Monday, August 15, 2011

Moe's gentle heart

I am a veterinarian. I usually don’t believe that your job should define you, but sometimes it is the most accurate summary descriptor I can use to characterize myself. I, like most of the rest of my colleges went into veterinary medicine because we like animals better than people. Not really an admirable quality, but honest. Of my many memorable veterinary experiences it is usually the pets that burn a place in my heart and head. This time it was the clients more so than my patient that made this case so memorable.
Any seasoned versed veterinarian will tell you that there are many important qualities to put in your holster on your way to becoming a great practitioner. You have to remember all of that stuff you were taught, tested on, and were supposed to have read, absorbed and understood while in veterinary school, then you graduate and have to learn how to integrate what you learned into what you are seeing, and on top of that, and probably the most challenging, you need to learn how to build a strong trusted relationship with your patients’ owners. Here is where the cavernous juxtaposition lies. We go into veterinary medicine because we like animals then we have to learn how to relate to people so we can help their pets. If a veterinarian can’t master this skill they may be able to practice great medicine but they will never feel as if they made a difference in a life. You see we have the ability to heal but without that human connection you can’t feel the difference you may have made in someone’s life. The longer I practice medicine the more I understand that it is the human’s lives I am impacting through the healthcare of their pets.
Those seasoned vets will also tell you that it is the people you help and touch and the lives on both sides of the file, owner and patient, that in the end leave you feeling as if your career, your talents, and what you give along the way are what makes this job rewarding. You also learn to not judge your clients. Sometimes the softest hearts come in the most unexpected packages. I have learned to treat every client as if they were my mom. You see my mom has a big heart but she is really bad at making healthcare decisions. Whatever her vet tells her to do she does. It isn’t an interactive experience. She cannot understand and decide what to do for her pets.  She wants her vet to decide for her. Unfortunately my dad has to pay the bills. So on many occasions the vet gets stuck in the middle of the healthcare professional and the accountant. I try very hard to present every owner with my professional findings and what treatment plan will be best for their pet. I also give estimates. Sticker shock is an unpleasant thing for all of us. But I cannot decide who gets offered the “great medical plan” and who gets offered the “discount corner cutting medical treatment” plan.
On one Sunday I met the Smitts. They were very kind, soft spoken gentle people. They didn’t dress fancy, and didn’t put on airs of being anything other than very concerned about their kitty Moe. They asked lots of great questions, were very involved in Moe’s care, and wanted nothing but the best care for their beloved kitty. They were clients that we hadn’t seen in a long while.  You see we keep tabs on our paper files that identify when the last time we saw you was. It had been so long that we didn’t have their paper file anymore. We only had a computer print out of the prior transactions they had with us. The last date in the file was the mid 90’s. Today they had brought Moe to see me because he was unable to walk, not eating well, lethargic, and had a large area of excoriation (abrasion) on the side of his head just below the right ear. I began asking for a more elaborate description as to the sequence of events with the wound to his face. They went on to explain that they believed he had ear mites and to treat them they picked up an over the counter ear mite treatment. Upon further inquiry I asked if this cat had been outside. “No, they replied, not in about 10 years or more.” I also asked if he had been vaccinated. “No, not in quite a few years.” I explained to them,( like I do to many clients), that an indoor cat still needs a rabies shot, and still benefits greatly from an annual examination.  It is a very common oversight amongst many cat owners. Veterinary medicine is just starting to get the word out to our clients, that we have been neglecting cats for too long. I understood that they didn’t intend to withhold care, they were just never told that Moe needed it.
My questions to the Smitts didn’t seem to be making my list of Moe’s possible problems shorter, but longer. I tried to politely recommend that in the future the diagnosing and prescribing be left to the vets. I had no doubt that they meant well I was just pretty sure that Moe wasn’t itching because he had ear mites, and that the well intended medication had not made him better. I was fairly certain that his problem lay in his brain, not his ear.
The inner ear lives right next door to the brain. Actually it is not so much as a neighbor but more like the other side of a duplex. There is a thin wall of bone that separates the two chambers but a problem in one side of the home can look a lot like the problem resides in the other. Because Moe was so weak, and unable to walk, I thought that he should be admitted to the hospital for fluids and aggressive treatment. I also explained to them that I had to have rabies on my list of possible diseases. I remind my client’s everyday that even indoor cats can be exposed to rabies and that it is important to have them vaccinated to protect them from this fatal disease. I use the saying “rabies kills everyone it meets” often. I have seen many rabid animals, cats especially, and I hope I don’t ever see anymore ever again. It is especially heart wrenching having to tell a family, including those with young children that they have been exposed. It is hard enough to lose my patients I don’t want to lose a person. They understood my concerns and agreed to have him hospitalized.
After 24 hours of i.v. fluids and antibiotics Moe stopped eating and was unable to get up at all. I called the owners and expressed my concern for him. They were always calm and kind and involved with his care. They came to visit him everyday. They cried over him in his cage. They offered him affection, all sorts of appetizing wet canned food. But nothing got him eating or better. Through every single poke, probe, needle, exam, and medicine he purred and cuddled. He was always so sweet. And his owners never gave up on him. They wanted him to get well despite every bleak prognosis we gave them.
Moe died a few days after he was admitted to the hospital. He purred everytime he was approached by every person in the hospital. He was a sweet, and gentle loving boy until his last breathe.
I hope that the Smitt's adopt another kitty. I can't imagine them not having a cat to share their life with.
I know that Moe was very lucky to have such kind and gentle owners, and I know he was a reflection of them. There is a part of me that truly wishes every kitty was as nice and gentle as Moe, and every client was as concerned and caring as the Smith’s.

If you would like to learn more about rabies please visit the link below;

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