, influence, albeit determine survival and outcomes of the lives those companions hold together. I never lose sight of this. I never deny hope, or miracles, or chances, or financial freedom for this to determine fate almost more than any other influence. Of all of the callings that going to vet school answered for me, it was this one reason more than any of the others. I think that lots of vets go to vet school because of the impenetrable bond we have with animals. Me, well, I was never going to surrender the power of protecting my beloved pets to not being able to afford to get them well, or at least try. I was never going to be stuck, trapped, tortured in not being able to keep them safe, healthy, and pain-free. Some women stay in relationships for all sorts of victimizable reasons. Me, I can give up everything else in this world, but, I will never lose the peace of mind that I never have to let go unless there is nothing else that can be done. That is power. That is what being rich beyond compare brings you. That is a Christmas wish that has nothing to do with </span><i style="color: #222222;">things</i><span style="background-color: white; color: #222222;">. That's the gift I want to give back. That is when you change lives.</span></p><p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgtBw4qjkkUyy0TbLr3Oj14mlmt1rVETldxC4G7u617nRKDrl-yOny46aREBVKOo5p7-C9cbdfrMqwAv6gIix-bzkqF03GSKhDOk2cfxZjoSwWa2sJ3D52DYk4s9ZoIdmjMIXFiXF1eTjCiqbwO7xIKtB4bTW_OrXgOvJD6blKOiazmLW8tet_ecQ-PgV0/s2856/IMG_0653.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2856" data-original-width="2142" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgtBw4qjkkUyy0TbLr3Oj14mlmt1rVETldxC4G7u617nRKDrl-yOny46aREBVKOo5p7-C9cbdfrMqwAv6gIix-bzkqF03GSKhDOk2cfxZjoSwWa2sJ3D52DYk4s9ZoIdmjMIXFiXF1eTjCiqbwO7xIKtB4bTW_OrXgOvJD6blKOiazmLW8tet_ecQ-PgV0/w300-h400/IMG_0653.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Storm. Rescue,, a dobie with ears and a tail!<br />She is the cutest!</td></tr></tbody></table><br /><span style="background-color: white; color: #222222;"><br /></span></p><p><span face="Arial, Helvetica, sans-serif" style="background-color: white; color: #222222;">What is your holiday wish this year? What are your New Year goals? How much of them just rely on giving vs getting, and why?</span></p><p><span face="Arial, Helvetica, sans-serif" style="background-color: white; color: #222222;">Oh, and let's not forget,,, go adopt a life. Start 2024 with the most incredible way to pay anything forward. Go save someone. Foster, adopt, read a book to the shelter animals. Take them for a walk. Come to Jarrettsville Vet with your whole heart on your sleeve and just give. </span></p>krista magnifico, DVMhttp://www.blogger.com/profile/15133566329579911573noreply@blogger.com0tag:blogger.com,1999:blog-4667516629745731439.post-88766855530815436662023-11-22T18:41:00.000-08:002023-11-22T18:41:59.149-08:00Critical Mass<p><span style="background-color: white; color: #222222;"><span style="font-family: inherit;">Critical mass. </span></span></p><p><span style="background-color: white; color: #222222;"><span style="font-family: inherit;">I am fixated with the concept of where that fulcrum lies between viable critical mass and the surrendering of life. In medicine, vetmed very specifically, we are trained to inspect and dissect down to the point of recognition of this place of fate. We learn to listen to a patients history. We perform a thorough examination and then recommend the appropriate diagnostics to solidify our presumptive diagnosis. All of this from a patient who cannot speak and often doesn't want you poking/prodding/palpating them. We have to be the doctor of every department and we have to stay on a budget. How any times am I expected to diagnose and identify without any of the diagnostics I need to be more certain? How many times can I beg and plea for mercy for the patient to be given some small chance at recovery when all their owners want to know is where is that critical mass point and will it be cheap enough and easy enough to allow passage of better days ahead? It will make you mad if you let it. It is why there is this protective parable preached to us about not being judgmental, and, not caring about your patient more than the owner does. Not recognizing the face for more than a number in a day of many. It is why we band together like refugees in a village of emotionally fueled hostiles. There is not one day where we aren't vividly reminded why life is so slippery and precious as why it is so wretchedly, painfully hard.</span></span></p><p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgHUL-msfElruV0MZswfYUQd8oZe17FAW1g7rRbsGqwIL-UdyGlK_rMsdYd-gYxDYqCn0cX7P_OXDJlz1KhRK39AsV93_2vyUw_OARAlOiGXxu8VEKh4HsjrgZoPbEW5vrOYeVgyyzNu1n51CbE1mSz8ITzMMh2kdvWqn1V-4aFzzNPU876VzCn2udaWpo/s2016/IMG_0119.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><span style="font-family: inherit;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgHUL-msfElruV0MZswfYUQd8oZe17FAW1g7rRbsGqwIL-UdyGlK_rMsdYd-gYxDYqCn0cX7P_OXDJlz1KhRK39AsV93_2vyUw_OARAlOiGXxu8VEKh4HsjrgZoPbEW5vrOYeVgyyzNu1n51CbE1mSz8ITzMMh2kdvWqn1V-4aFzzNPU876VzCn2udaWpo/w300-h400/IMG_0119.jpg" width="300" /></span></a></td></tr><tr><td class="tr-caption" style="text-align: center;"><span style="font-family: inherit;">Rudy. Rescued from Texas. So absolutely, adorably perfect.</span></td></tr></tbody></table><span style="font-family: inherit;"><br /><span style="background-color: white; color: #222222;"><br /></span></span></p><span style="font-family: inherit;"><span style="background-color: white; color: #222222;">It is the fated search of critical mass in a life of fearful brevity.</span><br style="background-color: white; color: #222222;" /><br style="background-color: white; color: #222222;" /><span style="background-color: white; color: #222222;">There is a place in all lives where that one cell too many costs the whole. One atom too few, one tiny piece of sand hits the pile below and all of fate is doomed. </span><span style="background-color: white; color: #222222;">The fulcrum, the pivot point and the place where you cannot force, intervene, and bend the will of the ghost that comes calling you home. </span><span style="background-color: white; color: #222222;">In vetmed I look for this place with endless relentless persistence always hoping I can outsmart and out will the critical mass headed toward my efforts being futile.</span></span><div><span style="color: #222222;"><br /></span></div><div><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhd1E2b8nVNX6gAiVWrF1d1Q2K2Mr-40GEVT9f3MO8YR7dEqFZpgJqWu3sqt2BDLm2648iCysTMajgzITlYtxDZpcDihYUsHIQcxjdo5Z_xh7SJQqIIsghgahI8GpgfKz7LGbWza8Joh7MfzISTCdWaEDxgD01gdegGVnoFn0ty4BxJ8bxddIjufETy4sQ/s2856/IMG_0304.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2856" data-original-width="2142" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhd1E2b8nVNX6gAiVWrF1d1Q2K2Mr-40GEVT9f3MO8YR7dEqFZpgJqWu3sqt2BDLm2648iCysTMajgzITlYtxDZpcDihYUsHIQcxjdo5Z_xh7SJQqIIsghgahI8GpgfKz7LGbWza8Joh7MfzISTCdWaEDxgD01gdegGVnoFn0ty4BxJ8bxddIjufETy4sQ/w300-h400/IMG_0304.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">My beloved Raffles.<br />Rescued as a kitten, forced to serve a 4 month quarantine for rabies.<br />We will never love all cats fully enough to permit even the most basic vaccine.</td></tr></tbody></table><br /><span style="color: #222222;"><br /></span><div><span style="font-family: inherit;"><br /></span></div><div><span style="font-family: inherit;">This place, the tiniest of differences between that one moment soon enough, and the next, where it is too late, is where I stay stuck in my cause. The place where I seem to hyperfocus, stare down, and too often get stuck. The place I think I owe in recognition to both my clients and my patients. The place I fear I will both not recognize, nor admonish. In vetmed we are expected to intuitively know this place when we arrive, articulate its magnitude, and spare all parties involved the futility, the suffering and the premonition to save both dollars and disappointments. We are expected to know it all, and then dictate a fate that fits the hands that pay the invoice.<br style="background-color: white; color: #222222;" /><br />How many times have I overstepped this place? Tripped over the threshold and found myself falling into the end before I knew it?</span></div><div><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjwo8vYquHWfY33ta0a3Cv-Yv-MYsLeDAzsImSsxxUVVCc1M-onrSwedKOHABGhCtgpSR-FhKZxbbXt14NFtmEYvxY-V_uOYDwfQH1H0iRZfTXLq5UkotU9GgG_uQm-mRLlw3SXDAT2mVVwS9zJD1FTLUGYV_8ic774Et6Sxal-Mhoc_2L6M_54_AnVMoE/s2856/IMG_0225.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2856" data-original-width="2142" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjwo8vYquHWfY33ta0a3Cv-Yv-MYsLeDAzsImSsxxUVVCc1M-onrSwedKOHABGhCtgpSR-FhKZxbbXt14NFtmEYvxY-V_uOYDwfQH1H0iRZfTXLq5UkotU9GgG_uQm-mRLlw3SXDAT2mVVwS9zJD1FTLUGYV_8ic774Et6Sxal-Mhoc_2L6M_54_AnVMoE/w300-h400/IMG_0225.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Minnie. One of my WHY's</td></tr></tbody></table><br /><span style="font-family: inherit;"><br style="background-color: white; color: #222222;" /><span style="background-color: white; color: #222222;">For my mom I knew we had lost her battle for her life, and all that that carried, when she was lifted from her wheelchair to the scale at her oncologists office and the numbers read 74. 74 pounds was not recoverable. She could not come back from here. She would not be able to regain her body mass. She would never walk again. The ability to stand up, blaze her trail to independence and freedom from all of the decisions that would soon follow was gone. Extinct. She was destined for death and there was no point in hoping, praying, wishing or cajoling anything further.</span></span></div><div><span style="font-family: inherit;"><span style="background-color: white; color: #222222;"><br /></span></span></div><div><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEje9F3qCGbmV9pqtYM_86m2S-PxmoMs-wO47gT3w_Ti5BvPN8zGlRnKzF2RQZd-n07aBxo14RCGtBiGXdqYGsQk2txi8-qaQm-b1sTlwnXv3O_KfyoQlhnADGY4QdUygzoanQV9D1jnKgyTlWnPhNAZ8q3dpPTyX16DTrOt1guS1qBeZLBi_GGhNqdmZfI/s2016/IMG_0108.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1512" data-original-width="2016" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEje9F3qCGbmV9pqtYM_86m2S-PxmoMs-wO47gT3w_Ti5BvPN8zGlRnKzF2RQZd-n07aBxo14RCGtBiGXdqYGsQk2txi8-qaQm-b1sTlwnXv3O_KfyoQlhnADGY4QdUygzoanQV9D1jnKgyTlWnPhNAZ8q3dpPTyX16DTrOt1guS1qBeZLBi_GGhNqdmZfI/s320/IMG_0108.jpg" width="320" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Me and mom.</td></tr></tbody></table><br /><span style="font-family: inherit;"><br style="background-color: white; color: #222222;" /><span style="background-color: white; color: #222222;">For my best friend Havah it was 31. The day she called me as I was driving to work. The one place we shared everything our veterinary lives brought us. The one place that solidified us as sisters, the fairytale of vet med and all the magical moments, and this was our road sign to never being together again. She was going in one direction that I couldn’t accompany her. She had yet another mri the day before and her headache culprit lay in 31 metastatic lesions within her skull. This conversion was the place everything collapsed around. For five years she had never wavered in her conviction to win her breast cancer battle. This was her Normandy. Her foxhole was exposed and her enemy was mounting its last attack to claim its host. It was the first time her voice cracked and her fire diminished to a spark of planning a legacy she could no longer add a chapter to. 31 was the count we knew we had lost each other and all of the many things we depended on each other to carry. We had to go the rest alone. I had to try to imagine being a veterinarian without her. She was the soulmate to my passion and the guard to my heart being safely nestled in some semblance of sanity simply because we both knew what it took to survive this profession and neither one of us would ever leave the other wounded soldier behind. She was my Forrest and I her Bette Midler Beaches. I had always banked on us going out like Thelma and Louise and now here we were having to decide how one could finalize a life still with so much left to write while I, the other, the one being left behind, knew it would never be happy ever after.</span></span></div><div><span style="font-family: inherit;"><span style="background-color: white; color: #222222;"><br /></span></span></div><div><span style="font-family: inherit;"><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhjZcoh3eav3m5YElZ1p3WnZ3hXaxu-Zi3vxQt66G8PaKLB7a-L59JzkFuhRLa4OaWpePfKOB5AidlJcbSBagVo6nvkMqdF31Shg-z47VOCWrZIHU4CRuVfHHK_PVlM69T2CPsOrjUDgAPSZEqfDvnGVmDmxJbz57cdYgzq7XFg_kc-7BTPim4EguQu00M/s2016/IMG_7700%20(1).jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1512" data-original-width="2016" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhjZcoh3eav3m5YElZ1p3WnZ3hXaxu-Zi3vxQt66G8PaKLB7a-L59JzkFuhRLa4OaWpePfKOB5AidlJcbSBagVo6nvkMqdF31Shg-z47VOCWrZIHU4CRuVfHHK_PVlM69T2CPsOrjUDgAPSZEqfDvnGVmDmxJbz57cdYgzq7XFg_kc-7BTPim4EguQu00M/w400-h300/IMG_7700%20(1).jpg" width="400" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Havah and my mom. Halloween, maybe 1999.</td></tr></tbody></table><br /><span style="background-color: white; color: #222222;"><br /></span></span></div><div><span style="font-family: inherit;"><span style="background-color: white; color: #222222;">The cases at the clinic walk in like a revolving cattle drive. Every 30 minutes the door deposits another sick, helpless cat or dog at my feet. I have 30 minutes to find that pivot point. Identify the underlying triangle that permits one side to slip into the abyss and recognize it for its power, while the other allows me to flex my medical prowess and save this life. The scant 30 minutes to identify which side of the fulcrum we are resting upon. How many of those once in a lifetime lives, those irreplaceable companions can I sleuth into being classified as savable before that last determining grain of sand slips into terminal. Can I see it for its critical mass of yet to be undetermined in its fate and push the tide back to sea? Where is that place of my endeavors can still matter and fate has claimed its next hostage for keeping.</span></span></div><div><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhK9ELedYFFJIQOVBz7XGKc0TlsCRqS90E1ztb5oxgy5qcMumZIfzL1ER2dZrnf1O3dZ6I3gvZvwZiZemPly7r-ajJ-ocjxsWMtBtIo_VzFtUcaWmNCv7c-aGHEW9CYq9deGZVd-wSiCeEbkt9XPMkgIpqANoKVFCKMc9usmQ8kDUN9NykWmCu8PG4XJT0/s2856/IMG_0356.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2856" data-original-width="2142" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhK9ELedYFFJIQOVBz7XGKc0TlsCRqS90E1ztb5oxgy5qcMumZIfzL1ER2dZrnf1O3dZ6I3gvZvwZiZemPly7r-ajJ-ocjxsWMtBtIo_VzFtUcaWmNCv7c-aGHEW9CYq9deGZVd-wSiCeEbkt9XPMkgIpqANoKVFCKMc9usmQ8kDUN9NykWmCu8PG4XJT0/w300-h400/IMG_0356.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Grizzly and Bear. Two patients I adore.</td></tr></tbody></table><br /><span style="font-family: inherit;"><br style="background-color: white; color: #222222;" /><span style="background-color: white; color: #222222;">I play this game in my head with every life I see.</span></span></div><div><span style="font-family: inherit;"><br style="background-color: white; color: #222222;" /><span style="background-color: white; color: #222222;">You don’t know you are strategically laying out your chess pieces until you try to pause from the game. Until you try to push yourself out of your chair so you can look at the board from above. How little your pieces influence the greater part of the landscape. How many pieces you can lose to protect the king as the queen does all the heavy lifting. Where is that moment that the game tips?</span><br style="background-color: white; color: #222222;" /><br style="background-color: white; color: #222222;" /><span style="background-color: white; color: #222222;">You don’t realize how much the tiny shuffles of all those pawns in front of you influence the outcome until the critical mass of your life’s work sit beside someone else on the opposite side of the table.</span><br style="background-color: white; color: #222222;" /><br style="background-color: white; color: #222222;" /><span style="background-color: white; color: #222222;">You don’t realize how much you’ve lost until you have to contemplate surrendering the whole endeavor.</span><br style="background-color: white; color: #222222;" /><br style="background-color: white; color: #222222;" /><span style="background-color: white; color: #222222;">Vetmed tries to measure loss in inches of acceptable intestinal resection as a way of predicting functional abilities. How many abdominal exploraties have I opened up to see lengths of black gut leaching into both sides of healthy adjacent tissue? How many times have I had to call a parent to guess, propose and confess the critical mass being lost already? That game. This duel of sizing up my opponent to try to mercifully protect my patient is the battle I obsess over.</span></span></div><div><span style="font-family: inherit;"><br /></span></div><div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjmzqgskIMl7J6uOpj-5y8vPlLUzMj10Bsut6Lh83uldqrqlHYl1gufkldze4MDDvrMrMq92MQ4cY8kR_LiokXp0OyGiUldxAx8nUc3plCAdtvM71zEwntAFXiYAejtd-IJjbMeotzA1bu-Rr-vu-mHtcN4jO-0n5UNRIYXbm8YkQqhclJjbFDJmOtRYHI/s1080/IMG_0404%20(1).JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1080" data-original-width="1080" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjmzqgskIMl7J6uOpj-5y8vPlLUzMj10Bsut6Lh83uldqrqlHYl1gufkldze4MDDvrMrMq92MQ4cY8kR_LiokXp0OyGiUldxAx8nUc3plCAdtvM71zEwntAFXiYAejtd-IJjbMeotzA1bu-Rr-vu-mHtcN4jO-0n5UNRIYXbm8YkQqhclJjbFDJmOtRYHI/s320/IMG_0404%20(1).JPG" width="320" /></a></div><br /><span style="font-family: inherit;"><br style="background-color: white; color: #222222;" /><br style="background-color: white; color: #222222;" /><span style="background-color: white; color: #222222;">It is the battle to not feel to pessimistic to the power of hope. It is the battle to not be so egocentrically dictated that I presume failure while dismissing miraculous chances. It is the most egregious aspect of vetmed. This insidiously absurd power that one life can be replaced. It’s mark left to be rewritten by another. Vetmed needs a slap in the face to wake up its indifference for another patient to follow. We need to see each individual as its own unique and meaningful life. So influential in its existence that it enriches our own beyond replaceable measure. We need to be ever vigilant in our inspection of mass that we seek purpose in saving and protecting rather than measuring and abandoning.</span><br style="background-color: white; color: #222222;" /><br style="background-color: white; color: #222222;" /><span style="background-color: white; color: #222222;">500 dogs. 500 dogs kept in 80 cages. Broog shelter in Ukraine was a war camp. A place where all were trapped in a hell that lived smack dab in the middle of a country under siege trapped by a war none could flee from. This is my ptsd. The place I go back to as a yarn of tangled intentions to distract from the weights and measure of assigning critical mass. The place of chaos to remind me that my decisions, as honorable as they may be are still just wished cast to the clouds as I grip the grass below. Y</span></span><span style="background-color: white; color: #222222;">et we all still wake up to another day of discovery and hope the compassion can out weigh the mass. That the tiny grains of moments collect into magic wishes of perpetuity for the next generations to reminisce about.</span></div><div><span style="font-family: inherit;"><br /></span></div><div><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjmqSCf-XMU9KF3UXapBfnFHBbdGb3m9LYeM2goBSnBtadBcEOkuXfNO5liHWhdLt0EJkaq_AZMUEXMKbwi2-mMA-5kFJv51f-puDcQQy8bv7LNApEaIBaY5DdV05DFK4Me0jME2x9R7s2lQo-JYoFW_ZzQTUYY8t1RLB0z6E6QPfzp3yD3lVhUEnSMQiQ/s2016/IMG_1519.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1512" data-original-width="2016" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjmqSCf-XMU9KF3UXapBfnFHBbdGb3m9LYeM2goBSnBtadBcEOkuXfNO5liHWhdLt0EJkaq_AZMUEXMKbwi2-mMA-5kFJv51f-puDcQQy8bv7LNApEaIBaY5DdV05DFK4Me0jME2x9R7s2lQo-JYoFW_ZzQTUYY8t1RLB0z6E6QPfzp3yD3lVhUEnSMQiQ/w400-h300/IMG_1519.jpg" width="400" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">The dogs from Droog, The group in one of the open spaces</td></tr></tbody></table><br /><span style="font-family: inherit;"><br style="background-color: white; color: #222222;" /></span><span style="font-family: inherit;">I am beginning to recognize that I cannot stay focused on the end. The place where there is less, and it is slipping away. I can only stay grateful in the present, and all of the joy here, the rest will find me, someday, regardless.</span></div></div>krista magnifico, DVMhttp://www.blogger.com/profile/15133566329579911573noreply@blogger.com0tag:blogger.com,1999:blog-4667516629745731439.post-55105445092701527342023-11-12T16:33:00.000-08:002023-11-12T16:33:23.610-08:00The profitability of Asclepius<p>I recognize that my veterinary clinic; Jarrettsville Vet, is succeeding because we are not following in the ever increasing footsteps of the rest of the parade of hospitals around us. I recognize that as we remain independent and committed to our patients and the people who call them family, others, in ever growing numbers, are becoming financially focused institutions. Under their guise of care people are being targeted for manipulation as they are held emotionally hostage for their pets care as the commodity. It is obvious that as so many other veterinary clinics fall into corporate, conglomerate hands, focused solely and singularly on profits, the wave of supportive leadership to make this happen is the keeping of the guards to allow passage of currency. The veterinarians are the backbone of every veterinary practice. The engine that keeps the machine allowed to run. They hold such power, permit the profession to promulgate, and, now more than ever before in our history, they are in such short supply that we are begging for more of them to find our unanswered want ads. </p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEimkOQ8t7DOT4pWLyQdn22jobia6koZgElhrMHNT6nfQAffGx2MEv8JZ3MK-6XJEr-Y21iAYXqiwVEElvJVrWA1vfOzru6OuBcH42ddWf-5xApXYtOxvrWpFtCAyzUZaYGV8txSYcPrKNgK9oVKj_1MhrMLDTeL4LF9XjQXv-19tMvCGBlgJrN-iV6JBCc/s2016/IMG_1141.HEIC" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEimkOQ8t7DOT4pWLyQdn22jobia6koZgElhrMHNT6nfQAffGx2MEv8JZ3MK-6XJEr-Y21iAYXqiwVEElvJVrWA1vfOzru6OuBcH42ddWf-5xApXYtOxvrWpFtCAyzUZaYGV8txSYcPrKNgK9oVKj_1MhrMLDTeL4LF9XjQXv-19tMvCGBlgJrN-iV6JBCc/w300-h400/IMG_1141.HEIC" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Given away at just a few days old someone took mercy.<br />Often the littlest lives need the most compassion.</td></tr></tbody></table><p>With any great demand comes innovation, competition and incentives. The ability to find a veterinarian in any of the traditional ways has become impossible. You cannot place an ad in the local, state, or country publications and get even one response. You can try to recruit from the veterinary colleges, but you will be met by large corporately run HR banks with their platoon of jesters who now recruit students at the freshman level as "ambassadors" who are paid to promote their hospitals and essentially own the student upon graduation. As with all choke hold demand there is great profit in finding that unicorn. So gives rise to recruiters. </p><p> Today I received an email from one. Here's how that exchange unfolded.</p><p style="background-color: white; color: #222222; font-family: Arial, Helvetica, sans-serif; margin: 0px; min-height: 1em; padding: 0px;"><i>Good afternoon Dr. Magnifico, </i></p><p style="background-color: white; color: #222222; font-family: Arial, Helvetica, sans-serif; margin: 0px; min-height: 1em; padding: 0px;"><i>I am sorry you have not had good luck with recruiters in the past. I try very hard to be transparent and have never been accused of being unethical. I have been a veterinary recruiter for 30 years and love the industry and what I do.</i></p><p style="background-color: white; color: #222222; font-family: Arial, Helvetica, sans-serif; margin: 0px; min-height: 1em; padding: 0px;"><i>I have attached the document that explains how we work and associated fees.</i></p><p style="background-color: white; color: #222222; font-family: Arial, Helvetica, sans-serif; margin: 0px; min-height: 1em; padding: 0px;"><i>Looking forward to hearing back from you.</i></p><p style="background-color: white; color: #222222; font-family: Arial, Helvetica, sans-serif; margin: 0px; min-height: 1em; padding: 0px;"><i><br /></i></p><p style="background-color: white; color: #222222; font-family: Arial, Helvetica, sans-serif; margin: 0px; min-height: 1em; padding: 0px;"><i>Gwen</i></p><p style="background-color: white; color: #222222; font-family: Arial, Helvetica, sans-serif; font-size: small; margin: 0px; min-height: 1em; padding: 0px;"><br /></p><p style="background-color: white; color: #222222; font-size: small; margin: 0px; min-height: 1em; padding: 0px;"><span style="font-family: georgia;"><b>The contract is as follows;</b></span></p><p style="background-color: white; margin: 0px; min-height: 1em; padding: 0px;"><span face="Arial, Helvetica, sans-serif" style="color: #222222; font-size: x-small;">Contingency Retained Recruiting</span></p><p style="background-color: white; margin: 0px; min-height: 1em; padding: 0px;"><span face="Arial, Helvetica, sans-serif" style="color: #222222; font-size: x-small;">Off-site identifying, sourcing, and recruiting</span></p><p style="background-color: white; margin: 0px; min-height: 1em; padding: 0px;"><span face="Arial, Helvetica, sans-serif" style="color: #222222; font-size: x-small;">Off-site telephone interviewing</span></p><p style="background-color: white; margin: 0px; min-height: 1em; padding: 0px;"><span face="Arial, Helvetica, sans-serif" style="color: #222222; font-size: x-small;">One year replacement guarantee</span></p><p style="background-color: white; margin: 0px; min-height: 1em; padding: 0px;"><span face="Arial, Helvetica, sans-serif" style="color: #222222; font-size: x-small;">Fee: 33.5% of first year annual compensation of each candidate hired. To begin process, sign agreement</span></p><p style="background-color: white; margin: 0px; min-height: 1em; padding: 0px;"><span face="Arial, Helvetica, sans-serif" style="color: #222222; font-size: x-small;">and pay retainer of $3,900.00. Retainer is deducted from invoice of candidate placed. Only one retainer is</span></p><p style="background-color: white; margin: 0px; min-height: 1em; padding: 0px;"><span face="Arial, Helvetica, sans-serif" style="color: #222222; font-size: x-small;">required per year, regardless of how many open positions we are recruiting for at the same time.</span></p><p style="background-color: white; margin: 0px; min-height: 1em; padding: 0px;"><span face="Arial, Helvetica, sans-serif" style="color: #222222; font-size: x-small;">Fee is calculated at offer and acceptance of candidate chosen and is due in full within 5 (five) days of receipt of</span></p><p style="background-color: white; margin: 0px; min-height: 1em; padding: 0px;"><span face="Arial, Helvetica, sans-serif" style="color: #222222; font-size: x-small;">invoice. Payment is due upon verbal offer and acceptance. If payment is not made on time as agreed, billing</span></p><p style="background-color: white; margin: 0px; min-height: 1em; padding: 0px;"><span face="Arial, Helvetica, sans-serif" style="color: #222222; font-size: x-small;">fees, interest, and late fees can be incurred.</span></p><p style="background-color: white; margin: 0px; min-height: 1em; padding: 0px;"><span face="Arial, Helvetica, sans-serif" style="color: #222222; font-size: x-small;">Retainer</span></p><p style="background-color: white; margin: 0px; min-height: 1em; padding: 0px;"><span face="Arial, Helvetica, sans-serif" style="color: #222222; font-size: x-small;">Retainer is non-refundable. In the event Client hires someone outside of VetProCentral services, the</span></p><p style="background-color: white; margin: 0px; min-height: 1em; padding: 0px;"><span face="Arial, Helvetica, sans-serif" style="color: #222222; font-size: x-small;">retainer is available to use on any placement within one year from date we are notified that the original position</span></p><p style="background-color: white; margin: 0px; min-height: 1em; padding: 0px;"><span face="Arial, Helvetica, sans-serif" style="color: #222222; font-size: x-small;">has been filled.</span></p><p style="background-color: white; margin: 0px; min-height: 1em; padding: 0px;"><span face="Arial, Helvetica, sans-serif" style="color: #222222; font-size: x-small;">Details – fine print is always necessary!</span></p><p style="background-color: white; margin: 0px; min-height: 1em; padding: 0px;"><span face="Arial, Helvetica, sans-serif" style="color: #222222; font-size: x-small;">Signed contract and retainer are required to begin the search. Retainer is non-refundable. Signed contract</span></p><p style="background-color: white; margin: 0px; min-height: 1em; padding: 0px;"><span face="Arial, Helvetica, sans-serif" style="color: #222222; font-size: x-small;">and retainer are required to begin the search. Retainer is non-refundable. In today’s market, we strive to offer a</span></p><p style="background-color: white; margin: 0px; min-height: 1em; padding: 0px;"><span face="Arial, Helvetica, sans-serif" style="color: #222222; font-size: x-small;">superb candidate experience as well as meeting client’s expectations. With that, a streamlined hiring process is</span></p><p style="background-color: white; margin: 0px; min-height: 1em; padding: 0px;"><span face="Arial, Helvetica, sans-serif" style="color: #222222; font-size: x-small;">essential when entertaining the best candidates available. We have adopted the 2/5/5 premise to achieve those</span></p><p style="background-color: white; margin: 0px; min-height: 1em; padding: 0px;"><span face="Arial, Helvetica, sans-serif" style="color: #222222; font-size: x-small;">goals. What does that mean? With permission from the candidate, we will present them to you for consideration</span></p><p style="background-color: white; margin: 0px; min-height: 1em; padding: 0px;"><span face="Arial, Helvetica, sans-serif" style="color: #222222; font-size: x-small;">after the initial phone interview with a VetProCentral team member. To follow, we expect a decision from our</span></p><p style="background-color: white; margin: 0px; min-height: 1em; padding: 0px;"><span face="Arial, Helvetica, sans-serif" style="color: #222222; font-size: x-small;">client to either move forward with a candidate or pass within two days of submission. Thereafter, an interview</span></p><p style="background-color: white; margin: 0px; min-height: 1em; padding: 0px;"><span face="Arial, Helvetica, sans-serif" style="color: #222222; font-size: x-small;">via zoom or on-site is to be scheduled within five days. Following a decision within five days of the on-site or</span></p><p style="background-color: white; margin: 0px; min-height: 1em; padding: 0px;"><span face="Arial, Helvetica, sans-serif" style="color: #222222; font-size: x-small;">zoom interview, a second interview is to be scheduled or an offer will be extended. This hiring tactic is used to</span></p><p style="background-color: white; margin: 0px; min-height: 1em; padding: 0px;"><span face="Arial, Helvetica, sans-serif" style="color: #222222; font-size: x-small;">give you a competitive edge against other practices. Our goal is not to rush our clients to an offer, but simply to</span></p><p style="background-color: white; margin: 0px; min-height: 1em; padding: 0px;"><span face="Arial, Helvetica, sans-serif" style="color: #222222; font-size: x-small;">move the interview process forward and ensure we do not miss out on excellent candidates as they wait in the</span></p><p style="background-color: white; margin: 0px; min-height: 1em; padding: 0px;"><span face="Arial, Helvetica, sans-serif" style="color: #222222; font-size: x-small;">interview pipeline.</span></p><p style="background-color: white; margin: 0px; min-height: 1em; padding: 0px;"><span face="Arial, Helvetica, sans-serif" style="color: #222222; font-size: x-small;">Replacement Guarantee</span></p><p style="background-color: white; margin: 0px; min-height: 1em; padding: 0px;"><span face="Arial, Helvetica, sans-serif" style="color: #222222; font-size: x-small;">Each Candidate placement is guaranteed. In the event a recruited and subsequently hired candidate is</span></p><p style="background-color: white; margin: 0px; min-height: 1em; padding: 0px;"><span face="Arial, Helvetica, sans-serif" style="color: #222222; font-size: x-small;">terminated for cause during the first year of employment, VetProCentral will replace candidate at no charge to</span></p><p style="background-color: white; margin: 0px; min-height: 1em; padding: 0px;"><span face="Arial, Helvetica, sans-serif" style="color: #222222; font-size: x-small;">Client. Guarantee follows title of person placed and location. The guarantee set forth in this paragraph will be</span></p><p style="background-color: white; margin: 0px; min-height: 1em; padding: 0px;"><span face="Arial, Helvetica, sans-serif" style="color: #222222; font-size: x-small;">void in the following circumstances: (a) Client chooses not to replace the candidate; (b) Client decides to</span></p><p style="background-color: white; margin: 0px; min-height: 1em; padding: 0px;"><span face="Arial, Helvetica, sans-serif" style="color: #222222; font-size: x-small;">promote from within to replace the candidate; (c) candidate is under contract for one year, and the contract is</span></p><p style="background-color: white; margin: 0px; min-height: 1em; padding: 0px;"><span face="Arial, Helvetica, sans-serif" style="color: #222222; font-size: x-small;">determined not to be renewable by either party, prior to year-end or (d) the candidate is moved from one Client</span></p><p style="background-color: white; margin: 0px; min-height: 1em; padding: 0px;"><span face="Arial, Helvetica, sans-serif" style="color: #222222; font-size: x-small;">location to another.</span></p><p style="background-color: white; margin: 0px; min-height: 1em; padding: 0px;"><span face="Arial, Helvetica, sans-serif" style="color: #222222; font-size: x-small;"><br /></span></p><p style="background-color: white; margin: 0px; min-height: 1em; padding: 0px;"><span style="color: #222222; font-family: helvetica; font-size: x-small;"><b>My response;</b></span></p><p style="background-color: white; margin: 0px; min-height: 1em; padding: 0px;"><span style="color: #222222; font-family: helvetica; font-size: x-small;"><b><br /></b></span></p><p style="background-color: white; margin: 0px; min-height: 1em; padding: 0px;"><i>Jesus Christ. I would have to euthanize half of my patients to increase fees enough in the other half to pay for this. </i></p><div><i><br /></i></div><div><i>Insane. </i></div><div><i><br /></i></div><div><i>When you hear about the cost of care for veterinary care going up and the subsequent loss of access to care because of this, and, all of the pet adoring parents who will never get another pet again because they cannot afford to, please recognize your part in the landscape that vetmed has turned into. </i></div><div><i>I just think it’s super important that we all share that responsibility. </i></div><div><i>You are either a part of the solution or a part of the problem. </i></div><div><i>May there someday be empathy for compassionate care again. </i></div><div><i>This is disgusting. </i></div><div><i><br /></i></div><div><i>Krista. </i></div><div><i><br /></i></div><div><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhyPp7lSlN6JM_b0ryFnfsNMP-B_dFwFsQEVoyCChjoBLe6xz1ixatZuMzcLGd2wbQYBtHaKaK3S_bYFi377bm9AwdG_-8WzNrCaoNV2V1V1QaLK2sGS8nJ1ja5rIMcWBOZe9HkiO-1c0Z3xzMXQ0TAnR2e6_svv4-U-5Euo3ciN4Z-1U0iuwpISumhDjo/s2016/IMG_1149.HEIC" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhyPp7lSlN6JM_b0ryFnfsNMP-B_dFwFsQEVoyCChjoBLe6xz1ixatZuMzcLGd2wbQYBtHaKaK3S_bYFi377bm9AwdG_-8WzNrCaoNV2V1V1QaLK2sGS8nJ1ja5rIMcWBOZe9HkiO-1c0Z3xzMXQ0TAnR2e6_svv4-U-5Euo3ciN4Z-1U0iuwpISumhDjo/w300-h400/IMG_1149.HEIC" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Earl, one of our rescues on his last day with us. He was adopted by one of our most beloved friends.<br />Here's to living the best life ever!</td></tr></tbody></table><br /></div><div>It will come to a place where this is really all, and only, about the money. Where only the rich can have pets, and only the richer care for them. There is a tipping point, a continent of opportunity for those with an entrepreneurial spirit to propel them, and a whole devastatingly destructive tidal wave of culpability to follow. If independently run veterinary practices continue to sell out to corporately managed investors at the rate they are the price for care, the salaries paid to do their bidding, and the death toll of those treatable cases will continue to rise. Who among us doesn't want to be paid more? Who among us wants to work harder, see more cases, and try to hold the line for ethical care at affordable prices against a wave that grows bigger, hungrier and more powerful? </div><div><br /></div><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjqGnmXxwHuUdzx4buAxmevlNVQN7HS0kjUn7pe8apVCQOCRN6G86Bxqd4CeVnL1URtiAzLpnKtSdKlwT8z2GRcJCNh-dKf5njJsHykqbiO4_WID1In67KYO9IcP2xzLM9pkLiQbH_bb1aDIX7KCBzB0F9HIwbpMiyJG_t_PtcHSy_lWftaiSshP8_Z80A/s1544/IMG_1137.HEIC" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1544" data-original-width="1158" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjqGnmXxwHuUdzx4buAxmevlNVQN7HS0kjUn7pe8apVCQOCRN6G86Bxqd4CeVnL1URtiAzLpnKtSdKlwT8z2GRcJCNh-dKf5njJsHykqbiO4_WID1In67KYO9IcP2xzLM9pkLiQbH_bb1aDIX7KCBzB0F9HIwbpMiyJG_t_PtcHSy_lWftaiSshP8_Z80A/w300-h400/IMG_1137.HEIC" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">My adorable Seraphina. My muse, my salutation salvation, and my Why.</td></tr></tbody></table><br /><div><br /></div><div>There is a cost for each decision all of us in vetmed make? I am bombarded by it every day. Today a person drove 11 hours to see me. He was afraid to go anywhere. Afraid his cat is going to die from a treatable disease that no one else wants to help him with. Eleven hours away I had to tell him that his cat was not treatable, savable, and that all he feared was about to unfold. I told him this for $500. The cost of an exam, blood work, xrays, radiologist reviewed, fluids, appetite stimulant, antibiotic, and a steroid as our last Hail Mary attempt to make whatever time she has left as pain free and peaceful as able.</div><div><br /></div><div>I know he drove by hundreds of clinics who would have given him the same advice, for about the same price. I also know he drove by hundreds of ER's who would have told him he needed $4,000 to get started on his journey of futility and not been honest with him. He would have felt shamed in not being able to afford the list of recommended line items to punt his cats diagnosis to a specialist, in network, of course. </div><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh0YOHMUgH7OE6sCza5WuWf4U_fTz3EdwG86IRzIcvV9e2sfz-bBVjgksjZP8WsEwzv0ASdbj6J9Z-3wJyaJTXqs7GIsXvomVJS7Qa6kan-a7DuDGI-ZJTQQoJoZGRGqbNqPd5d__suG0-jz0NH_9EVFrMuMYkQj3TUrUixlUsKc_SBgJ9fWxADUvjD0FQ/s2016/IMG_1038.HEIC" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh0YOHMUgH7OE6sCza5WuWf4U_fTz3EdwG86IRzIcvV9e2sfz-bBVjgksjZP8WsEwzv0ASdbj6J9Z-3wJyaJTXqs7GIsXvomVJS7Qa6kan-a7DuDGI-ZJTQQoJoZGRGqbNqPd5d__suG0-jz0NH_9EVFrMuMYkQj3TUrUixlUsKc_SBgJ9fWxADUvjD0FQ/w300-h400/IMG_1038.HEIC" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Daisy. Getting ready for her dental.</td></tr></tbody></table><br /><div><br /></div><div>I wonder if my end in vetmed will be left with me as the only DVM name on our shingle? </div><div><br /></div><div>There is a price for high wages. A cost to only providing care to the elite, the wealthy and the expected annual salary of $200,000 per vet and the 33% of that it would cost to be able to procure a vet from this agency. Veterinarians out in the world looking for employment hold great leverage and power. They expect sign on bonuses of over $50,000, annual pay of over $150,000, and every other benefit imaginable. While I recognize the great healing powers of all veterinarians, I also recognize that no where in any recruiter flyer, corporate descriptor, and "about us" website section is only about quality of care, work-life balance and income. There is not one single word, inuendo, or iota of responsibility with regard to the reason we all came here. There is no hint of caring, compassion, or the incredible magnetic force that is caring for these pets who hold our hearts, and now wallets hostage to the web of greed that we are engulfed within. There is no mention of how fulfilling, inspiring, and impactful it is to save the life of a companion that ties another human to wanting to stay within humanity. The gift that I receive day in and day out in saving the savable lives, showing compassion to those I cannot, and never denying that there is hope for each one of us in even the darkest of days is the elixir to all of our collective miseries.</div><div><br /></div><div>When will vetmed, and the powers who hold them in check, become honest about transparency with these influences? What I will call <i>cost of culpability</i>, be called out? When will moral integrity with all things that fall within the net of vetmed reign supreme again? When will the tipping points of treatable tip back from profitable? When will we all wake up from this catastrophic speeding train and recognize we burned every bridge as we transited to indifference?</div><div><br /></div><div>From Wikipedia; culpability;</div><div><p style="background-color: white; color: #202122; font-family: sans-serif; font-size: 14px; margin: 0.5em 0px;">The concept of culpability is intimately tied up with notions of <a href="https://en.wikipedia.org/wiki/Moral_agency" style="background: none; color: #3366cc; overflow-wrap: break-word; text-decoration-line: none;" title="Moral agency">agency</a>, freedom, and <a href="https://en.wikipedia.org/wiki/Free_will" style="background: none; color: #3366cc; overflow-wrap: break-word; text-decoration-line: none;" title="Free will">free will</a>. All are commonly held to be <a class="mw-redirect" href="https://en.wikipedia.org/wiki/Necessary_condition" style="background: none; color: #3366cc; overflow-wrap: break-word; text-decoration-line: none;" title="Necessary condition">necessary</a>, but not <a class="mw-redirect" href="https://en.wikipedia.org/wiki/Sufficient_condition" style="background: none; color: #3366cc; overflow-wrap: break-word; text-decoration-line: none;" title="Sufficient condition">sufficient</a>, conditions for culpability.</p><blockquote class="templatequote" style="background-color: white; border-left: none; color: #202122; font-family: sans-serif; font-size: 14px; margin: 1em 0px; overflow: hidden; padding: 0px 40px;"><p style="margin: 0px;">A person is culpable if they cause a negative event and<br />(1) the act was intentional;<br />(2) the act and its consequences could have been controlled (i.e., the agent knew the likely consequences, the agent was not coerced, and the agent overcame hurdles to make the event happen); and<br />(3) the person provided no excuse or justification for the actions.<sup class="reference" id="cite_ref-2" style="font-size: 11.2px; line-height: 1; text-wrap: nowrap; unicode-bidi: isolate;"><a href="https://en.wikipedia.org/wiki/Culpability#cite_note-2" style="background: none; color: #3366cc; overflow-wrap: break-word; text-decoration-line: none;">[2]</a></sup></p></blockquote></div><div>Every decision that I make as a veterinarian, a practice owner, and a human being, has influences on others. The meekest being the most obviously influenced. If I even entertained the idea of signing this contract with this, or any of the other recruiters, I have to pass on the expense to the patients I came here to care for. Period. The idea that the profits of the clinic not being passed down to the staff as unpaid wages is not present at this clinic where we post our prices, wear our hearts on our sleeves, and never shame based on financial limitations. We also are not afraid to try to save a life, even when we need to cut diagnostics to do so. We are honest in our mission, purpose, and compassion. It is not a tagline to infer trust that we simply break when you are not profitable to our business.</div><div><br /></div><div>It is wonderful to have the newest, brightest, shiniest, fanciest, modern pieces of equipment, but if you can only utilize on a tiny segment of the patients who need them it is a detrimental restrictive asset. It is a choice to be the Bower bird and not the Asclepius we were trained to be.</div><div><br /></div><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiY_E3tAOjIXpoh0oRfejTaq63juthBVHFgvHe9oHEUCxEAIq6lG5lBah8ulRRQLJ3wmuR1fpe2RDtxt3qhWoAAfFRUoriLEhfs3KSyjRThpp_ULm0YtZJqcAtffF1dYV0qg87Bpw3Iy_Li-_g4452WsREGqLSYGP4o2PyL3mY6kJYUTULn6eij0EA9PqI/s2016/IMG_0772.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiY_E3tAOjIXpoh0oRfejTaq63juthBVHFgvHe9oHEUCxEAIq6lG5lBah8ulRRQLJ3wmuR1fpe2RDtxt3qhWoAAfFRUoriLEhfs3KSyjRThpp_ULm0YtZJqcAtffF1dYV0qg87Bpw3Iy_Li-_g4452WsREGqLSYGP4o2PyL3mY6kJYUTULn6eij0EA9PqI/w300-h400/IMG_0772.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Rio. My heart lies here. In the stories of these lives and the memories of a life rich beyond the measure of societies currency.</td></tr></tbody></table><br /><div><br /></div><div>It's time to be honest again about why we are here. If you are a product of a sign-on bonus that compelled you to have to turn treatable patients away, and you told yourself that pets are a <i>privilege</i>, and that these patients with their treatable ailments, are "not your problem" because the CFO at your employers office will not permit you to try to find an affordable answer, then the issue with integrity lies at your feet. We are all responsible to help the animals who come to us in every capacity we are able.</div><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgQOdDO3tzgqCxXJOqxWgVUFOVgTq2LCPrNY1LBnuhirAau50l1G2Jp6OnvqKlHa8WnbU713Xsb682ldmOnLmQWSYJR3R7tugauFkeZZZ1e7_VswvU-Y0pSWGQxlWQfnNgmthpgJ-SF6dQhIcG9gTPYpROasHZZDioQLMxh8BsbBh0lk8loxvLu9bcFG1c/s2016/IMG_0757.heic" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgQOdDO3tzgqCxXJOqxWgVUFOVgTq2LCPrNY1LBnuhirAau50l1G2Jp6OnvqKlHa8WnbU713Xsb682ldmOnLmQWSYJR3R7tugauFkeZZZ1e7_VswvU-Y0pSWGQxlWQfnNgmthpgJ-SF6dQhIcG9gTPYpROasHZZDioQLMxh8BsbBh0lk8loxvLu9bcFG1c/w300-h400/IMG_0757.heic" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">One of the four blind puppies we have helped to rescue.<br />These are the reason we came here. Why this profession will always be more than a recruiters ability to sell, market and negotiate.</td></tr></tbody></table><br /><div>For more on this please follow this blog. Please find the real-life cases on my <a href="https://www.youtube.com/@kristamagnificoDVM/videos">YouTube</a> channel and follow along with us in our day-to-day lives on our <a href="https://www.facebook.com/JarrettsvilleVet">Facebook</a> page.</div><div><br /></div><div>Remember we are all here together. We all came into vetmed for the same reasons. None of us will grow rich on saying no, denying chances, and killing for the profits that bankrolled the guys who never have to get their hands dirty. Who's side are you on? </div><div><br /></div><div>Goodnight Gwen. God bless all those tiny creatures who are still out there in need, and the souls who still find their lives valuable enough to see the miracles in the chances of just being kind without a balance sheet.</div>krista magnifico, DVMhttp://www.blogger.com/profile/15133566329579911573noreply@blogger.com0tag:blogger.com,1999:blog-4667516629745731439.post-21436770701600578632023-10-31T06:20:00.003-07:002023-10-31T06:20:33.927-07:00The Right Question<p>Perhaps I had it all wrong all those years ago? Perhaps my
perception of the distant, reserved indifference that I saw on my older, wiser, decades in the trenches, weathered predecessors faces was the quiet contemplation of whether
or not to ask the question? More specifically, the right question. At the right
time. Maybe that is the whole secret to life and all of its layers? Maybe the enthusiasm of the young vibrant newbie vet got confused by the quiet contemplation?</p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgJUYMu_9G-OVt6QViVR_R3Wh-IbsBLcqDHVmjrcAu3eKFHm2rrpNX8c9GepZeFLgcV_ZGGiGXdhjav1NpcaEqGt655GDeAx_TMkdPeqyaTUVIuPSuCBcxZ4bJTyEJScMuMZZZ7l6lzkUGxWDuoBuZvTLGS_wvtPcQqZ29dm-ENBlKH3sNLczD-iu2TX50/s2016/IMG_0814.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgJUYMu_9G-OVt6QViVR_R3Wh-IbsBLcqDHVmjrcAu3eKFHm2rrpNX8c9GepZeFLgcV_ZGGiGXdhjav1NpcaEqGt655GDeAx_TMkdPeqyaTUVIuPSuCBcxZ4bJTyEJScMuMZZZ7l6lzkUGxWDuoBuZvTLGS_wvtPcQqZ29dm-ENBlKH3sNLczD-iu2TX50/w300-h400/IMG_0814.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">This little one is one of the many we have tried to save along the way.<br /></td></tr></tbody></table><br /><p>It is the maturing in medicine that has brought me to this
pondering on the mountain. The question for the ancient one that is the
singular question I will be allowed to ask?</p><p class="MsoNormal"><o:p></o:p></p>
<p class="MsoNormal">Medicine is built around questions. To be specific, the contemplation of the right questions, and the internal pondering of the dialogue it manifests. This is the place I feel
we have strayed the most at the cost of our patients’ outcomes. We don’t talk
to each other anymore. We don’t share information for the chance it might be
mutually beneficial. We don’t pause for reflective answers. And we don’t invest
in each other’s experiences nor heartfelt desires as the mortar to each other’s
foundational awareness. We don’t seem to care enough about each other to extend
a moment of contemplation. Without this, everything that medicine has to offer
is reduced to a tiny spark of its true power.<o:p></o:p></p>
<p class="MsoNormal">This is what sets the people of Jarrettsville Vet apart. We aren’t
just a face in a time slot. We are a person with an investment of ourselves
into each patient. <o:p></o:p></p>
<p class="MsoNormal">Last night, as with every night before it, I texted my husband to tell
him I was leaving the clinic and headed home. We are three years post COVID and he
has become the stay-at-home-dad to our 5 cats and 2 dogs. It was after 8 pm, he
had already inquired, hours earlier, if “I needed food?” (Don’t I always? I replied
to myself). I told him I would “love a glass of wine,” (don’t I always?) and,
that I was “bringing home a big box in the back of the car of the party lights,”
I had forgotten for weeks at the clinic, and a “little box with a kitten to
bury.” <o:p></o:p></p>
<p class="MsoNormal">There was no text reply back. Clearly, I would have to clarify that
this wasn’t an autocorrect mishap upon my arrival.<o:p></o:p></p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiV6iitHOw_IRF3K0eUumQhUgcJWyq1i8tFeBRJrwfEkIkre2a3NbkuEnCGAS1LEU3vkV9wAxXQIX_Bwqs_AoJrH-CEthq7b_HoFdT1QoJGWryUeGSicgWAL0n343UWdTR1nLdg22V0wyP1_G9Dxk4m65IO1BIDa7m-pE3x2QqNEukza1Dk13X7p1w0RrM/s2016/IMG_0755.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiV6iitHOw_IRF3K0eUumQhUgcJWyq1i8tFeBRJrwfEkIkre2a3NbkuEnCGAS1LEU3vkV9wAxXQIX_Bwqs_AoJrH-CEthq7b_HoFdT1QoJGWryUeGSicgWAL0n343UWdTR1nLdg22V0wyP1_G9Dxk4m65IO1BIDa7m-pE3x2QqNEukza1Dk13X7p1w0RrM/w300-h400/IMG_0755.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">What happens at JVC when a breeder brings in her litter of blind puppies and their mom and tells us they will all be surrendered to the shelter? They stay with us. <br />(P.S. they are all still looking for homes, see Black Dogs and Company for information on them).</td></tr></tbody></table><br /><p class="MsoNormal">“What's up with the kitten in the car?” he said as I handed the tiny box to him as he helped me carry the days fodder inside our home. He wasn’t upset, nor
surprised, but he knew there was a story. This is how we end each day. He meets me at the car as I drive in, glass of wine in hand, the other to help carry the days endeavors. The end of the work day summary is a quilt of crazy colored stories shared over a quick dinner and 30 minutes of taped tv. I came here, to vetmed, for the allure of the stories. The Herriott stories. The place where others who adored their pets as much as I do, would share their journey together. I have a place that I belong here in these stories. It is what keeps
me from retiring to greener pastures with sun filled vistas to nap upon.</p><p class="MsoNormal"><o:p></o:p></p>
<p class="MsoNormal">"Her name was Elouise," I began. She was a rescue. The family whom she was born into had forgotten
to spay and neuter their cats who were brother and sister. She was the last
survivor. She was as doomed as her siblings. I had known that from the second I
set eyes upon her.<o:p></o:p></p>
<p class="MsoNormal">Elouise arrived at the clinic swaddled in a small towel.
Tenderly carried in, too quiet to be healthy. If you pay attention long enough
you learn that the neediest patients in your clinic are the silenced. The ones
too weak to protest, too near the verge of death to allow their survival
instincts to protect them any longer. Only her tiny face was visible. A mottled
face the size of a tangerine, and oddly the same dimensions. A broad face with
wide set eyes. In the 18<sup>th</sup> century she would have been called a
Mongoloid. A horrible description of a skull that was burgeoning from within. Her
eyes were unresponsive and resting laterally (the left eye was turned outward
to the left, and the right faced far to the West). She was not present mentally.
She did however still possess the one magical power to keep us human’s captive
in fighting for her; she purred the moment a hand met her head. She purred, and
purred and purred. A trans-like rhythm that pulls an emotional compulsion to
continue to care when the biology has stolen the chance.<o:p></o:p></p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjXD3O6pZzgd89nTmCtO967NNQmm4Mp4khyphenhyphenxHsLac1y0jlfgSsCRLgsEwwopMevbu8_iB2dQCjuZ0yIJ1X8xNwHBrHZ2DLIeziaUqQCTh3nwxxpithxi78kfKH3ZojWVyYIFkCSoVQLkQc7hSLmT2tP8Lk_t0zol4M7zqJryzCfTGeHW2UeHZzis6Zc8QQ/s2016/IMG_0825.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjXD3O6pZzgd89nTmCtO967NNQmm4Mp4khyphenhyphenxHsLac1y0jlfgSsCRLgsEwwopMevbu8_iB2dQCjuZ0yIJ1X8xNwHBrHZ2DLIeziaUqQCTh3nwxxpithxi78kfKH3ZojWVyYIFkCSoVQLkQc7hSLmT2tP8Lk_t0zol4M7zqJryzCfTGeHW2UeHZzis6Zc8QQ/w300-h400/IMG_0825.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Gracie, found with severe wounds, covered in fleas and ticks, and microchipped.<br />It allowed us to find her home but she wasn't able to return. We have loved her everyday since.</td></tr></tbody></table><br /><p class="MsoNormal">I looked up at the foster mom who had brought her in. She
was so hopeful that I could hold a cure, a witch’s brew to turn the tide. The kind
of hope that lies in miracles, abandoned by medicine.</p><p class="MsoNormal"><o:p></o:p></p>
<p class="MsoNormal">I unwrapped the towel. She didn’t move. Made no
acknowledgement of the stranger I was, and the new place she was in. Elouise was perfectly captured by her name. So apt in her gentle, shy, peaceful demeanor. The kind of name
that accompanies a bicycle, a French beret, a windswept skirt, and a song you catch
yourself whistling on a clear summer day. The name of the heroine in a children’s
book, small curly white dog as the sidekick. A name as intentional as a romantically
fraught fairy tale heroine. As gently as possible I picked her up and placed Elouise
on the exam table. As it is too many times the harshness of a stainless-steel
exam table meets the wispy goodbye of a life taken too soon. It is not lost
upon me that these rooms are asked to absorb too much and be a vigilante to too
much sadness. One of the first places a veterinarian starts with an examination
is basic standing ability. She was a crumpled speck of jutting angles of bones
and fur. “Has her back leg ever been normal?” <o:p></o:p></p>
<p class="MsoNormal">“No, she has never been able to use it.” It stuck to her underbelly like a contracted, lifeless, muscle-less chicken-wing bought by the dozen for less than a buck. Her pelvis was tucked, her other back leg attempting to extend, but also lacking the muscle mass to support anything past behind her. Her mom told me about the time she had been with her which had been less than 2 weeks ago. "She came to us able to run and play. But, that had stopped days ago. <o:p></o:p></p>
<p class="MsoNormal">Elouise's story with me had started as an email in our hospital inbox a week ago. She was
in the care of the rescue, who had just been granted permission to take her
after the rest of her siblings had died. The foster mom was inquiring about a
surgery to correct Elouise’s inverted rib cage. A condition we call ‘pectus
excavatum’. Elouise was born with a ribcage so narrow it impacts her ability to
breathe normally. There are multiple ways to fix it, in kittens who are still
soft and pliable we place a cast around the chest to try to mold it back into
the shape it belongs. She is a rescue, and like all of them that I see I have
to be creative and thrifty. It is why I am so disappointed in where vetmed has
fallen. These cases, the millions who preceded them, over the hundreds of years
that we have been influencing animals outcomes without tech and stock holders
margins. She didn’t need a surgery, she needed merciful grace. She came to see
me not because I am a wizard at unusual congenital birth defect corrections,
but instead because I am wiling to try before I require a
3-plus-thousand-dollar deposit. Elouise had two women in her corner who see her
as more than a replaceable, over populated compilation of carbon. <o:p></o:p></p>
<p class="MsoNormal">Elouise couldn’t stand, she couldn’t react to physical exam
queries, and her gums were white. She was utilizing every ounce of whatever
marginal strength that she had left just to breathe. It was all she could
muster the energy for. She was dying and her mom, the person who had had her
for only a few days, was crying on the other side of the exam table.<o:p></o:p></p>
<p class="MsoNormal">“I knew that you would tell me the truth. I am just not
ready for this.” <o:p></o:p></p>
<p class="MsoNormal">We are never ready. That purr will convince you to hold on
even when life is being stolen away before your eyes.<o:p></o:p></p>
<p class="MsoNormal">Elouise was purring in my hands and she stopped, extended
her head back and thrust her front legs forward. <o:p></o:p></p>
<p class="MsoNormal">“She keeps doing that. Every so often.”<o:p></o:p></p>
<p class="MsoNormal">“I think it’s a seizure.”<o:p></o:p></p>
<p class="MsoNormal">“Oh.” It put another layer of despair onto her already bleak
pile.<o:p></o:p></p>
<p class="MsoNormal">“We can send her home with opioids if you aren’t ready yet.”
Try to give her a passing in hospice care. Truth was that Elouise had been
here, this place where dying is overtaking the mitotic cataclysm of living for
her whole short three-week long life. She is, as medicine would have labeled
her “unviable” from the moment she was born. Luck and love had gotten Elouise
this far, but there was nothing left to bargain.<o:p></o:p></p>
<p class="MsoNormal">“No, it’s the right thing to do. She doesn’t need to suffer
any longer.”<o:p></o:p></p>
<p class="MsoNormal">I knew it to. And so she came home in a little box in the
back of my car, to be with all of the other pets who had made my life as their
mom, their vet and my life’s collected book of stories so meaningful,
purposeful and richly rewarded.<o:p></o:p></p>
<p class="MsoNormal">“What do I owe you for today’s visit?” <o:p></o:p></p>
<p class="MsoNormal">“I am not charging you for Elouise. She is a gift to both of
us. You cared enough to give her a chance and love her despite knowing she
needed more than you could provide, (how many of us are willing to do that?),
and I needed a reminder as to why I am here. She is my WHY. The reminder that
this is, was, and always needs to remain more than a practiced profession.<o:p></o:p></p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjL8J-570NB_LWYt6VigH2p58IQ7-VmHZfM3FagN4k2G1Y5Wa8Nfj3K9_JevEFug_fWiXVOK3BPpFLUbcr7j_mCll2t0qs0bcP-KWwQ2MgR8r1mbga1WzOXRqRAKgZKTY9k6jbVq8ECCD-UbCh646yxrb_IbOLPNSBJVBKzsTwU6IVAsT0MUkkTwpXou5w/s2016/IMG_1249.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjL8J-570NB_LWYt6VigH2p58IQ7-VmHZfM3FagN4k2G1Y5Wa8Nfj3K9_JevEFug_fWiXVOK3BPpFLUbcr7j_mCll2t0qs0bcP-KWwQ2MgR8r1mbga1WzOXRqRAKgZKTY9k6jbVq8ECCD-UbCh646yxrb_IbOLPNSBJVBKzsTwU6IVAsT0MUkkTwpXou5w/w300-h400/IMG_1249.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Slater. Brought to us for vomiting.<br />His mom had rescued him from her son after he passed away. She struggled with homelessness, surrendered Slater to the shelter, saw him a year later featured as "pet of the month" and went back to adopt him. He was up to date on vaccines and preventatives and when he started vomiting she called her vet. They wouldn't even give him an exam without an $800 deposit, which she didn't have. He came to us. We worked with the shelter to give him a chance. His mom stated that she would surrender him back to the shelter if it meant giving him a chance again. An exploratory surgery revealed a large tumor on his kidney that was inoperable. He was put down next to his mom who knew there was nothing left to do for him. </td></tr></tbody></table><br /><p class="MsoNormal">And so I come back to my question. The right question. It
isn’t about how wealthy we are, it is about how enriched we become along the
way. </p><p class="MsoNormal"><o:p></o:p></p>krista magnifico, DVMhttp://www.blogger.com/profile/15133566329579911573noreply@blogger.com0tag:blogger.com,1999:blog-4667516629745731439.post-25957706329166895522023-10-06T09:19:00.009-07:002023-10-07T12:50:40.848-07:00The System Is Rigged In The Houses Favor. The hidden costs that keep rising because the public has no access to transparent pricing models.<p><b>The system, i.e., the whole profession of veterinary medicine and all of its affiliates, is rigged in the houses favor.</b> It's a harsh reality for the ever growing mob of pet parents who feel betrayed by the system they rely on for their pets well-being. The vet, the vet hospital, and the profession as a whole, has all of the power. Power can come in many forms, with many faces, but, the most powerful will always remain with those who control the emotional, mental, physical, and financial survival of those who do not. Power of that kind is totalitarian. Power like that has collapsed civilizations. Made extinction a reality. Power like that is dangerous beyond measure. </p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj1sfBb6JUgM_h_iz85vcfwR7WWIEsgxG32SAEnKPqvx_7GU4MRV1oH5DxNTt3Mx0lPyOm6rDZ2U4Zrk-7bESiJavvZBaieqXNn77pK0Qff8CbiFaK_2cGrTejnzREd5BD9I5KN8FxKT6RBetn5RNPHpJBTX-ElIdIuHrFhK_UvjThH810SjM3UF-oBj6c/s2016/IMG_0085.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj1sfBb6JUgM_h_iz85vcfwR7WWIEsgxG32SAEnKPqvx_7GU4MRV1oH5DxNTt3Mx0lPyOm6rDZ2U4Zrk-7bESiJavvZBaieqXNn77pK0Qff8CbiFaK_2cGrTejnzREd5BD9I5KN8FxKT6RBetn5RNPHpJBTX-ElIdIuHrFhK_UvjThH810SjM3UF-oBj6c/w300-h400/IMG_0085.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Serafina. My daily reminder of my <a href="https://kmdvm.blogspot.com/2019/02/serafina-why-in-who-i-am.html">WHY</a>.</td></tr></tbody></table><br /><p>Whilst some would say the house of vetmed has <i>always has been </i>rigged, I would add that is was, at one time not too long ago, centered on providing care that was utilitarian/agrarian based, not emotionally based. When that shift to companion based pet vs. food/livelihood based animals happened, and our four legged friends became bedfellows, the whole construct of vetmed shifted with it. Vetmed promoted, marketed, and richly profited from the elevation in pets status to highly valued <i>family </i>members. For an ever increasingly large section of humans our pets are truly the only thing we consider to be our children. We brought our critters inside our homes, gave them their own beds, and now we buy them their own gourmet food, sold by tv personalities, whose nutritional content often surpasses our chik-burger-plastic-wrapper-fast food convenient daily meals. Our pets have social media pages, monogrammed Christmas stockings, and matching family holiday outfits. We do not hide the fact that we spoil, spend and love them. We hug, kiss and fret over their happiness and health. We do not see them as property any longer. We see them as individuals we protect and advocate for. This whole pet based relationship has swung from livelihood based to heartfelt. This relationship with our pets, well, it became deeply, personally, and life-changingly, emotional. </p><p>Pets are, in many of my clients lives, (mine being no exception), the cornerstone to the joy in their day to day lives. We are so emotionally anchored to our pets that we will do anything to maintain their health as a reflection of the happiness they bring to us. There is no doubt that the loss of a pet hurts as much, and in many cases more than, the loss of many of the humans in our lives. We depend on them this much. As society grows more open via our handheld phone based computers and the endless flow of social content, we have become less social with humans and more satiated with our pets presence. Many of us went into vetmed, pet hoarding, animal rights/rescue/advocacy, back yard farming, and the like, to seek refuge from the harshness of people. Many of us just like animals better than people. People are painfully messy, and awkwardly sticky creatures whilst pets are perfectly ours.</p><p>The relationship we have with our pets is hugely impactful and elaborately delicate. This deeply adoring relationship has lead to a pet care market with ballooning revenues. Over the past two decades pet care based services have doubled to reach 5.8 billion dollars annually in the USA. This degree of growth has spawned a hailstorm of erupting opportunistic pet centered ventures. It has led to financial gains of which we have never witnessed before. When vetmed transitioned from veterinarians in muck boots over green coveralls with its after 2 am $50 field calls to look at downed cows in far off fields, to multi-million dollar practice owners working for shareholders dividends. With this the emotional well-being of patients and their people morphed into economically driven profit-mongering options. When money like this influences lives there are few exceptions to compassionate driven care. The practice will make money on your pet even if it is just in euthanizing them, again for a healthy profit. Lives are disposable, replaceable, property. Lives, no matter how impactful to the people anchoring the other end of the leash, are collateral damages. Vetmed has been reduced into heartbreaking too often economically based treatment decisions to protect profits. Pet care has gotten itself so profitable that the cloying underbelly has grown greedy, ugly and insatiable. As the cost of care continues to skyrocket upwards, (be mindful they are not done yet), it will continue to shatter countless more lives along the way. </p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1I7077QuKQ83Q511b3VAfK2sxTt9LfwO8zcKyctBGyEK3FjCKKqnEZ8JA-1UBh0qTO88BXZeM6vENJEBykdLWYbHqGeKIxPyC7p-R5QhCFcRIlWlhLE36iIUh8nDCK0fYCBghk2ddmIYuyWd2HkZaAFn1Ibo1wynrrsi7aa6jJSjuLV6-kNHXiqD85MM/s2016/IMG_0115.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1I7077QuKQ83Q511b3VAfK2sxTt9LfwO8zcKyctBGyEK3FjCKKqnEZ8JA-1UBh0qTO88BXZeM6vENJEBykdLWYbHqGeKIxPyC7p-R5QhCFcRIlWlhLE36iIUh8nDCK0fYCBghk2ddmIYuyWd2HkZaAFn1Ibo1wynrrsi7aa6jJSjuLV6-kNHXiqD85MM/w300-h400/IMG_0115.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Teddy.. and her dad,, who adores her</td></tr></tbody></table><p>The once single doctor practices have grown into large multi-doctor hospitals. It used to be that your vets face was the face of the mission and purpose of the practice. You knew them and they were approachable and accountable for your pets care. Today, many practices are owned by someone, or a board of someone's, you will never meet, nor even be told about. Today practices are sold in the dead of night to people who live in bank accounts of billionaires. Today your pet is an asset in someone else's portfolio to be traded, sold, or squeezed at their discretion. This is what property bears. </p><p>Many of the larger vetcare centers are being bought up by venture capitalists who now own much of the ER's and specialty clinics, (the really big money makers), which has created the foundation for a monopoly, (and been prosecuted for such), and escalated the cost of care in the process. The profession has lost its clients trust. We have lost the ability to communicate between the conflicts of property vs morality. And, we are unapologetic about our contributions to these dilemmas we have gotten ourselves into. Veterinarians are seeking never before conceived of compensation packages and being lured with multiple hundreds of thousands of dollars sign-on bonuses. We do so this a bravado that justifies as being "long overdue" without reflection on how this impacts our patients. To pay for these sign-on bonuses AND the formidable huge dividends the share holders require, the cost of everything they haven't conceded already has escalated to compensate. The latest, and not at all surprising escalation, is happening in the lab services department. Lab services is another way we can hide and escalate a cost and you won't know the difference, or be able to price shop elsewhere. The house is hungry, and the house needs more cash to keep the belly of the beast quiet. Lab services is that ever growing line items list after your pet is examined and before they are treated. Lab services in my veterinary hospital is the fat I trim to treat a patient before the finances are exhausted and economic euthanasia is the only affordable option left. Lab services is the BS the profession utilizes as "standard of care" to make our pockets deeper and your shame as a failed pet parent suffocating. </p><p>The new found profits of vetmed has led to advancements of diagnostic and treatment options. These benefit our clients and patients immensely. While we all share much of the same biology and physiological functions, we now share the same human based treatment options. There are truly no boundaries to what we can treat, or do, when it comes to our beloved pets. While this is miraculous to the desperate pet parent seeking novel care options it is an ethical black hole of queries conjured previously only for sci-fi movie plots. (Go watch Altered Carbon, Jurassic Park, The Island, or Google Top Clone Movies). Unfortunately, this fact has also gotten lost in the quest for profits. We don't talk to our clients to understand who they are, and what their pet means to them. We are medical centers of unbiased, automatons who deliver estimates on paper two and three pages long. We don't start at the clients wishes and hopes, we start at our most profitable. We do not practice best medicine, we practice stockholder strategies. We take people at their most vulnerable and we shame them into spending more than most of them can, without regard to all of the myriad of ways we can both help heal and give clients a way to afford the minimum diagnostics to make the treatable affordable. The whole premise for providing people assistance in navigating a medical dilemma is rigged and stacked in our favor. We know it, we refuse to admit it, and we profit egregiously from it. It is power than euthanizes without hesitation nor culpability. </p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhzYRSzAyZByh7q6VaO-Ms_d8FrzDuqjSTTyjYg6T2nSeYisZ0jnb0uOPAnCr2H_EaGep5tWOWPMFE1vazYuyooTsd3hofiw7nNyWZTR8sEiOgwRP3K4RuIdbH0bc3gg2dqMv4h_fUR9nZv11AYL3o-YUF4X1ztv_QIoYaJr0T-M1t6VMDKEjsKS8zTMZA/s1544/IMG_0111.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1544" data-original-width="1158" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhzYRSzAyZByh7q6VaO-Ms_d8FrzDuqjSTTyjYg6T2nSeYisZ0jnb0uOPAnCr2H_EaGep5tWOWPMFE1vazYuyooTsd3hofiw7nNyWZTR8sEiOgwRP3K4RuIdbH0bc3gg2dqMv4h_fUR9nZv11AYL3o-YUF4X1ztv_QIoYaJr0T-M1t6VMDKEjsKS8zTMZA/w300-h400/IMG_0111.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Pocket. All two pounds of her. Her mom is protective<br />and gushingly devoted.</td></tr></tbody></table><p>There isn't one veterinarian who wasn't taught to practice medicine via an understanding of a minimum database, and yet we are all collectively mute as a consortium so as to not tilt someone else's profitable apple cart as they try to make every patient visit as lucrative as possible. All in the name of "best practice." If our best practice is letting treatable pets die because we conveniently forgot to have open honest discussions at the collection of history and examination time, and not the long pregnant expectant pause of seeing if the client bites at the first (and let's be honest, always highest) estimate, then we are the problem regardless of how treatable the solution is. We must own this. In my opinion this is the fact that is killing us.</p><p>The house has you because you have nowhere else to go. The house also gets you at your most vulnerable for the most painful of all of the decisions you will have to make. Oh, and yes, we know you are out of your area of expertise, at the mercy of our prices, and without options to argue or negotiate (or at least you feel you are). I hear this over, and over, and over.</p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgjr8BvtEfAGXaJ_96_eBvSpAAA7naoagbRrCnxJamejkb250GVCz5I3iluLGRaDEZTFTbQDyqawPpv5Kex43Yy_5hNbf_mKoiKw8jPWFZIhqo9IK5bAhJ3VypBvEF3TAZaxS9QZk34sUnbgRoOn63KMu70uRbUNVIBtvbhklqRbwK1-hKqBV4nIHubAZk/s2016/IMG_0125.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgjr8BvtEfAGXaJ_96_eBvSpAAA7naoagbRrCnxJamejkb250GVCz5I3iluLGRaDEZTFTbQDyqawPpv5Kex43Yy_5hNbf_mKoiKw8jPWFZIhqo9IK5bAhJ3VypBvEF3TAZaxS9QZk34sUnbgRoOn63KMu70uRbUNVIBtvbhklqRbwK1-hKqBV4nIHubAZk/w300-h400/IMG_0125.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Birdie. My kitten who had to be quarantined for 4 months after her sibling tested positive for rabies.<br />How many of us would quarantine two kittens for four months while worrying about rabies?<br />The story <a href="https://kmdvm.blogspot.com/2023/01/kittens-and-rabies-my-n2.html">here</a>.</td></tr></tbody></table><br /><p>"It was midnight. My vet wasn't open. I didn't know what was wrong with my dog and I couldn't let her suffer until they opened the next morning. They took my dog to the back. They came out and gave me a paper with a dollar figure I was afraid might be the only way to save my pet. My head was spinning. I couldn't understand any of what they were saying. There seemed like no other options. I love my dog." </p><p><a href="https://www.youtube.com/channel/UCq7z_qtov_Al1dEEfjZt8iQ">My YouTube channel here</a>. </p><p>You can hear this example repeated by the thousands via the people who post on my YouTube channel, blog, or reach out to me directly. I know there are thousands more who have had the same experience. The house has you. You feel it, and you are so emotionally conflicted you cannot make sound decisions.</p><p>For all of these scenarios I ask two things; who did you talk to, and what did you sign? (More on this topic to come).</p><p>We, the collection of veterinarians who guard the gate to your pets access to veterinary care, will not permit passage without a price of admission that we see as suitable for the access to our healing hands. The house has the power. Your pets are still considered "property" under the law, and now that VC's are collecting record breaking revenues it's not going to concede or have a <i>conscious awakening</i> until the public forces their hands, challenges their intentions, or just plain old innovates a way out. It is the fundamental crux of every problem our patients suffer and die from. The house needs to start working in the patients favor, and that alone will be our collective salvation. </p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj8cGhSAk9IAL1cz-gAcxhP_4DzsxNQILgLj-GZS3k3oO7w6913i2PQMQGUNxtKSk_Rr1xGWd81VFRLi7TsjISvrk33fnYhTi8CMZQR9ZwLn3Jml__Kv4KYWkderDkGf-vxqculBB8ChvuIE9ePIHzT5dzRjg9nRrHSpsV9rJnIISEP6LC65Ymm4OzqgOM/s2016/IMG_9987.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj8cGhSAk9IAL1cz-gAcxhP_4DzsxNQILgLj-GZS3k3oO7w6913i2PQMQGUNxtKSk_Rr1xGWd81VFRLi7TsjISvrk33fnYhTi8CMZQR9ZwLn3Jml__Kv4KYWkderDkGf-vxqculBB8ChvuIE9ePIHzT5dzRjg9nRrHSpsV9rJnIISEP6LC65Ymm4OzqgOM/w300-h400/IMG_9987.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Mavis and her mom. Didn't every vet go into vetmed <a href="https://kmdvm.blogspot.com/2013/01/the-heart-of-first-grader.html">because we were this kind of kid?</a><br /><br /></td></tr></tbody></table><p>While the rest of the fringes of our profession taut insurance, third party billing, pet care wellness plans, low cost spay-neuter-vaccine clinics, and the transition of for profit to no profit as being the answer I will stand here firmly on my 20 years of private practice ownership and tell you that every time you think you alleviate one part of the dilemma another part shifts away from affordable while it drags accessibility with it. The system is rigged. It will remain this way as long as three things remain in place;</p><p>1. Pets are considered property. </p><p>2. Pet care does not need to be open or transparent in its pricing. This is protected by every state veterinary medical board. What they fail to protect consumers in is their availability to be given options outside of the ER at 2 am. Someone should be addressing this.. see Pawbly.com</p><p>3. People in society continue to be as hateful, divisive and uncompassionate as we have become. The greater the divide in our empathy for one another the more we will turn to our pets for emotional refuge. We all are pet loving people. It is time to remind ourselves this.</p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgo6G3QV3qzD356ohn4Bf0zvxLNXMsiWsjsmC_y6VwYASm9_IP01KhUaK_CsppMwK4Mdwu6kYfHWZI4CGlv0QqrSEJbqPYSzzGGZcbf04kNoIfpleofLvF-WAKb_pQWF8xoWkX5_HIsHU-UMGOVSNGd1gle4X4DpmnnsfFm2c_SIcwVBdpGLYHRqKpWWpA/s2016/IMG_9982.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1512" data-original-width="2016" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgo6G3QV3qzD356ohn4Bf0zvxLNXMsiWsjsmC_y6VwYASm9_IP01KhUaK_CsppMwK4Mdwu6kYfHWZI4CGlv0QqrSEJbqPYSzzGGZcbf04kNoIfpleofLvF-WAKb_pQWF8xoWkX5_HIsHU-UMGOVSNGd1gle4X4DpmnnsfFm2c_SIcwVBdpGLYHRqKpWWpA/w400-h300/IMG_9982.jpg" width="400" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">This girl was the first girl who required a whole lifetime of my courage to intervene on her behalf.<br />Courage only matters when the cost calculation requires you to put someone else first.<br />Here's to all of the other <a href="https://kmdvm.blogspot.com/2011/11/sadies-3-pelvic-fractures-and-still.html">Sadie's</a> out there who never get what they need because a veterinarian isn't brave enough to put there license where their mouth is.</td></tr></tbody></table><br /><p>While I will not argue that vaccinations and spaying/neutering are not vital to preserving your pets health, I need to remind you that the care you receive in a well, young healthy state are not the things that are likely to cause you to be forced to chose euthanasia as the only economically feasible treatment option available to you at 2 am. As the cost of care climbs into the stratosphere where only private billionaire rockets can take you there will only be three options left;</p><p>1. People elect euthanasia because it seems the only affordable option available and we need to feel good about giving up by labeling it "ending suffering". (Please see my article on the Power Of Consent below).</p><p>2. As the vetmed sector grows profitable it attracts investors. Investors are about one thing, profits. When you tilt the service of care into profits there is shrinking margins for compassion. Where one revenue stream drives up (pharmacy, food, preventatives) another is exploited, today lab services, tomorrow surgical intervention/specialties. </p><p>3. People get their hearts shattered by the system that holds their emotional glue together and in its grip, and they never get another pet again. The damage has been done to the point of extinction.</p><p>There are often numerous low cost options for the lowest hanging fruit at affordable and even accessible costs, (spay/neuter clinics and vaccine clinics.. all high volume and therefore competition based low cost), but you pay for that with the loss of something you will need far more down the line like that emergency 2 am pyometra surgery. That cost has gone from expensive ($1500-$2,500 a decade ago to $18,000 at one clinic I saw).</p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj8212_pHqD2Wf8uTAmfDmC5v-xlllAgroTUVZwWbUQBhrgVOMttQrn-YFawumiqAUasjhKy9i4jvn5v65OXboIfHutku41iiLUCzXGR5edHpHRLUlXwa_233kbXfoPMkkdrhwI6DAUyujPFNuog9IQYcPR4tn-JDHiLbJzbm1GQzh9vY3kDKjqJsD_3l8/s2016/IMG_0099.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj8212_pHqD2Wf8uTAmfDmC5v-xlllAgroTUVZwWbUQBhrgVOMttQrn-YFawumiqAUasjhKy9i4jvn5v65OXboIfHutku41iiLUCzXGR5edHpHRLUlXwa_233kbXfoPMkkdrhwI6DAUyujPFNuog9IQYcPR4tn-JDHiLbJzbm1GQzh9vY3kDKjqJsD_3l8/w300-h400/IMG_0099.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;"><a href="https://fb.watch/nvW0pDv0ar/">Tilly</a> after her spay. She was surrendered because she had four blind puppies. <br />Her breeder gave her up when she was no longer profitable.<br />She deserves better, she will get it. We will make sure of that.</td></tr></tbody></table><br /><p>In the last decade the veterinarians have lost two key pieces of our revenue pie. We lost our solitary foothold on in clinic prescription medications and preventatives to the likes of 1-800-online and then food to chew-on-me and I'll send you a painting when your pet dies, who can provide these at lower cost and still never have to go to vet school. Vets conceded an easy 30% of our revenue stream to innovators outside of our profession. Over this time a cascade of vet care specialists blossomed. For the benefit of our patients many once in clinic services are now farmed out to vet specialists; think cardiology, neurology, surgery, dermatology, and general practitioners have lost another big money piece of the pie. </p><p>There is a lot of self-justifying puling these days on the vet forums. They all too often are intended for the clients we have failed, and, therefore are likely falling on deaf ears. We have tried to seek empathy for our suicide statistics. Others beg for understanding wrt our over crowded exam rooms and appointment scheduling access. A few spew a banter to remind parents that "pets are a responsibility/privilege, not a right." Which is my personal favorite. I feel it is quite likely the most obnoxiously hateful based arrogance ever muttered. We love animals as much as our clients do. Why would we ever use that as fuel? Now there is an article being circulated to compare the cost of a human knee surgery to a dogs. Can we reiterate the cost of medical liability, lifespan, and macrophagic greed going on with our counterparts on the human side? Why are we so intent on justifying costs when we have boatloads of data that support the fact that if you want to call property "property" (i.e. limited liability and we can all dispose of our pets anytime we want to, which vets will defend until their dying breath). It is not a valid comparison for so many reasons I feel we are ever obvious entitled morons to share it. If any of us can remember that we are all here to "solemnly swear to use my scientific knowledge and skills for the benefit of society, through the protection of animal health and welfare, the prevention and relief of animal suffering," then why has it all become about how much money we make and not how can we help each other. They are not ever going to be anything but mutually vital for the other half to survive.</p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjE9WTQ3XD84iI2gb4OLVFvVxzNFqlIYCHX5l5RedV5VR_fcRSD9byZVCb9Yg32LWvY1ww-VyJBZbLTm2bPZOTHpyu2W8nrL3VxWYovf_tzJKkNDAt2tqcCQNsfBdR2ztiBKsyaoqGVRlYIfkJz1t4yOio2IXnzV_q55zPhN_aj_zIeeORpKFL4rUmpd80/s700/IMG_9970.JPG" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="493" data-original-width="700" height="281" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjE9WTQ3XD84iI2gb4OLVFvVxzNFqlIYCHX5l5RedV5VR_fcRSD9byZVCb9Yg32LWvY1ww-VyJBZbLTm2bPZOTHpyu2W8nrL3VxWYovf_tzJKkNDAt2tqcCQNsfBdR2ztiBKsyaoqGVRlYIfkJz1t4yOio2IXnzV_q55zPhN_aj_zIeeORpKFL4rUmpd80/w400-h281/IMG_9970.JPG" width="400" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Holy crap the degree to which I can pick this apart.. 🙄</td></tr></tbody></table><br /><p>Here's what you can do to have some tipping of the cards in your favor; </p><p>Know who owns the practice. This includes your primary care provider, your local ER, and the specialists you are sent to. If the same group owns the whole lot you should be very concerned about how much you are paying for everything you are recommended. Do you routinely get sent somewhere else for services, especially surgeries? It is not an uncommon practice to have your vaccines and the other most very basic services done at the primary care facility and everything else referred. What is the cost difference for a simple mass removal (and the majority are very simple) done at a private practices office and one been done at a specialty referral surgical facility (hint; about $2,000, or more). If every single pet loving parent walked out of the corporate owned practices the landscape would shift dramatically. For every pet parent who says "I stayed because I like my vet," I need you to ask them what they can do for you when the cost of your emergency care, mass removal care, enucleation, splenectomy, etc is soo astronomically high you have to euthanize your pet. If they say get pet insurance because I like my sign-on bonus more than I like saving savable lives, leave. Being loyal shouldn't mean having your heart broken when you realize your vet isn't on your pets side when it really counts. </p><p>Wellness plans are also stacked in the houses favor. Ask about a Pet Savings Plan that is yours to use where you want it. My clinic offers one through <a href="http://VetBilling.com">VetBilling.com</a>. Its yours for your pets care, I don't care where you need it.</p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgmU1T-FdF2bRxzXJVG6_KEy1RMbEhbKKapyV1LSfoGdR4spV7cPFl2vpey-6E6GELNGPjTtBjl9np_eppYYuKQjan1rGK2ophm_-lCsRg6zEP3ZjSrj0Mvu4DD4uyDIKGAvDArB7mH-z1xnyjw_5WXNy8TFlpdPEhJqLyWg4L6kq2-U8m70N11ZpFWPDg/s2016/IMG_9975.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgmU1T-FdF2bRxzXJVG6_KEy1RMbEhbKKapyV1LSfoGdR4spV7cPFl2vpey-6E6GELNGPjTtBjl9np_eppYYuKQjan1rGK2ophm_-lCsRg6zEP3ZjSrj0Mvu4DD4uyDIKGAvDArB7mH-z1xnyjw_5WXNy8TFlpdPEhJqLyWg4L6kq2-U8m70N11ZpFWPDg/w300-h400/IMG_9975.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Three years after the original 52 cats from the hoarding situation we helped with we still have reminders of what giving more than anyone expects can bring you.<br />More on this <a href="https://kmdvm.blogspot.com/2022/02/the-measure.html">here</a>.</td></tr></tbody></table><br /><p>I truly believe that good veterinary medicine is about saving lives, not making economic decisions because our student debt is so high and our sign-on bonuses were so grand. The problem does not reside in lack of insurance, lack of empathy for our off shore private vet school debt, our knee surgery costs comparisons, or our lacking reciprocal empathy for how hard our lives are while making shareholders millions of dollars in dividends, but simply in not reducing a treatable life to a replacement value chattel. We are the house. The house owes its residents the oath we took so many years ago.</p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiYCHhXjEKmNPMc2RPBZOycAhkgsMRwwcglegpHv3kelgGZVyBRLZrwcKXMptmMfbVMSuaKpHdOlls2gMn7usFenLzWVnymgdQkIl7zHz8ZqMIHTBUPZdPV4LiMcn_Eu2KdDBM7GSKKRxmDvSnwrgYx439fWlOitSPOGlvXsE3rWU3ixWydjMlcxO6bw_g/s2016/IMG_0096.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiYCHhXjEKmNPMc2RPBZOycAhkgsMRwwcglegpHv3kelgGZVyBRLZrwcKXMptmMfbVMSuaKpHdOlls2gMn7usFenLzWVnymgdQkIl7zHz8ZqMIHTBUPZdPV4LiMcn_Eu2KdDBM7GSKKRxmDvSnwrgYx439fWlOitSPOGlvXsE3rWU3ixWydjMlcxO6bw_g/w300-h400/IMG_0096.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">I am so proud of who we are, and how much we give back.<br />We are a culture, a mission and we do well by doing good.<br />We are the heart of vetmed.</td></tr></tbody></table><br /><p>P.S. If you would like to have a better understanding of the cost of common lab services please see Pawbly Storylines section. Go to Pawbly.com Storylines.</p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgbn3qs2Yw-ih2RmeWADnPAqJXr1hSw5Breda6PefbAW1u6D2cfshf5K_7nWZ5JLe6haLjtiy9gS_2LcyafgccMLnZdzli56JRSGsQpCt150iAodKHprG_ogMHaYTmZUVzFeCpIxAZNyqlGJKt2U4Ickgsqa7FgorRFBCgjlIufvuzXS6udTwdudbMD06I/s2016/IMG_0057.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgbn3qs2Yw-ih2RmeWADnPAqJXr1hSw5Breda6PefbAW1u6D2cfshf5K_7nWZ5JLe6haLjtiy9gS_2LcyafgccMLnZdzli56JRSGsQpCt150iAodKHprG_ogMHaYTmZUVzFeCpIxAZNyqlGJKt2U4Ickgsqa7FgorRFBCgjlIufvuzXS6udTwdudbMD06I/w300-h400/IMG_0057.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Jasmine gets a hug after her spay.<br />Every pet here at JVC is family.</td></tr></tbody></table><br /><p>Upcoming topics to discuss: </p><p></p><ul style="text-align: left;"><li>Social workers in vetmed. When the emotional turmoil is so high you don't know what to do. When the emotions get soo overwhelming your adrenaline kicks in. When the system that is supposed to care doesn't you need a friend/ally on the inside to help you. For this reason some hospitals have started to follow the human hospital infrastructure plan and employ a social worker. Someone to help guide your emotional journey without the medical or financial interference and influence. </li><li>The spawning of "Zero Tolerance" has grown into our new veterinary fight song. Seems everywhere we go in the world these days there is friction. Animosity is borne of broken hopes and unrealized promises.</li><li>What are some of the costs of veterinary care in my private practice?</li><li>What are some of the items you need to ask your vet at your next visit?</li></ul><div>What are your thoughts? I would love to hear them. Email me at krista@pawbly.com</div><div><br /></div><div>P.S. because every time I post one of these I need to add a disclaimer. All comments are posted after approval, and all hate mail posts get posted, or reported. </div><div><br /></div><div>If you are a veterinary professional and you don't understand how big the divide is, and how harmful our actions have become please read the comments on my YouTube channel. I have been practicing for almost 20 years. I have never denied care based on cost. While I stand a very strong line on serving my patients above all else I do so with 100% transparency and all options on the table at every single visit. I also do not allow any unkind behaviors towards anyone; patients, staff, clients. This is the ranking in which we serve. Please see my other blogs,, and P.S.S. this blog is appropriately titled. I am an open book,, its not always picture-perfect.</div><p></p>krista magnifico, DVMhttp://www.blogger.com/profile/15133566329579911573noreply@blogger.com1tag:blogger.com,1999:blog-4667516629745731439.post-88506393645369164612023-08-27T07:16:00.000-07:002023-08-27T07:16:00.902-07:00The Problem and The Compulsion<p>I have had this conversation a thousand times before.</p><p>A thousand times I have explained the same problem, the same outcomes, the current state of our profession, and the same desperate passionate plea to provide better for the sake of all living things.</p><p>With each plea for help, pitch for the solution, and nodding heads of understanding, the problem remains here at my feet grinning. </p><p>The problem sits, consumes and grows.</p><p>Problems this big, the kind of big that swallows lives and breaks hearts, can define a life. </p><p>I may have come to vetmed to save pets lives, but this profession is more than practicing medicine, it is about protecting and saving lives. When I can't do this it's a big problem. This problem has gripped my life's work and taken it into a place I never thought I would become so compelled and stuck within.</p><p>What do you do with a problem that allows suffering, denies culpability and consumes as it festers? Well, I guess if I am me I dig in. </p><p>I am now companions with my problem. My problem has become my compulsion. As compelled as I was to become an adult and leave the shadows of a small existence in an even smaller northern town. Compelled to be unburdened by the confines of a family fleeing a city that left them feeling monitored and microscopic. To the girl who I once was compelled to find a bigger life with a chance at freedom to the cost of a uniform. To be compelled to go to sea for a decade to buy your second chance elsewhere. Compelled to fight and outlast the years it took to get into veterinary school and quench that little girls soul still alive inside her and be the Herriott she heralded. I am compelled to do this too. Shake the ground so hard that the tallest tress tremble and the smallest beings benefit. Just like all of these before I will not stop until this to is notched in my belt and a little piece of kindness is given back to those who never formed the language to ask.</p><p>Here's the pitch, (for the one-thousandth-plus time), in small bites;</p><p><b>"The house is ALWAYS stacked against you."</b> Whatever veterinary clinic you walk into, (and for my analogy: any casino), they have the upper hand, almost all of the control, and very little, (if not intentionally absent), motivation to provide you all of the options available to you and your pet and no upfront transparency to allow you to be prepared, informed or flexible once you walk in their door. I used to hope that moral fortitude, ethical foundations, and our own soul-filled desire to make a difference within the profession we were all so passionate about might motivate a righting of the compass, but it appears the gap grows ever wider and the despair ever deeper. </p><p>"There are so few governing rules in veterinary medicine that it has allowed the single minded behemoths to eat up the landscape for profits without limitations." If you work in a profession that is being acquired by venture capitalists there is a dollar figure so alluring you take notice. Why is it happening so quickly in veterinary medicine? Money. Just money. We are perfectly positioned to be so lucrative the vultures are eating us up in record numbers in record time. Here's the facts that allow vetmed to be so profitable. For many people our pets are our reasons for everything. Price is not set by, nor limited, nor overseen, nor fixed, nor ceilinged, for anything from anyone at anytime. We, the profession, the individual and the facility, can charge anything we want for anything you need/want. The reason; well pets are property, and the market will bear what costs are, until it's 2 am and your pet is dying and you have no other options, AND, no one publishes their prices. Consumers don't ask, don't know, and don't have the ability to query costs before, nor, negotiate during a pet visit. You are a victim to an establishment that now has you hostage, and we know it. How does that feel when your pet is dying, sick, and you are both at the mercy of someone just out to make money? The house is ALWAYS stacked against you. And no, you shouldn't trust us. We don't work for us, or you, or pets anymore.</p><p>What is the price you put on your pets head? Maybe its not a question you have ever had to ask yourself but be warned it is the only question the VC's in this arena care about. If they think you will spend $20,000 for a pyometra that's what they ask. How many of you have access to that at 2 am? How many of you couldn't afford this and will have only one other option given to you; euthanasia. </p><p>The system is getting worse as the money gets fatter cats, fatter. Ask your vet if they work for a corporately owned VC? Ask them if they received a sign-on bonus? What if that sign-on bonus was $250,000? Who do you think is going to pay for that? How much is the price on your pets head worth? How else can those sign-on bonuses be paid? I promise it isn't coming out of the fat-cat at the top of the food chain who owns the place, and btw has zero interest, nor experience, nor knowledge of any aspect of vetmed other than its profitability.</p><p>So, now that you understand the money, let's talk about the other thing the house has on its side; <b>liability</b>.</p><p>Liability is managed in CYA documentation. We are very good at this. We are, after all now owned by the fat-cats with the fat-cat lawyers. Although the single veterinary practitioners liability insurance hasn't met any other kind of human medical malpractice comparison, we pay hundreds, they pay tens of thousands, when we start to ask $20,000 for a pyo, (remember pets are property, we only need to provide "replacement" value) it might be time to change the valuation of our culpability. </p><p>Are you beginning to believe that the house has this gig rigged yet?</p><p>Let's talk about signing documents? Are we the only profession in the world that has customers sign something AND NOT GIVE THEM A COPY IMMEDIATELY? Why is that? And why can't clients turn the table on this practice? Why aren't we providing guidance to save lives instead of practicing a professional skill to avoid liability while we with hold access and options? (More on this via Pawbly.com soon).</p><p>Here are some of the stories I get sent every day. (Find all of them on my YouTube channel and Pawbly.com)</p><p>From my friend;</p><p>"My cat was a diabetic. He was having some kind of crisis and needed emergency surgery? Our $5,000 walk-in deposit went to $10,000 within a few hours. We didn't have the $5,000 and we certainly couldn't pay the $10,000." I knew what was coming next. Yes, they euthanized."</p><p>What the actual,,,, I have never had a emergent diabetic case that needed surgery. And every, (yes people EVERY) case has options. Like, let's start with insulin and fluids. Basic medicine every vet was taught. We don't practice affordable care because it is not maximum-profits care.</p><p>The practice owner I met last week at the veterinary career fair summed it up perfectly. "It is our job to offer best practice care (i.e. most profitable) and if they cannot afford that, then we offer other options." Sounds kind of unfair to you, the consumer, doesn't it? </p><p>To the weekly requests I receive to unblock a cat, look for a nasopharyngeal polyp, or save a pyometra (all of these cases are given with real-life pets on my YouTube channel) for a tiny fraction of the costs being given elsewhere, I have to remind myself that I am not alone. I cannot fight for all of these pets, provide all of these services alone. And so my war with the current state of vetmed wages on. </p><p>Unblock cat <a href="https://www.youtube.com/watch?v=KrgPTvOPTH8&t=198s">here</a>.</p><p>Cat with polyp case <a href="https://www.youtube.com/watch?v=RCRwkQXd3Qs&t=18s">here</a>. And <a href="https://kmdvm.blogspot.com/2018/12/speechless-screaming-into-vacuum.html">here</a>.</p><p>Pyometra <a href="https://www.youtube.com/watch?v=7CBoMgtizwc&t=82s">here</a>.</p><p>For those of you who don't care, maybe you think you are sheltered? Some of you are. Some of you have a great vet who you know and care about, and, who you believe cares about you too. Some of us are still out here working for ourselves. Putting our own reputation and shingle on the line. We are affordable because we care about you AND your pet. We value what we always have; being a trusted part of our community. We care about lives, legacies, and ethical traditional vetmed values. But what will happen when we leave, or retire, or die? What will happen to you and your pet when we have to decide what the future holds for our clinics? What happens when its 2 am, we are closed and you need help from someone else? What do you think your vet will do for you when you are at the front door of the fat-cat clinic? Ask them? Don't wait until you find out in real-time with a real emergency.</p><p>Go back to rule number 1. <b>The house always wins</b>. When your pet needs something, critically needs something you will very quickly be reminded that pets are now a luxury for the rich. No longer the middle class, but the rich. Rich people seek other rich people to get richer,, they don't apologize for this. When I started in vetmed in the 80's an exploratory surgery, let's say for a corncob stuck in the intestines, was about $300. Ten years ago it climbed to about $1,000 to $1,500. Five years ago $4,000. Today, at almost every specialty, and some ER's it is $10,000. How many people can afford this? What happens when a corn cob isn't removed? Your pet dies. Dying of a treatable condition used to be far less common because veterinarians had obligations they took personal responsibility. We had our own practice to protect. We were a part of our community and word would get around fast if we failed to help, failed to provide care, or even worse if we failed to provide an affordable service. </p><p>the easiest thing for you to do, and the way the house insures its victory, is by you giving up. Once you sign that euthanasia form, it is over. You have conceded all and given permission. I know, and I do believe that there is no greater gift then ending suffering kindly, but, how many pets are given up on because vet med has made any other outcome impossible? There is a war coming to vetmed. There will be enough people forced to abandon the one being they love more than anything this world holds and the war will be for them. There is a class action lawsuit that will follow, and with this a littany of others will follow. People will have their voices heard and this profession will have the first righting forced upon them after never have had one before. </p><p>Property. As the legal liberties are awarded, and the price points become both transparent, publicly provided, and openly traded services will provide some degree of stability and fairness. Does the profession want to lose the legal status of pets being property? No. With this definition there is a limit to liability we face when clients seek compensation for damages. But, the classification of property </p><p>ways to escape being a victim;</p><p>independent practices. find, meet and ask the owner what you can do, or need to do, to be cared for. P.S. "get insurance" should not be, and cannot be, the only answer.</p><p>This profession has wounds that run deep. We have apologies to be spoken, and we have a path that cannot continue at the pace and prices we are requesting.</p><p>I have been a veterinarian for almost 20 years. I have seen every kind of case with every kind of pet parent behind it. Very, very few are without hope nor options. I have also owned a practice for almost all of this time. Are the prices skyrocketing into exorbitant? Yes, they already have. Are there veterinarians and owners out there profiting without remorse? Absolutely. When you live in a place that loves money more than life, profits more than </p><p>Be very careful what you wish for? Want to be the one-and-only decision maker for your pet? Then they are property. Want to have every treatment option available for the most beloved being in your life? Better have deep pockets and instant availability for those dollars. Want to be insulated from heartbreak because your love for your pet leaves you vulnerable? Just remember that the person who decides whether or not your pet gets the care they need has a limitless ceiling and you are at the ends of their strings. They give you care based on two things; your ability to pay, and their willingness to help you. Thats it. Feeling like a your pet is a pawn in a venture capitalists portfolio? They are. Welcome to my problem. I suggest you get pissed enough to do something about it before you get screwed and have your heart broken over the loss of your treatable companion.</p><p>And maybe think about the price on your pets head before it's 2 am and you have to consider it, and start demanding a change now. The divide between need and access is getting wider and the </p><p><br /></p><p>Here's what's ahead;</p><p>its time to put liability CYA paperwork in pet parents hands.</p><p>its time that pet parents be given all of the options, with written line item estimates, before a deposit is given.</p><p>its time for transparency;</p><p>its time to publish who owns the clinic you are at.</p><p>who was given a sign-on bonus that might have influenced the price on your pets head.</p><p>its time to publish average costs of care before a pet parent drives to your facility at 2 am.</p><p>its time for accountability outside of the faces of the veterinarians who are already emotionally bankrupt and emotionally unwell.</p><p>its time for the public to re-think the laws that dictate the unconditionally loving, uniquely beloved soul sleeping/purring next you in bed every night as disposable/replaceable property.</p><p>it's time to compel the house to meet your needs and standards and put them out of business before they bankrupt your ability to love your pet.</p>krista magnifico, DVMhttp://www.blogger.com/profile/15133566329579911573noreply@blogger.com1tag:blogger.com,1999:blog-4667516629745731439.post-73426980855398918452023-08-26T12:41:00.002-07:002023-08-26T12:41:48.940-07:00The Hardest Days.<p>The hardest days are lived in snapshots.</p><p>Frozen moments of the day that solidify, remain indelible, and scar. </p><p>I have collected mountains of them. Held them in my arms like a clutch of kittens too fragile to walk away from and too demanding to dismiss. I know they are the villains to my story that makes the read worthwhile, but when away and alone I sit and wonder if I need to be so burdened by them. How can I extract the color without bleaching the meaning they must hold for me to carry them for so long?</p><p>The past few weeks have been vibrant and jarring. The color that propels heartrates into arrythmias.</p><p>I live within the proverb; <i><b>intentions matter</b></i>. I also suffocate screaming for merciful reprieve because these two words are so impactful. Within these <i>intentions</i> you are left to question motives at every movement. Veterinary medicine is a quagmire of bipolar extremes. Emotionally charged, diabolically opposing, with violently swinging requests of the pet care spectrum you often cannot foresee. What gives a family the gift of a graceful, peaceful passage, also leaves the other owner with a disposable/replaceable burden they simply want eradicated. The purveyor of these passings is too often given a heavy burden. Or, what one family wants and will fight for another will dispose of without whim or wait. I have been bullied, berated and threatened for caring too much, and too little. Never have I euthanized a treatable pet without fighting to give them every chance, at no cost, which somehow vilified me even more. I have been dumped for an easier practitioner who works on an upfront-pay-and-I'll-remain-mute basis because I dared to open my mouth to attempt to defend a pets life. I have been threatened when I refused to be a part of a pets undoing unjustly. And with each I remind myself "that no good deed" often comes with punishment, however unintended, and unwarranted. I have also come to realize that a dignified end of life death is often a merciful act. But, dare I try to be the inspector of this intention, question the reason, and the tables will swiftly turn from humble request to angry accusations. How is it my place, my duty, and my obligation to question who dies and when? </p><p>I am often asked if euthanasia's are the toughest part of my job, (I have written about this before), and no, when I am being asked this it is always at the hand of someone who loves so deeply they see beyond themselves. A euthanasia request for a pet that hasn't seen a vet in years and is suffering from a treatable condition they still don't want to try to treat, yeah, that's soul-sucking. A euthanasia request because it's cheaper to buy a new one than deal with the old one, yeah, that's a cancer you never recover from. This is my life. The one I chose. The one I fought so hard for.</p><p>For the pet owner (emphasis on <i>owner</i> for this is the only title that provides such privilege), the mere perception that I would ever question their intentions or motives can/has unleashed raw anger and threats of questioning your own compassionate humanity. On the flip side there are so many euthanasia's I have declined for fearing my thinly skinned heart could not bear witness, nor survivors remorse, from the act. I believe that for almost all of us veterinarians our internal parting words for excusing these acts, even when we cannot understand, nor agree with the motive(s), are; "if not us, who?" For within these requests there is always a pet, this piece of property, that will be/can be abandoned, tortured, hurt, or dropped to be surrendered at the shelter for the same request. If an owner wants it to be done, it will be done. Just as all property can be disposed of. No law, shame, or unjust reason will change this. So it happens, almost always, that these pets can leave by my hand with me telling them softly that they mattered and they are seen. I, in every goodbye, steal a moment for myself to say that they are everything that holds value and they are loved. I can at least always give them that. And then pardon myself in silent solidarity later. </p><p>Euthanasia, in vetmed is the Medusa of intentions. I am the Master of my own acceptance that I am confident in my own intentions, I will never be everything to everyone. I have grown into an adult who rarely cares anymore if I am liked. I am not mute and I insist on this being married to my intentions.</p><p>This week brought us two families who tragically had to say goodbye to two pets within the same day, two days apart. When I admit that this has never happened before in my 18 years of practice I cannot believe it happened two days in a row. How is it that luck never translates to lottery tickets? I had been asked if I would do both dogs at the same visit? A way to condense the pain into a more efficient way to let one dog say goodbye to the other before we said goodbye to him? Thankfully we both agreed this would be too difficult on our hearts.</p><p>I have done double euthanasia's on two other occasions. Both were excruciating. After each I promised myself I wouldn't/couldn't do this again. The grief around these always leaves me reeling. I feel twisted in my intentions, and guilty in considering to deny it. How can I be a veterinarian who knows there needs to an end to a suffering we cannot avoid, and not feel a stab of feeling selfish within considering how to address and face this request. Euthanasia's however hard, can't ever be about me I reminded my inner gooey-yolk of a heart.</p><p>The first double euthanasia was two old black labs. They were 13 years old brothers, struggling to remain ambulatory. They had great difficulty getting up and walking more than a few steps without collapsing in pain. They lived on a sprawling, verdant bucolic farm and their quality of life was significantly impacted. The owner was not able to get one of them in the car, never mind two, so I agreed to come to the house. When I arrived they saw me approaching, and as if by some divine interventional miracle managed enough energy to get up from the front porch and run a half a mile in different directions. I followed the slower one to the west, sunset in my eyes, dragging my medical bag to the edge of the property to find him solo. I knew then that I had made a significant rookie mistake; coming alone, agreeing to do this in the first place and a massive miscalculation on time, ability to drag a deceased 80 pound dog back to the house and then repeat the process on the other. I too had not planned for how I was going to get them into my car. (Have we ever talked about the physics of dead weight being much heavier than alive? Someone has to have done a research paper on this?). The logistics, inability to walk so far, bring dogs back from so far and the emotional turmoil about how to make this horrible day less horrible for a pet parent who couldn't/wouldn't help me with this was traumatizing to all of us. Pets, all animals, all living beings, seem to sense goodbyes, and regardless of how warranted they are, they react. The reserve of adrenaline to preserve their life defies all diagnostics and prognostic indicators. The primitive call to get up and run even when you know you are no longer viable to evade allows bodies to defy biology and physiology. I can tell myself every moment of my professional, and personal life that I am here to relieve suffering, but yes, the desperate plea of those pitifully sad eyes looking at you as you send them away can hurt so bad you cannot find solace in the present, nor your intentions.</p><p>The second double pet euthanasia was a long time client who battled a many-years long breast cancer battle. When she went into remission after a year of treatment she bought herself a Corgi puppy. She had set that as her accomplishment prize and she wanted to be well enough to take on another Corgi. Her original Corgi was about 3 years old by now. Young enough for a sibling and sweet enough to allow one without bitterness or jealousy. She wanted to be sure she would be well enough to care for both of them. Almost 8 years passed and her battle reappeared and raged again. In a matter of a few short months she lost all of her body weight, her hair and her spicy wit. When she elected hospice her last wish was for her dogs to be with her in her casket. She made an appointment with me to ask me if I would be there for her in this request as I had been there with her in all of the rest of her pets lives. I struggled with this request so deeply and profoundly that it almost broke me. Truly, it was the single most wrenching thing to be asked. I was this woman's trusted veterinarian for almost 12 years. She valued my compassionate care for her dogs, and knew that I cared for her as I cared for them. We had been a team for all that was our lives with her most beloved companions and she had one more request for me to assist her with. She wanted the four of us to be together to say goodbye to her dogs that she could no longer take care of. I spent hours almost begging her to see if we could find them a place to go together. She was convinced that they would be neglected, mistreated, or unable to build a new life without her. She wanted to be present at their departure and she wanted them to be with her as she was laid to rest. It was one of the most emotionally gutting moments. How do I put all of my love, attention and energy into one euthanasia and then within moments try to muster it all genuinely for the other? I had flashbacks of being at the county shelter where the pets would be lined up as if in a genocide to clear the cages. One, after another, after another, Void of the dignity that ending a life turned into out right killing should be made of. It was the longest, most brutal, most conflicting experience. A few months later their mom passed away at home from metastatic breast cancer, I hope they are all together on a couch feeling like their family of love has enough belly rubs and wiggle-butt endearments to make the after life as magnificent as we all hope it to be.</p><p>These last weeks I have averaged about 3 euthanasia's a day. We joke that euthanasia requests always uptick in the days before major holidays, (Thanksgiving for the win), with all of the family arriving and the incontinent pet being the main incentive. Or the days before Summer vacation departure when you cannot come to terms with the emotional trauma of leaving a sick pet in someone else's care, or the inner turmoil of cancelling the trip because you expected they wouldn't have lived this long when you booked it 6-8 months ago. Or the back to school chaos and the days that you have to go back to work, the kids will be away all day and the luxury of constant care via Summers timetable. </p><p>Last week a very old, very poorly looking lab came calling for help. She could barely walk or lift her head. She was labored, exhausted and sporting a severely distended belly of fluid. Within a few minutes I had confirmed what my fears told me. She was bleeding internally and there were only two options and a stopwatch timer to decide them within. She was dying in front of us and we either needed to get her on the surgery table immediately or euthanasize her now before she died imminently.</p><p>The response is universally the same. A tidal wave of tears, and a few moments to talk amongst the family to decide. They decided to let her go but only after they called the kids to come say goodbye. What ensued was two girls under age 6 bawling and screaming in agonal grief. The girls insisted on being present, a decision I feel very strongly is not theirs to decide, and subsequent hatred toward the veterinarian who was "killing" their dog. I was yelled at, thrown fists at, and made to feel like the most horrible human on the planet, which to this day, and likely every day of their lives I will be referred to as. How else can they process their heart break? How would I have been any different at their age? Why do we have to let our little kids see things that aren't going to be anything other than devastatingly painful?</p><p>And why do my shoulders have to be so broad as my heart grows so hypertrophied, thin, big and bulging with the responsibility I cannot always accept as kind?</p><p>Why if I am so convinced about the inherent holiness of my intentions do my convictions question my motives?</p><p><br /></p><p>Ok, I know this one was a tough one,, so for all of us who need a reminder.,,, Here are some photos of my week and why I still love being who I am and doing what I do,, and how often one bleeds its color into the other,,, my ombre life.</p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiL0639m-SkyqIFeqRy8NSAf5d-cr-71l1mKMTbNST7I0rTBwK4P96rvnbOCg35bmkkPw7LQji9C49b-pEC5ynjMWbgl6a5xXNL-ke-dJeN5FR8Eqpbbss5p0cQ-_rHVk0cTNnYHKNZbww93YtZtPYpC9feaZhydqy0aPPo5XSp1-c29WcZvCkQmEOAQO0/s4032/71451567395__39F7604E-F352-4A94-86D3-C9DAEB1981E7.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="4032" data-original-width="3024" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiL0639m-SkyqIFeqRy8NSAf5d-cr-71l1mKMTbNST7I0rTBwK4P96rvnbOCg35bmkkPw7LQji9C49b-pEC5ynjMWbgl6a5xXNL-ke-dJeN5FR8Eqpbbss5p0cQ-_rHVk0cTNnYHKNZbww93YtZtPYpC9feaZhydqy0aPPo5XSp1-c29WcZvCkQmEOAQO0/w300-h400/71451567395__39F7604E-F352-4A94-86D3-C9DAEB1981E7.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Seraphina,, my beloved cat waiting for me to get back in my desk chair.</td></tr></tbody></table><br /><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiigL3Ch_9dW4WRxiNaZxtrIrC3jMjkg78OTdz5j07qX5Mpje_jKsmBM8-SVXlPMXdp9vMFkPe4Y65_K5NRXZNuQRTt8ib9dOZpXFcrq2Wg4VjPx2nEFzDO4rIvHRME-7jdLAIdctpoCGe44InJTQLdoXLgFTe1E6RqPbnhx_krcnJ8QG9cpESyMqOtL74/s4032/IMG_8613.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="4032" data-original-width="3024" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiigL3Ch_9dW4WRxiNaZxtrIrC3jMjkg78OTdz5j07qX5Mpje_jKsmBM8-SVXlPMXdp9vMFkPe4Y65_K5NRXZNuQRTt8ib9dOZpXFcrq2Wg4VjPx2nEFzDO4rIvHRME-7jdLAIdctpoCGe44InJTQLdoXLgFTe1E6RqPbnhx_krcnJ8QG9cpESyMqOtL74/w300-h400/IMG_8613.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Winnie takes a quick nap while waiting for more treats during her puppy visit.</td></tr></tbody></table><br /><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgxNF4QKI40m6To9Fx9P71PtvY3bYNitZ8WPoiqKTpCcvaxr41UzaFrg8Gvf29xcxICSintrThHVxaxKY0lngY3e7IR2Hv-tX6VMTLYMcQ5fo8MDoXGbnbMhuwhIVL4CchNbx6dqD_T4VKNB-wDPUA7R_Ikh7g5fHX0whRYYXawdAH2y3DymoabG3oe5Oo/s4032/IMG_8621.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="4032" data-original-width="3024" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgxNF4QKI40m6To9Fx9P71PtvY3bYNitZ8WPoiqKTpCcvaxr41UzaFrg8Gvf29xcxICSintrThHVxaxKY0lngY3e7IR2Hv-tX6VMTLYMcQ5fo8MDoXGbnbMhuwhIVL4CchNbx6dqD_T4VKNB-wDPUA7R_Ikh7g5fHX0whRYYXawdAH2y3DymoabG3oe5Oo/w300-h400/IMG_8621.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">One of my favorite faces,, this is Goose. He always makes me feel like being a veterinarian is the highest honor possible.</td></tr></tbody></table><br /><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhTHsYxR6a5eMzdgZO18Y5VocmM82h0hMCe1odSGG4LS1Jq4vArvuE92RCK8q6llgOSGXs_XkNi5PX4SGsjFNR1Q0rxUWU5LlV0m1fp-nd1RHXtJSEEWQLPq7Lfa6RnVvfMlliYxtnkaLenPbq0u_IOcaSIXiWViC9uzA5hj698dHtcRZR_k3CshP9g164/s4032/IMG_8645.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="4032" data-original-width="3024" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhTHsYxR6a5eMzdgZO18Y5VocmM82h0hMCe1odSGG4LS1Jq4vArvuE92RCK8q6llgOSGXs_XkNi5PX4SGsjFNR1Q0rxUWU5LlV0m1fp-nd1RHXtJSEEWQLPq7Lfa6RnVvfMlliYxtnkaLenPbq0u_IOcaSIXiWViC9uzA5hj698dHtcRZR_k3CshP9g164/w300-h400/IMG_8645.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Josie getting ready to go home after her spay.</td></tr></tbody></table><br /><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEikSG6qi77DVs94X5MTfUYAL7RzD7bN9PxzIr5HogSTre9R-sMimkJSWrgs5J4fFU7HBkwrT2zCQv9rvefFeA0idU2OfhtjDVs-pelv5PnM6PB16WhsITynA7Dbu9u8VyVipeAvhrNDgRqVN-L-mLjlYSD71waBWDhjTjgrjtvchApDqMJOXYD8qZJy1bM/s4032/IMG_8648.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="4032" data-original-width="3024" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEikSG6qi77DVs94X5MTfUYAL7RzD7bN9PxzIr5HogSTre9R-sMimkJSWrgs5J4fFU7HBkwrT2zCQv9rvefFeA0idU2OfhtjDVs-pelv5PnM6PB16WhsITynA7Dbu9u8VyVipeAvhrNDgRqVN-L-mLjlYSD71waBWDhjTjgrjtvchApDqMJOXYD8qZJy1bM/w300-h400/IMG_8648.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">These two are my giggles in my day., This is Lydia and Grace holding our beloved Hamilton.<br />If a clinic has a soul it is the reflection of the people who make all we do possible</td></tr></tbody></table><br /><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEheuyhV-WVwReS2mkRLWRVi_6I1cTY9Jsfbj_8Yp_IYbcekjFtU3wMJwEr1FZ0M-nP31whu6USYQxMb_ri8_KSQe0kueRzxMFjqhzkL2eG-_5oxDyXwt99IdSyFxgtboI6lSYBCPzIc_jqY1piXPkOBF6Z8SLgjpmfJPCO8PWpltUPwz84w6kNpMKYJ2k4/s4032/IMG_8660.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="4032" data-original-width="3024" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEheuyhV-WVwReS2mkRLWRVi_6I1cTY9Jsfbj_8Yp_IYbcekjFtU3wMJwEr1FZ0M-nP31whu6USYQxMb_ri8_KSQe0kueRzxMFjqhzkL2eG-_5oxDyXwt99IdSyFxgtboI6lSYBCPzIc_jqY1piXPkOBF6Z8SLgjpmfJPCO8PWpltUPwz84w6kNpMKYJ2k4/w300-h400/IMG_8660.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Penny,, and her worried face. Beagles are my favorite breed but the lack the badge of courage,, which they make up for in adorable-ness. She was here for a 2 second visit and a hug from her mom.</td></tr></tbody></table><br /><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgadsGAA-fZX5PMTrR2x-MMkcT9YGtn7y4K72XUQkN650K92XdBcvew3GIxzbU0w6mWvQkSpihZM3s8fWB1Ke6bzcTFAU9KrPyVPKz-8rJjSxK-vq1kRv6X_4uUHZ7MhAQNqYuStV9l2cAKrQCHs0WeRRiuu2opUOO4Jqk29-efEiEauNLpsNK4xCmszWE/s4032/IMG_8670.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="4032" data-original-width="3024" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgadsGAA-fZX5PMTrR2x-MMkcT9YGtn7y4K72XUQkN650K92XdBcvew3GIxzbU0w6mWvQkSpihZM3s8fWB1Ke6bzcTFAU9KrPyVPKz-8rJjSxK-vq1kRv6X_4uUHZ7MhAQNqYuStV9l2cAKrQCHs0WeRRiuu2opUOO4Jqk29-efEiEauNLpsNK4xCmszWE/w300-h400/IMG_8670.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">The most challenging internal medicine case of my career is crowned by this little one. This is Snickers.. the most loved pup you will ever find. </td></tr></tbody></table><br /><div class="separator" style="clear: both; text-align: left;"><br /></div>I write about the life I live. Complicated, conflicted and full of purpose. For more please search a topic and see what 10 years of blogging and 18 years of practice yields.<br /><p><br /></p><p><br /></p>krista magnifico, DVMhttp://www.blogger.com/profile/15133566329579911573noreply@blogger.com0tag:blogger.com,1999:blog-4667516629745731439.post-24609699150567264602023-08-12T19:35:00.002-07:002023-08-12T19:35:29.598-07:00What Am I Supposed To Do?<p>The question plays on repeat. Over, and over. And, over again.</p><p>It is inescapable. Perplexing, vexxing, and excruciating. All of these and sticky beyond excision. </p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj9jyzLsurDoUpYI143TntlL9XGY_FWLm1nlC4uaPKH69ASZgnQCIm8tW6DErdoqhJGH7l5t0ZGIuO17VeulsEa5mDN3uKOdw8gvbgtMQb1rvEA5YG4TtdElZ0l6qtbRT7yQ3FdjZ5vjlbdaJ3m4ZzX33On3FOT4Ayeysp7p9eXkPdcmzpokd29vMSXZPA/s2016/IMG_0774.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2016" data-original-width="1512" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj9jyzLsurDoUpYI143TntlL9XGY_FWLm1nlC4uaPKH69ASZgnQCIm8tW6DErdoqhJGH7l5t0ZGIuO17VeulsEa5mDN3uKOdw8gvbgtMQb1rvEA5YG4TtdElZ0l6qtbRT7yQ3FdjZ5vjlbdaJ3m4ZzX33On3FOT4Ayeysp7p9eXkPdcmzpokd29vMSXZPA/s320/IMG_0774.jpg" width="240" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Nana, broken leg, ER advice; "surgery 10k, or euthanize"<br />my advice; "cage rest" <br />she is alive and doing well today because her dad refused to have only two options for her</td></tr></tbody></table><br /><div class="separator" style="clear: both; text-align: center;"><br /></div><br /><p>There are fixable veterinary problems all around me. In my effort to provide exposure to these treatable and yet often ignored veterinary issues, encouragement to face and fix them, I seem to have made myself the wailing post. I have become the beacon for hope and last place for help when there is none to be found at the footsteps of present veterinary provider. </p><p>My question isn't why I have become this person, my question is how do I keep from becoming the only vet who cares enough to put the patient before the profits and the fear?</p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiv0cLe0SFgPN1Z622PkUJEQLhyTEAW4mMHtzFNuGLjHASjkQgZEpsRdKEcgREeOV1Ctx_IxtaiaDcajoWFUcEPjgcgdHFoLxH3WRyJn9pHQtUp8fOJS3x1fOWiK7Zf9cAkNQr9IvlLMhyZ-Z4Wh8r0G-ac4bM-1rMMMaAVM-0rGGLej7dG53wJHRqwXYg/s1280/IMG_7280.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="960" data-original-width="1280" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiv0cLe0SFgPN1Z622PkUJEQLhyTEAW4mMHtzFNuGLjHASjkQgZEpsRdKEcgREeOV1Ctx_IxtaiaDcajoWFUcEPjgcgdHFoLxH3WRyJn9pHQtUp8fOJS3x1fOWiK7Zf9cAkNQr9IvlLMhyZ-Z4Wh8r0G-ac4bM-1rMMMaAVM-0rGGLej7dG53wJHRqwXYg/s320/IMG_7280.jpg" width="320" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">And all of those blocked cats..</td></tr></tbody></table><br /><p><br /></p><p>I have spent a great deal of time asking me how I got here? Why I feel so alone here, and what the hell I do about it? </p><p>I have spent so much time in the problem that I cannot walk away. I cannot shutter it, suffocate it, stow it, or sacrifice it. I am in it, wholly and without reserve. </p><p>What would you do if you knew there were answers, some of them ridiculously easy to solve, answers that would save lives, save human hearts from being crushed, and right a wrong that just grows more egregious as it consumes the caring around it.</p><p>What do I do?</p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjR07J8OUN_Oj9ZW-Sc3MMNcWAvKoBmtLTm7NFThVDgARdt0UXdxxhHsJ79DLpQ8uHrG91whPmEQ9lvK5cbokaEaqa3LVR9yo2HSguzlDuAtG1O08jDxblHISj7nMVNGwvyauxlrgCOTzZxvd-3wEqJwrx3dNq5dzduZWCn2EK927RoPBK5BH-e1NRms4o/s2016/IMG_8499.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2016" data-original-width="1512" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjR07J8OUN_Oj9ZW-Sc3MMNcWAvKoBmtLTm7NFThVDgARdt0UXdxxhHsJ79DLpQ8uHrG91whPmEQ9lvK5cbokaEaqa3LVR9yo2HSguzlDuAtG1O08jDxblHISj7nMVNGwvyauxlrgCOTzZxvd-3wEqJwrx3dNq5dzduZWCn2EK927RoPBK5BH-e1NRms4o/s320/IMG_8499.jpg" width="240" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">And all of those PU surgeries</td></tr></tbody></table><br /><p>Today it was another desperate plea. A question on the Pawbly, the pet care site asking for help. They are always the same. </p><p>"I love my pet. They are my whole world. They have this problem..... I have been to so many vets, no one cares. I saw your video. Is there anyway you can help me?" .. and there is always a photo. A photo of the pet. So sweet, innocent, and fragile and in desperate need. How do I turn away from those faces? How do I stay in this profession if I sacrifice my ability to have compassion so strong it compels?</p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg4o1_dnHVcdrmT3yydaE9geiAIX9a_ebXQCnnbYGzlGRSHgsk7ZIj4a3kNhuuI8Bo-nCowxs98gW8ha87S9N_crqItJVOJSSk8P0JX8UDEayBymJefx2Sg-cSJnBAYpwUBXlKp1j4SjC-kp5LM_xFQhijj8Dr9ni13WOwGhRG-9-U28gubd8z-2jV_rvQ/s4080/20230502_233143.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="4080" data-original-width="3060" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg4o1_dnHVcdrmT3yydaE9geiAIX9a_ebXQCnnbYGzlGRSHgsk7ZIj4a3kNhuuI8Bo-nCowxs98gW8ha87S9N_crqItJVOJSSk8P0JX8UDEayBymJefx2Sg-cSJnBAYpwUBXlKp1j4SjC-kp5LM_xFQhijj8Dr9ni13WOwGhRG-9-U28gubd8z-2jV_rvQ/s320/20230502_233143.jpg" width="240" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Babybear</td></tr></tbody></table><br /><p>Veterinary medicine is about taking care of animals. Somewhere along the day to day grind this got lost. It became about money, and egos, and trying to be bigger than our britches. We became distant from our purpose, and divided from our clients. When it was not profitable, or easy, or worth our time we blamed them, the clients, the people who make all of this possible. We used cruelty to remind pet parents that this illness, this unforeseen accident, disaster, (albeit treatable), isn't worth us intervening if they can't pay us handsomely for it. The cost of care has skyrocketed, the treatment for all of the ailments remains what it was decades ago when everything was a few hundred dollars, or less. </p><p>.. and so I remain here. Asking myself the same question and dedicated to finding, exposing, and disrupting the same problem.</p><p>Want to see what I am talking about?</p><p>See my <a href="https://www.youtube.com/@kristamagnificoDVM/videos">YouTube</a> channel </p><p>or <a href="http://Pawbly.com">Pawbly.com</a> </p>krista magnifico, DVMhttp://www.blogger.com/profile/15133566329579911573noreply@blogger.com0tag:blogger.com,1999:blog-4667516629745731439.post-56050879405364740872023-07-16T08:49:00.002-07:002023-07-16T08:49:16.757-07:00The Cost Of Hope<p> Hope. When there is everything, and nothing, there is still hope.</p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhmH1MXrkNCfeMOGNqBjNU6zlC9AqzORs0o2h4E4HZOrqy9po2I9cL7OOi6eQoY25eFbTiu4puEH64njGEKLyyUqrx2LuKbhDzt3SYPSM6swypp93_ZOvqf1B_gMXV9nvuNe_W9Wvg33aHTnXTyyVAuDpHGluiEWl17BFSIIAoXF3lzwR9_NwEWoY6k5Qc/s2016/IMG_0596.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1512" data-original-width="2016" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhmH1MXrkNCfeMOGNqBjNU6zlC9AqzORs0o2h4E4HZOrqy9po2I9cL7OOi6eQoY25eFbTiu4puEH64njGEKLyyUqrx2LuKbhDzt3SYPSM6swypp93_ZOvqf1B_gMXV9nvuNe_W9Wvg33aHTnXTyyVAuDpHGluiEWl17BFSIIAoXF3lzwR9_NwEWoY6k5Qc/w400-h300/IMG_0596.jpg" width="400" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Hope, for me in vetmed, is all of those blocked cats who never see a chance at help <br />because we may it too expensive.</td></tr></tbody></table><br /><p>A long time ago there was a girl who was afraid. Of all of the things she was this one thing dominated. It was what propelled her, crippled her, and reminded her. It was the beast she lay victim to for all of the days. It was the affliction her mother had and her mother before her. It was everything and nothing. It was, and it was what she let it be. </p><p>It was like this for a very long time. A lifetime, and then, a lifetime more. </p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiViGkSN-i0RvCKcOETuPoao0THpO9Cqmxu0e77QfhtNBA7newFCofWGqvrUF1qla_Ts2lIj0XxQHEKVbND04G8NJGUWxVr2UX5Pbkx0DqWcuv849iv_i5HYN0fP75nbsVg9wPxewAOWDlnn8qm3llhLum2-K2k1TPBkHDk68lCGTUjfxb163s9If_vulI/s1632/IMG_8419%20(1).JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1224" data-original-width="1632" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiViGkSN-i0RvCKcOETuPoao0THpO9Cqmxu0e77QfhtNBA7newFCofWGqvrUF1qla_Ts2lIj0XxQHEKVbND04G8NJGUWxVr2UX5Pbkx0DqWcuv849iv_i5HYN0fP75nbsVg9wPxewAOWDlnn8qm3llhLum2-K2k1TPBkHDk68lCGTUjfxb163s9If_vulI/w400-h300/IMG_8419%20(1).JPG" width="400" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Mom in her barn for her first antique sale.<br />She was beamingly happy, can't you tell?</td></tr></tbody></table><br /><p>It took a long time to recognize the part of her she didn’t have to be. She knew that there had to be more to this journey. The one she woke up to everyday to repeat the whole pattern again. But when you carry a beast so big, and so heavy, for so long, it is hard to raise your eyes above it. Maybe fear is the antidote to hope? she thought. And, maybe hope was the cure for her fear? And with that it began; the daily ritual of pulling her bootstraps up and raising her chin above the horizon, just to see if maybe out there somewhere there was another option to her fear. Maybe there was a place she could leave it? Just to rest its weary head for a while. Maybe, it was as tired of her as she was of it? Maybe, they could exist without each other? The shell without the cortex. The cure without the disease. Maybe, if she could grow big enough and strong enough, she could outgrow its need for her, and with all things that persist long enough, her need for it? Maybe? Just maybe?</p><p>What happens is that time works its magic on you and you grow comfortable with even the most horrible. You get used to each other to a degree that makes it hard to coexist without each other, even when the other half is a cancer stealing you from yourself. A bad marriage arranged on the most horrific of terms. Life is like that. It will kill you if you let it. Leach you to anemia just to see what the reserve tank has in it. Medicine, the art of molecular life in the grips of another life, the host with its many moving parts all required to work in tandem even when they have opposing agendas, is just like this. A dance, a tango set to a music you cannot always chose. You try to lead but you know the tempo might change and there may be feet stepped on as you tip-toe across the floor. </p><p>Isn’t life like this for all of us? The calculations of actions you make silently within to try to make it through life with as little turmoil, pain, and scarring as possible. At what point do we learn that if you don’t have one side of the coin its impossible to know the other. Maybe with age there is wisdom and the ability to excise the fear so you can live with just the hope?</p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjy4YxEewxDdhzKGgzbGQlic6ZFNLX-8ZbmORZnItjhxD8moUJHS-j6Xd0Q8XbBQbZBKCg_7zsGtYKCOJ_TW0bnIxmoZQmdj8CwNL2lBNzfkcpGCFVPC1kJNS2_JjpfQU09bvRfsjYAm6wT6WeM-qdWARLs696qTeOw6pykbhbCl27w7NgPj8JCsVgmK8U/s1280/IMG_5183.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="960" data-original-width="1280" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjy4YxEewxDdhzKGgzbGQlic6ZFNLX-8ZbmORZnItjhxD8moUJHS-j6Xd0Q8XbBQbZBKCg_7zsGtYKCOJ_TW0bnIxmoZQmdj8CwNL2lBNzfkcpGCFVPC1kJNS2_JjpfQU09bvRfsjYAm6wT6WeM-qdWARLs696qTeOw6pykbhbCl27w7NgPj8JCsVgmK8U/w400-h300/IMG_5183.JPG" width="400" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Outer Banks. Duck</td></tr></tbody></table><br /><p>Today is Mother’s Day. The day that we all celebrate the origin of our existence on the double X chromosome in our own DNA. For me, 5/14 is the day my mother died. On this day at 4:14 pm in a little stone house not too far from my own, my mom took her last breath. I say this as it marks a date, impermeable, and in-excisable. The pivot point to which the calendar resets, and a life without another starts. I say this because that day changed so much within me. There is a book to write about her, and her impact upon me. A book that sits waiting for the time and the distance to write it without it eating me up. Consuming me like the fear that swallowed her and kept her trapped within.</p><p>Today I remind myself that there is life after another life passes on. I cannot call her gone. She is never gone. She is here all around me reminding me to always have hope. To always see the beauty and the joy in the life that exists even if you have a difficult time seeing through the tears. Today I talk about hope.</p><p>Today I opened my eyes before the sun came up. The sky crept from black to the darkest of blue. A grey-washed out kind of blue. Smeared in its blurry shadows. Quiet, heavy, and slumbered with a fog that keeps all of the earth’s tiny souls safe in their beds. The first rays of sunshine wake up the world and to this awakening the first chirp can be heard. It is my time to be alone and feel as if the world will remind me that I am never really solitary. One little chirp. Just a call in the almost-darkness to awaken the rest. I turn on my Merlin app, and start to record. I now know that this tiny rooster call is an American Robin. Maybe being afraid, and trying to replace it with hope is about seeing the bravery in the darkest of places and still singing?<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjgHdGNNY-JFwb-MJ3-OoXvnva009Iqp7BO_1GlSRmrcB7NwnfBdyhkC5yZaJ26MnxtkdnZXzs45GKNzytO7bow0ujVzUrVnK5xXbFVRAi1RDnsfI7NEwN9h5LB8JjUVmZZIFiHO4jgMe5wnmsGvHtW2SlscrNCfWNhK9RmNop1Oee3CeXqmuI7T-txmgw/s960/IMG_8339.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="960" data-original-width="720" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjgHdGNNY-JFwb-MJ3-OoXvnva009Iqp7BO_1GlSRmrcB7NwnfBdyhkC5yZaJ26MnxtkdnZXzs45GKNzytO7bow0ujVzUrVnK5xXbFVRAi1RDnsfI7NEwN9h5LB8JjUVmZZIFiHO4jgMe5wnmsGvHtW2SlscrNCfWNhK9RmNop1Oee3CeXqmuI7T-txmgw/w300-h400/IMG_8339.JPG" width="300" /></a></div><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><br /></td></tr><tr><td class="tr-caption" style="text-align: center;"><br /></td></tr></tbody></table></p><p style="text-align: center;">The potting shed. Mom and Diedra's boys</p><p>I made a video the other week about all of the clients I see who come to me having to lay their pet to rest after disease, and age, and all of the many afflictions that life can wear you down from. They always ask me the same thing, without fail; they ask, “this must be the hardest thing that you have to do as a veterinarian?” And I always reply the same way… “No. You loved your pet so much that you made them a part of your family. They were loved every moment of their lives. How lucky they are for that, and I know they are so grateful to have been yours.” That is the hope in the face of fear. That is the beauty in the face of death. Maybe losing someone you love is about remembering the hope they brought you every day you were together?</p><p>With hope springs gratitude eternal. Is there anything we wouldn’t give for that?</p><p>Happy Mother’s Day to you all. (regardless of what your chromosomes or current children roster looks like)..</p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjwp8DDHBg10y-qxxyE99HjrdFgvNWv9O0FTU0T2Ktiy2TXvco_fDDHU9wdn5eTGtU6SDzti2sE2yfClNWZdNrgr1Hvook3HOdISlsaY7MDByMtBo37uwFCfQv2PzGJThjYWu-VlP_vua_5kBcRUodtorVNw4vCnabsb7VRgZDWW1xnb69EK-Fxh_Rc8_8/s960/IMG_6928.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="960" data-original-width="720" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjwp8DDHBg10y-qxxyE99HjrdFgvNWv9O0FTU0T2Ktiy2TXvco_fDDHU9wdn5eTGtU6SDzti2sE2yfClNWZdNrgr1Hvook3HOdISlsaY7MDByMtBo37uwFCfQv2PzGJThjYWu-VlP_vua_5kBcRUodtorVNw4vCnabsb7VRgZDWW1xnb69EK-Fxh_Rc8_8/w300-h400/IMG_6928.JPG" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">The first icy drink of Summer. A mojito from our mint patch.<br />Diedra, mom and me.<br /></td></tr></tbody></table><br /><p>And P.S. go out and foster, adopt, and live life with someone else… pets count as kids these days,, so we are all moms here. Maybe there is life outside of the one you are living right now where hope springs eternal? And, maybe its time to go look for it? Let’s all look for hope in the love that reminds us we are all mothers. </p><div>P.S. I write about all of the issues that being me brings. I know that I am not alone and I hope (there's that word again), that others hear me and know that they aren't alone either.</div>krista magnifico, DVMhttp://www.blogger.com/profile/15133566329579911573noreply@blogger.com1tag:blogger.com,1999:blog-4667516629745731439.post-14387566847517164692023-07-13T10:05:00.004-07:002023-07-16T09:32:28.048-07:00Inspiring My Compulsion<p> I often wonder which I am,</p><p>how much of the current circumstances dictate one v. the other. And, why I have to allow the <i><b>compulsion</b></i> to have such a negative connotation even when I know that they both play off of each other and feed into each other. </p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgjEyukXQLoFOq_Fg54oRgyQ6PvK4Y5S9845_lGs8dVQNM4odIl9MEpaSTgJq9aAHSN6kCm1Z3YOthZWNW3Ol55qgWx6yJXTKfmpcOLPUa1mcBElnQYuVetvKPo-ULa7c6nE7SLM-dnYj6d6Kb-zSmr8L8wW8ZLmjh49fJbeTtxkb7WxCFzarr0aV9pY3o/s2016/IMG_0717%20(1).jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgjEyukXQLoFOq_Fg54oRgyQ6PvK4Y5S9845_lGs8dVQNM4odIl9MEpaSTgJq9aAHSN6kCm1Z3YOthZWNW3Ol55qgWx6yJXTKfmpcOLPUa1mcBElnQYuVetvKPo-ULa7c6nE7SLM-dnYj6d6Kb-zSmr8L8wW8ZLmjh49fJbeTtxkb7WxCFzarr0aV9pY3o/w300-h400/IMG_0717%20(1).jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">My kitten Birdie, who I saved from being unwanted, from a 4 month long rabies quarantine, named, spayed, vaccinated, and then gave her a home full of love. <br />She is checking out her Easter basket I made and the flowers we grew and bouquets I created. </td></tr></tbody></table><br /><p>I tell myself over and over, like some meditational affirmation, that as long as my intentions are pure and genuine with the goal being to serve something and someone beyond me, that it isn't terribly important to categorize and profile. Right? </p><p>Can I be both <i><b>inspired</b></i> and <i><b>compulsive</b></i>? Is one beneficial and the other detrimental? Can I be a half of two and more than one as the product?</p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi2irhHgIqj1HrzWfTCKlJEhXxkvCLyMvNi9L7r8ryZw_LFSs2Lm0tRTc23_0v9TQj2c6hxF2p30FcM8wiibVYNPxvtBCJZHj6FxPabUne4EHmJlUGmRb6P3BqN2hK1Sc2LZUeRn7xGGjdVYPh0CoLIywnBDpIX2LXmLel0_Dt-tbBRXLJlsApBNv8xwwE/s1280/IMG_7037%20(1).jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1280" data-original-width="960" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi2irhHgIqj1HrzWfTCKlJEhXxkvCLyMvNi9L7r8ryZw_LFSs2Lm0tRTc23_0v9TQj2c6hxF2p30FcM8wiibVYNPxvtBCJZHj6FxPabUne4EHmJlUGmRb6P3BqN2hK1Sc2LZUeRn7xGGjdVYPh0CoLIywnBDpIX2LXmLel0_Dt-tbBRXLJlsApBNv8xwwE/w300-h400/IMG_7037%20(1).jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">The bike path, Georgetown to Lewes, Delaware<br /><br /></td></tr></tbody></table><p>Yesterday we went for a run with the dogs. We are staying at my friends beach house in Lewes, Delaware for the week. Myself, my husband Joe, my sister Diedra, and her two boys along with one of their friends. Our normal routine is to get up around 8 (a good two hours past our normal at home chore and make it to work time), and run with the dogs before it gets too hot outside. The typical mid-July day temps are mid-nineties, and the sun is brutal in its prime. The dogs are excellent vacationers. They are used to being included in all family activities, but they still need outside time and bathroom opportunities. We have a short jog to the old railroad trail that is now blacktopped and wide enough for the brigade of bikes that it hosts. We can go right and head to downtown where The Station on Kings resides. The Station is a barn like looking structure with a sunbathed sky-light interior and a garden store adjacent. White marbled countertops showcase delectable baked goods that are irresistible to all of the senses that attempt to talk down the blood sugar count. This particular morning we ran to the left. Two miles to the left is Old World Breads bakery. Old World hits you within a half mile of its ovens. The invisible lasso of egg sandwiches, fluffy yeasty crusted rolls and coffee is cosmic. The dogs prefer left too. Like the horse returning to the barn these pups pull you to the breads in a hopeful dash to carb-ed bliss. The jog in either direction is only a few miles under a tree canopy tunnel. The dogs are used to sharing the road and they love the adventure almost as much as their chaperones do. </p><br /><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhdIs0zmPa7djhwpOzlr9R531-vwWVVFBSeRHWJN0Q2uQkZNb5c9FwlES2NU31NXy83lrG-hfuhmq8CXA-HOlfKKhOZ0ZY7mL5b3hM7IiS3b1IPVfkMOqR8OKyZuYfVsZieF-Al4sMvsJhYeihwTDKcYi9CyMw2Eoy7KbnExepROcetU9osB-_ywC4sjTE/s1280/IMG_7052.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1280" data-original-width="960" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhdIs0zmPa7djhwpOzlr9R531-vwWVVFBSeRHWJN0Q2uQkZNb5c9FwlES2NU31NXy83lrG-hfuhmq8CXA-HOlfKKhOZ0ZY7mL5b3hM7IiS3b1IPVfkMOqR8OKyZuYfVsZieF-Al4sMvsJhYeihwTDKcYi9CyMw2Eoy7KbnExepROcetU9osB-_ywC4sjTE/w300-h400/IMG_7052.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;"></td></tr></tbody></table><br /><p>At each destination we take turns going into the bakery. Dogs aren't allowed and I would never trust mine to not whine and beg in some pitiful display of unmet needs. I stick to a coffee, small. Pack light and stay prepared for the run back. This morning we collected our coffees, packed a backpack with goodies and headed to the nearby park bench to swallow gulps of hot coffee and plan the rest of the day. </p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiW6AlmLlMQRVdc9_QsWjUGUhb58OTiNNd78BtPbmXSlQTB9xDbhO6NBaOvnNpEmrTwISmCRKgZfcIX0fF-OpsRDX1Oo8jyuyB2Ns9o-J3r1rivhZZOloMaFkFyYjB_yHOkXqQd0W0Olo5vHnW-FF819K6wy4RBeWVR4HjII0RAfTidWuJMuS1vSl1o2l0/s2016/IMG_6867.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiW6AlmLlMQRVdc9_QsWjUGUhb58OTiNNd78BtPbmXSlQTB9xDbhO6NBaOvnNpEmrTwISmCRKgZfcIX0fF-OpsRDX1Oo8jyuyB2Ns9o-J3r1rivhZZOloMaFkFyYjB_yHOkXqQd0W0Olo5vHnW-FF819K6wy4RBeWVR4HjII0RAfTidWuJMuS1vSl1o2l0/w300-h400/IMG_6867.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">The Station On Kings, Lewes, Delaware</td></tr></tbody></table><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj0I-v_7digSnVxQQSTIscZe04_GHEEVK6QC7ae8U4XoscpzO4C9-0mX8DzmmiuH9exfnf2lLoE1yeeUuwBCtxE8_2KpegwkIAq0P0q0zI_ULuQ5kAKRiCWfsrA4BY1hWfXkYHkqVmY3-fnaWkD57-SZ25ro_rIDhQ8R6IsFW7gsqs2B6tKOvMQY-cQm-c/s1280/IMG_7046.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1280" data-original-width="960" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj0I-v_7digSnVxQQSTIscZe04_GHEEVK6QC7ae8U4XoscpzO4C9-0mX8DzmmiuH9exfnf2lLoE1yeeUuwBCtxE8_2KpegwkIAq0P0q0zI_ULuQ5kAKRiCWfsrA4BY1hWfXkYHkqVmY3-fnaWkD57-SZ25ro_rIDhQ8R6IsFW7gsqs2B6tKOvMQY-cQm-c/w300-h400/IMG_7046.jpg" width="300" /></a></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: center;"><br /></div><p>There is only one bench. Sitting there smiling in the shade was a young woman and her flat tired bike. We asked to sit next to her and watched as the dogs approached wagging and gleeful. It is a beach town where dogs are ubiquitous, but that doesn't imply everyone's affirmation to pet loving. Thankfully as they approached she offered a hand of hello. Within minutes we had exchanged basic introductions. Dogs names first, her predicament second. She was biking 20 miles to run her errands for the day and enjoy the sunshine. She, like us, does everything she can to avoid cars, heavy traffic and the bustle the rest of the world accepts as collateral for living in the beaches. She was waiting for her daughter to wake up and come rescue her. We offered to head home and come back to get her with our car. </p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEijwrQELJkG3_lAStVeTKuZZv40eUXm4-pYz1NwwWg3TXxTvazdkL6khX2wg2yXpP-cLq8lFsf8HaAe483NgromO225-9wanDeLTZQZB8WkqGxiUtJVTGTiAsheKbgJLDMuxBptsweDF8mQvcD5E5tqbmX_eP9k7FMUNVJyv6NIT6wlTni3BhOWJyquQck/s1280/IMG_7042%20(1).jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1280" data-original-width="960" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEijwrQELJkG3_lAStVeTKuZZv40eUXm4-pYz1NwwWg3TXxTvazdkL6khX2wg2yXpP-cLq8lFsf8HaAe483NgromO225-9wanDeLTZQZB8WkqGxiUtJVTGTiAsheKbgJLDMuxBptsweDF8mQvcD5E5tqbmX_eP9k7FMUNVJyv6NIT6wlTni3BhOWJyquQck/w300-h400/IMG_7042%20(1).jpg" width="300" /></a></div><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhiFls_b-VEH2l5egAE94_z2Htfyo95Onczh_a5-Sgo2LNTZePwxcADgvYvjHct8_AYPIzWYGPIyWbICzO6u1sMva-57RDFiRgtTOcOJowfpNX0NtamiZNGPI4E2w4VtMLy4iD8dltkPYSF5ONQCMOeQVfxAhIRdC1Y2C6PO0DyHB-0rNVGKesC4rQJGq0/s1280/IMG_7067.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="962" data-original-width="1280" height="301" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhiFls_b-VEH2l5egAE94_z2Htfyo95Onczh_a5-Sgo2LNTZePwxcADgvYvjHct8_AYPIzWYGPIyWbICzO6u1sMva-57RDFiRgtTOcOJowfpNX0NtamiZNGPI4E2w4VtMLy4iD8dltkPYSF5ONQCMOeQVfxAhIRdC1Y2C6PO0DyHB-0rNVGKesC4rQJGq0/w400-h301/IMG_7067.jpg" width="400" /></a></div><br /><div class="separator" style="clear: both; text-align: center;"><br /></div><p>"Nope, it's a beautiful day out. So, I am just going to enjoy it here." She was perfectly content to sit and watch the rest of the beach ride by. </p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiPhcYOcYv0snOasILLsU6uAiOffZVReuZwhJaSfunBT8jCLC6wDNpmCb7P7BOsWGBUxxX0vRi-z1UC0y5f_y8XNGGeCdQoOR0cC6ftsgn7-yNFH_MZztfCmYfKT8kHS34M5j6gNP7P7nX6ShF43U301wObF6PPmljP949npjizwwKuT8pRLUUpMBmgIC8/s1280/IMG_7050.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1280" data-original-width="960" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiPhcYOcYv0snOasILLsU6uAiOffZVReuZwhJaSfunBT8jCLC6wDNpmCb7P7BOsWGBUxxX0vRi-z1UC0y5f_y8XNGGeCdQoOR0cC6ftsgn7-yNFH_MZztfCmYfKT8kHS34M5j6gNP7P7nX6ShF43U301wObF6PPmljP949npjizwwKuT8pRLUUpMBmgIC8/w300-h400/IMG_7050.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Old World coffee counter</td></tr></tbody></table><br /><p>I was struck by her answer. I don't think I can remember the last time that I took joy in being stranded and having to rearrange my list of errands for the day because of it. </p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg-Ezwl9qCSb4Nl-7ZjcYKFWumi_kONpbLBboIC7Bnrg1wIJ0P1xtkuaRNqwMynfjXV3KGESDGylQR_OKfHn93G6Z0UlOJXI1gwAD2kuqo2MRi5A2YbjlTGspOBPJcBHrIHukIsBFapjSs4pQbgBkq70_3CTmw-2QQqep9nr7kEctA5trg5HOeWPpMrZRw/s1280/IMG_7055.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1280" data-original-width="960" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg-Ezwl9qCSb4Nl-7ZjcYKFWumi_kONpbLBboIC7Bnrg1wIJ0P1xtkuaRNqwMynfjXV3KGESDGylQR_OKfHn93G6Z0UlOJXI1gwAD2kuqo2MRi5A2YbjlTGspOBPJcBHrIHukIsBFapjSs4pQbgBkq70_3CTmw-2QQqep9nr7kEctA5trg5HOeWPpMrZRw/w300-h400/IMG_7055.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Old World Breads pretzel</td></tr></tbody></table><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi3ij_Hkd63JMRGidCTR-ZLVpUaOjQOIWMmMt2X9kcnbe7o2oNd6_9V6zPWTYbZK8wgiExO_i-UzegIRtHytyowFwJhBVMtDl6InANF3p9Ob-u4PAHKySlcThwsAPga5OoOqAL0DhARWvuWw3i30H0ZaWCvzFyfZ8nwOoFmMlxpbnDgW_yYHmTPujvyCxY/s1280/IMG_7059.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" data-original-height="1280" data-original-width="960" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi3ij_Hkd63JMRGidCTR-ZLVpUaOjQOIWMmMt2X9kcnbe7o2oNd6_9V6zPWTYbZK8wgiExO_i-UzegIRtHytyowFwJhBVMtDl6InANF3p9Ob-u4PAHKySlcThwsAPga5OoOqAL0DhARWvuWw3i30H0ZaWCvzFyfZ8nwOoFmMlxpbnDgW_yYHmTPujvyCxY/s320/IMG_7059.jpg" width="240" /></a></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhjzzEfiYyIVqVmMoqQmVSic-w9CEHl6h1nUwtrUm7KKWJand5kChRn0b4CqAOwTTA6RoIjo9dGyR5zphlc-GGuoXvV7vIA8tq7WnF8n7Ry9W9IsnfO_tzwKwnx8dMeeoNfo495gQIErDWwGCRY0H9Xg1esf5ajmGw1nSD4B0S1JxOF9DWQQSpURpJWi2c/s1280/IMG_7060.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="1280" data-original-width="960" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhjzzEfiYyIVqVmMoqQmVSic-w9CEHl6h1nUwtrUm7KKWJand5kChRn0b4CqAOwTTA6RoIjo9dGyR5zphlc-GGuoXvV7vIA8tq7WnF8n7Ry9W9IsnfO_tzwKwnx8dMeeoNfo495gQIErDWwGCRY0H9Xg1esf5ajmGw1nSD4B0S1JxOF9DWQQSpURpJWi2c/w240-h320/IMG_7060.jpg" width="240" /></a></div><p><br /></p><p><br /></p><p><br /></p><p><br /></p><br /><br /><br /><br /><br /><br /><br /><br /><p>Diedra chatted her up and together they both realized they were teachers who agreed that the pulse of the Summer allowed the rest of the years chaos to be permissible. My sister is a math teacher. All rules and animosity to students who struggle to conform to its rigidity. This mom with the flat tire, an art teacher in the local high school. She has been here for over two decades. Long enough to have seen this place balloon into high rises, condos, and vanishing farm lands. </p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh4M_UzEcfnLJyZV7GuhvS2jtFGjM5N1mj33MJldbb1UWwRwwucdk_tSWrY4ZSeBEevQPDRcS4XDPnSAMY2B9vXxisMk4o0JzYnkC4W4FBpJwQGhqoSNXgcTxdUPFHWbLpkrWBGfMiUeq6QYX1CQAbHWqa1j7SiNVtovSgFkgN_HUbgsox-QTXQdIe5R_E/s2016/IMG_6940.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh4M_UzEcfnLJyZV7GuhvS2jtFGjM5N1mj33MJldbb1UWwRwwucdk_tSWrY4ZSeBEevQPDRcS4XDPnSAMY2B9vXxisMk4o0JzYnkC4W4FBpJwQGhqoSNXgcTxdUPFHWbLpkrWBGfMiUeq6QYX1CQAbHWqa1j7SiNVtovSgFkgN_HUbgsox-QTXQdIe5R_E/w300-h400/IMG_6940.jpg" width="300" /></a></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: left;">"I came here as a child. It was always our Summer retreat spot. When I graduated college I got my first job here, lived on the beach in the Summer and I couldn't leave." She now has ids of her own and still cannot get enough of the sunshine and its Summer vibes.</div><br /><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj5RiuNg319fOna6f1Hd6eoFXUlBIZBdgimSleVEW7TDU177Fa9GQisgib694OS5K71KreaRJbDszti_qu9rDbzK1hmLr2cV88XQXMgOvPzyVqfKezdF4HkjL8iTGsRTd0I0k9FPyK2e7xiHAhirnKKjc8Guc_OKk8jByxqu6vWkfY5Y4SeuGYl-mKGnaM/s2016/IMG_6942.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1512" data-original-width="2016" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj5RiuNg319fOna6f1Hd6eoFXUlBIZBdgimSleVEW7TDU177Fa9GQisgib694OS5K71KreaRJbDszti_qu9rDbzK1hmLr2cV88XQXMgOvPzyVqfKezdF4HkjL8iTGsRTd0I0k9FPyK2e7xiHAhirnKKjc8Guc_OKk8jByxqu6vWkfY5Y4SeuGYl-mKGnaM/w400-h300/IMG_6942.jpg" width="400" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Beach life</td></tr></tbody></table><br /><p>She got me thinking about my life. Where I am, how I got here and how much the sun, the sand and the sea influences my joy.</p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEivSLWSURXy5ZivK3Ox_kKHtAUBoKfxsyC1LAgsikC1J-m3SWBUdL9OkCVwqDzmips4u8GOzHupqOU-y2oOp8ZOdMZEzgroP9KqZXqc0XRTyDNdaLzkBra6i9qv29EVULznoxuDYci_biXlnwiHMciZdjj_r91ol6PX5wgP7gpa_PkLzteUeEoHRcj0HnI/s2016/IMG_6852.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEivSLWSURXy5ZivK3Ox_kKHtAUBoKfxsyC1LAgsikC1J-m3SWBUdL9OkCVwqDzmips4u8GOzHupqOU-y2oOp8ZOdMZEzgroP9KqZXqc0XRTyDNdaLzkBra6i9qv29EVULznoxuDYci_biXlnwiHMciZdjj_r91ol6PX5wgP7gpa_PkLzteUeEoHRcj0HnI/w300-h400/IMG_6852.jpg" width="300" /></a></div><br /><p>I used to dream of being an artist. immersing my whole soul into color, The creative outburst of just feeling set into the world for pure joy. It is the reason I do so many incursions into my back yard and excursions into the big city. The reason I write and read and find escape in other peoples work. </p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiSFVEYhMKa06LN_CnFlhUYsjeWxi12kGHIijrMYAXgLBiSO2k6XK5fyV4PYQ3gHbssHFz8cLLd8MontbYewqvWoBpcsHCT_fkOl_K5mkfvX_h2P5ggWC98exlzCMV12HwyiAYIe0JuNMe3qqyKO3jTaYI3-XLuDXMEMtxf5lZ10fqU_dKTNHL6z6Ii8tY/s1372/FullSizeRender.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="945" data-original-width="1372" height="220" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiSFVEYhMKa06LN_CnFlhUYsjeWxi12kGHIijrMYAXgLBiSO2k6XK5fyV4PYQ3gHbssHFz8cLLd8MontbYewqvWoBpcsHCT_fkOl_K5mkfvX_h2P5ggWC98exlzCMV12HwyiAYIe0JuNMe3qqyKO3jTaYI3-XLuDXMEMtxf5lZ10fqU_dKTNHL6z6Ii8tY/s320/FullSizeRender.jpg" width="320" /></a></div><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgRdOW7ItAoIY1Pv8TNZw6eCpN11ka9hbrs3VGJlebamRCz3uG326RFSXHKX9dlYVa1wIUA7Jn5jXgkmGoDgFlDpJ6OHpDE-dieCyDQitCNAPtdKb5gEiLEfoJwSunxDJDGgfI2Jg_XzDrRCI_VoXn6_iFYhamWIEI7t4Kdrwo75y0aQX9_HarM33RI5AE/s2016/IMG_0842.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="2016" data-original-width="1512" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgRdOW7ItAoIY1Pv8TNZw6eCpN11ka9hbrs3VGJlebamRCz3uG326RFSXHKX9dlYVa1wIUA7Jn5jXgkmGoDgFlDpJ6OHpDE-dieCyDQitCNAPtdKb5gEiLEfoJwSunxDJDGgfI2Jg_XzDrRCI_VoXn6_iFYhamWIEI7t4Kdrwo75y0aQX9_HarM33RI5AE/s320/IMG_0842.jpg" width="240" /></a></div><br /><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhsjTKBn303yQ3VoDjDQJHzagaj6mRBCmJATuOYgCVf15OL7nqlbS_RHntAal_hWm-pId1chaITF0u-BswQEWyBDChtRqR7exjjImQZYXL9FktrlJqmTPNOw07nBZ6N77Px_9jNUZm0aJi6WADkcnMuvcD5zZNJdXE8Nk_SCXQ2W-qYAatAiMhc3IFJ-L8/s2016/IMG_3024%20(2).jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1512" data-original-width="2016" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhsjTKBn303yQ3VoDjDQJHzagaj6mRBCmJATuOYgCVf15OL7nqlbS_RHntAal_hWm-pId1chaITF0u-BswQEWyBDChtRqR7exjjImQZYXL9FktrlJqmTPNOw07nBZ6N77Px_9jNUZm0aJi6WADkcnMuvcD5zZNJdXE8Nk_SCXQ2W-qYAatAiMhc3IFJ-L8/s320/IMG_3024%20(2).jpg" width="320" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">The photos of my kids,, at home.</td></tr></tbody></table><p>I live vicariously through others. I surround myself with clothes, shoes, jewelry and interior design. I build and acquire and put little pieces of my soul out into the world. Some of it is buried in an abdomen. The magic of surgery set to make the patient a more viable soul to go back into the realm of the living. </p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEivhX_ugoSij-RelVs0XGeLyuG0-voSGCy-7RlZ_8aEfycRoGGmfTPLmPQZULnZv17Z4PDFh04yfCYrgbBKYZlTTXBuHpU_0wimpR2wqpjCqmgN-UkfOEDWBNPQ9YqFpHLOzjKhelu9_7bL1UDd8HQYUQABowxXUj0bkyJmNhkKw_g1xxaH6I3XMyW3Pkc/s1440/4A268EAB-9931-4E38-AFF2-611344002AFB.JPG" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1080" data-original-width="1440" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEivhX_ugoSij-RelVs0XGeLyuG0-voSGCy-7RlZ_8aEfycRoGGmfTPLmPQZULnZv17Z4PDFh04yfCYrgbBKYZlTTXBuHpU_0wimpR2wqpjCqmgN-UkfOEDWBNPQ9YqFpHLOzjKhelu9_7bL1UDd8HQYUQABowxXUj0bkyJmNhkKw_g1xxaH6I3XMyW3Pkc/s320/4A268EAB-9931-4E38-AFF2-611344002AFB.JPG" width="320" /></a></div><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgFjDS5QtOkmDERRHxkKbMMpInHoARtTjrrx9Q2hE5dsPN-1mE8ce6nPDIQjYp9UE8UmqsOjG-wqYr8E19zK891WKHG-iN6MknLFhMN1n1A6Po50KokMN_5fCO6qGhqov9YmhXwf_irWtdGCb1-A4CpHWVBsulx7NRxE3kbHP3ykTY6lSbGDyS1kB-RJ0g/s2016/IMG_6526.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1512" data-original-width="2016" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgFjDS5QtOkmDERRHxkKbMMpInHoARtTjrrx9Q2hE5dsPN-1mE8ce6nPDIQjYp9UE8UmqsOjG-wqYr8E19zK891WKHG-iN6MknLFhMN1n1A6Po50KokMN_5fCO6qGhqov9YmhXwf_irWtdGCb1-A4CpHWVBsulx7NRxE3kbHP3ykTY6lSbGDyS1kB-RJ0g/s320/IMG_6526.jpg" width="320" /></a></div><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEht7lOK97Me0CchKlFr9j7Sa7IZB25BC7-q7JQANttJQn_AdT5MlFQK9Q2rHWQUUvky4HygaXnBVI2Y_UxKXA_8Vw9-ZhPB5xwRyJt1AvGgPF2PgZN7a-j2szU2rSP_3FNfLlOUGlzmUnGgOAgSo08Z7gXhFryYIxdQt8bxgItAGVl2G0ZlKIHRRtfzmMM/s2016/IMG_6527.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1512" data-original-width="2016" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEht7lOK97Me0CchKlFr9j7Sa7IZB25BC7-q7JQANttJQn_AdT5MlFQK9Q2rHWQUUvky4HygaXnBVI2Y_UxKXA_8Vw9-ZhPB5xwRyJt1AvGgPF2PgZN7a-j2szU2rSP_3FNfLlOUGlzmUnGgOAgSo08Z7gXhFryYIxdQt8bxgItAGVl2G0ZlKIHRRtfzmMM/s320/IMG_6527.jpg" width="320" /></a></div><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgDEVdhK2VlUY4EiiNEoW9fWOf-QvokhBE8YvK-XsQZj57h8k1jKNiO_FuBFUwbmNiCXUsMq7DKpRqxBZCde4ZWlrrJ-0sH13sP7j9dKjtL3sziHVvudGXzcD2ReSXeM-z65rmc-eEPichXHtshwZ1-3MXNebwPlxQNMyKzdiCTyPj-xoi74ayAN5Kl1Po/s1544/IMG_7413.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1544" data-original-width="1158" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgDEVdhK2VlUY4EiiNEoW9fWOf-QvokhBE8YvK-XsQZj57h8k1jKNiO_FuBFUwbmNiCXUsMq7DKpRqxBZCde4ZWlrrJ-0sH13sP7j9dKjtL3sziHVvudGXzcD2ReSXeM-z65rmc-eEPichXHtshwZ1-3MXNebwPlxQNMyKzdiCTyPj-xoi74ayAN5Kl1Po/s320/IMG_7413.jpg" width="240" /></a></div><br /><p>Maybe I get the creative process mixed up with the artistic influence? And maybe the work I build doesn't have to be for pure aesthetics. Maybe the work I do is all about feelings and the hidden magic that building yourself into an expert entails.</p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgVqEtTznLvnGpTp_cdVkhxRCNBhXGPBCy1F3NQKBi2UZ8CbC94cZF3DDqnjZMpXTgdm05p07Y2aiFlx_sh_BKUmiAW_FRHJstLKsakwiLpJi5oABWme37YGjNZan5Tr7_t8r0mtE0IXLkT0aNNtVvflXs5eoJnAZjBYuuGvdGbqcPMYgGgh3ACbpUQ4l0/s1544/IMG_5770.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1544" data-original-width="1160" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgVqEtTznLvnGpTp_cdVkhxRCNBhXGPBCy1F3NQKBi2UZ8CbC94cZF3DDqnjZMpXTgdm05p07Y2aiFlx_sh_BKUmiAW_FRHJstLKsakwiLpJi5oABWme37YGjNZan5Tr7_t8r0mtE0IXLkT0aNNtVvflXs5eoJnAZjBYuuGvdGbqcPMYgGgh3ACbpUQ4l0/w300-h400/IMG_5770.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Seraphina and me. A very good example of my work.<br />my inspiration and my compulsion.</td></tr></tbody></table><br /><p>Is my passion the same as my inspiration and my compulsion? Yes. Call me what you want but I get to live a life that allows me personal expression, freedom to live and love and the acknowledgment that it makes lives better,, even if those lives can't pay me, or thank me, or allow me to sign my name to it. It's all about giving back and sharing joy. The mark of any great artist. </p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg9eQKyXjNzrlUmQqyLL-tPUeH5SWSl-ps4sQNW533Eat75MQez27ARmkt8rl9Mbdesw_qpbV-MAUXicjvhJQeMBQ7uV1n1loWkIihWVUwnnMpZyDOBJWmd3iRbbmGiS_F_l4_MIodiEiSjMM7Jr4rVQOgzkbm7hrRP2ydDcf_zlsXV5jaZSpjJopUhoXc/s2016/IMG_1775.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg9eQKyXjNzrlUmQqyLL-tPUeH5SWSl-ps4sQNW533Eat75MQez27ARmkt8rl9Mbdesw_qpbV-MAUXicjvhJQeMBQ7uV1n1loWkIihWVUwnnMpZyDOBJWmd3iRbbmGiS_F_l4_MIodiEiSjMM7Jr4rVQOgzkbm7hrRP2ydDcf_zlsXV5jaZSpjJopUhoXc/w300-h400/IMG_1775.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">The Artists Village in Asheville NC</td></tr></tbody></table><br /><div class="separator" style="clear: both; text-align: center;"><br /></div>What inspires you? And, is it enough to compel you to do something?<br /><div class="separator" style="clear: both; text-align: center;"><br /></div><br />krista magnifico, DVMhttp://www.blogger.com/profile/15133566329579911573noreply@blogger.com0tag:blogger.com,1999:blog-4667516629745731439.post-40619766301203813082023-07-11T19:19:00.000-07:002023-07-11T19:19:07.993-07:00How Our Pets Define Us.<p></p><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: left;">This is a copy of my most recent Facebook post on my veterinary clinic's page.</div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgDC5cOuaAQm37Fta34qgdP6lhcJfW3JRR6lad8c5E6NahOio9hfmZP9mVXtxvdcoIycz-C4SBbokziYQBAVaZp-EpAW_24_x1HGKLhnJPX_iWlzvcjrAdZ7LSuNpvqy28LVgwetEta-9Lrd0ez0k_iBurW7AydNYsvXNj18Fs6y2jZT1VNyElh5P6fQY0/s4032/IMG_4953.jpeg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="4032" data-original-width="3024" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgDC5cOuaAQm37Fta34qgdP6lhcJfW3JRR6lad8c5E6NahOio9hfmZP9mVXtxvdcoIycz-C4SBbokziYQBAVaZp-EpAW_24_x1HGKLhnJPX_iWlzvcjrAdZ7LSuNpvqy28LVgwetEta-9Lrd0ez0k_iBurW7AydNYsvXNj18Fs6y2jZT1VNyElh5P6fQY0/w300-h400/IMG_4953.jpeg" width="300" /></a></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: left;"><div class="separator" style="clear: both;">This is me. On any given day. There hasn’t been one patient, or one moment of my veterinary life, (or, personal life), where I don’t tell my patients how much I love them. </div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;">I’m working on a project about how much we love, adore, and live for our pets. </div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;">I know my story about <i><b>why</b></i> I am so dedicated and devoted to my pets, (and patients), but I want to hear your thoughts. What does your pet mean to you? How much do you love them and why? DM me or post here. (And let me know if I can use your story). Go!</div></div><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgbUKX8MRdICgYtzIAJGP2kXg7w4nwIwFN-MSC-qdZpXl63OgEv-gP42hnucEQ8oQ7pMy6yVGtNFGUzheYMzHAAJNz9-Tcx2_-yex7ov-s9vCaNdbk-jDOgbNSFnAvi1743uYx3zF1k4s_0b7jWDC4iSIKdXwm_4bDJzwMyZZaEdy3mrnYk1inqKIxt-vs/s4032/IMG_4954.jpeg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="4032" data-original-width="3024" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgbUKX8MRdICgYtzIAJGP2kXg7w4nwIwFN-MSC-qdZpXl63OgEv-gP42hnucEQ8oQ7pMy6yVGtNFGUzheYMzHAAJNz9-Tcx2_-yex7ov-s9vCaNdbk-jDOgbNSFnAvi1743uYx3zF1k4s_0b7jWDC4iSIKdXwm_4bDJzwMyZZaEdy3mrnYk1inqKIxt-vs/w480-h640/IMG_4954.jpeg" width="480" /></a></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: left;">Here are the responses I received:</div><div class="separator" style="clear: both; text-align: left;"><br /></div><div class="separator" style="clear: both; text-align: left;"><b>From Kristen;</b></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgAjujJEZqOCcEJkPiu81xAA3FmMrFZk4hWvWCbTW4VYm3-mfoAw6TCuXfUDymDZpm1olgXg3W5IseoctzLyR6Hf49J1Z2wqU5VpOHdIn3VugAJ9MuvHsWT6GtmHJPL1TPHnKEVQIq6IMAqeahIhzZ8HMqABAat8bll_KlfqJGXmPLsPkO0FnpOccbSzMQ/s960/IMG_6918.JPG" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="960" data-original-width="540" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgAjujJEZqOCcEJkPiu81xAA3FmMrFZk4hWvWCbTW4VYm3-mfoAw6TCuXfUDymDZpm1olgXg3W5IseoctzLyR6Hf49J1Z2wqU5VpOHdIn3VugAJ9MuvHsWT6GtmHJPL1TPHnKEVQIq6IMAqeahIhzZ8HMqABAat8bll_KlfqJGXmPLsPkO0FnpOccbSzMQ/w225-h400/IMG_6918.JPG" width="225" /></a></div><br /><div class="separator" style="clear: both; text-align: left;"><br /></div><div class="separator" style="clear: both; text-align: left;"><div class="separator" style="clear: both;">This is Sarge. I have other pets (who I love dearly) but Sarge is the first dog I had on my own as an adult. He’s been with me through everything for the last 7 years. He’s been with me through the best times and he’s been with me through the absolute worst times in my life. He’s never judged me for mistakes I’ve made. He loves me unconditionally and I love him just as much if not more. He’s not the brightest bulb the majority of the time (lol) and he may be terrified of a 6lb cat but I love him anyway. He’s getting older and his muzzle gets more and more grey every single day it feels like. The day I have to say goodbye to him will be the absolute worst day and I hope it doesn’t come anytime soon 🐾💙</div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;"><b>From Karen;</b> </div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjw2zizSfgbnDpXSonNigq_kXWK7audaykhtbPBbJwDeVZPu-rpoL0eC2E2VP7TKFMGTgCCL3N3CxI81ZS_3nhfFQnW7lOu-eL7HDROUezDcJuZGZ16l7u4NBIagSDMpANVsF1k_vEip1hArS8bCESyV0J9QWglnpiKJWBwZHDY3-SvY5q8G8cA2jAtPuQ/s2015/IMG_6924.JPG" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="2015" data-original-width="1120" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjw2zizSfgbnDpXSonNigq_kXWK7audaykhtbPBbJwDeVZPu-rpoL0eC2E2VP7TKFMGTgCCL3N3CxI81ZS_3nhfFQnW7lOu-eL7HDROUezDcJuZGZ16l7u4NBIagSDMpANVsF1k_vEip1hArS8bCESyV0J9QWglnpiKJWBwZHDY3-SvY5q8G8cA2jAtPuQ/w223-h400/IMG_6924.JPG" width="223" /></a></div><br /><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;">California Cotton( CeCe). And yes, she feel & looks as soft as cotton. She came to me in the summer of 2011, a feral born kitten sleeping on my patio chaise lounge one morning. Making a long story short, I was able to gain her trust & bring her inside to become my constant companion. She made the 1960 mi cross county trip with our retirement relocation from south Cali to west Tn. I love her dearly!!! She is a snowshoe Siamese, 12 yrs old now. You may use my story.....CeCe loves suitcases.♡</div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;"><b>From Katie:</b></div><div class="separator" style="clear: both;"><br /></div><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiQgP9SKUy3fDitvi_FdPymwCPSt30VfQvvqpFAlY15IMXAjtSfhjW9j9lFjKKZZtN4DVMZ981wuAIpp7IuTG8_2lzncu69QGrOd0REP6umNFjAZ0kQub4I1AjwFhhIDKvhJ13nNXBLzkomc2fpeGVnX_hva9--QZakxmPrTydIU35AAPJ_AHXozzYmqj8/s960/image0.jpeg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="960" data-original-width="720" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiQgP9SKUy3fDitvi_FdPymwCPSt30VfQvvqpFAlY15IMXAjtSfhjW9j9lFjKKZZtN4DVMZ981wuAIpp7IuTG8_2lzncu69QGrOd0REP6umNFjAZ0kQub4I1AjwFhhIDKvhJ13nNXBLzkomc2fpeGVnX_hva9--QZakxmPrTydIU35AAPJ_AHXozzYmqj8/w300-h400/image0.jpeg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Fiona</td></tr></tbody></table><br /><div class="separator" style="clear: both;">When I got Fiona a few months after my cat, Pumpkin tragically died, my dad told me that she was so special and Pumpkin sent her to my life for a reason. I thought he was crazy, until my little Fiona saved my mom’s life. </div><div class="separator" style="clear: both;"><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;"><div class="separator" style="clear: both;">Fiona and my mom’s dog, Sophia, got in a little spat and my mom tried to break it up. Fiona inadvertently bit my mom’s breast. Fast forward a few weeks, her breast was very tender which sent her to the doctor and then to get a mammogram. The mammogram showed breast cancer. My mom wasn’t due to get a mammogram for some time and luckily the cancer was caught early enough, she only needed a partial lumpectomy and radiation. </div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;">Without Fiona, this event would have never happened and the cancer would most likely still be undetected. </div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;">Fiona has brought so much joy to our lives and there is nothing we wouldn’t do for her!</div></div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;"><b>From Jewel;</b></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjaywKnPh3PcQhmeAr4-x8hYN3qVxabDh_YFsIMVdVFT6nevYZaiNEwcQ1J7PdrPOwo6MGd-pg3xLCFX5wBp7cv80eM89e_uarBf0fHrhhS1DTqNMwjt2-oXT6_mziosPVFfWjtz6mhaml8InGsn8Ly9lPfjjK0CGDCgsHfvugn6r7lJ6eLcqKW5-wBX40/s1280/IMG_6919.JPG" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1280" data-original-width="964" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjaywKnPh3PcQhmeAr4-x8hYN3qVxabDh_YFsIMVdVFT6nevYZaiNEwcQ1J7PdrPOwo6MGd-pg3xLCFX5wBp7cv80eM89e_uarBf0fHrhhS1DTqNMwjt2-oXT6_mziosPVFfWjtz6mhaml8InGsn8Ly9lPfjjK0CGDCgsHfvugn6r7lJ6eLcqKW5-wBX40/w301-h400/IMG_6919.JPG" width="301" /></a></div><br /><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;">I have always had dogs. Some touch you deeper but you love them all. My son died 15 years ago and his dog passed 2 years later. It was so painful. Several years later I brought home a stubborn, arrogant Chessie pup. We didn't bond right away. Something kept getting in my way. Well, then he bloated and during his recovery, they had me come to the clinic and feed him because he wouldn't eat. You could see his eyes light up, giving me side eye, waiting for me to hand feed him. He is still stubborn but we are forever bonded. He saved me and he sleeps in my bed!</div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;"><br /></div><div class="separator" style="clear: both;"><br /></div></div><div><br /></div></div><br /><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgy9Y8de4d8qdgaMs9SWllmxjxyvHZPCFpZKSKhNG532gzJ26LVVyIDFKh1zUTylRIW_f-SXtcbfjQOv3JayDctbEn35jTK8PQEiU2fg88u4Cdl5WI-MKmkJ7ix_lfzrnD4c7c9w_XBNKGI6PcAjP-RJNVUxEvBvUMc-rcCsH46oVEhtHuLoHafeJncQmg/s4032/IMG_4961.jpeg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="4032" data-original-width="3024" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgy9Y8de4d8qdgaMs9SWllmxjxyvHZPCFpZKSKhNG532gzJ26LVVyIDFKh1zUTylRIW_f-SXtcbfjQOv3JayDctbEn35jTK8PQEiU2fg88u4Cdl5WI-MKmkJ7ix_lfzrnD4c7c9w_XBNKGI6PcAjP-RJNVUxEvBvUMc-rcCsH46oVEhtHuLoHafeJncQmg/w300-h400/IMG_4961.jpeg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Milla and Morrocco</td></tr></tbody></table><br /><br /><div><b>From Dee;</b> <div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhycD4Epngzk4krJHCZOVbZycW7B0g69W7wPypDwvKEYwcoK5tRQ0FdU4-GcpwlOaGrPC1uBAvKcoyF1KALmbOFIxyBffAJ5BFmxDaZymjS3w4Vcbfb863UYWwWkbwY4FWod3l90ga4u7c9bXfrKRzwFoDBCwVnPX2obyQqGmTQuTf_R5ku-U1kiJ14xNA/s960/dee.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="960" data-original-width="540" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhycD4Epngzk4krJHCZOVbZycW7B0g69W7wPypDwvKEYwcoK5tRQ0FdU4-GcpwlOaGrPC1uBAvKcoyF1KALmbOFIxyBffAJ5BFmxDaZymjS3w4Vcbfb863UYWwWkbwY4FWod3l90ga4u7c9bXfrKRzwFoDBCwVnPX2obyQqGmTQuTf_R5ku-U1kiJ14xNA/w225-h400/dee.jpg" width="225" /></a></div><br /><div><br /><div>Unconditional love, no judgement, wet kisses, & wants nothing but a nice belly rub & daily walks with daddy. Archie is a rescue from a kill shelter. Best thing my husband & I ever did was bringing this funny 4 legged animal into our home. He is loved & he gives so much love in return.❤️</div><div><br /></div><div>From Robin;</div><div>Simply unconditional love from all my pets. Even on days where I am a bit down, they cheer me up just.by being there....They're dependent on me for everything and give so much love in return..3 cats and 1 dog..all rescued! ❤️</div><div><br /></div><div><b>From Melinda;</b></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhuqmqQecL1H9ISqJYdi8nZnreunzQtf4AcPjWkA_yogH-mWkKPHj1mi-hOW22YElDjqrwFX4CyagvRAhSxLp8EvI1bkY9smAwrMNqdeupYIcpfL7gwM1Rx1MYkxIWE1IdytazwyPVNNO8wUyWZpI6qn6FDhMrrFDkoOtbpeEnCmgPspWLbMUPnTYdjbKQ/s213/stella.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="213" data-original-width="160" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhuqmqQecL1H9ISqJYdi8nZnreunzQtf4AcPjWkA_yogH-mWkKPHj1mi-hOW22YElDjqrwFX4CyagvRAhSxLp8EvI1bkY9smAwrMNqdeupYIcpfL7gwM1Rx1MYkxIWE1IdytazwyPVNNO8wUyWZpI6qn6FDhMrrFDkoOtbpeEnCmgPspWLbMUPnTYdjbKQ/w300-h400/stella.jpg" width="300" /></a></div><br /><div><br /></div><div>This is my Stella, she came to me about a year before my 14.5 year old pit had to be put done Christmas night from what y’all believed was a brain tumor, Stella has been my heart dog as Carolina was my soul dog, Stella makes my life a little brighter everyday she’s always so happy and full of life but willing to cuddle with me Ans give me lovings at the same time. She’s not my only one I also have a male trouble And recently added Jack to the pack. There is also 4 ferrets and 3 cats that are all part of the family they all keep my busy but i wouldn’t have it any other way and of course use away</div><div><br /><p><b>From Susan; </b></p><p>I have no children of my own...my pets have always been my children. ❤️</p><p><br /></p><p><b>From Marko:</b></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjZ0lHBebHPJIgEpSxnc16F_9BVqxUi2FALSD2gcN4NeTQqCOaeUNyuylwZRSGKxaUGNm4JPnEyJBFVrcd62P2JndiJy3AjeBdf-9poTPFqRpq3TiKNz_jhBnz7CZQ2r0wk75eKfl99rz6R3LKT80y99eEWr_VviGgMkmuSm1FR8D5iqX9JzisoO9ufMfw/s960/markos.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="960" data-original-width="720" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjZ0lHBebHPJIgEpSxnc16F_9BVqxUi2FALSD2gcN4NeTQqCOaeUNyuylwZRSGKxaUGNm4JPnEyJBFVrcd62P2JndiJy3AjeBdf-9poTPFqRpq3TiKNz_jhBnz7CZQ2r0wk75eKfl99rz6R3LKT80y99eEWr_VviGgMkmuSm1FR8D5iqX9JzisoO9ufMfw/w300-h400/markos.jpg" width="300" /></a></div><br /><p>My wife and I have been married for almost 31 years now. She had never had dogs but always wanted one. Even before we got married we got our first yellow lab. Had 5 additional labs over the ensuring years, unfortunately several passed from cancer. 6 years ago we had lost our last best friend and thought we could never go through it again. But time passed and the pain dulls and we started seeing lots of puppies on Facebook. We got the bug….ok I got it and she put up with it. We were very lucky to get our best friend ever, Riptide. For the past 18 months he has grown and gotten more sweet every day. He’s smart, goofy and utterly affectionate and loyal. He loves to go on walks with me, we talk all the time, he tries to talk back. He’s funny and knows it and it has lifted my heart on many occasions and is a joy to wake up to in the morning. While at times he can be a bit mischievous and I get exasperated with him he then does something that melts my anger. He is the best dog we have ever had and we have had some very good companions over the years. How can you not look at this face and smile? I dare you!</p><p><br /></p><p><b>From Susan;</b></p><p>Our first family dog, was the result of much begging. We went to a 'shelter' in the country. My brothers liked the cute black and white that was scared of her own shadow. My dad, ever the RAF officer, had words with a large noisy German shepherd, but I wanted the sandy dog, chained to a pile of sand. I won. All the way home we got lectured about walking, and bathing, brushing, finishing with, "he's not coming in the house till he's had a bath"</p><p>So in the pool outside, we bathed him. He came out sparkly white, with 3 tan patches. The most beautiful border collie, he lived till he was 17 🙂</p><p><br /></p><p><b>From Autumn</b> (vet tech here at Jarrettsville Vet, mom to Hamilton);</p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj_mww-YEbdoCyDskeBDsbcrNnAPdE41pqGNqAa_wF0q4C_9jPCa44uokCY-ZdEVq94RnLKDYAkAS9BOOD0ZmawhmH3LpNaOiBBf-PshCfhwrSIQGbMrtHyyTqs8p2zRZRZ02YeiDItDUl1VsDFst6VjcDlDdOJCuFAVCQqMl81pa7xXOjkyDx9BKm15hU/s960/hamilton%20and%20peaches.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="960" data-original-width="442" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj_mww-YEbdoCyDskeBDsbcrNnAPdE41pqGNqAa_wF0q4C_9jPCa44uokCY-ZdEVq94RnLKDYAkAS9BOOD0ZmawhmH3LpNaOiBBf-PshCfhwrSIQGbMrtHyyTqs8p2zRZRZ02YeiDItDUl1VsDFst6VjcDlDdOJCuFAVCQqMl81pa7xXOjkyDx9BKm15hU/w184-h400/hamilton%20and%20peaches.jpg" width="184" /></a></div><br /><p>Two of my sweet boys- peach will always always hold the biggest spot in my heart. He has not had an easy road what so ever and we have learned that nothing is perfect and to make each day a memory. 🧡</p><p>little ham has forever changed my world and I am so grateful that the individual brought him into work and that Cindy came and got me right away! I won’t ever forget Dr. mags face when I held up my floppy little fish.. she looked at me like I was absolutely crazy, but knew that she’d be right there with me learning the world of ham.</p><p>Both of these orange babies have taught me patience and to just know that everything will be okay. And for that I’m forever grateful to be in the veterinary field helping dogs & cats everyday ❤️</p><p><b>From Suerena;</b></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjVezfnGy4LXf13BQRHyNT0qmyMa2rKMzRAivuzJ8Nf1lXZCdPbMz-YlN17an74qoglDBVfA4QHbMoX8Kz165EDYb11hopGJTK1-Ntc_HVdFk_gG-vuf-pHjPs2Rgylo3I6fSc8Lz6B2_QWj_akV_eYBydmUPuE9UCKIYTZebfhwd1tnmiFnXWU0L7uMlE/s960/suerena.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="834" data-original-width="960" height="348" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjVezfnGy4LXf13BQRHyNT0qmyMa2rKMzRAivuzJ8Nf1lXZCdPbMz-YlN17an74qoglDBVfA4QHbMoX8Kz165EDYb11hopGJTK1-Ntc_HVdFk_gG-vuf-pHjPs2Rgylo3I6fSc8Lz6B2_QWj_akV_eYBydmUPuE9UCKIYTZebfhwd1tnmiFnXWU0L7uMlE/w400-h348/suerena.jpg" width="400" /></a></div><br /><p>My father was an avid animal lover and made sure we grew up with them in our lives. Our cats and dogs were family members, not pets. As an adult, I’ve been fortunate enough to continue that with my children. Animals teach us kindness, forgiveness and unconditional love. That look of love in their eyes when they hone in on you is unmatched. We raised, loved and eventually had to let go of too many babies but somehow our hearts remained open to do it all over again. This is our Odie. He was special. He saw your heart, knew what you needed and when you needed it. He was truly one of our children. We were honored to love him and be loved by him for almost 17 years. My heart still hurts and it’s been a little over a year since we lost him. We’ve opened our hearts once again and adopted and I know she won’t be our last. Because our lives are not complete without the barks, meows, purrs and licks that these precious babies give us. </p><p>Thank you for loving our pets as much as we do. You’re a very special woman with equally special people that you surround yourself with Jarrettsville Vet. You’re welcome to share if you like.</p><p><br /></p><p><b> From Linda;</b></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg4194tyugtxZKF0lfBJJkYMLgWXt5A_-aI_ZONIJO1NLP7bs4SWDC3yLssg2fZ-Ljvod8n721as5DbZvk_VEehvbtMZKhlXjAVgueSpNPTXYAsB74UlM0AUeV3RHVV-nhPUVzlPuC6sGa0j6i9vj3myC0HDYifTx-TGOPAbIudfXpvpF12pzuRgOXL0EA/s2015/linda.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="2015" data-original-width="1079" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg4194tyugtxZKF0lfBJJkYMLgWXt5A_-aI_ZONIJO1NLP7bs4SWDC3yLssg2fZ-Ljvod8n721as5DbZvk_VEehvbtMZKhlXjAVgueSpNPTXYAsB74UlM0AUeV3RHVV-nhPUVzlPuC6sGa0j6i9vj3myC0HDYifTx-TGOPAbIudfXpvpF12pzuRgOXL0EA/w214-h400/linda.jpg" width="214" /></a></div><br /><p>This is my baby Paulie (Paul) we adopted him from a local animal shelter this past January when he was roughly 6months old. He was an early birthday gift. Only the best gift ever!!!! He is sweet, loving, very affectionate, funny & just fills our hearts & our home with Joy. He really keeps us laughing with his crazy antics. We had 3 boy brother cats that we raised from babies. & after our George died , our home was very empty & just void- missing that special spark & love that only having a furrbaby can give. He has helped heal our hearts. I became very ill last summer & spend a lot time in bed/@ home. He stays by my side on those though days & makes me laugh & makes the hard days have some joy.</p><p>So to me, having a pet is having unconditional love & joy.</p><p><br /></p><p><b>From Dolly;</b></p><p>My little Missy means the world to.. Adopted her 7 years ago and never a day goes by I don't thank the Lord I found her. There are so many precious little fur babies out there just waiting for a loving forever home. Please consider adoption....You will never be sorry.</p><p><br /></p><p>From Sue;</p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg98XacOHOt9O87iVOzB3a6E6I7020TveWAeayg5QaukIgbrfEIdDetgoSk9dWgvKcugg0PYq1YYki9M3JmwoRzlwCUdLRsreuujSxU-rkX76JZD_SatoSfpnVcSFXYtGGc545ccO3M44YhPhKFbK4yVV1mAFKAdH-UVPbmdIe8aVacG-T31oUCpnvLrqY/s235/tigger.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="212" data-original-width="235" height="361" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg98XacOHOt9O87iVOzB3a6E6I7020TveWAeayg5QaukIgbrfEIdDetgoSk9dWgvKcugg0PYq1YYki9M3JmwoRzlwCUdLRsreuujSxU-rkX76JZD_SatoSfpnVcSFXYtGGc545ccO3M44YhPhKFbK4yVV1mAFKAdH-UVPbmdIe8aVacG-T31oUCpnvLrqY/w400-h361/tigger.jpg" width="400" /></a></div><br /><p>I have always had pets. As a child, I had ducks, gerbils, rabbits, cats, dogs, guinea pigs and I even hatched a killdeer (bird) that was abandoned in a nest. We also had a dog that we got from the Humane Society. He was not socialized and crazy as all get out. I remember the first day we had him. He stole the dinner off the dinner table. As an adult I always had dogs and cats. I really didn’t intentionally get them. They found me. Of course I loved them all. As I got older dogs became harder because of my illness so once my last dog died, I only had cats. Those always found me too and they were wonderful. I don’t know if I’ve ever gone very long without having a pet. My last pet, Tigger help me through a very difficult time in my life. He was the sweetest, most caring, I don’t want to say human because sometimes humans are not nice, but he just had this quality about him that we just seem to communicate in a different way. He understood when I did not feel well and stayed with me the entire time. When others did not understand my illness, he did. I still miss him. It’s been nine years and as I write this, I am tearing up. I did not want to get another pet after he died of kidney disease. He really had a hard time. We had to give him fluids and he hated it. He didn’t feel well, and he didn’t like what we were doing, but he always cooperated. Not too long after he died my daughter rescued two semi feral young cats and they needed a home. I was not ready but they needed someone and so as it had gone many times before I took them in. They are very sweet and I love both of them and I wouldn’t have it any other way❤️</p><p><br /></p><p><b>From Rebecca;</b></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh99dF6ogBZiVyuPUPV9i_oEFTkCU_SKo9RUj4rWfIGaa1eRnCkpf4QVtsc5CJYos8ontAaV4dPQumagTLZ5lFaoN9T0BffGW2EduXxudGqWg_pK4vquNUTzPmcQAO4A1bMMQLrrQwEm9mx8PYqJyFybjA96gceTlltkWlEVJLMPm0yP_qgiqlb6pNKlCM/s1792/rebecca.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1792" data-original-width="1008" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh99dF6ogBZiVyuPUPV9i_oEFTkCU_SKo9RUj4rWfIGaa1eRnCkpf4QVtsc5CJYos8ontAaV4dPQumagTLZ5lFaoN9T0BffGW2EduXxudGqWg_pK4vquNUTzPmcQAO4A1bMMQLrrQwEm9mx8PYqJyFybjA96gceTlltkWlEVJLMPm0yP_qgiqlb6pNKlCM/w225-h400/rebecca.jpg" width="225" /></a></div><br /><p>This is the middle of my 3 pups, Hunter. He's been with me through a really tough few years( extended family estrangement, mom died, etc). He helped me through every day with his joy and his unconditional love. He's struggling through some serious health issues now but still has moments of joy. I've got you, my sweetest boy💜</p><p><br /></p><p><b>From Jennifer</b> (Jarrettsville Vets business administrator);</p><p></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg2DtdjQN3ztRVzdixjq4wonTralWauoKqtLPCICJVM2V4ZBNYuv7TcG0XW_j3dKbiY47VwgAlorYcjGefdBiVU4SH7Kf7Nv09XPhgxFChRrx1Wh7ACvhGgfD0UPj9ndiXIixSMrRKjwlkEwbTger_RTn_ZiSwfF_-GR2pRwNRFPnDnnUqRXvroUezqX60/s960/johnny%20cash.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="960" data-original-width="720" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg2DtdjQN3ztRVzdixjq4wonTralWauoKqtLPCICJVM2V4ZBNYuv7TcG0XW_j3dKbiY47VwgAlorYcjGefdBiVU4SH7Kf7Nv09XPhgxFChRrx1Wh7ACvhGgfD0UPj9ndiXIixSMrRKjwlkEwbTger_RTn_ZiSwfF_-GR2pRwNRFPnDnnUqRXvroUezqX60/w300-h400/johnny%20cash.jpg" width="300" /></a></div><p>Johnny Cash ❤️ Because of him I learned puppies do die in shelters right here in our own backyard. I found my way back to Rescue, and found my voice for these animals who do not have a voice. Because of him my family has fostered over 100 dogs and puppies, and countless cats over the past 10 years. And because of him I met all of you at JVC. He is my daughter’s best friend, our constant protector, and a dog who’s paws will never be able to be filled. There have been countless times when I want to throw the towel in on this Rescue thing, but I look into his eyes and remember there are many other dogs, just like Johnny Cash, who are waiting in the shelter for a family to call their own too.</p><p></p><p>I’m quite sure that is why Zorro found his way back to me; so that when Cash is gone I will look into his eyes and find my purpose there too. 🐾</p><div><br /></div><b>From Otto;</b></div><div><div><div>My 2 cats 😺 Squeak & 😸 Missy r “my whole world” !!!! If someone asks if I have children, I say, “I have 2 daughters” - lol. 😂😆</div><div>I love ❤️ these 2 to the moon & back - (even more than people or my family - true !). I say pets r “the best thing” that God 🙏🏻 created !!!. They luv u “just as u are” ….. 🥰</div></div><div><br /></div><div><br /></div><p><b>From Jayne;</b></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi-FWnigNaJGhFhjwR4EhiEScv0yngAGPVDMHGOy-xJMYKOa0-NR8oiEJHQZUQJWGht4rHWZkoCAytGZWNQTgYafy13hb213MP8BQX_uWTPh2kB-whzz7V1n5rM2lPM0vMfQmijohMjssnc4Y0_gWtRzEGguq83QAFjkyWx2L_qj48nXzjSO77F3zYgJuo/s960/jayne.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="960" data-original-width="720" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi-FWnigNaJGhFhjwR4EhiEScv0yngAGPVDMHGOy-xJMYKOa0-NR8oiEJHQZUQJWGht4rHWZkoCAytGZWNQTgYafy13hb213MP8BQX_uWTPh2kB-whzz7V1n5rM2lPM0vMfQmijohMjssnc4Y0_gWtRzEGguq83QAFjkyWx2L_qj48nXzjSO77F3zYgJuo/w300-h400/jayne.jpg" width="300" /></a></div><br /><p>They say our pets are an extension of ourselves, and I believe there is a lot of truth to that. And through that bond, they take us on many adventures, provide us with endless joy, help us create connections with others, and give us a sense of purpose.</p><p>My journey started at age 53 when I got my first dog. All my life I’ve had multiple cats and wanted to experience being a dog parent. I still have 3 cats, but have expanded the household to include 3 dogs. I honestly cannot recall my life before dogs, and will never go without ever again. How could I have lived so long without having a dog?</p><p>My first was a Weimaraner puppy (Chloe Marie who is 2 1/2). I resorted to a breeder after trying to get a dog, any dog from local rescues for almost a year. After the 4th “we don’t feel you are a good fit,” I did what I said I would never do and lined the pocket of a breeder. Chloe brought me so much joy that it broke my heart how sad she was every day when I went to work. A friend of mine told me about an adoption event at Petsmart, and although I was looking for a smaller lap dog, for some reason I just knew I needed to adopt this Great Pyrenees who is the best dog and we call Marty.</p><p>6 months later, being so in love with both of my dogs, I decided I needed to volunteer for this rescue that easily let me adopt my baby girls best friend and brother. Needed to pay it forward so to speak. First I found myself unloading stinky dogs at 5 am., then a few hours later cleaning out poopy crates, telling people about the dogs, and facilitating meet and greets. When you make that human/dog connection and see how happy the people and dogs are when they are United you fall down a rabbit hole of dog rescue, and there is no coming back.</p><p>Which brings me to dog number 3, Buddy. Buddy was my 5th foster, and he was an epic fail. He was a 5 year old Wolfhound/Pyrenees mix that had been a working LGD, had been taken into protective custody with 52 other dogs and was still recovering from being attacked by a pack of Coyotes. There was no way I was going to let that dog take another 18 hour trip back to Texas. It took me a while to get him out of the car and into the house. And probably a good 3 months to see him come into his own. But I knew however long he had left on this Earth, he was going to be with me. The entire dynamic in the house changed. He had a calming affect on my Weim, and my Pyrenees had someone to patrol the perimeter of the backyard with. I would take him to the dog park with the Weim, and on the rare occasion when he had a Zoomie all the regulars in the park would cheer. He doesn’t have Livestock to guard anymore, but there are chickens on the other side of the fence. He always goes to that part of the yard and simply sits there guarding the chickens he has never seen. But he is safe now. Retired, and is very nurturing when I bring fosters into the house. We all have a purpose and a role in our little pack here. These 3 guys have connected me to more people and provided me with more joy than words can possibly express. Here is a picture of Buddy, my rescue puzzle who I am still piecing together 9 months later. Little by little we find the pieces, together, each and every day.</p><p><br /></p><p><b>From Donna;</b></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh_bNKqgmPr-bdn_mnlQQi3t8MBFXRxRAQkxNjFg2VPD60QzX3j5yk-ZNSJLqslfN9EIvVXEuFPjpchVJQuAYGlZM069jlqzplGQgXYhpVy6ID4ddguhVI-bypEOz5fxnbgRMvdV0VRe00nF79v0H978u1IQmb0LK4KT_XGTQfIkXqtOwk86GzzfNT3gUk/s1440/donna.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1080" data-original-width="1440" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh_bNKqgmPr-bdn_mnlQQi3t8MBFXRxRAQkxNjFg2VPD60QzX3j5yk-ZNSJLqslfN9EIvVXEuFPjpchVJQuAYGlZM069jlqzplGQgXYhpVy6ID4ddguhVI-bypEOz5fxnbgRMvdV0VRe00nF79v0H978u1IQmb0LK4KT_XGTQfIkXqtOwk86GzzfNT3gUk/w400-h300/donna.jpg" width="400" /></a></div><br /><p>These are my babies, Jackson sitting up and Sugar Plum lying sternal. I adopted Sugar Plum in October of 2014 by direction of my Mom who was recovering from heart surgery. Mom could tell I was missing my fur baby Jessie who I lost in June. Mom passed away December 29th, but she fell in love with Sugar Plum. In July of 2015, Jackson adopted me unexpectedly and we all fell in love. Since January of 2019, I've been dealing with severe injuries sustained at work and without these two beautiful souls, I think I would be insane. There is a reason DOG is GOD spelled backwards. The unconditional love is beyond words but my heart is so full. Thanks for listening and thanks for all that you do for your pets, patients, and clients. ❤</p><p><br /></p><p><b>From Susie;</b></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgfw3PTtFqG9vo1JCfh9OksjILymuodwIKH02XK2ckt0YNge91FfzMZxJKhh2v-t70feyI0hzNv3GaZw92L4MtOpi244ugyf_2mRbm3gttdBmVeCu8S1PFYwWHW8-BxDhlkLfZptZuhz3a1g9Oz0yxYAiapFSB7OCEuEaohg_Gunxwe0OvhuPVJnWkXqQE/s960/poe.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="960" data-original-width="720" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgfw3PTtFqG9vo1JCfh9OksjILymuodwIKH02XK2ckt0YNge91FfzMZxJKhh2v-t70feyI0hzNv3GaZw92L4MtOpi244ugyf_2mRbm3gttdBmVeCu8S1PFYwWHW8-BxDhlkLfZptZuhz3a1g9Oz0yxYAiapFSB7OCEuEaohg_Gunxwe0OvhuPVJnWkXqQE/w300-h400/poe.jpg" width="300" /></a></div><br /><p>This is my 9yo Springer Spaniel Poe. I love him so much and he is my little shadow all day long. He follows me wherever I go around the house and yard. I talk to him constantly. He is very well-trained and always eager to please. A true pleasure to be around. We enjoy our daily long walks to the creek where he loves to swim. I hope he lives forever. I can’t imagine my life without Poe.</p><p><br /></p><p><b>From Donna;</b></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgEt-qhqdBK6K3Ci4FYrtl-rWKIjNLhkbKxQth9mwOLcpanGK67yKeq_1EHdoo_avDbh-RdCNIY55BVRPa9se57qE8CQFuGxPRBpzLQgn3OsRA4du51GsChU8x4MvP9nWUyt0fuBrjy2NxQZbfT8CD2JFJBVhus4KulaYlOFnotHWSqJhI3CpeXx2om420/s2015/chessie.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="2015" data-original-width="1504" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgEt-qhqdBK6K3Ci4FYrtl-rWKIjNLhkbKxQth9mwOLcpanGK67yKeq_1EHdoo_avDbh-RdCNIY55BVRPa9se57qE8CQFuGxPRBpzLQgn3OsRA4du51GsChU8x4MvP9nWUyt0fuBrjy2NxQZbfT8CD2JFJBVhus4KulaYlOFnotHWSqJhI3CpeXx2om420/w299-h400/chessie.jpg" width="299" /></a></div><br /><p>You can often judge how a man will treat you by how he treats animals. When my husband and I first met he had Sady, a black lab/German shepherd mix (100 pounds of dog). She was the smartest, most well behaved dog I had ever met and she was the love of his life. And he was hers. She went almost everywhere with him. I had Duo Maxwell, a pure bred papillon who was dumb as a box of rocks but I loved him. My husband swore he was not a cat person but in 2009 we found Chessie in the woods behind his parents house. Chessie was about 3 weeks old and had been bitten by a snake on his paw. We originally took him in just so we could get him to a vet and then find him a home. Now the old man is 14 and even with some health issues still going strong. We lost Sady the same year we got Chessie and he helped heal my husband's broken heart. We lost Duo in 2018 and I don't know who mourned more, my husband or Chessie. Fast forward to March 2020, I had seen a skinny black cat wandering the field next to our house. When I mentioned it to my husband he said "don't feed it, we don't need another cat". He went out one Sunday evening to get firewood and there it sat on our front porch. Within minutes my husband had a bowl of water, a bowl of food, and a box with a blanket in it for the cat outside. By the next weekend he had built a platform for the box to sit on so that it wasn't on the cold cement. By the following fall Tuxedo had a house with a ramp, shingled roof, insulation board, and a heat lamp. He also gets a fan in the summer. He lives better than some people! Tuxedo prefers to live outside but he is a total lovebug. My boys (as I refer to Chessie and Tuxedo) are our life. They depend on us and we vow to take care of them until their final breath. Sure, sometimes life would be simpler (and cheaper) without pets but their unconditional love and companionship makes it all worth while. I just wish they could live forever.</p><p>JVC, thank you for what you do for all of the animals that come through your door. I am a huge fan of Hami!!😄 </p><p><br /></p><p><b>From Sherry;</b></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiGesaLfCBu6H72GCS0AH3zXN9JG2G85LAQp6uBuYhp18b5IneBtPEj0xpEwk1_q2GKChAeR6-tp1hjuUUKfyC8-lppCiesPKSGE-Gv5aj2xwIMzYB_FDdaO6CJKkCRBYlHYjuoQrwPX-UG_aiG4ydjEZglkM0HDDiggrAvCQHQ75fVyK47h0_qX40nbmQ/s1440/sherry.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1361" data-original-width="1440" height="378" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiGesaLfCBu6H72GCS0AH3zXN9JG2G85LAQp6uBuYhp18b5IneBtPEj0xpEwk1_q2GKChAeR6-tp1hjuUUKfyC8-lppCiesPKSGE-Gv5aj2xwIMzYB_FDdaO6CJKkCRBYlHYjuoQrwPX-UG_aiG4ydjEZglkM0HDDiggrAvCQHQ75fVyK47h0_qX40nbmQ/w400-h378/sherry.jpg" width="400" /></a></div><br /><p>My kiddos have brought me so much joy, laughter, and love. I learned about rescue through the adoption of my first poodle Bentley, and I've been volunteering for over 20 years now. All of my pets have been rescues. They are the greatest loves of my life, and I will forever be an advocate and voice for animals. This my Roo. Today is his 6th birthday!</p><p>I grew up with rabbits, cats, three dogs, snakes, a cockatiel. I read James Herriot’s books until I’d nearly memorized them. I was one of those young horse girls who swore she was going to grow up and be a vet. Vet turned to pre-med, pre-med led me to Latin, Latin led me to Archaeology and archaeology took me all over the world. My life of transatlantic moves, six weeks in Italy, six weeks in Scotland, hoping from project to project in England, the Netherlands, Turkey. I was certain there was no space for pets in that life. But every time I saw a dog on a walk in the hill where I happened to be digging, I’d stop and chat and eventually befriend dog and owner for some sad surrogate dog experience-anything I could get! But life changed. I came back to MD, accompanied by a British husband whose most notable family pet was a gerbil they lost after two weeks. He was overwhelmed by my family’s multi-large-dog household. After a year of living here, and the growing certainty that we would not be moving off-continent, it was my husband who started lobbying for a dog. Mourning my past life of cliché archaeological jetsetting, I thought a dog would ‘tie us down’ and resisted.</p><p>We got Nausicaä ‘Nausi’ (far left) (I chose this for my future dog during my very first Greek class, she’s named after a character in Homer’s Iliad), my perfect heart dog. She is compassion and quiet joy in 51 lbs of cream golden and I was wholly unprepared for just how deeply I would love her and how much she would prove how open I could be to loving and caring for another living thing. Friends joke that I love Naus more than my husband, they aren’t wrong. She came to me at a time when I wasn’t being honest with myself about how broken I was by the loss of my ‘past life’ across the ocean. She gave me something to focus on beyond ruminating in the past, living a half life disappointed that I wasn’t always somewhere else.</p><p><br /></p><p><b>From George;</b></p><p>I was the owner of Georgie ( yellow lab) he had diabetes and wasn’t expected to live very long. He had been getting his shots by me only and on time. Anyway he lived 6 more years before he passed away at Belair animal hospital. He waited for me to get there and be with him when he took his final breath. Broke my heart. My late wife decided to get another dog ( pit bull terrier) Posey to help me get over my broken heart. 4 months later my wife died and Posey was her dog ( 4 months old when we got her. Animal rescue for $500. That dog never left my wife’s side and slept in her lap . Today Posey is going to be 2 yrs old and loves everyone. Loves kissing people. She plays with the cats outdoors and has her own cat inside the house. They play and chase each other. I’m working on trying to get Posey to be like Georgie was . Go for morning rides in my truck but she won’t be still even harnessed to the seat. She’s a good young dog and loves her walks around the property. And is always sniffing around everything. She tired herself out and comes over to take naps laying on my lap. At night I kiss here good night and she sleeps all night. Until I get up then she waits for me to kiss her good morning and tell her I love her. I’m going to be 75 years old ( 5 days ) after Posey’s birthday.</p><p><br /></p><p>Why did I ask for all of these? Because I think it is imperative that we all remember our Why. Why we always see our work as being the most sacred of responsibilities. Why when we have those little choices in a tiny room, where life is hanging in the balance, that you can make a decision to be more. More than you have to be, more than the rest of the world expects you to be, and yes, just enough to be a hero,, to that pet and that person who adores them as their whole world.</p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg67dufK9jIp8q8DVInoIFO3A9rBGrFSiXaxmHqWVWnh1jn-9LkVivXStOsPQ5ZsV3u4pTBQ6cljpCcUbzyRudjyYC1UdetQbvwE6P4KS86GIXZvzah5maf6bwigQG1q-5BI0ZvQlyKpYen5YgJlXY-VUW_LtlpkBWeQODMo8kgG3RABg11PoQNq3QrnY8/s2016/IMG_6338.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg67dufK9jIp8q8DVInoIFO3A9rBGrFSiXaxmHqWVWnh1jn-9LkVivXStOsPQ5ZsV3u4pTBQ6cljpCcUbzyRudjyYC1UdetQbvwE6P4KS86GIXZvzah5maf6bwigQG1q-5BI0ZvQlyKpYen5YgJlXY-VUW_LtlpkBWeQODMo8kgG3RABg11PoQNq3QrnY8/w300-h400/IMG_6338.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">My inspiration. This little girl loves her kitten, who she named Baby Ketchup, just as much as I always have, and always will.</td></tr></tbody></table><br /><p>When my days are long, hard, heart-breaking, and grueling I remember why I am here, and how important what I do is. </p><p>There is more to come. More on why we have to be more to all of those we ate sworn to serve. More on how we can advocate for our pets even when it seems that the profession holds all of the cards. Why transparency is lacking. Why we have abandoned our ability to fight for a patient. Why it is easier and still profitable to euthanize instead of provide the needed care. And why we can convince ourselves that we should treat everything, offer a plan that costs more than it should, and seek compensation regardless of the degree of futility we almost always know it provides. </p><p>Vetmed comes from a place of humble beginnings. We are now a place being consumed by venture capitalists with no rules, no boundaries and a whole heart of emotional influence that will bankrupt a pet parent if able. </p><p><br /></p></div></div></div>krista magnifico, DVMhttp://www.blogger.com/profile/15133566329579911573noreply@blogger.com0tag:blogger.com,1999:blog-4667516629745731439.post-38361168838001427742023-05-14T09:00:00.005-07:002023-05-14T13:15:28.323-07:00Hope and Mother's Day 2023<p>Hope. When there is everything, and nothing, there is still
hope.</p><p class="MsoNormal"><o:p></o:p></p>
<p class="MsoNormal">A long time ago there was a girl who was afraid. Of all of
the things she was this one thing dominated. It was what propelled her,
crippled her, and reminded her. It was the beast she lay victim to for all of
the days. It was the affliction her mother had and her mother before her. It was
everything and nothing. It was, and it was what she let it be. <o:p></o:p></p>
<p class="MsoNormal">It was like this for a very long time. A lifetime, and then,
a lifetime more. <o:p></o:p></p>
<p class="MsoNormal">It took a long time to recognize the part of her she didn’t
have to be. She knew that there had to be more to this journey. The one she
woke up to everyday to repeat the whole pattern again. But when you carry a
beast so big, and so heavy, it is hard to raise your eyes above it. Maybe fear is
the antidote to hope, she thought. And, maybe hope was the cure for her fear?
And with that it began; the daily ritual of pulling her bootstraps up and
raising her chin above the horizon, just to see if maybe out there somewhere there
was another option to her fear. Maybe there was a place she could leave it? Just
to rest its weary head for a while. Maybe, it was as tired of her as she was of
it? Maybe, they could exist without each other? The shell without the cortex. The
cure without the disease. Maybe, if she could grow big enough and strong enough,
she could outgrow its need for her, and with all things that persist long
enough, her need for it? Maybe? Just maybe?<o:p></o:p></p>
<p class="MsoNormal">What happens is that time works its magic on you and you
grow comfortable with even the most horrible. You get used to each other to a
degree that makes it hard to coexist without each other, even when the other
half is a cancer. A bad marriage arranged on the most horrific of terms. Life
is like that. It will kill you if you let it. Leach you to anemia just to see
what the reserve tank has in it. Medicine, the art of molecular life in the
grips of another life, the host with its many moving parts all required to work
in tandem even when they have opposing agendas, is also just like this. A dance, a
tango set to a music you cannot always chose. You try to lead but you know the
tempo might change and there may be feet stepped on as you tip-toe across the
floor. <o:p></o:p></p>
<p class="MsoNormal">Isn’t life like this for all of us? The calculations of
actions you make silently within to try to make it through life with as little
turmoil, pain, and scarring as possible. At what point do we learn that if you
don’t have one side of the coin it's impossible to know the other. Maybe with
age there is wisdom and the ability to excise the fear so you can live with just the
hope?<o:p></o:p></p>
<p class="MsoNormal">Today is Mother’s Day. The day that we all celebrate the origin
of our existence on the double X chromosome in our own DNA. For me, May 14 is the
day my mother died. On this day at 4:14 pm in a little stone house not too far
from my own, my mom was given her last breath. I say this as it marks a date,
impermeable, and in-excisable that is the pivot point to which the calendar resets,
and a life without another starts. It is that day changed so much
within me. There is a book to write about her, and her impact upon me. A book
that sits waiting for the time and the distance to write it without it eating
me up. Consuming me like the fear that swallowed her and kept her trapped
within.<o:p></o:p></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhFNhKdHCgocHYge838PhblOesV9R-zLZSjFwMGaAnVS_ywogJRcdxkFORcsu4CNb2vxJFzr3JNU-aL3Itc4u9edb5F9mW93mY7LLdgBNUK797TY1G33ezZsgMGywRPaIeMlJLMAkRkVk66F-R9v74GAQunyGosjajX08-rmXG799l0aGqlf7qu_swe/s2016/IMG_0108.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1512" data-original-width="2016" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhFNhKdHCgocHYge838PhblOesV9R-zLZSjFwMGaAnVS_ywogJRcdxkFORcsu4CNb2vxJFzr3JNU-aL3Itc4u9edb5F9mW93mY7LLdgBNUK797TY1G33ezZsgMGywRPaIeMlJLMAkRkVk66F-R9v74GAQunyGosjajX08-rmXG799l0aGqlf7qu_swe/w400-h300/IMG_0108.jpg" width="400" /></a></div><br /><p class="MsoNormal">Today I remind myself that there is life after another life passes
on. I cannot call her life gone. She is never gone. She is here all around me reminding
me to always have hope. To always see the beauty and the joy in the life that
exists even if you have a difficult time seeing through the tears. Today I talk
about hope.</p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgs1xnQRcKmDMPCBeWIN4tr2RtdPGKuIWMnaj9Ht7ckK948fyP-bC3qMctaS5YTxa8xM0F6ABL_CQTIMgGePlH3nO8Yb2kcIMjLIgFEQZ8PmAQeR_k5Ta79gPfIGF4poDMx_PIESlQiMCdwb6E-C5F79mZHrhwQjwSKhPGMUakhWafxJAMEZwhbdY4o/s1819/IMG_5968.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1365" data-original-width="1819" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgs1xnQRcKmDMPCBeWIN4tr2RtdPGKuIWMnaj9Ht7ckK948fyP-bC3qMctaS5YTxa8xM0F6ABL_CQTIMgGePlH3nO8Yb2kcIMjLIgFEQZ8PmAQeR_k5Ta79gPfIGF4poDMx_PIESlQiMCdwb6E-C5F79mZHrhwQjwSKhPGMUakhWafxJAMEZwhbdY4o/w400-h300/IMG_5968.jpg" width="400" /></a></div><br /><p class="MsoNormal">This morning I opened my eyes before the sun came up. The sky crept
from black to the darkest of blue. A grey-washed out kind of blue. Smeared in
its blurry shadows. Quiet, heavy, and slumbered with a fog that keeps all of
the earth’s tiny souls safe in their beds. The first rays of sunshine wake up
the world and to this awakening the first chirp can be heard. It is my time to
be alone and feel as if the world will remind me that I am never really solitary.
One little chirp. Just a call in the almost-darkness to awaken the rest. I turn
on my Merlin app, and start to record. I now know that this tiny rooster call
is an American Robin. Maybe being afraid, and trying to replace it with hope is
about seeing the bravery in the darkest of places and still singing?</p><div class="separator" style="clear: both; text-align: center;"><iframe allowfullscreen='allowfullscreen' webkitallowfullscreen='webkitallowfullscreen' mozallowfullscreen='mozallowfullscreen' width='320' height='266' src='https://www.blogger.com/video.g?token=AD6v5dwbRUPvkzGL33L6Mzcsp1CIkq1szRyi_lDKRtpEYu9VXqKIBCnOdvGk7W0K7f_PVB4DN_DZ2_mjN4qUqxGIiw' class='b-hbp-video b-uploaded' frameborder='0'></iframe></div><br /><p class="MsoNormal">here's this mornings first recording; (and try the Merlin app. You can listen and identify all of the birds. It's amazing, and you will part of something that is alive around you that you never felt before. And maybe it can help us all remember that we are all mothers to each other?). </p>
<p class="MsoNormal">I made a video the other week about all of the clients I see
who come to me having to lay their pet to rest after disease, and age, and all
of the many afflictions that life can wear you down from. They always ask me
the same thing, without fail; they ask, “this must be the hardest thing that
you have to do as a veterinarian?” And I always reply the same way… “No. You
loved your pet so much that you made them a part of your family. They were
loved every moment of their lives. How lucky they are for that, and I know they
are so grateful to have been yours.” That is the hope in the face of fear. That
is the beauty in the face of death. Maybe losing someone you love is about
remembering the hope they brought you everyday you were together?<o:p></o:p></p>
<p class="MsoNormal">With hope springs gratitude eternal. Is there anything we wouldn’t
give for that?<o:p></o:p></p>
<p class="MsoNormal">Happy Mothers Day to you all. (regardless of what your chromosomes
or current <i>children</i> roster looks like)..<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEisSVMPccGvhsGmUWyXtdVFe7TT_K_GQtBLAfCe4N_e4_hvGfCash2SC8aoQ48eEvYYdUm4LBolReHmnIwZYDyK_Ggl8WnGX6RRssmP8YUCwMu0-6q9xngFU5fh8IKO-DkN3vyCQ1rBhX5N54rKymsulklGrB0QbwljVUq2Sr13wWdv9RAD1snVD6cr/s240/IMG_8249.JPG" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="240" data-original-width="240" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEisSVMPccGvhsGmUWyXtdVFe7TT_K_GQtBLAfCe4N_e4_hvGfCash2SC8aoQ48eEvYYdUm4LBolReHmnIwZYDyK_Ggl8WnGX6RRssmP8YUCwMu0-6q9xngFU5fh8IKO-DkN3vyCQ1rBhX5N54rKymsulklGrB0QbwljVUq2Sr13wWdv9RAD1snVD6cr/w400-h400/IMG_8249.JPG" width="400" /></a></div><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhoNXAupO9QD0uuQpZqKxY3v6v8xff34IVjcBmIULWJwDt7EeHEPlFYfkebwOzscfelli9sQcHEqy93TJwZoejKwB21zMKkxrbcjSrh9LCYOVzk0BCyXS6wM4xuaC0tbPk0_HW8hmMnV51qosf53OACjTUedT4GLuOmt1EZ5aANjPosf3KpWZ-2uvSm/s1544/IMG_5770.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1544" data-original-width="1160" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhoNXAupO9QD0uuQpZqKxY3v6v8xff34IVjcBmIULWJwDt7EeHEPlFYfkebwOzscfelli9sQcHEqy93TJwZoejKwB21zMKkxrbcjSrh9LCYOVzk0BCyXS6wM4xuaC0tbPk0_HW8hmMnV51qosf53OACjTUedT4GLuOmt1EZ5aANjPosf3KpWZ-2uvSm/w300-h400/IMG_5770.jpg" width="300" /></a></div><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjH5I9FGOirPk0etmIsSW_wf4M_tRDwCsb8Po6WRaeBlZr4zeOdSnuLuyd39XE_OmXMNI6ydOEHT6iYAPgwzLEu-Yqcof63EWv0dCADeElQnkgZYt6tqmmXvwyJGro2ZJ9QRyedrPv2G3j1fmMinzHLs7p4To8FvJnyVoOi1U-efZLFxzht0ZbsdzAX/s960/IMG_5198.JPG" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="960" data-original-width="720" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjH5I9FGOirPk0etmIsSW_wf4M_tRDwCsb8Po6WRaeBlZr4zeOdSnuLuyd39XE_OmXMNI6ydOEHT6iYAPgwzLEu-Yqcof63EWv0dCADeElQnkgZYt6tqmmXvwyJGro2ZJ9QRyedrPv2G3j1fmMinzHLs7p4To8FvJnyVoOi1U-efZLFxzht0ZbsdzAX/w300-h400/IMG_5198.JPG" width="300" /></a></div><br /><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiCjHA6M8AYZPnxW-Hj07U7n46pbmzrtxu9BjRE4LqbRvqLCOgpntUaIkRkoU-9k3OwDj9LP1UrrravDceUkf9CcM6JwjET8tGFAZemo9dOQFL-7f0OEtePzoWml4PYiADQFpTh6o2gSEn1xsoJY08MRgNP34whUAkBARwxtNJour8b9mpOIlZJ66K1/s1280/IMG_3024%20(1).jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="960" data-original-width="1280" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiCjHA6M8AYZPnxW-Hj07U7n46pbmzrtxu9BjRE4LqbRvqLCOgpntUaIkRkoU-9k3OwDj9LP1UrrravDceUkf9CcM6JwjET8tGFAZemo9dOQFL-7f0OEtePzoWml4PYiADQFpTh6o2gSEn1xsoJY08MRgNP34whUAkBARwxtNJour8b9mpOIlZJ66K1/w400-h300/IMG_3024%20(1).jpg" width="400" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;"></td></tr></tbody></table><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjtdR_YlEQ8SfOrHsoZo9DSaoId6IQfCvGk8QB91meuXGSpu8wVj0vT-PRSphdKOPQA6DaCw_wDESso_7kRbefQW1Q_JF0SyowkJspewA0-ed3UW317uU2M0kHrHcfh-WNuTN9JCId2cnpO6lzhm2xZ5s7-r6IkzyLPmmh7J-d-hXZVkGf0MuC_qyee/s2016/IMG_2964.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjtdR_YlEQ8SfOrHsoZo9DSaoId6IQfCvGk8QB91meuXGSpu8wVj0vT-PRSphdKOPQA6DaCw_wDESso_7kRbefQW1Q_JF0SyowkJspewA0-ed3UW317uU2M0kHrHcfh-WNuTN9JCId2cnpO6lzhm2xZ5s7-r6IkzyLPmmh7J-d-hXZVkGf0MuC_qyee/w300-h400/IMG_2964.jpg" width="300" /></a></div><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh-RGql1pjEFLnBawbB3608HvcLf6BpnCld6mvUrUK6a5gDke36JLCBaDJkdVCTKOMJV_xc_6EE-F3RxMjS8B9kfrn601Jqd9MdQrffXK0IZAiDWBj9J9j3pG51kYxyPOoFBKN80Wmwr0rrOEP1LGJCushYJJoz4jiPCK77hCY_Vxb_Gp_-t5Oiltsl/s2016/IMG_2954.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1512" data-original-width="2016" height="480" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh-RGql1pjEFLnBawbB3608HvcLf6BpnCld6mvUrUK6a5gDke36JLCBaDJkdVCTKOMJV_xc_6EE-F3RxMjS8B9kfrn601Jqd9MdQrffXK0IZAiDWBj9J9j3pG51kYxyPOoFBKN80Wmwr0rrOEP1LGJCushYJJoz4jiPCK77hCY_Vxb_Gp_-t5Oiltsl/w640-h480/IMG_2954.jpg" width="640" /></a></div><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjxsnjhPcqJvFiwOCK4XSSvetHIH7GWn3TAJNK8nVUP-ktS46AnGij7Y5UwpyebPvyvwEkp1c77knHc5sSDSOrFe2nhBcR-Gjj0DmOIMiquzl5brvUekqBaUXjdrrnLC1iK5jbCB1UKFizAtm5kwVxbdV0YqnWKQyOuzQREYVHmch40Kl0kJ7pplOo-/s2016/IMG_2945.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjxsnjhPcqJvFiwOCK4XSSvetHIH7GWn3TAJNK8nVUP-ktS46AnGij7Y5UwpyebPvyvwEkp1c77knHc5sSDSOrFe2nhBcR-Gjj0DmOIMiquzl5brvUekqBaUXjdrrnLC1iK5jbCB1UKFizAtm5kwVxbdV0YqnWKQyOuzQREYVHmch40Kl0kJ7pplOo-/w300-h400/IMG_2945.jpg" width="300" /></a></div><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiFDoJ57Y26ncGOhRnSep-tAHuJNJstbTZDnSxcSg9g-ojH2URW29X196zsQU2Ni-9Jdglo76SixVNgN3nHcxFO9m2JBnenN1Gdt7Kdap4OY63a2p328ucRlnnl10hitH8odOeYOvJKvUMVw_Sdx3HYLyrpb96iAv2o--OYBq7WzwOB7G1C8dQoOvBX/s2016/IMG_2852.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiFDoJ57Y26ncGOhRnSep-tAHuJNJstbTZDnSxcSg9g-ojH2URW29X196zsQU2Ni-9Jdglo76SixVNgN3nHcxFO9m2JBnenN1Gdt7Kdap4OY63a2p328ucRlnnl10hitH8odOeYOvJKvUMVw_Sdx3HYLyrpb96iAv2o--OYBq7WzwOB7G1C8dQoOvBX/w300-h400/IMG_2852.jpg" width="300" /></a></div><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgH5UAXKaJ0k65RdktamnVv3KUidr7NJF278utYighmFXiu7eecvcu7K_FOz7m8Ea5uKIyA98dXpdqXrsfve0h1wg3UwIUQ4xXSLPkqASAoxFtslrTpHp2XDMBk6kjaxK-q4pkU9ZQNFF6e2pIrOykvgwlQNzR1W1BfXB50Dy2m6SS-abRJ1XabCrZB/s2016/IMG_2827.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1512" data-original-width="2016" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgH5UAXKaJ0k65RdktamnVv3KUidr7NJF278utYighmFXiu7eecvcu7K_FOz7m8Ea5uKIyA98dXpdqXrsfve0h1wg3UwIUQ4xXSLPkqASAoxFtslrTpHp2XDMBk6kjaxK-q4pkU9ZQNFF6e2pIrOykvgwlQNzR1W1BfXB50Dy2m6SS-abRJ1XabCrZB/w400-h300/IMG_2827.jpg" width="400" /></a></div><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiJmAjlVeGIoSI2NuHYJUsEkGIK-5Ma-w7SB6VQkWLEpjqJliiMcsYMMJqqrZffx4abA88tRdctK4y1vlVccN14Y1nqi3MnIKZIIVFN6kRv5hBZNcL7Hh9VHGja0QXC4rep0oAr3cu6M3FOWXdtVh5X_YdKpRgj6Wh58f5Nn0jqy_QWZFQrb4n91MPa/s2016/IMG_0683.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiJmAjlVeGIoSI2NuHYJUsEkGIK-5Ma-w7SB6VQkWLEpjqJliiMcsYMMJqqrZffx4abA88tRdctK4y1vlVccN14Y1nqi3MnIKZIIVFN6kRv5hBZNcL7Hh9VHGja0QXC4rep0oAr3cu6M3FOWXdtVh5X_YdKpRgj6Wh58f5Nn0jqy_QWZFQrb4n91MPa/w300-h400/IMG_0683.jpg" width="300" /></a></div><br /><p></p>
<p class="MsoNormal">And P.S. go out and foster, adopt, and live life with
someone else… pets count as kids these days,, so we are all moms here. Maybe
there is life outside of the one you are living right now where hope springs
eternal? And, maybe its time to go look for it? Let’s all look for hope in the
love that reminds us we are all mothers. <o:p></o:p></p><p class="MsoNormal">More on my mom here.</p><p class="MsoNormal"><a href="https://stonehousebeautiful.blogspot.com/2017/12/the-ross-house-delta-pennsylvania-aka.html">The Ross House. My Mom's Decorating and The Things She Treasured.</a></p><p class="MsoNormal"><a href="https://stonehousebeautiful.blogspot.com/2020/12/the-first-christmas-without-her.html">The First Christmas Without My Mom.</a></p><p class="MsoNormal"><a href="https://kmdvm.blogspot.com/2023/03/the-sensuous-bean.html">The Sensuous Bean.</a></p><p class="MsoNormal">And to identify the songs in your back yard; <a href="https://merlin.allaboutbirds.org/">Merlin app information here. </a> </p>krista magnifico, DVMhttp://www.blogger.com/profile/15133566329579911573noreply@blogger.com0tag:blogger.com,1999:blog-4667516629745731439.post-41120076002165495302023-04-21T15:01:00.001-07:002023-04-21T15:01:19.203-07:00Blocked Cats; My Cause and My Advice<p>A "blocked cat" in vetmed terms is a cat who cannot pass urine normally, or, at all. "Blocked" refers to urinary bladder blockage. A blocked cat is a medical emergency and should be treated as such.</p><p>Here is how I treat a blocked cat, and, why/how these cases often come to find me.</p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiLd5fMpcIT4brDGpMirLNEbpLAGzCd4axo7VPTsKbwGCFqbGwB4xfWW7D9GD5F71EafzreklMCz52s3kzKF4b6bQUrMlq5_uUQdijDZdC_ZmBo9abT-JBb0d9-OXGbX_7w_WiCqOAtNlaz_oiGmfeXoeE58j0psjDIffH0tp3Ywj_eZh1w0fCa2CzJ/s2016/IMG_8487.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1512" data-original-width="2016" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiLd5fMpcIT4brDGpMirLNEbpLAGzCd4axo7VPTsKbwGCFqbGwB4xfWW7D9GD5F71EafzreklMCz52s3kzKF4b6bQUrMlq5_uUQdijDZdC_ZmBo9abT-JBb0d9-OXGbX_7w_WiCqOAtNlaz_oiGmfeXoeE58j0psjDIffH0tp3Ywj_eZh1w0fCa2CzJ/w400-h300/IMG_8487.jpg" width="400" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Stripes. Presented blocked and unhappy about it.</td></tr></tbody></table><br /><p>The typical scenario for a blocked cat presentation is this;</p><p class="MsoNormal"></p><ul style="text-align: left;"><li>Cat is
in and out of the litter box, </li><li>Often
crying, meowing, and/or, in distress </li><li>Little
to no urine is being produced</li></ul><p></p><p class="MsoNormal"><o:p></o:p></p>
<p class="MsoNormal">Client and blocked cat show up at vet office or ER. Cat is examined and owner is asked to produce a $2,000 deposit for care. Most struggle to afford this. Many cannot. Therefore, they call me for help.</p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgnkGLIXVvrjnq_o2Ell9cAszovjgaEF3r9kMiTNIt45Gcw7yfpxbJ-BRe3Ohx5UtvbeJkHWU4B-wdZTbB2MAOcn-ml2FiRB82yezYgrYMqHZTEF57n1CE7nl1EB-IW1bdAYmXbjpXIbDM-vVavnfX4hpOY_13a7AMNQpOxiU6or_L9yq8S1r-jIrWN/s1280/IMG_7280.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="960" data-original-width="1280" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgnkGLIXVvrjnq_o2Ell9cAszovjgaEF3r9kMiTNIt45Gcw7yfpxbJ-BRe3Ohx5UtvbeJkHWU4B-wdZTbB2MAOcn-ml2FiRB82yezYgrYMqHZTEF57n1CE7nl1EB-IW1bdAYmXbjpXIbDM-vVavnfX4hpOY_13a7AMNQpOxiU6or_L9yq8S1r-jIrWN/w400-h300/IMG_7280.jpg" width="400" /></a></div><br /><p class="MsoNormal">Here is a look at how I manage blocked cat cases with financial constraints at my veterinary practice.</p><p class="MsoNormal">Almost all cats can be
diagnosed without diagnostics (outside of the above mentioned physical exam and history). I DO NOT RUN DIAGNOSTICS IF IT WILL AFFECT A PATIENTS ABILITY TO RECEIVE TREATMENT. This is a practice that has become all too common place and the systemic practice of economic euthanasia to allow for diagnostics is unethical and warrants state board and AVMA scrutiny and policy changes.</p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjO0bPfOy_4nLo0OURii1mk7y-_kW05fi9xxKX45am86K5dALMUn8RsHCnIuYCgbZAE9X5OER5lhsjeULAjV5pt-PADSQ04qujnZtPHL2W_dBUGNprFxUFLxr4rVMPRpaiSxIxqLXBH4VY4-EoQ45VA_zwHksCIM7YvGyfjZkhvZIS6N1KUNo6pN0rr/s2016/IMG_8490.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjO0bPfOy_4nLo0OURii1mk7y-_kW05fi9xxKX45am86K5dALMUn8RsHCnIuYCgbZAE9X5OER5lhsjeULAjV5pt-PADSQ04qujnZtPHL2W_dBUGNprFxUFLxr4rVMPRpaiSxIxqLXBH4VY4-EoQ45VA_zwHksCIM7YvGyfjZkhvZIS6N1KUNo6pN0rr/w300-h400/IMG_8490.jpg" width="300" /></a></div><br /><p class="MsoNormal"><span style="color: #2b00fe;">KEY POINT;</span> This should be provided in documentation after the examination is done. At each client documentation/signature request the client MUST get a copy, and, there MUST be current patient status listed. A client has the right to deny diagnostics and still receive life saving care. The egregious practice of turning away clients if they will not meet a practices proposed standard of care, and the corresponding costs associated with them, is also in need of AVMA and state board examination. We allow the euthanasia of patients because we reduce them to property status when it suits our prejudice and financial gain discretion. A blocked cat is typically young, otherwise healthy and free from any other medical conditions. They may present looking, and feeling, bad, but, they are treatable in almost 100% of these cases IF UNBLOCKED.</p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjRDF2QZhPS8odIppxkPJ0EpQSrHAvZHk7CkQ-FwdPDttxo8amqd36dBs8VmSpTyA3xcEogEw4hWmlvVj-xtE5pXlgPnDT2j1udtt6dN51j0hhCU8fjhWuBkMVlmXhVRaPe9LCQ-5W34xKFRkTB2R5fwiLRer1_r6ahOEcM_BI45kz6Q70dpywf_xy-/s2016/IMG_8497.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjRDF2QZhPS8odIppxkPJ0EpQSrHAvZHk7CkQ-FwdPDttxo8amqd36dBs8VmSpTyA3xcEogEw4hWmlvVj-xtE5pXlgPnDT2j1udtt6dN51j0hhCU8fjhWuBkMVlmXhVRaPe9LCQ-5W34xKFRkTB2R5fwiLRer1_r6ahOEcM_BI45kz6Q70dpywf_xy-/w300-h400/IMG_8497.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Urine, rally bloody, from a recently unblocked cat</td></tr></tbody></table><br /><p class="MsoNormal">I am going to describe the typical blocked
cat cases that I see, and, how I manage them. Almost all of these are owned by people
who have financial limitations. I am also providing <i><span style="color: red;">challenges</span></i><span style="color: red;"> </span>to the typical way an ER manages these cases to help
highlight areas we can help allocate resources to as I call it, “get out alive.”</p><p class="MsoNormal"><o:p></o:p></p>
<p class="MsoNormal"><span style="mso-tab-count: 1;"> </span>First <i><span style="color: red;">challenge</span></i>; diagnostics are not needed to diagnose.
Short of a very obese cat a competent physical exam AND thorough history will
diagnose the majority of these cases. Why does everyone run diagnostics? Why,
again, are we not talking about the client’s budget at the beginning of
spending their money?<o:p></o:p></p>
<p class="MsoNormal"><span style="mso-tab-count: 1;"> </span>Second <i><span style="color: red;">challenge</span></i>; diagnostics, regardless of their
findings do not influence the care needed. ALL of these cats need to be
unblocked immediately. In some very rare cases there are some patients who
should not be treated, or, have a poor prognosis regardless of treatment. (i.e.
geriatric cats with comorbidities, fractious, feral, unknown rabies history, cats
we will not be able to safely manage fluids/urinary catheter on, loss neural function, etc).
These patients/clients deserve to be notified before treatment, or estimates,
are provided. Futility* medicine should be as ethically bound as economic
euthanasia defaults, and over padded invoices that prohibit care ability because
finances have been drained in the diagnostic phase.<o:p></o:p></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjKqVOs4YDVSS5rfOMoRKYaZbNQamSQADnQi5BDKdXCNVM2sJUj8u6_O8cF9XsjQAi-LoAvYauj_QB67lzyNPTB_ADpteV0IUCtrg-Us3a5UDQi2E8laU_1HstDawS-H_9nY3_U__KD2z8f5YPjuHaGEcMp82yqTgJH2Z2FHaKyxo_NVbOYBRtBFRsZ/s1280/IMG_7299.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1280" data-original-width="960" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjKqVOs4YDVSS5rfOMoRKYaZbNQamSQADnQi5BDKdXCNVM2sJUj8u6_O8cF9XsjQAi-LoAvYauj_QB67lzyNPTB_ADpteV0IUCtrg-Us3a5UDQi2E8laU_1HstDawS-H_9nY3_U__KD2z8f5YPjuHaGEcMp82yqTgJH2Z2FHaKyxo_NVbOYBRtBFRsZ/w300-h400/IMG_7299.jpg" width="300" /></a></div><br /><p class="MsoNormal">I would like to provide users with a step by step approach
to their cats care. Challenge the suggested treatment protocols to save clients
from economic euthanasia</p><p class="MsoNormal"><o:p></o:p></p>
<p class="MsoNormal">Next <i><span style="color: red;">challenge</span></i>; vets
do not talk to clients about managing financial resources to allow for the expected
stumbles in this disease process. <o:p></o:p></p>
<br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEixCGBeQ6mS17MYU6-o2JUn7XVCKCP3GzzPoaFrN8PVIzC3coynIugqLMlcOC3cXHCBl4AdSsdyaJpnN_QVL5sZM_T9rM6cWNT28kLgLHqVmi6Jm0n2lf1Igw5aA4M9Lo3YnIYtvgZ0ain8rsSe9_hrM8ybl0vYE9cftWPn2vRq5lC7Eg04NPT1gIGW/s2016/IMG_8499.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEixCGBeQ6mS17MYU6-o2JUn7XVCKCP3GzzPoaFrN8PVIzC3coynIugqLMlcOC3cXHCBl4AdSsdyaJpnN_QVL5sZM_T9rM6cWNT28kLgLHqVmi6Jm0n2lf1Igw5aA4M9Lo3YnIYtvgZ0ain8rsSe9_hrM8ybl0vYE9cftWPn2vRq5lC7Eg04NPT1gIGW/w300-h400/IMG_8499.jpg" width="300" /></a></div><br /><p class="MsoNormal"><i><span style="color: red;">Challenge</span></i>; talk about
whole pet care, not point of care emergency. Who else talks to clients like I
do? I say, once we start treating we are all committed to a positive outcome.
This is NOT based on financial ability. It is based on needed patient care. Vet
med withholds this until it is perceived that clients are dry and then we offer
euthanasia as the only affordable option.</p><p class="MsoNormal"><o:p></o:p></p>
<p class="MsoNormal"><i><span style="color: red;">Challenge</span></i>; these cats
are typically young (under 3-4 years old) and otherwise very healthy. We are over-euthanizing
young, previously perfectly healthy cats simply because we have priced them out
of care. These cases have been around for decades. Decades where we treated
them at minimal cost and saved the majority of these cats. Why are more cats dying
now? We priced people out of care while better educating the public on this
disease. That is unethical. This needs to be challenged.<o:p></o:p></p>
<p class="MsoNormal"><i><span style="color: red;">Challenge</span></i>; why do we
run blood work on ALL of these cats? And then tell owners that ALL of these
cats blood work looks bad, because, well simply they are sick, they are
critical and they do look bad. What were we expecting the blood work to look
like? We do it to make money, and, we do it to CYA, and we do it because someone
made us believe it was a liability otherwise? It’s time to challenge pricing
pets out of care while we CYA.<o:p></o:p></p>
<p class="MsoNormal"><i><span style="color: red;">Challenge</span></i><span style="color: red;"> </span>ALL of these cats in my experience go back to
perfectly normal blood work indices after their obstruction is removed and they
are given time to recover. They do not start out in kidney failure although all
of them have blood work that looks like kidney failure while they are blocked
and present for care. Vets use this to their advantage when discussing
euthanasia, or repeating blood work. It is deceitful.<o:p></o:p></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhYevEjibn2SyDHafUH73TWCNDuquo4Zqv4y3F_ouxE_iWri1VD3RVcH_pI6tZnlDNbslSnC16BdMuS5bp979J9PLroKNnURbaF7P6URt6GUiprbBoMEnbqQKAmdYO504Pr3OqYElSH2zfchvo2DYc7tS5WlKY4Ts5v-0iTSgUSMGlCxWkOj3YY1A8-/s2016/IMG_1384.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhYevEjibn2SyDHafUH73TWCNDuquo4Zqv4y3F_ouxE_iWri1VD3RVcH_pI6tZnlDNbslSnC16BdMuS5bp979J9PLroKNnURbaF7P6URt6GUiprbBoMEnbqQKAmdYO504Pr3OqYElSH2zfchvo2DYc7tS5WlKY4Ts5v-0iTSgUSMGlCxWkOj3YY1A8-/w300-h400/IMG_1384.jpg" width="300" /></a></div><br /><p class="MsoNormal">In cases of financial limitations (this is decided up front
at the first visit/interaction) we have an ethical obligation to discuss what
we expect, what we have seen to be true, and that this is not a one and done
fix. We need to start with a whole cat case approach, not a singular point in
time under emergency induced emotional duress and take clients for a one and
done as much as we can get them for and to-hell-if the cat is euthanized
along the way approach. We know better, even if our clients don’t.</p><p class="MsoNormal"><o:p></o:p></p>
<p class="MsoNormal"><span style="color: red;"><i>Challenge</i></span>; This ridiculous, archaic practice of not having
vets discuss money (see equally ridiculous reasons <a href="https://todaysveterinarybusiness.com/lets-talk-money-recommendations/">here</a>)<o:p></o:p></p>
<p class="MsoNormal"><span style="color: red;"><i>Challenge</i></span>; most ER vets are unblocking without general
anesthesia between cases. We can do it so quickly that the charge given to the
owner is exorbitant. In many cases we can unblock a cat in the same time it can
take to pass an i.v. catheter. <o:p></o:p></p>
<p class="MsoNormal"><span style="color: red;"><i>Challenge</i></span> a line item list of how a cat is unblocked is not
provided to the client.<o:p></o:p></p>
<p class="MsoNormal">Documentation on the procedure and the time necessary to
unblock is not provided. This should be provided before treatments are given AND confirmed before invoice is given. <o:p></o:p></p>
<p class="MsoNormal"><span style="color: red;"><i>Challenge</i></span>; Removing a urinary catheter before 72 hours, or before the
urine is running diluted and clear is setting the patient up to reblock. I
would argue that we use time based estimates which are always egregiously too
short thereby setting the patient up to reblock. Veterinarians should expect,
and do, the cat to reblock within a very short period of time. We make more
money with the cats failure. The ethics of this should be challenged. If clients cannot afford to keep a patient in the hospital they should be allowed to be transferred to a primary care facility, i.e. their normal veterinarian (even if they do not have 24 hour care), and/or allowed to go home with the intravenous catheter AND urinary catheter in place to be monitored at home. <span style="color: red;"><i>Challenge</i></span>; I have never seen this happen. In all cases these are removed by the ER facility. These critical goods are paid for and owned by the client. Removing them without consent is a breach of consensual care and a done to the detriment of the patient.<o:p></o:p></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh81SwkrUxReRPmfPXC-3l8TLl1vlifb5OahlhCuetF1FHPtFsG2w9KBHZk20YOsiTJ4hE_ucyWFQdWlGx5-Ux15obwuvV3lzc-mQSizlJk9iKNsZap644s01KcZwK-GIRW42_gY-aZhIp5VTynMNzl-Gcj85nDTj4rWHWqvMHNmDB5NRmBjc30DA-g/s2016/IMG_1385.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh81SwkrUxReRPmfPXC-3l8TLl1vlifb5OahlhCuetF1FHPtFsG2w9KBHZk20YOsiTJ4hE_ucyWFQdWlGx5-Ux15obwuvV3lzc-mQSizlJk9iKNsZap644s01KcZwK-GIRW42_gY-aZhIp5VTynMNzl-Gcj85nDTj4rWHWqvMHNmDB5NRmBjc30DA-g/w300-h400/IMG_1385.jpg" width="300" /></a></div><br /><p class="MsoNormal">We should all expect that a cat that has blocked once, will soon block again. How many times can the client pay for this? We should be addressing this at the first visit. We should be using the clients ability for the expected treatment course, and not the typical one time financial hit. We require a deposit for care, and that deposit is typically exhausted within the first 12-24 hours leaving cats to be discharged before they are ready, and setting the client up for a repeat obstruction within days to weeks. Where a small percentage of cats are treated on the first obstruction many are not on the second. Further the trauma of the blockage compounded by the passing of a urinary catheter causes excessive damage to the patient urethra. I would argue that the removal of a urinary catheter prematurely causes an increased chance of reblocking and therefore makes the veterinary team responsible for re-current obstructions that frequently occur within days. </p>
<p class="MsoNormal">The inflammation from BOTH the blockage AND the urinary catheter always needs more than 12-24
hours to resolve.<o:p></o:p></p>
<p class="MsoNormal"><span style="color: red;"><i>Challenge</i></span>; a client pays for the goods and services provided
to the patient. Why then do vets insist on removing these? At least we should
unblock and transfer elsewhere to provide these patients a longer fluid therapy
plan. We need to be documenting and insisting these cats continue care
elsewhere. Even if this at the owners home, if it cannot happen at a veterinary
facility.<o:p></o:p></p>
<p class="MsoNormal">Although not ideal we keep cats in our vet hospital for 3-5
days even though there is no overnight care. <o:p></o:p></p>
<p class="MsoNormal">These cats need fluid therapy AND urinary catheterization
for 3-5 days. <o:p></o:p></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgThBajxjmNsJd8sIt6FX0fpgDwKS4oZSrEgnbgETwARTbirK2DB1XKv6kndbFyEFvbLHWtZJzsGi3E24vQMaOdkONGuLGlbeOD4tx5-TqaUmsLcX8LNE-Jzzm8RGhqpLbjpzmCJmrrBKOSQncrYSe5F6FDngEoNEsaAYgC8FAOUbTnNuOBYZUhOj2h/s2016/IMG_0520.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgThBajxjmNsJd8sIt6FX0fpgDwKS4oZSrEgnbgETwARTbirK2DB1XKv6kndbFyEFvbLHWtZJzsGi3E24vQMaOdkONGuLGlbeOD4tx5-TqaUmsLcX8LNE-Jzzm8RGhqpLbjpzmCJmrrBKOSQncrYSe5F6FDngEoNEsaAYgC8FAOUbTnNuOBYZUhOj2h/w300-h400/IMG_0520.jpg" width="300" /></a></div><br /><p class="MsoNormal">Unblocking a cat at my clinic; Client call to front desk with any of the above clinical signs is sent immediately to the Charge Tech. They immediately notify a veterinarian of the cat being blocked. If the cat is an existing patient we direct them to go to the ER immediately, or come to us. Upon arrival we immediately<span style="text-indent: -0.25in;"><span style="font-feature-settings: normal; font-kerning: auto; font-optical-sizing: auto; font-size: 7pt; font-stretch: normal; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variation-settings: normal; line-height: normal;"> </span></span><span style="text-indent: -0.25in;">examine to confirm bladder is large, painful and no
urine will pass. Do not squeeze too hard. Bladder can rupture. This is always a
surgical emergency, financially constrained clients will not be able to afford
this.</span></p><p class="MsoNormal"><span style="text-indent: -0.25in;">Treatment tree looks like this; </span></p><p class="MsoNormal"></p><ul style="text-align: left;"><li><span style="text-indent: -0.25in;"><span style="font-feature-settings: normal; font-kerning: auto; font-optical-sizing: auto; font-size: 7pt; font-stretch: normal; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variation-settings: normal; line-height: normal;"> </span></span><span style="text-indent: -0.25in;">cold laser therapy of prepuce. Will reduce
inflammation and allow some sediment to pass. </span><span style="font-feature-settings: normal; font-kerning: auto; font-optical-sizing: auto; font-size: 7pt; font-stretch: normal; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variation-settings: normal; line-height: normal; text-indent: -0.25in;"> </span></li><li><span style="text-indent: -0.25in;">massage penis to remove calculi. May allow urine
to pass, </span></li><li><span style="text-indent: -0.25in;">a</span><span style="text-indent: -0.25in;">ttempt to place/pass a urinary catheter.
Catheter selection matters, avoid tomcats and red rubbers, try Tom Tiddle, 3.5
french. Lots of lube!</span><span style="font-size: xx-small; text-indent: -0.25in;"> </span></li><li><span style="text-indent: -0.25in;">Start i.v. fluids as fast as able. These cats
die from dehydration causing cardiac fatality.</span></li><li><span style="text-indent: -0.25in;"><span style="font-size: xx-small;"> </span></span><span style="text-indent: -0.25in;">If unable to pass Ucath, try to relieve urethral
obstruction with olive tipped syringe and 20 ml saline to retropulse
obstruction back into the bladder. Lots of lube<span style="font-size: xx-small;"> </span></span></li><li><span style="text-indent: -0.25in;">If unable to olive tipped syringe decompress
bladder with 22 gauge needle. Remove as much urine as able. I leave needle in
bladder and switch out 20 ml syringes until bladder is soft. Warning, bladder
rupture is possible. </span><span style="font-feature-settings: normal; font-kerning: auto; font-optical-sizing: auto; font-size: 7pt; font-stretch: normal; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variation-settings: normal; line-height: normal; text-indent: -0.25in;"> </span></li><li><span style="text-indent: -0.25in;">Continue laser, massage and retropulsion with
olive tipped. In almost all cases you can feel obstruction move as these are
done. </span></li><li><span style="text-indent: -0.25in;">Attempt to place Tom Tiddle and suture stopper to prepuce. If able;</span></li><li><span style="text-indent: -0.25in;">Flush bladder with sterile saline to remove as
much debris, and blood as able.<span style="font-size: xx-small;"> </span></span></li><li><span style="text-indent: -0.25in;">Place collection back onto Ucath </span></li><li><span style="text-indent: -0.25in;"><span style="font-size: xx-small;"> </span></span><span style="text-indent: -0.25in;">Start iv fluids. We use NaCl for ivf therapy </span></li><li>If a higher degree of difficulty in passing ucath take
lateral caudal ab xray to look for bladder stones. This may indicate a
cystotomy is needed.</li></ul><p></p><p class="MsoNormal"><o:p></o:p></p>
<p class="MsoNormal"><span style="color: red;"><i>Challenge</i></span>; it is easier to unblock a cat then spay a large,
fat dog. Why then is this done at 4 plus times the cost to the owner?<o:p></o:p></p>
<p class="MsoNormal">Why is it ethical to be charging so much just because this
is an emergency? I would also challenge that these cats are easier to treat than a big aged dog spay, Which we do routinely and charge for at a fraction of the cost, because people can find this surgery at almost every veterinary facility. Where there is competition there is a lower price point. Further a spay is (typically) elective.<o:p></o:p></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgrBKGwFHZx25TA705FP7MzD6RS8L5fVmxSkS6cjG0EZD02HnySxyE3tjGpVcifwf04fBPKN8A9gc4N7mCDJBG5YVvGchgt_dY-xLqZWJpXfWyducnPJN0944qbgoxNuVgypuw7y_IvsWjP92qTfqW6kt7lnECgQj57bkf7Ls3YptOUyehK6txxCYwe/s2016/IMG_0596.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1512" data-original-width="2016" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgrBKGwFHZx25TA705FP7MzD6RS8L5fVmxSkS6cjG0EZD02HnySxyE3tjGpVcifwf04fBPKN8A9gc4N7mCDJBG5YVvGchgt_dY-xLqZWJpXfWyducnPJN0944qbgoxNuVgypuw7y_IvsWjP92qTfqW6kt7lnECgQj57bkf7Ls3YptOUyehK6txxCYwe/w400-h300/IMG_0596.jpg" width="400" /></a></div><br /><p class="MsoNormal">At home care after urine is clear; the following are my patients;<span style="font-size: xx-small;"> </span></p><p class="MsoNormal"></p><ul style="text-align: left;"><li><span style="text-indent: -0.25in;">Teach owner how to palpate for the urinary
bladder.<span style="font-size: xx-small;"> </span></span></li><li><span style="text-indent: -0.25in;">Place patient on a steroid to encourage drinking
water and reduce inflammation.<span style="font-size: xx-small;"> </span></span></li><li><span style="text-indent: -0.25in;">Feed a wet food only urinary diet. Add water to
each meal. The diet should be a urinary prescription formula and it should be
used for the rest of the cats life.<span style="font-size: xx-small;"> </span></span></li><li><span style="text-indent: -0.25in;">Encourage water intake with a fountain,. </span></li><li><span style="text-indent: -0.25in;">E</span><span style="text-indent: -0.25in;">ncourage play. </span></li><li><span style="text-indent: -0.25in;">Reduce stress in any and every way possible. </span></li><li><span style="text-indent: -0.25in;">Monitor litter boxes lifelong. New litter
options are being produced to help guide clients in detecting and monitoring
for possible issues. </span></li><li><span style="text-indent: -0.25in;">Use anti anxiety medications like gabapentin. </span></li><li><span style="text-indent: -0.25in;">Or, long term medications like fluoxetine.<span style="font-size: xx-small;"> </span></span></li><li><span style="text-indent: -0.25in;">Use analgesics like transmucosal/dermal buprinex. Pain medications will help these patients quality of life. Reduce stress and reduce likelihood of recurrent stress induced cystitis, further reducing chances of reblocking. </span></li><li><span style="text-indent: -0.25in;">Give sq fluids at home for days to weeks post op. Fluid kits are available on Chewy.com</span></li></ul>We need to develop ways to allow in home care and supervision. Pawbly.com can help. <span style="font-size: xx-small;"> </span><span style="text-indent: -0.25in;">Start a savings account for the next urinary
issue. If necessary discuss a PU surgery as the next treatment option. See </span><a href="http://VetBilling.com" style="text-indent: -0.25in;">VetBilling.com</a><span style="text-indent: -0.25in;"> for pet savings plan options. </span><div><div style="text-indent: -24px;"><br /></div><div><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjjGp7XIGvRFsiK6Yaf2xrAw6JbtWRwncYMLIZfe5J13BFvYlil1WZ0EBxZ2KEp4c0p0IGOyJ6KjYSDYdtKbvci6oBn7qdOk38u0Oecd5tQHZnKz-yfX7g7OqW2OsaMoXDF2VKAbDcLwX1oEun-u7vB4uvaA6TtRbZCJBVCBktUVnz3jOpsoy-mnmsx/s1280/IMG_7278.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1280" data-original-width="960" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjjGp7XIGvRFsiK6Yaf2xrAw6JbtWRwncYMLIZfe5J13BFvYlil1WZ0EBxZ2KEp4c0p0IGOyJ6KjYSDYdtKbvci6oBn7qdOk38u0Oecd5tQHZnKz-yfX7g7OqW2OsaMoXDF2VKAbDcLwX1oEun-u7vB4uvaA6TtRbZCJBVCBktUVnz3jOpsoy-mnmsx/w300-h400/IMG_7278.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">PU surgery.</td></tr></tbody></table><br /><div><p class="MsoNormal"><o:p>Here is a video from my YouTube channel on unblocking a patient of mine. More videos can be found there. Link <a href="https://www.youtube.com/channel/UCq7z_qtov_Al1dEEfjZt8iQ">here</a></o:p></p><div class="separator" style="clear: both; text-align: center;"><iframe allowfullscreen="" class="BLOG_video_class" height="266" src="https://www.youtube.com/embed/KrgPTvOPTH8" width="320" youtube-src-id="KrgPTvOPTH8"></iframe></div><br /><p></p>
<p class="MsoNormal">How do I get these patients treated for about $1,000 (and, yes, even I admit this is too costly for many people), I invest in my clients
AND patients care. We start with a goal. We talk about options. Every single option. They are all weighted equally to reinforce that we are in this together. From start to finish. If none of these seem acceptable to the client I ask, "what will it take for me to help your cat?"<o:p></o:p></p><p class="MsoNormal">We start there.</p><p class="MsoNormal">If you have a cat, particularly an adult (greater than 1 year of age), indoor, neutered, male on a dry food diet (particularly a grocery store brand) you need to ask your vet what would happen if your cat blocked? Would they refer you to an ER? If so. how much might this cost? Be prepared before this happens to you. Please follow my blog, my Jarrettsville Veterinary Center <a href="https://www.facebook.com/JarrettsvilleVet/">Facebook</a> page, my <a href="https://www.youtube.com/channel/UCq7z_qtov_Al1dEEfjZt8iQ">YouTube</a> channel for more on this, and other pet care issues. Please also stay tuned for a step by step guide to managing your cats emergencies, especially if you do not have an emergency pet care fund with at least $2,000 in it, as we are working on it now.</p><p class="MsoNormal">For more help you can ask our pet care professionals for free at <a href="http://Pawbly.com">Pawbly.com</a></p><p class="MsoNormal">References;</p><p class="MsoNormal"><a href="https://www.carecredit.com/providers/insights/hate-talking-money-not-alone/">CareCredit. Hate Talking About Money? You Are Not Alone.</a></p><p class="MsoNormal">*Futility Medicine; </p><p class="MsoNormal"><a href="https://depts.washington.edu/bhdept/ethics-medicine/bioethics-topics/articles/medical-futility">UW Dept Of Bioethics discussion</a>.</p><p class="MsoNormal"><a href="https://depts.washington.edu/bhdept/ethics-medicine/bioethics-topics/articles/medical-futility">Medical Futility Is Commonly Encountered In Small Animal Medicine.</a></p><p class="MsoNormal"><br /></p><p class="MsoNormal"> </p></div></div></div>krista magnifico, DVMhttp://www.blogger.com/profile/15133566329579911573noreply@blogger.com0tag:blogger.com,1999:blog-4667516629745731439.post-75139925701475587572023-03-12T15:50:00.132-07:002023-03-16T06:50:51.151-07:00The Sensuous Bean<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgjB3cugbYOsyKTAnTt2f3iZjBSoXGJQHuz724G3hSFj_SP75dUr4511ZWrCwCR0LU51wTekcsOi1O4jRAg_CpLgibsIQao-vfYaEgS3tEoXOuUiGz0juAPjd1nwHhqZogEHgFKTkZqYMESziOlhNhctFqJyJjw5bisSnVirpxAyz83Fhzi2NE2AD3d/s2016/IMG_6842.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1512" data-original-width="2016" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgjB3cugbYOsyKTAnTt2f3iZjBSoXGJQHuz724G3hSFj_SP75dUr4511ZWrCwCR0LU51wTekcsOi1O4jRAg_CpLgibsIQao-vfYaEgS3tEoXOuUiGz0juAPjd1nwHhqZogEHgFKTkZqYMESziOlhNhctFqJyJjw5bisSnVirpxAyz83Fhzi2NE2AD3d/w400-h300/IMG_6842.jpg" width="400" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Bollo's</td></tr></tbody></table><br /><p><span face="Arial, Helvetica, sans-serif" style="caret-color: rgb(34, 34, 34); color: #222222; font-size: small;">I go to a particular coffee shop a street away from my apartment. It isn’t perfect. Not the perfect replica of the one I have spent the last 20 years trying to replace, but, it’s good enough. I feel a sense of belonging there. Silly, I know to find a sense of belonging in a $3 cup of coffee delivered to me in a tiny chit of a chat to make room for the other paying customers behind me. But it’s enough. Enough to feel warm within. Enough to call me back to every morning. Enough to find solace within, and comfort around. </span></p><p></p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgQ6knnGN1wazRU_jmMi2Vm3zILnKdGqVF7vJO9BpQI3OPJ_TyXbnhfDjuodtpo-Hfv0qQCW9KBCpsGHYM00wZS-ZjdspfvydaPC0VLJz56v6ENtqTYxLLzCVe1EQmnTT8h7SoB0Ld075fO7owHT7qcZtxsP7-YCU2TRVaVhoWNqwzH2_OG_kx1ZVgL/s1544/IMG_6831.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1544" data-original-width="1158" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgQ6knnGN1wazRU_jmMi2Vm3zILnKdGqVF7vJO9BpQI3OPJ_TyXbnhfDjuodtpo-Hfv0qQCW9KBCpsGHYM00wZS-ZjdspfvydaPC0VLJz56v6ENtqTYxLLzCVe1EQmnTT8h7SoB0Ld075fO7owHT7qcZtxsP7-YCU2TRVaVhoWNqwzH2_OG_kx1ZVgL/w300-h400/IMG_6831.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Gillies.</td></tr></tbody></table><span face="Arial, Helvetica, sans-serif" style="caret-color: rgb(34, 34, 34); color: #222222; font-size: small;"><br /></span><p></p><p><span face="Arial, Helvetica, sans-serif" style="caret-color: rgb(34, 34, 34); color: #222222; font-size: small;">Most days it's just that. A large cup of black coffee; strong, dark, bold, intoxicating. I breathe it in. That first hello. Steam from its surface filling my foggy head with wakeful inspiration for the days needful wanting. </span></p><p><span face="Arial, Helvetica, sans-serif" style="caret-color: rgb(34, 34, 34); color: #222222; font-size: small;">Today, standing in line, I thought I saw her. She is always near. I can always feel her around me. But she has never appeared to me in human form until today. Today she was working far behind the counter in the small staff area half hidden from the line I waited in. Today she was there, standing back toward me, hair down, filling the monster coffee grinders just out of my view. And just for a second, the briefest of seconds, I saw her. I knew as my heart overrode my heads sensibilities that this was her. Her hair was long, straight, just past the shoulders, as it always was, with the tinge of silver her box color couldn’t confiscate. She was standing tall. Taller than she had been in the last few years when the weight of the painful burden of her bodies betrayal had permitted her. Today she was 50 again. Time had slipped two and a half decades. Oddly, or poetically, this is the same morning our clocks had been pushed forward an hour. She worked quietly. I could only see a part of her from the back. Just enough to tell my heart that she was still among us. She had decided to hide in a coffee shop. She must have known I would settle upon this one. It’s deep, sensuous allure calling me in. The cry of a baby to its mom. It’s how we just sense the other needs us. </span></p><div style="-webkit-text-size-adjust: auto; caret-color: rgb(34, 34, 34); color: #222222; text-size-adjust: auto;"><div class="ii gt" id=":p1" jslog="20277; u014N:xr6bB; 1:WyIjdGhyZWFkLWY6MTc2MDIwNDgyMjk2MTY5MDMyOSIsbnVsbCxudWxsLG51bGwsbnVsbCxudWxsLG51bGwsbnVsbCxudWxsLG51bGwsbnVsbCxudWxsLG51bGwsW11d; 4:WyIjbXNnLWY6MTc2MDIwNDgyMjk2MTY5MDMyOSIsbnVsbCxbXV0." style="direction: ltr; margin: 8px 0px 0px; padding: 0px; position: relative;"><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="font-family: "Google Sans", Roboto, RobotoDraft, Helvetica, Arial, sans-serif; font-size: 0.875rem; margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhUyquYAXHv--dj6Y97Tqr3HtPEGNS8MRteLppc1yi7gTJMSZGsMZfabr_29naGsrNxAbn2XXT02YzkhRaPZbZGzKidPf3k5U9e5eFf0brBgSOTdJVQGkY1-yfq4Nl_BCHb9J5W8BkQt5HqloMcAQKfkW52NUUScOfY74ULdO72m7Cy_jK9O3A67a6e/s2016/IMG_9805.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhUyquYAXHv--dj6Y97Tqr3HtPEGNS8MRteLppc1yi7gTJMSZGsMZfabr_29naGsrNxAbn2XXT02YzkhRaPZbZGzKidPf3k5U9e5eFf0brBgSOTdJVQGkY1-yfq4Nl_BCHb9J5W8BkQt5HqloMcAQKfkW52NUUScOfY74ULdO72m7Cy_jK9O3A67a6e/w300-h400/IMG_9805.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Sensuous Bean</td></tr></tbody></table><p><span face="Arial, Helvetica, sans-serif" style="color: #222222; font-size: small;">I know she turned around at some point. I know she did, but there was no face my mind could correct itself into seeing. Just the back of her. When it was her. The rest I don't need, and, so, I let her stay. </span></p><p><span face="Arial, Helvetica, sans-serif" style="color: #222222; font-size: small;"><br /></span></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgwdIOqIx9WRQf_Dzd-3iVdPTO6O1QFZvLlnCy8YUwwMfQ2exuStotXcBB-Xlr-18vY6UGWNWTgCH6pQNdKVs6XXvcXfpGqYIRef_eBNxmMjTLPjY6VEwzajI3Pd30DAKoUoE9Qp9Kvn84UvCl60oxj7vCxMyR0C6gf2i31il-xsGd1m4Yd0NK5uG13/s2016/IMG_6835.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgwdIOqIx9WRQf_Dzd-3iVdPTO6O1QFZvLlnCy8YUwwMfQ2exuStotXcBB-Xlr-18vY6UGWNWTgCH6pQNdKVs6XXvcXfpGqYIRef_eBNxmMjTLPjY6VEwzajI3Pd30DAKoUoE9Qp9Kvn84UvCl60oxj7vCxMyR0C6gf2i31il-xsGd1m4Yd0NK5uG13/w300-h400/IMG_6835.jpg" width="300" /></a></div><br /><p><span face="Arial, Helvetica, sans-serif" style="color: #222222;"><span style="font-family: inherit;">No, I countered. It's not her. She never wore black. And yet between the coffee and the crowd I was content and comforted to just know she's near.</span><br /></span></p><div style="-webkit-text-size-adjust: auto; font-family: "Google Sans", Roboto, RobotoDraft, Helvetica, Arial, sans-serif; font-size: small; text-size-adjust: auto;"><div class="ii gt" id=":p1" jslog="20277; u014N:xr6bB; 1:WyIjdGhyZWFkLWY6MTc2MDIwNDgyMjk2MTY5MDMyOSIsbnVsbCxudWxsLG51bGwsbnVsbCxudWxsLG51bGwsbnVsbCxudWxsLG51bGwsbnVsbCxudWxsLG51bGwsW11d; 4:WyIjbXNnLWY6MTc2MDIwNDgyMjk2MTY5MDMyOSIsbnVsbCxbXV0." style="direction: ltr; font-size: 0.875rem; margin: 8px 0px 0px; padding: 0px; position: relative;"><div class="a3s aiL" id=":p0" style="font-family: Arial, Helvetica, sans-serif; font-size: small; font-stretch: normal; line-height: 1.5; overflow: hidden;"><br /></div></div></div><div class="a3s aiL" id=":p0" style="font-stretch: normal; line-height: 1.5; overflow: hidden;"><br /></div><div class="separator" style="clear: both; font-family: "Google Sans", Roboto, RobotoDraft, Helvetica, Arial, sans-serif; font-size: 0.875rem; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgiWtm1BoAVL6zaQe8dsVWF6ARIRCujPFCkGyztj6-Q-iTFIEHuFjWp-nD-GhtkJax8o-olQhlcMQLNLQCVrunclm7vUy8CcydGOhYj3a_Ns6K-ItCwSnfUtSTlTs7M2-xsmigPjZbP_o98UfFLu7y6djPWYYvPqFY6tv_0H55k6YR0xjleMxsi9_tz/s1544/IMG_6830%20(1).jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1544" data-original-width="1158" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgiWtm1BoAVL6zaQe8dsVWF6ARIRCujPFCkGyztj6-Q-iTFIEHuFjWp-nD-GhtkJax8o-olQhlcMQLNLQCVrunclm7vUy8CcydGOhYj3a_Ns6K-ItCwSnfUtSTlTs7M2-xsmigPjZbP_o98UfFLu7y6djPWYYvPqFY6tv_0H55k6YR0xjleMxsi9_tz/w300-h400/IMG_6830%20(1).jpg" width="300" /></a></div><br /><br /><br /><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="font-family: "Google Sans", Roboto, RobotoDraft, Helvetica, Arial, sans-serif; font-size: 0.875rem; margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhzGgjl_Oi52MBDXAOc5SKlg4eC9G_R1Ri3g3p5VMQgxTCZfdQUnnoMmNgfghVnmptlyZE7TYOz2tL6i-gTxqJPXRDQaDakfvBhHw1XdkyTgWdRkFFFMu6EL25dCb7AeT70-Yn6bZOruLz9MnwtXvKl-YPcaZtw8WE65TddxsI2tlMSLtAT9u31IZYV/s2016/IMG_6841.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhzGgjl_Oi52MBDXAOc5SKlg4eC9G_R1Ri3g3p5VMQgxTCZfdQUnnoMmNgfghVnmptlyZE7TYOz2tL6i-gTxqJPXRDQaDakfvBhHw1XdkyTgWdRkFFFMu6EL25dCb7AeT70-Yn6bZOruLz9MnwtXvKl-YPcaZtw8WE65TddxsI2tlMSLtAT9u31IZYV/w300-h400/IMG_6841.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">I spent the best part of 12 years sitting here studying.<br />Bollo's. My corner</td></tr></tbody></table><br /><div class="a3s aiL" id=":p0" style="font-family: Arial, Helvetica, sans-serif; font-size: small; font-stretch: normal; line-height: 1.5; overflow: hidden;"><br /></div><div class="separator" style="clear: both; font-family: "Google Sans", Roboto, RobotoDraft, Helvetica, Arial, sans-serif; font-size: 0.875rem; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjMnoC5m-Dfkb_Oavgy7YBwJwqm7iFVrGLCC4cDHn098dQUbaFm4dO5GYLx3POO5itUuzZBhnueFX90h7fkosRKEWfDzBSKaMYZ21TfU2Z1wzXA9YpP0VDYtfVfwTbjsRFtsSBUj4MPRGbdFIOjUrlUobzhWYqEnrMqdoEVNWliMQqIj_QMTZ-533wg/s2016/IMG_6846.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1512" data-original-width="2016" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjMnoC5m-Dfkb_Oavgy7YBwJwqm7iFVrGLCC4cDHn098dQUbaFm4dO5GYLx3POO5itUuzZBhnueFX90h7fkosRKEWfDzBSKaMYZ21TfU2Z1wzXA9YpP0VDYtfVfwTbjsRFtsSBUj4MPRGbdFIOjUrlUobzhWYqEnrMqdoEVNWliMQqIj_QMTZ-533wg/w400-h300/IMG_6846.jpg" width="400" /></a></div><div class="a3s aiL" id=":p0" style="font-family: Arial, Helvetica, sans-serif; font-size: small; font-stretch: normal; line-height: 1.5; overflow: hidden;"><br /></div></div></div>krista magnifico, DVMhttp://www.blogger.com/profile/15133566329579911573noreply@blogger.com0tag:blogger.com,1999:blog-4667516629745731439.post-55481911492092819572023-03-12T15:07:00.005-07:002023-03-14T08:46:27.847-07:00The Tipping Point. When There Is More Behind You Than In Front. <p>The tipping point.</p><p>There is a place, a moment, a collection of revelations, where you realize, bring to your own attention, that you are looking back, (horrifically in some cases even attempting to relive, revive and recollect the exact details of what was before), more than looking forward. </p><p>That place where there is more behind you than in front of you, and not only is that the truth, but worse, your preference defers to back versus ahead.</p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhKY3oCU-lOO_i3D4otchSWaT9-2ZL0kfawhUj8rXBKyJZFtAVVSH1LFk4lOwHRknPxR_YriNljTBLYseHOJEs4MoCBdmbBolA7DUAeZRx9fZcDiM5paoMG83gci1l7pbANjDYQ-2NgDAZmF7tXdjCnXHxHJyORSkTfX4JCR2s1fItT04kYII_226pw/s2016/IMG_9587.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhKY3oCU-lOO_i3D4otchSWaT9-2ZL0kfawhUj8rXBKyJZFtAVVSH1LFk4lOwHRknPxR_YriNljTBLYseHOJEs4MoCBdmbBolA7DUAeZRx9fZcDiM5paoMG83gci1l7pbANjDYQ-2NgDAZmF7tXdjCnXHxHJyORSkTfX4JCR2s1fItT04kYII_226pw/w300-h400/IMG_9587.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Gracie. Just rescued. Her mouth was soo diseased the smell would knock you over. <br />All of her teeth had to be removed. This is her waking up.<br />She was a different (soo much happier) cat 24 hours later.<br />The degree of neglect she came to us with was pitiful and compelling.</td></tr></tbody></table><br /><p>In the misery of many a childhood moment I would sit, close my eyes and imagine the magic that lay ahead. Too often the allure of what might be. What I could salivate over. Some lustful moment. A momentous accomplishment dreamt of but yet to be fulfilled. A far away land with all of its exotic flavors. I got by, (a theme song from my favorite Grateful Dead anthem), because I projected forward. Those invisible carrots of motivation lay just at the tip of my tongue. Propelled me forward through what turned out to be some pretty traumatizing growing up. </p><p>At 50ish I have realized that the carrot has shape shifted. It no longer hovers above calling. It lays beside me waiting. The small dirt-dusted, blunted, jaundiced nut in a collection resembling a sickened nest of eggs to ride out the Winter. </p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEikO7Q_rm19Z_963dBWddufsGk0oRQ2gnHQWV0wmzRcZePr_PFCozRL280LlMJdasHGcq-QLn_PXmGwMwd47h54P-_ApIqLnHzUbsSDM4F1nOnLfrVIP4y-7G5tajK9Kpr0lai6UqW96qayGieR1ImeXVQFZFq77upYjLqIfZ5XlwnM3j6u3QFiAGIB/s1890/FE932420-49DE-4C9F-B306-15A0ADB11025.JPG" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1890" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEikO7Q_rm19Z_963dBWddufsGk0oRQ2gnHQWV0wmzRcZePr_PFCozRL280LlMJdasHGcq-QLn_PXmGwMwd47h54P-_ApIqLnHzUbsSDM4F1nOnLfrVIP4y-7G5tajK9Kpr0lai6UqW96qayGieR1ImeXVQFZFq77upYjLqIfZ5XlwnM3j6u3QFiAGIB/w320-h400/FE932420-49DE-4C9F-B306-15A0ADB11025.JPG" width="320" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">The snowdrops and the crocus. <br />They remind me to believe in beginnings,, even after all of the endings.</td></tr></tbody></table><br /><p>Unbeknownst to me the tipping point hasn't evolved into a concession, rather a gentle acceptance that the To-Do list, my collective life accomplishments still yet ephemerous, need to be fast-tracked. That list cannot be allowed to outlive me, good intentions, or fate deciding.</p><p>Perhaps other people spend their autumnal time reflecting on the amassed possessions as some aging dragon in her liar of pillaged treasures? Perhaps not having children to leave a better life to isn't the motivation to dying with assets left behind? Or, perhaps even more disturbingly I recognize my stash will outlive me. I will not be able/chose not to, exhaust it before the timeline draws to a close. Perhaps this is the tipping point? that place where your efforts tip to giving back versus gaining more? Perhaps that's what aging, retirement, exhaustion and a worn out body brings to your peace of mind as the collective cacophony of a chaotic world swirls around you?</p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhL9n5Xm5KfHrZXHLoeDRBR58x58AIgdSZRE-rI31ncZq5UWtO046oj4Wa3iT9C-HOyUINfyesXRCJc1jJEZayJ_qoX4eeSwY0Q8LVoAjXKYfqaOyrQPpAzLx6O3NqlmNS7vwEf9nm8iZyi80sZcLBMT5tKVk76aWbG4SE0sFlNFLRfbpUqNMjL0DUL/s1544/IMG_9586.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1544" data-original-width="1158" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhL9n5Xm5KfHrZXHLoeDRBR58x58AIgdSZRE-rI31ncZq5UWtO046oj4Wa3iT9C-HOyUINfyesXRCJc1jJEZayJ_qoX4eeSwY0Q8LVoAjXKYfqaOyrQPpAzLx6O3NqlmNS7vwEf9nm8iZyi80sZcLBMT5tKVk76aWbG4SE0sFlNFLRfbpUqNMjL0DUL/w300-h400/IMG_9586.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">My Raffles kitten. She was given up on because her sibling came up positive for rabies.<br />Four months of quarantine and she is mine.<br />Life for me works like this. These needful souls find me.<br />I am as much grateful for them as I am for the fate that brings them to me.</td></tr></tbody></table><br /><p>Maybe that's why I am so much happier in the looking back than the drive to accelerate forward?</p><p>Oh, that's right, today is Tuesday. I must get dressed and go fight those diseases and dragons for another good day of deeds in the small animal vetmed trenches. I'll rest tomorrow and save a carrot for the slumber another day. </p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhEsrsSrDFjtC_IoS1hTywP3RWLTzghv7iJf-3GPOhDz49ybC81-m3nTw5mMkC1hRujGJZt90HLz07Aeesisd2hMNNYFNU5Fow_PSxWKfiHBK4YOpGU0eIlaxvCY2Q7R-JHjKH7dC1GWaG8RC8mOdtywYZPcQ7FDqcujwhhVz4_U8uQ0tmF4XRji6YB/s2016/IMG_9584.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhEsrsSrDFjtC_IoS1hTywP3RWLTzghv7iJf-3GPOhDz49ybC81-m3nTw5mMkC1hRujGJZt90HLz07Aeesisd2hMNNYFNU5Fow_PSxWKfiHBK4YOpGU0eIlaxvCY2Q7R-JHjKH7dC1GWaG8RC8mOdtywYZPcQ7FDqcujwhhVz4_U8uQ0tmF4XRji6YB/w300-h400/IMG_9584.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Raffles watches as Birdie wakes up from her spay surgery.</td></tr></tbody></table><br /><p>Tipping points too often get me confused between tipping and pivoting. I don't know if I can recognize one versus the other any longer.</p><p>There is a real-life plight in vetmed these days. Those of us who grew up in the trenches, took on a place of our own, led or our community practice for a few decades, sunk our whole lives into. We are at a place now where we have to decide how to exit. Do we take the big cash out from the guys who might as well have a Hamburgler face on. Their shifty eyes, smooth talking and thick gravid unexplained check books? Or, do we try to find some new grad willing to take the reigns and care for the next generation of pets the way our previous generations of vets did? Is that even possible?</p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj0ZsaggXTkmNNxQQB64XArswXWqzXcFBzRj1Da5N29t1KxH5bLWLWlJIlxZ4-u3tf9JKD73y_qoaUldChdf4P4400l14E-iGocLtzMmrGK-zlMtQxcOLnIy4Z6crbMuVgPTlcnux-WNLh07QLxNvwknAIRybrq_--sIjIDx9qyyxVom1lGEdMA_XcN/s410/Hamburgler.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="284" data-original-width="410" height="278" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj0ZsaggXTkmNNxQQB64XArswXWqzXcFBzRj1Da5N29t1KxH5bLWLWlJIlxZ4-u3tf9JKD73y_qoaUldChdf4P4400l14E-iGocLtzMmrGK-zlMtQxcOLnIy4Z6crbMuVgPTlcnux-WNLh07QLxNvwknAIRybrq_--sIjIDx9qyyxVom1lGEdMA_XcN/w400-h278/Hamburgler.jpg" width="400" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Hamburgler holding the American icon hostage</td></tr></tbody></table><br /><p>Me, I am at a place where the box has to be rethought, reinvented and repurposed for the greater good and not the singular cash out retirement/burnout plan. Me, I'm pivoting before the tip pulls me under.</p>krista magnifico, DVMhttp://www.blogger.com/profile/15133566329579911573noreply@blogger.com0