Saturday, September 26, 2020

Who do you bet on? The horse or the rider?


Do you wager on the horse? Or, the rider?

What if the horse is the medical staff, and, the rider is the patient? Who then?

Let’s say the medical staff is Johns Hopkins. One of the most influential, advanced, respected medical entities in the world. Or, what if the medical staff is a single veterinarian, who has a solo practice and is expected to wear every hat you would find at Hopkins.

Let’s play our scenario out even further. What if the patient was my mom? Diagnosed with end stage breast cancer, and, quickly thereafter told it was in every bone in her delicate barely identifiable out of pubescent body. What if this diagnosis with its formidable prognosis finds her when she has never faced a challenge of personal merit defining obstacle in her life? My mom was always the easy way out option elector. Too much sweat, effort or scrutiny and she would immediately decline. Politely wasn’t even considered. She was adamant about easy living. She died less than 6 months after being diagnosed without a wrinkle to weather her face.

Then there is Havah. She is my dearest friend. The person who has been my most consistent bestie for over three decades. She was given the same diagnosis, same prognosis, similar disastrous landing of a cancer too invasive to shell out, this time her brain, spinal cord, and meninges, and yet, she has faced every toxic infusion of chemotherapy, every radiation eradication, and every step as a short jaunt to a recovery via hope-based endeavor. She has never wavered on her mantra to recover. To survive this regardless of how insidious it had grown. Not one modicum of doubt has entered her process. She is the rider on a life saving journey to the other side of terminal. She is the fearless mercenary who keeps charging on to a disease that has no eluding.

Both of these; my dearest, closest, most cherished souls are in the same fight. Both have unparalleled medical teams, and yet, my mom lived 5 months, Havah, well, it's been over three years. It was the rider who made all the difference in the race.

Why is this relevant? For me the doctor of animals, the rider is never the question. Every animal fights to survive with their chin up as they press on, with no time for self-pity or reflection. They face each moment focused on little else. Amputate their leg riddled with cancer and they walk on three with little instruction within a day. Animals fate is determined primarily in the medical access they are provided. Nothing else influences a pets prognosis more impactfully than the pet parents decision making process. It is where I find the most difficulty in being a doctor whose single goal is hope based care. Electing to “do nothing,” “let nature take its course,” “end suffering at the onset of a medical challenge,” has always implied giving up without attempting to palliate. It is a tough, bitter, jagged pill to force down. Especially in light of knowing how well most of these patients will do with even the minimal cost of effective pain management.

And then I ask myself if my personal opinion, my belief that medicine has all the answers? Is too biased? Maybe the quality of my mom’s short life was better than the medical maze of the labyrinth that the human system fills its unprecedented greedy coffers with? Maybe content and "comfortable" at home is just as hopeful as fighting with every cell you have? Maybe faith is based on fueling liberty and independence to heed your own cause and not my biased based case-based experience?

As I try to dissect, categorize, and compartmentalize the losses that I am reeling within I am finding that I cannot help find the answers to the personal choices made around me, only the ones I have to face for my personal healthcare decisions and those of the animals I am responsible for. I don’t have answers based on fortune telling crystal balls. I simply have gnawing for loss I cannot resolve without understanding the influence it has had on my own personal beliefs. I still grapple with the “quality versus quantity” of life arguments that is soo prevalent in my profession. I still take a quiet humble step back when my clients ask for my opinion as to which path they should endeavor upon. The all out fight for every best chance at life and possible recovery which almost always includes a life altering schedule of specialists, treatments, and tens of thousands of dollars, often to buy a few more weeks or months. Or, the go home stay eating, comfortable and as stress free as possible and let fate decide for you.

Even as a veterinarian my choices have spanned all aspects of the decision making spectrum. I still don’t know if I made the right choices, or even if hindsight has helped me evolve into a more accepting parent for their lives. I fought so hard for Jekyll, Savannah, Ambrose, and yet, I peacefully let D.C. Belle, the pigs go. I hope that knowing them, the individuals they are, helped me in those choices. If so, how well do I know myself? I wonder if the inner turmoil is focused there? Coming to terms with our own mortality. It was the one over looked, too painful to ponder place for Havah and my mom. They were so afraid to die. So unprepared to pass on, afraid for the loss and the unknown, and yet it has been so heavy to unravel it stole the last pieces of life worth feeling.

Maybe my lesson to learn lives here. That my decision is mine alone. Maybe theirs was theirs to live, die, learn, accept? And maybe the answer is fluid, influenced, nuanced, and never truly defined or settled?

I think that is what I need to live through. I say to others almost daily, “I deal with death every day. The loss of a life that mattered. Was hugely influential and deeply sorrowful to prepare for, live through and move beyond. How can I see my life so differently than theirs? I don’t feel as if I do. I don’t wear, consume, or associate with the cruelty in animals sacrificing for my life, how can I elevate myself, my death over theirs? We are all equal. Missing me is as earth shattering as them. We all go someday. The goal is to live now, and accept that when it comes to call for you. For me this will be after the folks at Hopkins tell me it’s a game I’ve already lost. Accepting that with gratitude for all that I leave behind is the key. Its all a gift up unto then. After it’s the price for the ride.

Related blogs;

Jekyll's story; 

Grieving the Loss of Your Pet.

The Aftermath of Losing Jekyll.

My Beloved Jekyll-Pup

The Turmoil of Contemplating How Long To Fight For Your Pups Life.

The Agony Of Being The Patient. How the Vet Mom Faces The Reality of Being The Vet Client.

Here is a story on my mom's journey;

My Mom's Story; Dying In The Pandemic.

For more on us, our journey, and this life we lead please follow us here;

Jarrettsville Veterinary Center (did you know that we post our prices?)

Jarrettsville Vet Facebook page, the most amazing, fact-filled, pet driven place on the planet. Meet our clients, patients, staff and learn about what we do and who we are. (Mostly we share adorable pet photos and pet related current events). We are passionate pet people!

Follow my blog by selecting the "follow" key above. is the place I built to provide personalized answers to pet questions and the sharing of information to educate, inform and enrich pet peoples lives. You can find me there, and its FREE!

YouTube channel videos offer case based stories and always include tips, tricks, and expected costs of care.

Friday, September 11, 2020

New Beginnings and Old Responsibilities. The Building Of My Legacy

Lately I have been hung up on this legacy thing. The idea that I haven't left enough meaningful pieces behind to have ever mattered enough for a memory. A condolence without substance. A farewell without a book of accomplishments to pass on. It's the curse of caring. Its really not a prideful thing. This late in life I don't care enough about others opinions of me to let it mold me into a more normal-vanilla being. I still fear not in posting defamatory remarks on the politicians. Broadcast my shame on others as the naysayers of climate change. Fight for a greener planet, a more compassionate place to share with all other species, my personal protest to single use plastics and my unwavering devotion to never being able to kill anything never mind consume them. I am so hard on myself it is unfulfilling. In vet med they call it imposter syndrome. I strive to live this perfect life of example within a cold place of global consumption. The veterinarian in me is no different. She has to know everything, be everything, and answer every tiny meow in the night. It is facade we put up to sound like we don't "just play one on t.v."

Getting to this place was a series over-analyzed, albeit well intentioned, steps. The plan was never set in stone. It began as a loose leafed alternative to a life I was pretty miserable in. (Note to all of my sea going and KP buddies here, I do sincerely love you and am incredibly grateful for the time we had together.. You helped shape me into the cast iron kernel of uncompromising charlatan sitting at this crossroads. P.S., no sarcasm here, promise). I was going to go to college, and I was going to go out into the world and do something meaningful. Seemed simple and honest enough.

The plan was derailed almost immediately. College, the stepping stone to adulthood, had little options that were palatable. My parents didn't have college funds prepared, and, I wasn't going to go if it was on their dime. If there wasn't a scholarship with benefits for ancillary costs it simply wasn't an option. I was expected to go to college, and, it was expected to be free. It was, it just wasn't ever my choice. Military academies work like that in some cases.

The lack of options has often led me to a search for uniqueness. I discovered I had to push through the endless hallways of the closed doors and never be discouraged from trying another avenue. In the worst places I landed, which were never the places I chose, I learned to survive. I learned to look for the long game as I was fumbled in the short haul. Sending a girl who wants to be an artist to a military school suffocates the soul of creativity. That muffled girl did her time. Time that was almost always spent alone, and almost inevitably dangerous. I never made a courageous decision, but I never walked away from being backed into a corner. I learned to silently strategize and I learned to not be afraid to fight. I could further reduce that to I learned to not be afraid.

How can a self speculating imposter not be afraid? Well, you learn to face every decision with a clearer mind and a definitive goal. That is part of what the military instills as a leadership quality. I am also grateful for that. You aren't born with that. You earn it.

Being a veterinarian is not dissimilar. You need to know how to manage people, decisions, look at a problem from all the possible angles and be prepared for your enemy to outsmart you. Not being caught off guard is as an important a survival skill as those years of medical training.

Four years of college and a degree in hand I set sail for the only thing I was trained to do, and, the one thing I thought would be the biggest challenge I could face. I went to sea. Tell me I can't do something and I will exhaust all efforts to not have to swallow the opinion of others as my own. It's not anything anyone should be proud of. It took me another decade to learn that I only had to make myself content in this lifetime. Everyone else was following that, why didn't I??

I did what I had learned at the Academy. I put the plan for the long game into action. I went back to school for what I wanted to do. (No, it wasn't art. I wasn't that brave). I went for my other passion. I was going to become my version of James Herriott, (minus smelly farmer and muck boots) who had carried me dreamily through that decade at sea. I read, re-read and lived a life of honorable purpose through his books all those many long days melt into nights abroad on an ocean. It took 6 years to get from able bodied seaman to vet school applicant. Everyone told me I was delusional. I was too old, my grades from the Academy weren't strong enough, I had a career path ahead of what others thought was "extremely lucrative and desirable" right in front of me.  No one changes their successful trajectory mid-way through. Do they?

For all of the  too numerous to mention sacrifices I had already made it seemed silly to walk away from a job that paid so well at the pinnacle of the ladder to accomplishment. But, for everyday at sea, coveralls, steel-toed boots, hard hats and solitude, what I really wanted was more broken kittens to mend.
Weasely. The tiny meow with the deformed legs.

I left a hundred grand a year for 6 months of solitary confinement work on the ocean for a chance at beginning my own story. It wasn't a leap of faith as much as a "get out alive" escape.

It took me years to get into vet school. Years of beating the odds, outlasting the competition, and, perseverance to determination leading to the acceptance of my own limitations. 

I learned that after a dozen "No's" I could more easily accept their diminishing worth. The value of excess dilutes the emotional impact. All the many "No's" allowed me to accept a challenge. After years of failing you learn to embrace the challenge as a way to reflect upon your own value. I learned to not back down from a challenge unless I thought it wasn't worth my time. That little decision took until my late 30's to recognize. It had to be my challenge to accept, not someone else's taunt to prove wrong. There was a tiny bit of growing up in the process of weeding out options.

I left shipping after 10 years with a Captains license and the promise of a new ship, a new build and a legacy of a girl with four stripes on  her shoulders leading a unique, albeit incredibly lonely, life to say adieu to. I yearned viscerally for things like the smell of fresh cut grass, the sound of my own refrigerator opening, my purring cats to sleep with at night, and some small group of friends to hold close. You just lose these little sparks of normal life when you are at sea. Where others see Hemingway tales of far away lands and secrets you can harbor in places no one else bucket lists I just felt alone, and always vulnerable,, the bad kind of vulnerable. 

Once I had tasted the top of the heap I would never accept an apprenticeship again. And so upon graduation from vet school I bought the clinic I was newly employed at. One episode of witnessing the previous owner euthanizing an 8 month old treatable puppy because the wealthy owners knew it was cheaper to replace than repair and the line in the linoleum was drawn. I wasn't working for him, or them, or anyone else who didn't care enough to try. There wasn't room for two sheriffs in this one horse town.

It was a brief, urgent leap of faith into practice ownership about 8 months after vet school graduation. Slightly insane decision for a nubile practitioner. It had to be this. There weren't any other palatable options to survive this profession I had spent a decade to fall within the ranks of.

And now 15 year later I am at the crossroads again. Twenty years left within this career and I have to decide one again how many cards I am willing to throw on the table and whether or not I believe in my hand, or ability to bluff, to see if I can come out of this alive again.

We are at the place where we are about to double the working footprint size of our vet clinic. It's time to reinvest back into my heart and soul and commit to another decade, or two, of being the sock puppet user I swagger through the hallways as. I have to recommit to another project, a long term goal, and all of the faces, souls, voices and emotionally invested beings I make this commitment to. It is not an easy undertaking to jump into. I have to do this wide eyed, willing and prepared to meet and exceed all of the needs of those I have made a promise too, and on top of them, the scores of others who will cross our threshold.

As I grow older it seems the consequence of decision, and vice versa indecision, have more magnitude. A more perceptible punishment, the times isn't as plentiful to squander and the resources have a finite time frame.  With this I also have this immense burden of feeling like I never shied away before so why start now? And, if I do start now how many more places will my feet hesitate to step? What value is there is being timid now? I have lived with nothing and flourished, abandoning my mission now is not only shying from responsibility but blunting my own vision.

I have to swallow the imposter, overcome the fearful intimidation of this price tag, the loan, the risk every small business owner assumes. I have to become the artist composing my own legacy and jump arms wide, chest thrust forward, chin up, eyes full of possibility.

To all the Kevin Costners out there with dreams as big as the ghosts who honor them, "if I build it they will come."

This is Cora. She came to us looking much sadder than this. This is her submissive plea for affection after she recovered from the parovirus her family abandoned her from. She is the subject of the Herriott stories I yearned for. She was a total financial loss, and I am immensely proud of her, and us for taking the leap of faith to try to save her. She is 8 years old today, living in Maine with my college friends, and she is alive, perfect, and the miracle that courage and dedication built.

At this place I have to jump in. I have to build this dream. If I don't it will be the fear talking. The doubt deciding, and the artist losing her belief in a vision that imagination too wing to.

For every person out there wondering what the limits are I guess I can only offer this tidbit..

  • You won't know until you try, and, failing is more important than surrender.
  • Your legacy is yours alone to scrutinize. Be kind, even to yourself.
  • Never lose the girl you dreamt you would become. Her vision is your guide.
  • As long as you have love and compassion you have all you need to thrive.

This is Dunkin. He never had one break of luck,, except us, who loved him every day of his short, completely unfair life. And yet he is one of my greatest joys. He reminds me to see the beauty in life every single day and just be grateful for it.

My pups, Storm and Fripp, This morning. They remind me to stop and enjoy the sunshine.

We are one month away from the ribbon cutting. Eight months into 2020 where so many chapters have already closed, and I stand on the precipice of a new chapter of an 80 year legacy two other Herriott's of their own right built. I am the third in line of the  place so many have called their place of healing. We have shared stories, saved lives, ended those who were suffering and all the way we have been honest, accessible, and affordable. 

When we started this new chapter I had one over arching requirement; we would never lose our place or our purpose to those we serve. JVC has been a part of this community for over 80 years. We carry a legacy forward and I am not going to allow this new chapter to cause change for those who need us and have always depended on us. 

JVC is my legacy. We are not going to build a big-bright-shiny practice that doesn't meet the same needs of all who enter. We aren't going to start excluding people to pay for the McMansion the ego armored imposter needs to feel better about our own place in others lives. Isn't that what vet med is all about? We serve others, all others who need us, not those who can afford us as we 

The all too often abusive statement that rising pet care costs are a reflection of veterinary costs is vulgar. If you couldn't afford vet school, your vet hospital, your equipment, or your ego you shouldn't pass it on to others as their complicity. Its not theirs to own. If I am not affordable because I made poor decisions my patients pay for it. That's what a legacy is and that's the way we slay our imposter syndrome.

For more information on anything and everything pet related please ask us for free at

For more information on Jarrettsville Veterinary Center please visit our Facebook page, or website;

I am also posting lots of informative videos at my YouTube channel here.

Monday, September 7, 2020

The veterinarians life in the grips of the pandemic of COVID-19.

 The veterinary plague in the pandemic.

That's exactly how I have felt for the last 5 (plus) months.

These are unprecedented times. No one can argue that. It is a time none of us have ever seen. The layers and the ripple effects are worldwide and life changing. None of us could have guessed all of the layers of impact it would have upon us all.

When the whispers of a blazingly fast deadly virulent disease began in the late Winter of 2019 the science lover within me was steeped with curiosity. Infectious disease, population dynamics and the decisions that arise from these are the fodder we live everyday in veterinary medicine, and, to a much greater extent than human medicine gets to participate in. Over in vet med we deal with death from poor vaccine management, viruses, and transmission from multi-species hosts daily. Think about parvovirus for a moment. For every sick puppy I see I have to pine over poor, if not often absent, vaccine records, question interactions, clinical signs and scant hard to accurately elucidate human observations. I also know I have to test sooner versus later to get our best chance of survival as care needs to be aggressive and early for the best prognosis. I see upwards of 2-5 puppies a day in our current pandemic case load. In one day I saw 10. For every sick puppy I start with parvo and hope for anything else. Want to make the scenario even more bleak? Add lack of emotional bonding (new after all implies, haven't bonded with yet), and, almost unmanageable costs (average estimate for care, and btw should be at the 24/7 ER, about $3-6,000 USD) which almost no one can afford. 

Rabies is the other viral monster with even more devastating reaches. There are still multiple patients walking in every day who have never (I saw a 10 year old with this presentation) been to a vet before. Or, have only been for sick visits, and, hence were never been fully vaccinated. Pouring over sketchy, to non-existent, medical records takes time I never have at hand. How can this be more devastating than parvo? Rabies kills humans. People can, and do, get rabies from cats and dogs. With every case I have to make sure I am protecting the public by monitoring for rabies.

The case load for my 7 day a week, five doctor practice has been steadily increasing over the last decade. Growing on trend with the industry standards. We have our typical seasonal quiet season, February through March, and, our busiest time of year May through October, with one little blip in business at Thanksgiving to Christmas. With the pandemic getting more news attention, the growing number of cases spreading through Europe and mounting pressure to begin government mandates to promote slowing the spread, we faced March with huge uncertainty trailing fear for both our own lives and the viability of our business. 

When it became increasingly obvious that the virus had reached our shores and invaded our inhabitants I knew we had to do some hard talking and face some quick decisions. We had to face yet another outbreak in our clinic, except this time the victims might be us.

The first action I took at the clinic took was to ask each employee privately what they felt comfortable with? Who wanted to shelter in place, versus continue to work. Self isolating was being instituted in adjacent states and we knew we were not far behind. Each employee was given a letter to state our dedication to them in supporting their decision with whatever choices they made. If they chose to stay home we would promise to hold their positions. We would assist in unemployment benefits or exhaust benefit packages for as long as possible.While other veterinary clinics around us mandated employees remain working, I was not going to take worst case scenarios and force anyone to do anything. If that meant that I was going to be running the clinic alone, with my husband as the only receptionist and technician available, I was going to do it. If I had to open 24/7 and live there I was prepared to. 

I was preparing myself for worst case scenario. This is the typical approach to everything in medicine. Personal and professional life are one in the same. I was preparing myself to stay at the clinic for endless hours melting into endless days. Man the caseload alone, or, enlist the help of my family, and work 24/7 to keep both the lights on, i.e. keep the business alive, and, keep the patients of my community cared for. If other vet clinics closed I was determined to not lose a patients life due to inaccessibility. Summoning the troops to see who was with me was where I started. Much to my surprise most of the staff wanted to stay working. The reasons varied from employment security, maintaining an income, age based health security (not that this came from my personal disease preference viewpoint), to boredom associated isolation avoidance. Personally I felt I had an ethical obligation to the pets JVC had taken care of for decades that have almost accumulated into a centennial. "This ship wasn't going down on my watch," once again rang in my head.

As the commotion of human hospitals reaching maximum capacities almost overnight in our surrounding states ballooned the realities of our potential doom motivated action. Within a few weeks of the diseases arrival half way around the world the state governor ordered a very quick mandate to self isolate. A list of "essential businesses" was circulated and our importance to world health became endorsed. Veterinarians were expected to stay open. How we were to do this safely was open to scantly provided guidelines and interpretation. 

The world around us slowed to a snails pace of cleared roads, hysteria based grocery shopping (none of us will ever look at toilet paper the same will we?), and, solitude like we have never seen outside of a few days of a previous weather catastrophe. The news was buzzing with charts, graphs, daily tallies and "curve flattening" chants. Masks became a commodity I felt oddly out of place wearing in public. My work life of disposable clothing, replaceable and disposable was now the new normal. Coming and going to work included placards for the car announcing my place of importance in the pandemic saturated society. Working was a risk we were all volunteering for. Would there even be a reason to show up? Would there even be clients brave enough to go out into the infected world around them to get their pets care? We didn't know how bad this would be, or, how bad it would get, never mind the collateral damage we would invite ourselves into. What if I went to work and brought the virus home unknowingly? I had a very sick mom to care for. A husband who fit the age based "high-risk" classification. Me, well, I was comfortable with steam cleaning clothes I changed out of at the office. I was fine breathing in a mask, wearing gloves to work, and washing my hands like death was colonizing with complacency. Me, well, I was ok with me facing a ventilator, but being the fomite who brought it to others, nope, no blood on these hands please.

What happened was a 20% decrease year over year for the first month, March. Then a steady April. Business was running its (almost) normal course and people went to and from 2 week quarantines if they felt sick, or were told to do so by their physician as the tests took weeks to process. Temperature monitoring, letters of CDC guidance on what to look for, when to play it safe and stay home, and the myriad of vague clinical signs to alert oneself to possible COVID exposure/illness were circulated, signed and kept on file. 

There were weeks of one, two, and, even three staff members being out for quarantine at a time. Managing the staffing schedule was a best attempt daily. The teams further isolated us, and magnified the difficulties of scheduling appropriately for the days case loads. We didn't know if we would be able to manage with either our own staff being too short to function, or, the clients being too cautious to take their not-going-to-wait-for-the-pandemic to abate pets. Would we lose a whole generation of puppies to distemper (which we have never seen before because our clients are too sensible and savvy) to have been susceptible too? Would we see a huge influx of rabies cases as people avoided vaccinating? What about pregnancies when spays and neuters (aka "elective surgeries") were ordered to be postponed to save valuable short supply medical equipment for the front line workers? SO many questions and no guidebook to assist in assuaging the fears. Would those staff members who were out at home come back to us as "positives" and throw the whole rest of the apple cart into hysteria? Would I lose people I cared about and feel responsible for that for the rest of my days? When I asked myself the really hard questions I couldn't come to terms with the idea I might be swapping one life for another. Was my efforts to save my four-legged patients going to cost me any of my two-legged colleagues? Was it a trade off I could ever justify? Deep down I strongly considered closing the clinic. Shuttering the windows and leaving a "gone fishing" sing without a due back date. I would prefer belly-up versus 6 ft under.

I just got up everyday and went in. I left my husband at home with the animals. He was telecommuting and able to take over their care regardless of what my day might bring.

What happened was totally unexpected. Business exploded. It blossomed and burgeoned on record breaking. People fostered, adopted, paid attention in much greater detail and scrutiny to their pets and we struggled to meet the demand. We, for the first time ever, had to turn new clients needing emergency care away. It hurt me bitterly to do so. We received pleas form the local ER to help. They routinely had 4-24 hours wait times. I went into work exhausted and unable to catch up. I left the house at 8 am, arrived after 9 pm and the time in between was case after case of sick, dying, intensely managed patients. While the rest of the staff saw the routine vaccine appointments I saw the immediate need walk-ins. It was grueling and mentally so taxing I fell into bed every night wondering how I would manage the same day tomorrow. I started to fall apart physically, emotionally and internally. I understood why everyone else defaulted to their protective limitations, and, I wondered if I would get out of this wanting to be who I thought I was. Sleep became a fleeting precious and unreliable commodity.

The other side of the pandemic sword was anger. The quarantine brought out the best, and, the worst in us. We had to call the police to have people forcibly removed from the premises. We had to use strong language. Make ultimatums and have the courage to lose clients for them. We drew hard lines with harsh stern mandates behind them. We split the staff into teams with the hope that if illness ran through one team like wild fire the other would be safe. I did everything I could to minimize the villains reach, potentially deadly grip and keep the people I care about most safe and feeling secure at work. It was harder than I had imagined it would be, washing, cleaning and sanitizing after each day. Seeing one team lose more members than it could function without to stay at home orders. We were tired, worried and facing unknown client aggression every minute of every day.

We applied for loans we didn't know if we could meet, or get, or payback? The unknowns mounted to stress at unparalleled and nauseating levels. I remember telling myself everyday that I just had to breathe, go into work to try to help people and the pets I was so devoted to taking care of, and I had to tell myself that "this too will pass" as everything else behind me had. I had to remind myself that I know what disease looks like. It isn't personal, it isn't fully fatal, and there was a myopic meets universally pellucid lens that made it all relatable, comprehensible, and even purposeful. We have to remember we are a part of a whole. A tiny piece if a planet that is complex, self-regulating and unforgiving in its counterbalancing efforts. we are mortal. You get one life, one chance and you better be analyzing your place, your value and your compromises along the journey.

It is September. 2020 has cost me dearly. I lost my mom to cancer that COVID crippled, arrested and tortured her within. We had so few options for a deadly cancer that swept faster than most of the cancers I have dueled with. Cancer has plays. Definite steps it takes. Obvious signs it flags, and yet hers was just as swift, devastating and immobilizing as any I have ever witnessed. I have seen thousands of pets get, battle with, and eventually die from their neoplasia, but, my mom died and suffered more severely than any patient I was ever charged with. She suffered. Nothing should ever suffer to the extent she did. Medicine has better to pardon such pain. So many of us lost to this pandemic. Time, loved ones, events, experiences, vanished to trying to stay alive. There is still no normal to our newest evolution to the current pandemics plight. We are still not allowing clients into the hospital. Still providing mask enforced curbside service, and, I am still turning away non-clients so I can meet the fact that we are booked weeks in advance, while we receive requests for immediate care from our current the clients with their same day emergency requests. I have worked to the point of physically debilitating exhaustion, and then worked through that. It has been challenging and for someone who thrives on adrenaline based medicine I can say I cannot keep this up. I have to turn away people who I know need us because doing so will cost us a mistake we cannot forgive ourselves if we make. And yet through the worst of my veterinary journey I have been reminded that hope springs eternal. That little lives were saved, protected and spared because we showed up and did our best. Friends brought posters, cakes, wrote letters, and reminded us that we mattered. We made a difference, and we were appreciated. There were layers of kindness that were returned in waves more powerful than a disease can encroach upon. There are people whom I saw give the most incredible acts of compassion. Spread love and hope with generosity, kindness and for which I will never forget and never stop repaying.

So far I have lived to tell the story. We have all done such amazing things through the most troubling time of our collective lives. We have no end date, but, we do have the confidence of knowing what perseverance feels like and it's as good a guide as we will ever need.

I have learned that the foundation I am most assured of is that life is precious, short and fleeting, and at the same time it is invaluable and magnificently beautiful. I wouldn't trade one for the other. You cannot have one without the other. I also know that the more I give the more that comes back. It has to be genuine, but it is always enough to get through the worst of days.

Thank you to the clients who share their stories, photos, and lives with us. The photos above have no relation to the events or cases. They are snapshots of the days through this story. The loves that mold us, touch us and shape our views on crisis. They are reflections of what we can be if we chose to see value in sharing.

 For more information on anything and everything pet related please ask us for free at

If you are a pet care provider who is willing to help pets in need with your advice and compassionate words of kindness please consider joining us and adding your pet care experiences and thoughts at We are always in need of reputable professionals who can educate and inspire.

For more information on Jarrettsville Veterinary Center please visit our Facebook page, or website;

I am also posting lots of informative videos at my YouTube channel here.

Saturday, August 29, 2020

Why are we so focused on getting our pets to eat, instead of fixing the reason they don't want to? My dad and Shelby.

This is a story about how perspectives shape and influence decisions. How one small characteristic, a clinical sign, (as a veterinarian would label it), changes the quest of a pet parent and their companions’ journey. This is a story about my dad and his care of my recently deceased mom’s dog; Shelby. Shelby is 15 years old. A rat terrier by mine own expertly amassed breed-i-pedia visual inspection, a mystery by means of the trucking couple who sold her to my parents at a rest stop. 

She is short, squat, compact and spunky. She walks with a high step and a butt wiggle. A tiny stub of a tail to mark her cadence. She has always been stubbornly independent, and loyally devoted, singularly to my mom. My dad, on occasion cuddles her, but she remained the apple of my mom’s eye and the shadowed sidekick to her every move. 

My mom passed away in May. It had been a 5-month journey of surprise, horror and decline. Shelby, like all of the pets who live beside seriously sick, and/or, dying parents got left by the wayside. She was, short of the essentials of eating breakfast and dinner and the obligatory bathroom breaks, forgotten. When life gets reduced to impending imminent death the periphery gets pushed into the corners.

While my mom was struggling with her cancer and our lives were filled with obstacles and medical silent policemen causing you to halt, hinder and ponder, Shelby lost her advocate, parent and support system. She was still with us, but her needs took second place. She was still able to eat, walk, and maintain her bathroom schedule. There wasn’t anything to alert us she needed more, and we had a very sick, incapable and frightened mom to care for.

While my mom declined my sister and I began to increase our focus on Shelby. For all we could no longer do for our mom we refocused our time and attention to Shelby. It was what we knew she would want from us, and, it was most certainly what Shelby needed as my mom could no longer think, call for, or even provide any affection for her. Seeing my mom pull away from all of us, in succession of our ability to provide for her was heartbreaking. Within two weeks of her passing my mom stopped asking about Shelby. Within a week she stopped asking for anyone. As she withdrew, we refocused. It was a tiny way for us to still be taking care of her when she could no longer see anything outside of her immediate ability to breathe or stay comfortable. The moments of dying color you in a way that makes the world a murky vat of misery. There is no sky outside, and there is no future to dream of. We were all a part of the vacuum it created.

The other side of life will find you. There is an after after death. Shelby was on the other side. My dad had a two-week recession. A place he retreated to and couldn’t speak from. We all deal with grief in our own way. Shelby has become the soul we covet. The last piece of a person we all long to find, and resurrect and yet cannot. 

I see her looking for my mom, as I do too. This quest to find the thing you lost, misplaced and yet believe to be hiding. Waiting to be found again. 

Shelby is what I would call the last piece of a life I try to desperately to fan from a smoldering pile of ashes, life back into. She is the last piece of my mom that is alive. The houseplant you over water in desperate hope to grow with additional vigor, only to drown from good intentions. My dad, well, to be honest, I’m not sure how he sees her? An obligation to a promise no one can provide consequence for? A left-over piece to a chapter already finished? A companion when a couple has only one half? A broken piece from an engine with too many accessories? 

He called, texted and complained for weeks before and after my moms passing that “she was getting picky,” or, “wasn’t eating well.” All with a hint of responsibility that I, as the resident family veterinarian, had to fix. That her eating was my fault, my obligation, my responsibility to figure out. I had to have the answer to what the ‘right’ food option would be. He, left on his own, had decided that she ate the high-protein unlabeled dollar store options best. The kind of canned crap, that I seriously call ‘crap’. The stuff with gelatinous goo at both the top and the bottom, as if suspending the only product scantily considered ‘food’ in the middle section. Shelby, as I mentioned at the beginning, is 15 years old. She literally is these days, only as good as what she eats. She was eating sodium suspended protein (from yet to be determined sources) in a can, at the bargain price of 69 cents. No matter how hard I tried to argue about the short-term losses of his small victories of her eating, the long-term costs were further kidney damage. But, in the tragedy of a loved one passing, whose first true sign of demise is food refusal, the small gains are often enough to appease the immediate fears of loss.

The veterinarian inside of me has a problem separating perspectives here. I see all food refusal, “the picky eaters” the “poor eaters,” the pets who just start to eat less, select options with greater care and scrutiny as the beginning whispers for help. For many of my clients, and my dad now, the eating is a frustration met by compromises that delays our abilities to diagnose and treat. Sure, some dogs are given the latitude to become connoisseurs, choosing as a sign of stature and liberty, but, most become inappetant, hyporexic, because disease is telling them to do so. For many clients not eating is a slap in the face sign of failure. People fixate on eating as much as they do on having normal poops. It is, in absence of all other meaningful signs, the most important request from a pet parent. They don’t care why they aren’t eating, or pooping at less than desirable frequency or consistency, they just want it to be normal. Preferably, right now. (The request to the vet is; cause be damned, just fix it!).

In Shelby’s case the cause was not so clear. Shelby had bad teeth, (as every small dog over 8 does). She had needed a dental for about the last two years. Fear kept that from happening. Fear that her heart murmur would result in heart failure under general anesthesia, and death at a time of ombre dying transitions was too much for us to manage. We couldn’t risk Shelby while my mom surrendered. Shelby had her dental about one month after my mom passed away. It was overwhelmingly frightening for me to perform. I knew it would be a long procedure. I knew she wasn’t an ideal surgical candidate, and, I knew it had to be done. I knew that she would require extractions of numerous teeth, yet through the procedure there was this quiet calming peace around me. Peace that she was being watched over. That she would be safe and better on the other side of waking up. For as much as I was petrified to put her under anesthesia, pull all of those rotten teeth, get too cold, stay under just a little too long, and lose her ability to wake up, during the procedure I knew she would be ok. She was carried by mom, and I could feel her all around me, taking care of her, and me in the process to get through this last long surgical procedure to be benefited on the other side. For my dad he firmly believed that the excision of the bad teeth held the answer to her persnickety food denials. 

It turned out that this wasn’t so simple. Shelby woke up from her dental, slept for a few days a little more than she had before, and went back to turning her nose up at the offerings he proposed. Rotisserie chicken was nibbled at for about a week, maybe two. Then sliced turkey was plated, about a week there. To canned cat food, then hamburger or steak, but, only if it was freshly prepared. All the while, all these weeks, my dad texted requests for food options to save her.

Shelby had a thorough exam, a full blood work panel and every other diagnostic I could provide. X-rays, x-ray evaluations, blood, urine, fecal and every possible ancillary test from these. All were normal, or at least very close to perfect for a 15-year-old. There wasn’t a medical explanation for the inappetence. As each test was taken and passed, I tried to remind my dad that there was more to her health than bleeding and numbers. As with so many cases I see people forget, or omit to admit that we are all our own beings. That Shelby is more than a being with a mouth and an ability to urinate and defecate... they the ways in which we measure her, and her abilities are much more than our observations. Shelby was a soul who was confused and now grieving. Her world although still geographically located in the same place was no longer her own in the way that matters to her. It was upside down, inside out and missing its most imperatives pieces. She, just like me, was lost in the searching for the foundation of who defined us. With out my mom we had a tough time realizing who we still are. 

Shelby came to stay at my home for about a week last week. My dad, as he has been consumed with, was so worried about her poor appetite while away from home. Shelby, like all dogs, is resilient. She is capable of so much more than many of us give them credit for. My dad arrived early the morning of his departure with her in hand. He dropped off cans of food, the ones he had most recently had success with, her bed, a leash and her harness. He fretted, as my mom had always done also, about leaving her here, in my pack of three much larger dogs, and the four opinionated and bossy cats. 

“Just put her down dad, she will be fine. She knows where she is.” I said. She had been here for weeks when my dad was in the hospital about 8 months ago. She quickly adapted to our routine. Embedded herself in the pack that is our home. After a few days of adjusting she followed step on the daily walks. She took pride in being fed in her own space on her own time. She did very well with all of the activity a full house brings. 

“She’s suffering from boredom.” My words falling on deaf ears as he sorted through his own grief.

While my dad was away, she fell right back into our routine. Walks, bedtimes, carried to our bedroom to be sleeping next to all of the others. There is life here. She ate full bowls twice a day. Had long walks where she, like the rest, can smell the diet. Process the scents of the world she lives in. there are not the quick ins-and-outs of rushed bathroom breaks. She gets to explore, find questions in her head and answers in her feet, nose and sounds. She gets to be a dog, a family member and a companion again.

Here’s where my dad forgot what the life of a dog is about. 

Shelby, like all of us, needs, and thrives on being acknowledged at every single interaction. Her vision is failing, but she knows there are people around her. We always approach slowly, kindly and with a “hello.” She will lower her ears, bow her head, stand still, and we always (always!) take a moment to stop and pet her. Where she used o fear footsteps, fear being in the way, too close underfoot, she now revels in the affection. 

Your pets want to be your pets. Loved, cherished and acknowledged. 

This has to be the basis for everything that follows. It was the simple reason Shelby isn’t eating. She is bored, she is lonely and she is lost.

 For more information on anything and everything pet related please ask us for free at
If you are a pet care provider who is willing to help pets in need with your advice and compassionate words of kindness please consider joining us and adding your pet care experiences and thoughts at We are always in need of reputable professionals who can educate and inspire.

For more information on Jarrettsville Veterinary Center please visit our Facebook page, or website;

I am also posting lots of informative videos at my YouTube channel here.

Saturday, August 15, 2020

The unprecedented times of veterinary medicine and the pandemic.

It is the middle of August 2020. We are 5 months into full on COVID-19 pandemic mode. Within my professional life as a veterinarian the ripple effects of this have reached places I never saw coming.

We are a 7 day a week, 5 doctor veterinary clinic about 45 minutes north of Baltimore, MD and we could not have imagined, never mind prepared for, what COVID has delivered. I have been a veterinarian, and practice owner for 15 years, and although there have been numerous rough spots along this journey there has never been a time where I more question my stamina, and fret for my patients, than now. The current state of our profession has become an ever growing chasm of unmet needs meets unparalleled exhaustion on all fronts. There is also no discernible end to this "new normal." The degree of personal stress, emotional questioning for well-being, and the public's visceral anger and ugliness has us all at a boiling point of which I fear great personal, professional and accessible losses will result.

Here is a break down of where we, my little vet clinic is, and, how we got here. Jarrettsville Vet used to be the routine general small animal veterinary clinic where doctors saw appointments with pet parents holding their pets on their laps, or on a leash, all the while going over important patient points. It was a calmer exchange where personal time was fostered. I have always been honored to be a part of a pets care, and, to a great extent also their parents life. Feeling needed an appreciated is the purpose so many of us strive for. In clinic personal care was delivered in real-time with multiple options given for treatment care and an all-for-one team approach. We have always taken pride in being transparent with affordable prices for a huge range of pet ailments. We do not turn away care for anyone who needs it. We have stayed true to our values and we have been in business for over 8 decades.  With this pandemic a few things have altered our approach on delivering this care. We have to wear masks, we have to stay distant, and, we still have to hold onto what makes this personal emotionally enriched care genuine. 

We began curbside services, thereby keeping the public out of the clinic because we could not provide adequate or acceptable social distancing, began in April. We split into teams to try to insulate at least half of the staff if a positive staff member would cause us to have to quarantine, or even shut down. We did everything we could to stay viable while also trying to stay safe. It has not been easy to lose the personal connections, most notably for the terminal, the dying, and the euthanasia's, as we tried to stay open with some semblance of doing the best we could in meeting our patients needs. We have had to rush dying patients into the clinic and witness them die without their families who were outside in uncontrollable hysterics. It is not who we were, nor ever wanting to be. 

With all of this change it has also brought along a never ending list of unmet expectations and needs. We are not unlike many, if not most, of the veterinary clinics in the U.S. right now. The current state of this pandemic has left us saying we cannot help, and, we cannot keep up. We also are afraid more then we ever have been. It is a mounting storm without ceasing winds to calm. 

What's the cause to our current patient care dilemmas?

Demand has over run supply.

There is an increasing demand for care, as there has been an increase in pet care ownership, and, a decrease in vet staff availability.

As of this week my clinic, we are booked about two weeks out for routine care. This has never happened to us before. We are now having to place blocked appointment slots into each doctors schedule for every shift to try to manage the same day requests for urgent cases. There has rarely, if ever, been a time before where we couldn't fit someone in within 24 to 48 hours for an exam. Almost all emergency cases were provided a spot within the same 4-8 hours. We  are a small town, deeply rooted within the community, practice and we know that long term relationships built us. To abandon our clients in their time of need only undermines the trust and reliability we have worked so hard for so many decades to establish. For most of the clinics around me they are booked days, weeks, or even months out. When they are and they get an urgent call the client is told to "call around," or, "go to the ER." No one wants to be told that. But, it is the reality across the board for all vet clinics. We are seeing more cases than ever. Why would we be immune to a pandemic, or, even over burdened with patients within it? 

The answers lie across our spectrum. 

Where did the increase in pets come from? This is the results of a multi-factorial burgeoning of demand.

  • increase in adoptions/purchasing of pets.
  • clearing of shelters.
  • people have at home and personal time they never had before.

The shelters were placed on indefinite closure as they had to keep the public out. If they cannot allow the potential adopters in to help advertise their adoptable pets then the outflow was going to come to a halt. To avoid this many shelters offered free, if not significantly discounted adoption fees, to try to clear them before the next shoe dropped, (i.e. staff gets sick and no one is available to feed, water, clean and house). 

Pets have been adopted/purchased at record rates. Along with the increase in demand for adoptables has been an increase in now-full-time stay at home workers to have the pet they never had time for before. People hit the internet looking for a companion as they socially distanced from the rest of the human world. 

Dwindling supply for pet healthcare caregivers;

  • vets and vet staff who are home self-isolating.
  • staff were hard to find before the pandemic.
Just like a swath of the population, there are veterinarians, and veterinary staff who do not want to expose themselves, or their families to infection from a disease they are at high-risk for. I have staff members with elderly parents they are caring for. The risk is too great for them, and hence, they are on an extended undefined leave of absence. at any given time 10-20 % of my staff is out due to COVID influences. We started this pandemic short on staff. COVID has exacerbated it.

The stress of a trying to be everything to everyone and not knowing if any decision is right.

  • the difficulty of managing a practice through ever evolving,and changing, information.
  • the strategic planning needed to try to stay open and safe.
  • the ripple effect of bad practices now magnified by a greater need.
  • the poor planning of not being able to catch up as you try to prognosticate ahead.

The allegiance and the pressure to meet all the demands across all spectrum's of personal, professional and ethical standards. Feeling like I am expected to meet every need of every soul under this practice is overwhelming on our best days, add the stress of non-stop phone calls for help, and knowing my own physical limits are at the brink has me thinking that maybe the vets sending all the excess elsewhere are serving best by serving self first? 

The fear/anxiety/and division while trying to keep ourselves safe and alive.

We all feel it, don't we? The anger/fear/and degree of stress we have never before experienced, and now it's daily, worldwide, and on a magnitude we cannot comprehend by any previous experience. People are stressed in a way we cannot ignore as real, and, they take, are taking out, this anxiety out on us. Add the emotional element to the package and the boiling point lowers. If you fail to serve them they can, and have, opened a wrath that leaves you with bad reviews, crying staff, and yet another reason to not work when pay is available elsewhere regardless.

Burnout. The staff, outside of the doctors, and hospital administrator, are all on hourly pay.  I have to keep this in place, even though we need them all at almost every breathing moment, to force down time. They stay longer than needed. Ask repeatedly about leaving us, and whether we will be "ok?" And, yet I have to tell them to just walk away. There is not an end to the day past the automatic shut off of the phones. 

I leave everyday with an unsurpassed list of things being left undone, and a chorus of faces I worry about overnight. Will they be ok throughout the night? Will their families stay safe and healthy to provide them the oversight they need for their own survival? Can they reach me if needed?

The vets, we are maxed out. We feel compelled to help. To answer every call. It is what we are cut from, and yet, we cannot work enough hours to meet the demand. 

The place we have found ourselves.

Emergency veterinary clinics are seeing the cumulative effects to the greatest degree. Many of these new pet parents cannot establish a veterinary clinic based relationship. They are not finding a clinic who will see them in the time sensitive manner all new pets are ideally seen within. (I say three to seven days max!). 

Where do people go? they have been turned away at the vets office, the ER was already too expensive for many, and, now the wait is, and can be, from 4-24 hours. Puppies with worms, and/or, who are sick are being told by their vet that the wait to be seen is weeks. They don't have weeks to wait. So, parents head to the ER to be told the wait might be 24 hours. Am I responsible for this puppy? What about if I know that minutes matter for survival? What would you do?

A larger number of the clients going to the ER have no primary care vet. They are turned away at every vet clinic that they call. The ER is all they have left.

My clinic is open for walk-in appointments on Sundays. Sundays have turned into our receptacle for all the non-emergency cases I couldn't find time for during the week. I am taking Saturdays off to rest, because I have to. My core has to, and without being able to see the spill overs on Saturday they are told to come in on Sunday. Last Sunday for the walk-in hours of 1-3 pm, I saw 20 cases. All sick, all in need of care. I stay all day Monday through Thursday. I see everyone who is a client and calls. Fridays I go into work to catch up, to see the spill over. 

How am I coping? I am not sure I have a clear answer yet. I am desperate to keep the long game in focus. Remind myself that I carry the lives of my staff at my forethought, while reflecting on the legacy of the veterinarians who bore this clinics torch before me. Those who survived wars, depressions, and the plights of a rural community whose animals allowed them simple basic survival. Without the veterinarians who built this clinic I would not be here, nor, would my self-inflicted responsibility to carry on through whatever adversity facing us be so profound. We are deemed essential as we control the tide of zoonotic diseases, maintain a food supply, and protect the family members so many of us relegate our pets to. "Essential" adds a layer to this complicated bitter onion I never saw previously. With that I feel even more compelled to not lose my footing as I run this never to be seen horizon race. 

There are personal stories I have never shared. The clients who call needing immediate emergency care, or hiding within self-isolation and attempting to manage potentially life threatening cases via video calls. None of this is ideal for the patient, and yet I have made judgement calls I know I could be sanctioned for. I continue to practice medicine within a web of uncharted waters and a public as jarred as I am. 

Where I have seen this community come together and assist in ways I couldn't imagine outside of an invasion, I have also seen people react with vile vitriol I feel immeasurable to the insult at hand. The slightest, (seeming to me), insignificant annoyance reels people into fits of anger that leaves the staff fearing personal harm. I have forced clients in unprecedented numbers out of our practice in a desperate attempt to nix a fuse that I can only see more emotional trauma stemming from. We have had to add signs asking people to "wear masks and be patient," and, with these I still have people refusing. There are words coming out of my mouth that I feel will only add more vinegar to a wound surfacing before us. "This is private property that I own, it is my mandate that everyone wears a mask." To be met by spitting seething rebukes of "you cannot tell me what to do," and, "you cannot catch COVID outside." The point of helping a pet in need has soo often being overshadowed by an on-the-brink-of-breakdown of a human, and, too often I fear I am that human.

I am exhausted. More exhausted than I have ever been. This includes vet school training, working multiple day long shifts on the high seas, and the pains of being both a new grad and a new practice owner trying to shoulder a burden beyond my experience and expertise. The days I am working now start at 8 am and extend to, or even past, 9 pm. No bathroom breaks, no food, and so mentally stretched I have to tell the staff that I cannot safely handle another cases. For as much as I want to help, and cannot bear the idea of turning away a patient who may not get help otherwise, I have limits. If I push them any further I am going to make a mistake and it may hurt, injure, or even possibly kill someone. Fear, exhaustion, and pressure to be a vet, an employer to people I deeply care about, and keep the business alive when I feared for months I would not be able to, has me needing help I have never asked for previously. My village has become an interstate of traffic coming and going as friends leave food, walk my dogs when I cannot find time to, and help with laundry and household chores I cannot dream of returning to. I have had to say previously impossible "No's." "No, I cannot do a TNR." Or, "I cannot see that dying kitten," "I cannot take home that patient for overnight care as I fear I cannot get up if I fall asleep." No's I hate myself for uttering. No's that might cost me my personal legacy as I triage the others I am desperately trying to keep alive.

I have my email posted in every corner of every client interaction. We use Facebook messages, personal phone numbers are given to any client in possible need of immediate return. I have socially distanced from everyone outside of work so that I can remain at work with the least amount of risk possible. All decisions have been made to protect the hive. Isn't that what I promised myself at the beginning of this Pandora's nightmare box?

In the end, and the whole point of the lessons we are learning within this pandemic is, that we have to get out alive. For some this is best believed achievable by sheltering in place until the world rights itself again, a year, or two from now. Just stay away from people, accept the risks associated, and, hope this bubble approach doesn't cost you a fatal delayed decision. For others, like me, I go to work, I diligently wear a mask, wash my hands, stay 6 feet away from clients, and only allow close proximity for euthanasia's which we do in a separate location. And for the non-believers, the people who haven't seen a death from a bug you never saw coming, I am reminded that negligence is too often the backbone of all medical professions. 

Like all inferno's this pandemic is alike in that it will end. Will there be a Jarrettsville Vet on the other side? Yes, of course. It is bigger than me. It has always been bigger than me. There is comfort in this as the small one doctor practices shutter when the quarantine forces their closure. But, will I be alright with my choices? I am not sure? I, like all of the rest of us paddling upstream to a place we have no knowledge of, all feel the same. We all have to get out alive.

For more information on anything and everything pet related please ask us for free at

If you are a pet care provider who is willing to help pets in need with your advice and compassionate words of kindness please consider joining us and adding your pet care experiences and thoughts at We are always in need of reputable professionals who can educate and inspire.

For more information on Jarrettsville Veterinary Center please visit our Facebook page, or website;

I am also posting lots of informative videos at my YouTube channel here.