All In

 After 20 years as a veterinarian and practice owner, I have come to realize that what my best clients want two things;

1. Be present with them.

2. Be all in.

Madelelaine March 2018

Sure, it's super helpful to have gone to a great veterinary college. Invested myself in learning, growing and challenging my skill set, but, above all of this, people need know/believe/feel that you are genuinely there for them in their greatest moments of need. 

It's what all of medicine needs.

Madelaine Sept 2018

Too often the medical relationship is intentionally, and almost always detrimentally, compartmentalized. The soul gets overlooked as the rest is dissected into its parts for inspection. We lose the whole organism as we focus on the individual pieces. While we can provide exemplary knowledge in the minutia, the organs, systems, the specialties called cardiology, respiratory, orthopedics, etc.. as you divvy them up people begin to feel denigrated to insignificant when weighed next to their parts. Medicine, the true art of it exists in its greatest beauty when the individual remains at its highest value when viewed from its inherent, individual, amorphous self; its soul. We each have our own. We are each our own being beyond the organs, flesh, and carbon connected bits.

March  2019

The beauty of being a general practitioner is being witness to the arc of each life. The spectrum that it displays. Appreciating the beauty and glory of the beginning as much as the end. Being present for all of it. That place where life is new, curious, and unmapped. The reason puppies and kittens are so compulsively adorable is to offset the lack of these established emotional bonds. The oxytocin infusion to the unknown being that depends so completely upon its new parents. To the final days where the emotional ties are so deep the roots won't allow the being to depart. There is so much power in the end that it leaves us changed. Forever missing a part of our lives that we cannot displace the hole. We, I would argue are ALWAYS better off knowing that these holes exist within us. They verify our existence as being genuine. You can attempt to love your spouse, your kids, your parents, your best friends fully and unconditionally, but none of them will truly exist simply for you. Your pet companions will. Your pet will be all in. All in for you and your life, even at the expense of their own. Who could we ever ask this of? Not another human.

May 2021

All in inherently requires that you be genuine. I believe that we all came into this field because we genuinely needed to be here. Somewhere along the road the death by a thousand paper cuts cost us our vulnerability, our mutual trust in other humans, and our deflective desire to be needed as much as we need our patients. I don't know how to untrain that, but, I will attest to being so protective of the naive vet I always dreamt of being has proven to be my greatest attribute.

July 2022

I will live and die within this profession and always be grateful for every tear it cost me. It is the purpose in every breath I own as mine. It is the reason I will post videos, blogs, stories and content that infuriates the rest of my profession as I advocate for the companions we are all here to be advocates for,,,, I am all in.

September 2023

July 2024

January 21, 2026

Madelaine passed away Friday January 23, 2026. Her mom, and grandmother loved her as much as anyone could ever be loved. She was with them every moment of her life. She was the luckiest, most beloved girl. I am so honored to have known her, and them, and been able to be a part of their lives. She is my WHY, just as much as she was theirs, She is everything vetmed could ever hope to be. 

I will miss her, never forget her, and never be able to live any other life than this one. 

Sending her family all of the love that sent us every day of her life.

January Dulldrums

Never go grocery shopping when you are hungry,

and,

never make executive decisions in January. 

Neither will end well.

Hazel

It took me too long to realize these. I am a slow learner. More trial by fire than contemplation. (Aren't all successful endeavors found through tripping and slipping than skipping?).

It's January. I am melancholy. Or depressed. Tomato/tomatoe. 

Willow

It is time for me to look back at the clinic, our progress. Our wins vs. losses. Figure out if the clean slate is a blessing or disguise. Resurrect the little kernel of caring that is the tinder in the passion-driven heart. That heart as too often been my compass. Perhaps it was supposed to be the machine just pushing oxygen and nutrients to the rest. Not the workhorse that was responsible for all that led and followed from it. Maybe I just placed too much expectation on one little organ? 

Biology was my favorite course. For all of the many ways people love math. The building an argument to arrive at a finite, firm, answer. Laws that are concrete. Rely on each other. One need met by many steps and a solution.

Raffles

The hardest part was always the separating myself from the equation. Feeling like I was the defining character needed to get to the solution. The camel with all of the straw. The law that cannot be omitted. Gravity. Decay. Death. Eventual loss. 

Tomato/tomatoe.

Its January. I will go cut out pink, red, blush hearts. Paint, glue, sequins and make Valentines. February cometh if I can get through today.

Left foot, Right foot. Try to see the good in all that is today. Tomorrow is never promised.

Maybe I am just hungry?

Maybe it's time to go to the grocery store?

Tomato?

.... or kittens?

Burdens and Burnout

My veterinary friend Pam sent me this news article. She lives far away and we console each other on the ever challenging state of vetmed. She is a true friend. The kind that sticks by you no matter how muddled in the mire you get. She also understands. Empathy holds tighter when you know another soul really gets you.

Kingston

Email from Nov 22, 2025, 5:50 PM 

Not such a nice way to frame it I hope you’re doing ok. From FB seems maybe you are suffering from compassion fatigue? Or perhaps you always are, like many vets

Pam XXX DVM

This article is from News 5 Cleveland;

Veterinary bills are rising, but so are the chances your pet will survive

By: Elizabeth VanMetre

CLEVELAND — A single social media post asking whether viewers had noticed their veterinary bills increasing quickly became one of News 5’s most-engaged call-out posts ever, prompting hundreds of Northeast Ohio pet owners to share their struggles with affording care.

Some comments described heartbreaking choices between paying for a pet’s treatment and covering basic household expenses.

Veterinarians said the rise in prices is real.

Dr. David Wong and Dr. Victoria Smith, veterinarians at PetVetWell in Mentor, said their work has evolved dramatically in recent years.

“Generally with exams, too we don’t only talk about pets," said Dr. Wong. "We get to know the clients really well.”

Smith said the shift largely stems from how pet owners see their animals.

“Our pets are now viewed as part of our family and sometimes our children,” Dr. Smith said.

That deeper emotional bond has led many families to pursue more advanced treatment options, even when the cost is steep.

Jennifer Rogers, a Northeast Ohio pet owner, shares her home with two bunnies, two cats and three birds. She considers them her lifeline.

But the price of caring for them, and for pets she has lost along the way, has pushed her deep into debt.

Rogers estimates her veterinary expenses total roughly $50,000.

“We’re looking at six maxed-out credit cards from my son," Rogers said. "Two from me. It’s to the point where there is no more credit cards to pay. So it will come down now to do we make the mortgage payment? Do we make the car payment?”

According to the Consumer Price Index, overall prices are around 25% higher than they were five years ago. During that same period, the cost of veterinary services rose approximately 41%, according to U.S. Labor statistics.

Veterinarians said that the increase reflects the fact that they can provide better medical care than ever.

“We’ve seen a lot of advancements in veterinary medicine, I’d say even in the last five years," Dr. Wong said.

That means the veterinarian you see today has more training and more options than ever to treat your pet.

“We’re running the same diagnostic approach you get when you go see your doctor. The blood work. The x rays. I mean we can do CTs. We can do MRIs in this field. Which is something we haven’t been doing in the past," Dr. Smith said.

The investment in equipment, medication and specialized staff has raised operating costs for clinics.

“More modern equipment [and] more advance treatments all end up costing a little bit more,” Dr. Wong said.

As costs continue to climb, veterinarians say communication and early care are key to avoiding overwhelming, unexpected bills.

Tips to not Waste Your Money on rising vet costs

1. Consider pet insurance: Monthly premiums can help offset emergency or long-term treatment costs. Use comparison tools like Pawlicy to match coverage to your pet’s age, breed and medical history. Not all plans cover the same conditions, so read the fine print.

2. Don’t skip yearly exams: Many costly health problems, from dental disease to organ issues, are cheaper and easier to treat when caught early. Preventive care can save hundreds or even thousands of dollars over your pet’s lifetime.

3. Ask about payment plans: Some veterinary clinics offer in-house payment arrangements, CareCredit, or other financing options. Establishing a relationship with a trusted vet makes these conversations easier.

4. Price-check medications: Pet prescriptions can often be filled at human pharmacies for less. Ask your vet if a generic or alternative medication is safe and available.

5. Build an emergency fund for your pet: Even a small monthly contribution can help cushion unexpected care. Setting aside money consistently reduces reliance on high-interest credit cards or loans when emergencies happen.

While I agree with almost all of the above advice, I will add my own derivations. You get back what you put in. If your relationship with your pet is one of the most important and vital parts of your life there are people who understand and relate. Build impenetrable bridges with them. Your vet should be a local, capable, independently owned business who gives back. Every town has one. 

Pippin

Here is my reply to her.

Hello,

God only knows what I am suffering from. Life as an empath in a world full of greedy assholes. 

Compassion fatigue is a constant. A constant motivator and detriment. 

I am not going to lie in my grave feeling anything other than accomplished. I am really grateful for all of it. Even the hard parts. I won’t be angry or feel cheated. I asked for all of this and turns out the universe is delivering. 

Where there is struggle there is also hope. And I know I am not alone. Which honestly is the most consoling part. I’m just not afraid to speak up. Bear it all. Be vulnerable. But it isn’t a sign of weakness or resignation. 

I appreciate that you think about me. And send these along. I am here. Anything you need just reach out. 

Take good care of yourself. 

Xoxo 🐾

Krista. 

Sadie

Why am I sharing this? Well, because it is honest. So many people feel that vulnerability, honesty, and being outspoken about any or all of it is a show of weakness. A red flag of imbalance. A reason to resist less, be more self-centric. Me, well, there are too many souls out there in need of help who don't have a voice. Who aren't given a place of compassionate liberty. I will not stop until I cannot continue. On my own terms in my own time. 

Am I incredibly grateful to have friends who reach out? Absolutely! I am most grateful to those who also walk in my shoes and know how real the burden is.

The Best Advice For New Team Members

There isn't one of us in vetmed who didn't start out as a kid with a dream. Typically we were a kid who wanted more pets in the house and parents who weren't consenting to acquiring more of them to the degree we longed for. 

I am asked daily to allow a young pet enthusiast to visit the clinic.

Volunteer. Start there. Don't expect me to give my time and skills without you giving the same, or more, back. (P.S. The secret to thriving in a profession built on compassion is to always give more than you have to,, and be fulfilled in giving more than anyone else. Especially if you are in vetmed, because no one ever gives more than our patients do).

Cookie. She is always the most generous hugger in the building.

Here is the advice I gave this morning;

"Here’s my first piece of advice for being the best vet tech ever;

Always start every new interaction with a pet and their parent with a genuine hello and a smile on your face. The best techs in the world are not the smartest, or the ones with the most accomplishments (like certifications and letters after their names), or the ones with the most diverse skillset (we can teach you all of that), but the ones who are the kindest and the most compassionate. You don’t have to go fast, or know everything but nothing will ever make you more valuable and appreciated like being kind.

It also really helps to say hello to your patient. You don’t have to let or touch them (they might be scared and a caution). People always want to feel like they are at a place that cares about them and their pet and you are the first (or second) person they see. So you make a huge first impression.

See you later!"

Seraphina. My WHY,

Veterinary Ethics Bio

Kisses from Cookie

I was asked to do a podcast from the Vet Ethics Committee. With that I had to add a bio. ChatGPT helped. It was an odd way to add an unknown perspective to a life I have outside of the clinic and its reach. Here's what I submitted...

Dr. Magnifico is an innovative veterinarian and passionate animal welfare advocate. She hopes to continue to build a legacy of being known for her commitment to an innovative, ethical and a patient-centered approach within veterinary medicine. She sees every animal, and their caregivers, as being worthy of compassion and is committed to preserving and maintaining the bonds we have with the pets we call family. She is currently specializing in the management and treatment of FUO/blocked cats by utilizing a minimum database, managing costs with outcome and budget as the starting point, and never giving up regardless of the obstacles presented. In essence she practices the way her patients need her to; the old fashioned way when integrity, loyalty and trust were all paramount to longevity and viability.

As the owner of Jarrettsville Veterinary Center, Pawbly.com, founder of the Pet Good Samaritan Fund (a 501c3) and Not One More Pet, Dr. Magnifico operates with a strong ethical foundation, prioritizing compassionate care and client education. A key area of focus is finding solutions to economic euthanasia, where financial barriers often force difficult decisions for pet owners. By offering a spectrum of affordable care from the onset, Dr. Magnifico ensures that every animal, regardless of their owner’s financial situation, has access to the veterinary services they need, thereby preventing unnecessary suffering and premature decisions.

Dr. Magnifico is an advocate for fair access to care, transparency in treatment options, and informed consent in every facility, in every case. She has proven that you can do good and do well in your practice. For every act of kindness, good will, and pro bono care the return has doubled. She shares her cases, challenges, and obstacles on multiple social media outlets and has built an Army of change who support others in kind. It is possible to be ethically driven and financially successful. She has also proven that it is also possible to wear your grubby, fragile, intense heart on your sleeve and be peacefully content within your practice. It is possible to be the vet your little girl self dreamt of becoming.

With a dedication to both medical innovation and ethical integrity, Dr.  Magnifico works to shape a future where veterinary practices are accessible, sustainable, and rooted in compassion for both animals and their families. 

Thank you again for considering me and for all that you do to help others.

With gratitude,

Krista

The Ethics Of Choosing Welfare Over Profits

One.

There isn't one hour of any day that we don't discuss the financial impact of veterinary care and its influence on the pets we share our homes with. 

The strategy for balancing care and cost is to prioritize animal welfare and focus on providing the most effective, cost-efficient care possible. This may involve recommending alternative treatments or procedures that are less expensive but still effective, or working with clients to develop a treatment plan that meets their needs and budget.

I have been asked to give a talk on ethics in vermed to the SVME, or, Society of Veterinary Medical Ethics. Now maybe every veterinarian doesn't spend as much time in the veterinary mire as I do, but, every veterinarian, heck, every human is muddling through this minefield every day.

For me it comes down to who I am. Why I am here. What veterinarian did I set out to be all those years ago. The years when I was small, helpless, feeling overlooked in a world of other meek beings who were always at the mercy of someone bigger and stronger. The perspective of need was the place I dwelled. I was alone in a world that had other creatures around me in the same bucket of existence between luck and mercy. I grew up primarily on a farm. For all of the beauty and joy it held there was disease, suffering and death. I was never a child to go quietly into the night. I was, as those around me taught me to be, resourceful, resilient, and determined. Every dog, cat, sheep, horse, bird, bug and other showed me how to be at one with my surroundings yet waiting for fate to come challenge you at your most vulnerable. I learned this at a very early age. I learned value was relative. It came with a perspective that dictated fate based on the pocketbook, whim, and emotional value its own placed upon them. I also learned too early, that I had little to say in matters of care when a bill was included. When our dogs found porcupines and cried in the laundry room all night awaiting the vets office to open. When the cat got stuck in a fence but wasn't worthy enough for surgery. I never accepted that my dearest companions were any less worthy than any other being around us. I failed miserably at state fairs, thanksgiving dinners, and any other event/entertainment that allowed animals to be used for amusement or waste at our expense. I was shaped by so many instances of seeing the world differently because the animals who insulated my life brought love and I couldn't be a part of cruelty to any of their brothers or sisters. 

I was, and remain the same girl. The girl who looked so deeply into the eyes of her sheep and horses that she saw a reflection of herself within them. At least a reflection of gentle kindness she wanted to be. Those moments of companionship for comfort were my first biology, anatomy and ophthalmology lessons. I was learning as I was being cared for and to them I owe lifetime of debt.

When medicine came I knew that I was here for more than a professional reimbursement. I was here to put them, their health, happiness, and liberties above profit and gain. For as much as vetmed emulates and follows human medicine we have lost the connection that binds us so passionately to our professions purpose that we cannot be dissected from it. My mission, the seed of the soul of who I am and why I am here is so metastatically entwined with how I practice that I would walk away from medicine before I would surrender her to it. There are few cases where a humans life is endangered by my patients, these are the choices that I struggle with. The behavior cases, the rabies suspects, the ailing parents who cannot manage their pets care and cannot see that they are incapable of seeing the part their forgetfulness plays in their pets lives. These are the ethical dilemmas I call my minefield. These are the places I cannot tell if I am enabling cruelty albeit disguised as loyalty and ownership.

If human medicines primary ethical obligation is to the patient, why then can't mine be the same? Why would I put a Standard of Care above the ability to provide care? Why does money always find itself at the root of all evil?

If this profession wants to reap the benefits of following in human healthcare, all of the advancements, miracles and yes huge profits then maybe it's time to remind ourselves why our clients are willing to seek, and yes, pay for them. Maybe it's time to remember that our clients come to us because they, just like the little girl I was, and am, want to protect the being in their lives that give it peaceful acceptance and purposeful worth. Maybe it's time to gaze into our clients eyes and see a reflection of ourselves as we want to be seen.

Cookie. How I adore this girl.
Addisonian. The purpose lies within

The physician’s first professional obligation is to his patient, then to his profession. His ethical obligation to his community is the same as that of any other citizen.

The Avenues Of A Legacy

We are open from 8 am to 8 pm Mon through Thurs. On a typical day, I'll pick yesterday as an example, I see about 11 appointments in 30 minute slots and then as many emergencies as call and need to be seen. Yesterday 3 vets, all working a 12 hour shift, saw 17 emergency same day fit-ins.

At 745pm a 9 year old up to date on its annual exam and vaccines presented for an acute onset of lethargy, inactivity and inappetance. Within 1 minute of the physical exam my gut told me this dog was in trouble. It is the gut feeling that you get with experience. I spoke to the owner. I had to have a quick, frank, troubling conversation without any diagnostics to lean on.

"I am worried about your pup. We are dehydrated, the gum color is mucky, and our belly looks distended and is painful. I think you need to go to the ER." She shook her head in agreeance. 

"I just knew something wasn't right." She replied.

"Ok, I am going to go make some calls."

I called the two local ER's both are about 30 mins from the clinic. 

In the days of the ER's opening and inception the primary objective was to honor the referrals of the local general practices. We were the bread and butter of their business model. There was an understanding that if we referred it meant these cases took priority and needed to be there. The acute episodes of milder emergencies would be deferred, or wait. Last night when I called to transfer both places refused to take the case.

I called both of them the next day to try to understand.

I was given very different answers, neither I expected, from the veterinarians who are the medical directors.

The first ER told me that when they say they are full they are full. Hard stop. She did add the perfunctory exception. "We always take the euthanasia's. We don't want to make them wait." Now, it might sound like an act of basic compassion, and in some cases it is, but, it is the easiest money a veterinarian makes. If you cannot make room for patients that are trying to live but dying, versus the dying and can't afford other, then I am skeptical. Disturbed. Irritated. Do I understand the reality of over extending and over burdening an engine? Hell, yeah! There are times where I know I cannot add one more case to the day without repercussions. There are moments that I want to run screaming from the building, ripping my scrubs from my body to be thrown in the trash as some last desperate act of freedom. But, then I remember who I am and why I worked so hard to get here. And, so it remains that many of our emergency patients won't, can't, refuse to go elsewhere. 

The other provided an apology. "We always take veterinary referrals. It is our first obligation." Well, thank you. Thank you very much. I reiterated that I would only send them on after we were unable to provide care. I also promised to go over expected costs and scenarios so the pet parents wouldn't be caught off guard. There is a painful reality to being sent elsewhere with a potentially dying pet and then being given the news that you cannot afford to be here. You have no options and the vet that you knew and felt you could trust has been responsible for it.

The subject of emergency care at our general vet practice is a harried history so long that it bears context and consequence to discuss it.

Jarrettsville Vet has been around for over 80 years. A long, long, long time. Over that time we have been the place for all things animal related. We have seen the transition from farm animals as our primary patients to dogs and cats that are now provided every luxury a human has. We have grown from a clinic with 2 exam rooms renovated from a single story home, to an 8 exam room facility open 7 days a week. We have done (almost) every surgery imaginable. Open chest, transfusions, horrible accidents, wounds, and cruelty. We have worn every hat from every specialty because we had to. We can transform from a bleached, pressed, white coat to a trauma center in seconds. We are still the people of the place this has always been. A rural, humble, practice built upon longevity and honesty. 

We, the team at JVC, has learned together that there isn't much we cannot do. We are never alone in our cases and we never abandon each other. Maybe that is the marrow of a legacy that 80 years grants you? Maybe it is just the collective fabric of a group that has always understood their place, their importance, and the legacy that time and dedication grants you.