The 33 Parvo Puppies of Ukraine.

It's Wednesday morning. I am drinking coffee like its an Egyptian reincarnation elixir. Smooth, strong, bold. I close my eyes, grip the cup firmly. Sit back and breathe hoping that some magic vapor of it will infuse my body and reignite its desire to go on. There are remnants of the ashes of me left to try to re-assemble into a human being once again. Feel alive. Get up. Just move forward. For just one more day. If I can make it to Thursday I think it will be ok.... I think...  I hope. I breathe. I sip,,,

My mom,, she loved her coffee

It is the same every week. The long, endless days of too many people with too many sick patients and never enough money to allow them passage anywhere else. This is my life now. Arduous and yet so fulfilling I cannot remove myself from the pride shadowing the exhaustion.  Breathe. Sip.

I love mine too

I remember being in the Ukraine. The exhaustion I existed within there. That place, those memories. It is my litmus test for measuring grit, determination, and life. It is my pivot point. The inflection marker. The spot in my timeline that has become the yardstick for everything else. All of life before, and after, can be boiled down and reduced to that. That survival for all you know, and how hard you will fight. How hard you will push your body because your mind is so determined to make this existence not become your life-long reality. Nothing will measure up against Ukraine. Nothing ever could. 

Ukraine. Our compound cat

Ukraine was an ominous, looming feeling more than a place. Equal parts haunting, cruel, and inspiring. Mankind is always at their most impressive when its at its lowest, most desperate place. I remember driving for hours. There is no airport inside. The trains are few and far between. In a war the infrastructure gets hit first. It cripples the country. Cuts them off from the outside. Choke holds are strategic. You see mountains of fortified make-shift guard posts along the roadside. Whole town's blown to pieces. Detritus of shambled foundations with jagged edges and displaced lives beside them. As if still staking claim to a place they used to belong to. Elderly people staring off as if entranced or paralyzed. That despondent despair is pervasive, catatonic, sad married to depressing. People are lost, afraid. The air raids go off all day and night. The constant reminder that Russia has sent another weapon into their home. There are no middle class residents left. They all bailed in the beginning. The teenagers were all drafted via the fast track into soldiers. Alert, swarmed, clustered in groups, heavily armed, chatting like teenagers do, giggling and yet not looking at each other. Always scanning their surroundings in a reverse football huddle. Army green fatigues obviously new to them, but already worn out from the accelerated training they were thrown into. A visual reminder that these kids were forced to grow up too fast. Around them barricades of sandbags 2 stories high. Always smoking. People looking at death within months smoke, and get pregnant. The only place a teenager is not glued to their phone is a war zone. I rarely left the compound, hours deep into the country, but when I did I always traveled with a translator. A Ukrainian resident who made my passage, as limited as it was, safe. I never spoke in public. I never gave myself away. I recorded everything in photos and a journal. It seemed too unreal to be believed later without current proof that it had all happened. The indelibility of it all put to paper and video. Photos of the 500 plus dogs at the Droog shelter hidden away in the middle of a blown apart country.

Droog shelter. 500 dogs crowded and trapped

One of the many byproducts of war

So many things stir inside from that time. The oddity of not seeing my feet for weeks. (You never change your socks if it is cold, wet and you have no access to laundry. As long as my feet were warm and dry I just had to believe the toes still lay beneath). The degree of dirty your hair gets in a dark compound full of dogs and cats and a kerosene heater. The walking the dogs all day, trip after trip. Some mad carousel with no destination. Walking the dogs was my only escape. They loved it more than I did, and I can tell you I cherished it. An abandoned parking lot around some dilapidated warehouses with few areas of grass. The few grassy knolls we could find were littered with broken glass and needles. Another reminder that peace would not come easy. The hardness and grief that sticks and stays. You cannot ever get away from it. It owns you, worse than fear, more suffocating that despair. It is loss, and fear, and mercy, wrapped in hope with shards.

I went to Ukraine for reasons that will never be fully explainable. I have written and admitted to most of these before. 

The reasons I left have not been disclosed. Not fully. 

In the last days of my well-intentioned-visit I realized the full extent of the naivety of the self-inflated avaricious goons, (mostly American, Canadian and Bulgarian), I was housed as a guest with showed its true colors. These chain-smoking tatted hooligans were so broken and medicated that their intentions to rescue and protect the animals stuck in the middle of this war zone were never completely thought out, nor discussed. They went on these secret middle of the night raids to "save" animals and rarely understood, nor planned the consequences of these decisions. They had recruited me to be the vet for these rescues, yet they never asked for their experts perspective or advice on anything. I was a credential expert expected to be quiet and clean excrement. Cleaning cages and commiserating with the caged rescues was at least a purpose. These rescue trip charades, their testosterone fueled mid-night escapades, brought horrors of epic proportions. I was the only one who saw and prepared for the inevitable consequences of pillaging and hoarding animals in a war torn country without rails. I was brought into Ukraine to help the animals. I was recruited into the country by the ringmaster of said gang by urging me that I just wouldn't be any help outside the borders of Ukraine. (He was right about that). Getting anything out of Ukraine was ridiculously muddled and therefore impossible with ever changing policies, people and paperwork. Getting in, well, that was easy. Ukraine took anyone willing to step across three zones of barbed wire, an Army of assault weapons, tanks, and air so stale it felt suffocating. Nothing on this planet can describe the transition zones of a country at war and their geographically free neighbors. They met you at the border with open arms, and a smarmy shadow of lost boys trying to negotiate anything to be permitted the chance at being smuggled out (anyone between 14 and 60 was drafted and required to stay). There is a cafe, just inside Ukraine at the border entrance that stays dimly light, serving never ending cups of rancid coffee, 24/7. It is the gas station you fill up at as you wait the days it might take to get wherever you think you can alive in. This is the dead zone. Dead to those trying to leave. Dead to those weary of wandering in. 12 hours into the country by car the compound with the rescued animals I was supposed to care for sat. A cement barracks so dark you couldn't do anything without a flashlight we were warned to use with caution, or waiting for daybreak. Everything was done while the sun was up. A dozen dogs and cats caged to keep safe for some unknown break in a war so they could resume a life. It was long days and a bleak existence. I might have been recruited to be a veterinarian in a place that needed one desperately, but, I was not permitted to actually practice what I had been trained to do. 

A fridge of vaccines sat quietly hooked to the only generator we had. It was the only thing that was kept cold outside of a cooler used for the long car rides the boys had to go rescue some pet somewhere when the Ghostbuster phone rang.

 It is all a muddled dream of mankind's worst and humanities intentions. All gone awry in between. 

More on Ukraine here

Two weeks in to my stay and the moral in the compound was low. This team existed on the next adrenaline fix and the tank was low. One early morning, (the gang always left after midnight), they took the trucks and rolled out. When they returned that afternoon, the boys showed up with 33 puppies in 5 cages. They marched into the compound full smiles.Lumbering in like Santa with a gravid sack of new presents. They legitimately thought that they had "rescued" them to have them be better off with us. I had witnessed them before buying the animals as some kidnapping meets hijacking ransom. They had paid for the bear, the wolf, the diabetic dog. They had cash from their viral videos and they had no problem buying an animals "freedom." I knew the second that I saw these puppies that they were all likely to die. I still believe that these puppies were props for social media fodder and fundraising. The rest of the volunteers spilled them out like candy. They spent the rest of the day in bouncing, baby, bitey-kissey puppy piles. The kids with their Christmas toys. All new and excited. I left the next day. Over the next weeks all but 3 died. The veterinarian who remained, (also recruited), and two others worked all day and night for 14 days to save them. This is not just the outcome of war, this is the outcome of power plays and idiots deciding how to manage infectious disease. I heard that three of the other older dogs also died. Three of the dozen that the "head vet tech" wouldn't let me vaccinate. I was told I couldn't vaccinate because I wasn't a Ukrainian vet. The dogs and cats didn't care who vaccinated them, but most of them died because no one vaccinated them. I left because I was part of some guys mistaken altruism. I left because I knew I wasn't helping animals I was harboring infectious disease agar. I left because I can help the pets of my community in a real way. There is parvo in my own backyard. There are unvaccinated dogs in my own backyard.

Poe. Our parvo puppy. Story here

This plays out to this day. The local shelter is stuck in a save face powerplay that is just costing pets their lives. Infectious disease is going to find a way to survive in the weakest, smallest and most vulnerable. It is an inherent, omni-present reality of too many lives in too small an enclosed space. It is the cost of mixing populations. Housing the lost, surrendered without previous adequate medical care, and just plain old bad luck fate. I purchased the parvo treatment on my own dime to save the lives here I can try to save. I offered it for free, and any supplies that would be needed, to save the 30 puppies I couldn't in Ukraine. The shelter had an outbreak. These are inevitable in large populations of animals. When it happened I offered care immediately. I was dismissed and the puppies were euthanized without a chance at recovery, and to my knowledge without veterinary oversight. A tragedy yet again, and this time in my own backyard. 

More on our parvo outbreak here. 

There are a lot of layers to this tragedy. A lot of people who are responsible and want to make excuses as to why this is acceptable. I will fight for these three puppies (there were 4 that died in total), and hope that it makes the next outbreak allow some survivors. There is no chance when euthanasia is the only option provided. There HAS TO BE A veterinarian at the forefront of medical cases. There has to be a group effort to save them and not just try to eradicate the disease that they are afflicted with as collateral consequence. The common thread is that you have to have credentialled experts leading the decisions. If you don't it will cost lives. If you don't the responsibility for those lives is on the hands of the leaders behind the decisions. That is called accountability. It's the collateral damage to being in charge.

There is a treatment in a bottle that offers help. As soon as it came on the market I bought it. It stays in the freezer at the clinic with the hope that it might save one puppy I couldn't save in Ukraine. I give it away as some small way to pay it forward. There will always be that vial in my freezer and that hole from those 30 puppies in my heart.

Watching a dog die, always a puppy, from parvovirus is wrenching. Knowing it died when it was preventable, infuriating. If needed I would give that vaccine away too if it meant I never had to endure watching that suffering.

My puppies. Rescued from shelters.

Did we talk about the shelter buying/transporting from high kill states down south puppies for adoption events at the Motor Show at the Baltimore Convention Center? Why bring your own dogs when you can import puppies? More on that soon. (Deja vu, right? except wrong continent). 

When No One Else's Opinion Matters

 "... so if I come in this week to put her down will you be ok with it?"

It isn't the first time someone has said this to me. Asked me for grace wrapped in permission.

It always strikes me as quixotic. This asking for forgiveness to be given as a form of equal parts willing participation and peaceful acceptance. As if I hold some power I do not recognize myself.

What does my opinion matter? Why would you let anyone else's judgement cloud your own?

I always take great pause to reflect when this is directed at me.

Who am I in your pets life? What influence do I hold? Why should you care about what I think?

...and yet I surmise that I know the answer, or part of the answers, to all of these. 

I have been the navigator to this girls every medical challenge and endeavor her whole life. I have been a part of every choice, decision, obstacle and surgery. There has never been a time where her life's choices haven't been discussed together. Her mom is a dear friend. She has grown into someone I adore and cherish. We did this, we grew into this, over Bella.

Maybe I am shying away from the weight of this question? Too comfortable in the minutia. The advocating for all that kept her safe and healthy, yet, deflecting cowardly when the final decision has to be made. 

Maybe I am a fairweather friend? So deeply entrenched I cannot see her past myself?

Maybe I am too deep to bail out?

Too thin to save from shattering.

Too ingrained to know where the professional obligation ends and the rest of me that still adores her begins?

Maybe we are in this together and she wants me to pick sides knowing Bellas story is ending and we will still need each other on the other side. The survivors side. The remorseful, guilty, heartbroken and alone side.

Bella is now 15. A shepherd mix who was once a spry, spicy, opinionated and complex. She was calculating and discerning. A true shepherd. They love you the first time they meet you and dislike you increasingly exponentially with fervent disdain every next time. I take great pride in being the exception to this universal rule. She has tolerated me, accepted me, and I dare say even liked me, from day one to today. 

Her mom tells me that she still gets excited to see me, looks for me as soon as she enters the clinic, and smiles as I approach. As I enter the room, just like every time before, she pushes her way to me and beside me. I wrap my arms around her and whisper our traditional "hello," and "I love you."  

"You love her and she is dying. My opinion shouldn't matter." I told her what she needed to hear, what I truly need her to hear from me. 

"I am here to help you. I am always on your side."  

What I hope she knows is that Bella could have never had a better life with anyone else and I am honored, grateful and humbled to have been a part of it.

It’s times like it is that everything falls back into perspective. We are reminded about what’s important, and what isn’t. And all of the other little problems just become minutia. 

Then I remembered it’s always this way. I live in this world. The world where life is fleeting and short and precious, and never to be taken for granted. That is the life of anyone in medicine and anyone who loves anyone else.

What I know is that this life I have lived, these souls I have shared it along the way with, these people at the other end of the leash, they all mattered. The reasons that people love their pets so much. They were the reasons I came here. The reasons I can't ever leave. There is purpose, and fulfillment, joy, grief and every shade of every meaningful emotion in between under this roof. It is the marrow of a lifetime that being vulnerable, honest, dedicated and absolutely completely emotionally invested without care to what that might cost you delivers. Bella is the reason we are who we are. 

What I hope that others see is that its ok to throw your whole heart into something. Its ok to grieve like life will never hold its color again in the same way. It's an honor to be a part of a journey so rich and deep it changes you. Its life that is intended to hurt so you know how good it is. We are all in this together. It is what makes us so fortunate and rich. Mankind would be better off as a whole if more people had pets in their lives. Nothing else holds more influence in compassion, companionship, and community than the interdependence of sharing your life with another. They don't judge, they ask so little, and yet they reflect more kindness back than you ever invest. They keep us feeling human as we are reminded that humanity is our greatest attribute.

I don't just bear witness to these lives. We are a part of them.

The End From The Beginning

 ....what if we all started everything here?

The End.

...let's start every decision, every big life event, every meaningful intention-led action by imagining ourselves at the end,,

and then march yourself back.. 

by living the life you want to end at.

Me, I want to close this book of my life with one single thing as my legacy.

I was always my patients best friend,

biggest advocate,

fiercest warrior,

and most adoring fan.

Nothing more mattered enough to change these..

The End begins, begins again, and will always be here.

mic drop

Fresh Meat

You Don't Know What You Don't Know..

Penny. One of our dearest friends and a local rescue

The staff have notified me that you are headed to a nearby practice that has just sold to corporate. I want to respectfully and sincerely share my experience and insight on this decision. And apologize for the tone. 

I spoke to the seller, (a veterinarian I have known for the 20 years I have been a veterinarian), about two weeks ago. She told me that she sold to corporate, (a corporate company I also know), and I told her that I understood why people do it, I just could not understand her doing it. She was the last and only other practice owner besides myself who I believed would never imagine selling corp. 

Here’s what I don’t think you know. You are young. Just starting,  In debt yes, but you still have your heart, compassion and integrity. Your sign on bonus and contract are going to challenge that. Corporate companies have no interest in patients unless they have deep pockets. You will be expected to turn away or euthanize treatable pets because they are not inline with their profits. Period. They don’t care about anything unless there is a profit driven reason. They only care about you because you have a license and a contract. Without them they don’t care about you either. I could put you in touch with a dozen former corp vets who worked for them. They would all verify this.

If you think being in debt is the worst part of your current position it’s not. Being burnt out and turned into an indifferent person who doesn’t love vetmed is. Even worse, becoming a part of the statistic that is so shameful we bury it. We can talk about all of the myriad of reasons that veterinarians choose suicide, but, losing ourselves in the process of trying to care for others is at the forefront. 

Corporate medicine is so insidious in our profession that they now start recruiting the most debt-ridden students, (it is not a coincidence they start here), in their first or second year of vet school. By third year they have "signed." They are receiving "pay" in the way of stipends and expected to take their internships at their corporate run practices. They are constantly groomed and persuaded to pay back the favors enticed by large (always secret) sign on bonuses and long restrictive contracts. The contracts are the most horrific parts of this recruitment trade. I don't know if anyone on the university side has these graduates interests on their job description, but I know that when I was in vet school I at least had a professional advisor on campus. A recent new grad was sharing the details of the contract they had signed. $160,000 for 60 hours of appointments. Sixty hours is twice what any of the vets at my practice carry. The state average is about $130,000. This is endangerment labor. I strongly challenge the viability of anyone being able to learn effectively, care for patients effectively and then being locked in for 5 years!? An internship and residency last 5 years and when they are completed the expected salary triples. What is going to happen to this student? She is going to want her life back. Or, she is going to quit vetmed feeling like toast.

I never require a contract with new vet’s because I never want them to feel obligated or pressured to be anything other than who they are. If you aren’t happy here I want you to find the place you are. You cannot give your heart and soul and feel purposeful and good about yourself if you are contracted to anyone. 

I know this is not what you want to hear. But, I want you to know I am here for you. 

A veterinarian who sells their practice to corporate is asked to stay around for awhile. Help it look like the transition is gradual and under their guidance and acceptance. Maintain a facade as the new regime takes hold. It is all a part of keeping the most profitable plan by the new owners. In exchange for a whole lot of money the departing practice owner has to give up all that they built and all of his decades of building something amazing to vultures. They will always know that they profited from this sale and their staff clients and patients will pay for that. 

I hope that you find a place that you love. And love vet med as much in 5,10, and 20 years down the road. Never ever let anyone take away your passion or compassion.

I wish you well. I hope I am wrong about the direction that the clinic is headed for. The seller thinks it will remain the place she built and is proud of. I hope she is right too.

 Krista. 

Spencer, always shy and skeptical.
A local rescue

This is the letter I sent to a former employee who is started work at a corporately owned practice upon graduation. He has a big heart and he has worked hard to get into and out of vet school. He is like so many students who are lured by corporate reps who promise all sorts of things to get them to enlist. I spoke to one student who was given a big sign-on (about their first years salary ($140,000) for a 5 year commitment and a 60 hour a week appointment schedule. This leaves them to make phone calls,, review blood work/diagnostics and write up their cases on their own time outside of that. I would expect that will leave them working 80 hours a week. They are now earning $33/hour, and miserable.

What you don't know, you don't know. Maybe the first person who approaches you with the shiny objects and the impressive dollars doesn't have your best interests in mind? Maybe it's time the vet schools take a stance on predatory practices if they aren't already one themselves?

Maybe it's time we start asking some hard questions as consumers and start whistleblowing for the sake of our patients, our emotional bonds with them, and the people we entrust with their care. (More on this to follow).

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The Venom In The Terminology

A message came to me from a colleague about a post on LinkedIn drawing some attention. 

The post centered around what we (the veterinary profession) calls "futility of care." 

It was hard for me to read. Hard for me to internalize. Hard for the words to carry so much gravity and deliver so little of what our clients need from us. 

I don't know when it exactly happened. When that pivot point was. But somewhere along the way our message about treating out veterinary patients like family became treating them in the way we allowed.

I want the profession to start to pay attention to their words. I plea for the profession to also pay attention to their intentions. The gravity of the judgement within them;

Here are some of the most offensive;

"Pets are a privilege, not a right." Why would poor people deserve something to adore them? Someone to make you feel loved back.

"Futility of care." We decide when you stop caring, and, therefore,, stop looking for hope. Some pet parents struggle with grief and loss on a level veterinarians have refused to comprehend. People should be allowed to feel as they feel. Our job, well, that is to provide them the tools to do so. Hope is as integral in medicine as vaccines. Hospice is absolutely an acceptable avenue in medicine. Every kind of medicine. We, the veterinary profession, want to follow in the footsteps of our human counterparts and offer every billable option to our patients, so, why is it then that we also won’t offer hospice? Why are we so intent on being morally superior and yet still not empathetic to those we are here to serve? 

PS futility care is most often seen as cold and uncompassionate. Why would we ever use that term? Small animal medicine is about taking care of family members. Nothing is futile here right?

"Economic euthanasia" The fact that the profession has increased the cost of care so staggeringly fast that this is the last vestige of care we will permit, affordably. You cannot advocate for your patients to be treated like family and then decide they aren't worth options that work for the rest of the family. In 20 years of practicing medicine I have (hopefully) never denied care because it didn't work for me. It has taken me time to understand how different we all are. There have been clients who don't value their pets in a way congruent with care. 

"Replacement value" There are people who see pets much like food animals. They have a value that is defined by "replacement value." That dollar figure where it is cheaper to replace them than to fix them. Ask me to expose my soft vulnerable underbelly and help your pet out of a difficult situation and I will jump in. There isn't one person at the vet hospital who wouldn't jump in with me. But, don't ask me to look into that disposable pet and see them as replaceable. 

Elsa.. recently rescued and adopted

This blog comes from a post from a fellow veterinarian who started the post with;

"Today I had a client for which I refused treatment." The veterinarian went on to describe an elderly patient at the end of their disease. The pet parent bringing that pet is was back at their vet hospital, again, seeking help. The parent did not see the pet in the same light, the same degree of dying, that the veterinarian did. The pet parent wanted help. With that plea for help, with nothing more to offer that was feasible in helping the pet get better, with only euthanasia left, the vet posted that they were refusing treatment because watching this pet show up at the clinic was stressful for the staff. Like so many other instances this is a veterinarian who refuses to see the pet in the light we make such financial gains from and meet them where they need us to be. The parent wants to feel hope. They are aren't ready for the passing of their family member. Futility or not, there is absent compassion here for what the pet parent needs. We are turning our back on them when they need us most. Why can't anyone say, "what can I do to help?" When is declining a hand of empathy abandoning our responsibility?

I replied; "Today you decided to stop being a doctor."

For more on my veterinary hospital please follow us on our Facebook page; Jarrettsville Veterinary Center.

YouTube channel here.

For more information on the non-profit work we are doing to help save pets from economic euthanasia please follow us on the Pet Good Samaritan Fund page.

Pawbly.com for pet questions and pet care cases with cost of care included.

When The Veterinarian Decides Who Is Worth Care

"I need to talk to you privately."

It is the beginning of another chaotically busy day and this is my least favorite preamble to start it off with. I tell myself to stop what I am doing and just go face the discussion head on. Rip that band-aid off and then return to GO. It is the only way I will get to the end of the day intact.

Magpie

She is the vet hospital floor manager. She has been here for about 9 months. (New to us by the law of averages that the rest of the staff holds. Most have been here for over 5 years). She is the Sergeant who keeps the cadence. Monitors the staff and doctors to stay on time. Ensures the blood tubes are labeled and the diagnostic table stays organized and orderly. She fills in to hold a patient, address a problem with a client to keep the vets on schedule. Picks up the phone to answer the random, often completely inane question. (Like yesterday's; "my dog ate a treat toy. What do I do?" No idea of size of dog, size of treat toy, what said treat toy was made of, or how well their dog chews before swallowing). She is on her feet, in everyone's business, and still keeps a smile on her face and an optimistic cheer in her stride. She used to manage race horses. She is ideally qualified for this crew of, (authors note; I wanted to use the analogy about 'busy as a beavers' but it just might be construed aberrantly.. ;-) ),, let's say ants... yes, or bees, or thoroughbreds, they all substitute to make my point. 

Storm, morning naptime

The conversation centered around one of our oldest clients. Old in both age and years with our practice, (must be about 70, as he is about 85). His family has farmed the lands in this county for over a hundred years. He is known by every person who has lived here for more than a few months. He is an indelible character. Always a farmers baseball cap atop his head, (which I have never seen naked). Always a pair of pants missing fabric in key places. And, always a long tale about some physical ailment of his unrelated to the cat he has brought. And, yes, always a cat. He used to have dogs, farm dogs, (of course), but cats, he has  decided are far easier to care for, and he far prefers their company. He lives in an equally old, equally worn out, farm house. Every room of his home has been converted into a cat dormitory. Every room is sectioned by feline family. All of his cats, 40-something in total, are related. He is as old school rural farmer as they come. He absolutely, unequivocally loves his cats. They are his family. 

"I don't understand why you didn't tell him that he had to put the cat down?" She is referring to his cat that we saw late yesterday. His cat was pitiful. Dying, and in horrific shape. He was matted, foul-smelling from feces that had caked on his back end, and emaciated. He was also sweet, gentle, purred the whole time, and knew only love from a human. His cat needed help, he knew it, and he was here looking to us to provide it. We are, after all, doctors. This is, afterall, a hospital.

Her question is so heavy you can reduce to a few minutes and a clock that ticks impatiently. 

I know that I have to try to answer this for her. Find some analytical reasoning in her black and white perception. I also know that her question comes from a place of respect that she trusts me, and concern that she is a part of a patients suffering she doesn't feel right about. 

The answer to this question is seated in the ethos of who you are. It comes down to this; who are you here? Specifically, who are you in veterinary medicine. 

The successful small animal veterinarian is able to keep their business open because they understand every pet parent sees parenting differently. Veterinary medicine exists in a place of whim and will. Every pet in every home is there as a guest in the eyes of the law. While they may have some basic rights in a few states they are still considered property. Pets are the reason veterinarians worked so hard to attain a degree. They are our purpose. They influence us. When you are so deeply invested in something it becomes painfully purposeful. It becomes ingrained in who you are. This is a curse as much as a blessing. Understanding the emotional seat of pets is imperative. 

Frippie. Also morning naptime

If my purpose is to help pets I have to provide it within the confines of what works for their family and caregivers. Veterinary medicine is forgetting this. We are getting judgemental and restrictive as we become more profitable. We have influence tied to our preferences and our gate-keeping for their health. It leaves people like this farmer in a place where he now will not go to the ER, and he will not go to other veterinarians. They have judged him, lectured him, reported him, and he will not share his life and the dearest individuals he adores. His cats are his family. He will protect them as such. 

A practitioner who wants to stay in the community they live, work, and practice in, needs to meet our clients where they are, not where we want them to be. This is the key difference that specialty medicine is lacking. You cannot be a part of someone's story without being embedded within it.

His cats are crowded. He has too many. He knows this. He spends all day everyday cleaning for them. Feeding them. He treats them the way the rest of the world treats the animals they eat. Crowded and housed like they cannot have freedom to pursue free-will. Why do cats and dogs deserve different standards of care? Different living standards? Why if you think they are more deserving of minimum standards of care and yet not deserving of end of life care like humans are? Every hoarded started with love and good intentions. Every pet under their care still deserves care.

This is what she didn't recognize yet.

The view from my kitchen window

For every client that I see who doesn't want to euthanize their pet because they do not feel it is their place, their right, their duty, their decision to make, the profession has to be respectful of this. Hospice is their right as much as it any other aspect of dying is. This farmer has never put a cat down in my clinic. Whether or not I can do the same with my beloved pets is not relevant to his decision. He loves them. He cares for them. He dedicates his life to them. Do his cats love him back? Yes? Is he wealthy, influential, hold some power over others that can afford him a different set of rules or standards? Is this the country we live in now?  Is this yet another instance of inequity deciding who is or isn't worth empathy? How many cats are looking for homes in my county? (Hundreds). Do these facts influence our compassion?

A decade ago we had a long, hard conversation about his colony. It took me years to convince him to spay and neuter. It has been a decade of no kittens, which was very difficult for him to give up. It was what his cats needed. It took him a while to see their world from this perspective. There has been a huge decline in respiratory infection, illness, and death outside of old age from this. He needed to see the colony from this vantage point before he could give up the joy of having kittens. This is medicine. This is the emotional glue trap that having pets causes. This is the life every veterinarian chose even if we couldn't see, or comprehend it during the early years or vet school.

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They Will Break Your Heart.

The months within the abyss never clarified the question. Was the sense of abandonment worse than the sense of loss?

Twenty five years later I still can't find the answer. All those many years ago, when I was the new bride with the husband asking for divorce I couldn't answer this question for myself. Would it have been better/easier if I had been grieving over his casket. Widowed, alone, and yet everyone would know my story without me actually having to mutter the words aloud. Sparing me the humiliation that his truth held. I could have had a life again. Someday. Sure, I would have lived in the shadow of our wedded life contracting so fast. Being so fresh and small then wiped away cleanly. The nuptials of a black holed loss. Our life together compressed with so much into so little. A proverb of a marriage story. Just a few sentences; we came, we tied the knot, we died. The End. But, nope. Me, my marriage, this story, had to have mystery. Intrigue. Substantial tabloid worthy dirt to smear with shame, horror, judges and public notices. Mine had to have an arrest. A secret charge for child endangerment. A pregnant teenager. A mother of same said pregnant teenager who called our house aghast at the thought her daughter was capable of complicit consent. 

He had left before. But, he always came back. When he left for good I realized he had only come back as some sense of pity. Imagine that. He pitied me, and I was the one with the clean record. Nothing more than guilt kept him. After a few weeks not even that was enough. That's a slap in the face with a reminder to listen the next time. Listen to what people tell you. Not only to what you want to believe you hear. I hadn't heard him the first time. I hadn't wanted to. 

While you watch other married couples around you treat their spouses far worse than you know you ever treated your ex the truth remains that they never left each other and yours did. Yours did it in everyway to make it feel soo atrocious you lost your own identity in the mire.

All these decades later I am not grateful for the time my ex-husband and I had together. I am still fuming from the way he left. What shit came out of that departure. My dogs and cats, the dozen plus little lives that I have lost within this same time frame, well,  I am still searching my insides for those little pieces they took with them from the weight of their loss. I miss every precious moment of everyday I had with each of them.

Frippie in the poppies. (Poppies seem appropriate, right?)

At a continuing education conference a few years ago. Three of us sat cross-legged on the carpeted floor, all hoping that it didn't have as many germs as we knew it likely did, eating our bagged lunches. I, always the oldest of the group of my vet school classmates, had by this time, owned my own vet clinic for about 17 years. They, they were 10 years younger and about 14 years shy of my ownership anniversary. New to the game, still optimistic in making all of the pieces fit, sat and talked about motherhood, toddlers and juniors of their own, and finding that elusive balance to it all. Me, I ate. I know better than to offer unwanted, pessimistic advice or lessons. They had loads of questions about bookkeeping, scheduling of staff, adequate staff to veterinarian ratios, payrates. Marketing, websites, inventory buying power, and cases that seemed too odd to be real. Their questions required minimal time to answer. They were most inquisitive about our internal slush fund, its use and my unwaivering dedication to treating every patient who crossed our threshold. They asked many questions. The one that I had learned and they had yet to feel first hand was that one lesson that time makes truest. 

"What's the hardest thing you have been through so far in owning your clinic?"

"Heartbreak. The cases can be difficult. The acceptance of life just not being fair. But, the hardest part above all, without question, is the staff. They will break your heart. You won't see it coming. You won't be prepared for it when it happens to you. You will question everything."

Its bereavement in shades of grey. 

Frippie, cold Sunday at home.

The stickiness of this, my own veterinary clinic, is the same glue trap of my existence. There is such great emotional depth here that it is impossible for it to not bleed into every other moment of our lives. It is the same canvas that paints a families portrait. Dysfunctional, adoptive, ugly with infighting at times, yet still all coming together in times of disaster, trauma, and need. We are that bunch. Proud as I am to have them all home for supper, each with children of their own. This clinic, our veterinary hospital, has weathered storms. Tragic deaths. Departures from unforeseen epidemics. Boyfriends, babies, and ambulances. Waves of changing tides, yet still trying to stay the same course. I have to be the one to leave this time. Abandon the web in the hopes it doesn't force exodus to those that remain behind. If I can logically see myself as the common denominator to all of this then maybe the problems solution remains in the crossing out, cancelling of the common thread? Afterall, excision is curative in so many other cases.

Storm, also never sure of much.

"What do you want to do?" My husband sat quietly across from me. Worried about not being there for me as much as saying the wrong thing.

"I just want to be a veterinarian, and still have a little time left for the rest of the life we amassed." Our house, now finally done. The cats and dogs all healthy enough to not leave me counting days, and pills and obsessing over calories in, weight loss out, and the pennies in the 'good day' versus 'bad day' jar to help measure the quality of life scale.  

"What are you most worried about?" He loves to live here. In the doubting-Thomas shoes. The red spiked tail and pitchfork always at the ready in his back pocket. 

"I am always to blame." You cannot feel anything other than this. The imposter friend. The imposter boss. Never truly a part of the group. Never in on the inside scoop. The pulse of the practice. Always aloft in the crows nest looking for a speck of dry land, or, the iceberg. Sure both are there re-plotting their courses to intercept yours. The sweeping line leading to the bullseye dead-center on your radar screen. Game Over. You know you will go down with the ship. They won't save a seat on the lifeboat for you. They never even counted you into the articles. 

I left the conversation with my business partner/spouse/wise old owl that he is, with this. "I understand now why Dr S and Dr L just walked away from their practices. They had no other way out. They hadn't become different people. They just couldn't stay trapped within their own prison any longer." I am not sure he heard me. It wasn't a nugget of information for him anyway.

In the end you will find yourself alone. Life will remind you periodically to get comfortable with this. It will remind you to be at home in your own heart. That people will tell you who they are. It's up to you to listen. They will come, and go, and try to come back again. You might not be the same person the second time around. It's up to them to listen to that person too.

Serfina

Me, well, the animals, the pets I adore, the places I always invested my whole heart within, well, they never broke me. They might have stolen my heart. Sent me into grieving as violently as anything else ever dared to, but they never broke my heart in a text message or email. Humans, they are the glue trap you will chew your own arm off to get away from. They are the ones you have to become at home with indifference over.  There are people who come and go. They don't have a calling card to notify. They have a history of half hearted attempts. Broken wings. Fledglings who keep flying to a different nest, but, never set up a home. Well wishes and bon voyage. What else can you do?

 It has taken me forever to learn this. I am never the person to leave. There are cobwebs on every facet of my existence. I don't know if I am the wiser or the poorer for this. I just know I am still here. Roots, legacy and epitaph intact.