Tuesday, October 18, 2011

The Delicate Dance of An Over-Possessive Owner

I have previously explained the intense bond between Mrs. Stompf and her little Yorkie Sydney. They were inseparable. But in many ways Sydney’s dependence on Mrs. Stompf was mirrored by Mrs. Stompfs dependence on her husband. Mrs. Stompf came into every appointment with a concern about Sydney explaining his problems in the third person. She was the primary care giver to Sydney, but she reported his problems from the voice of her husband. Now mind you, I never saw or met her husband. He was the elusive patriarchal lord of the house. I know that I made it more difficult for Mrs. Stompf to treat Sydney. Mrs. Stompf would bring Sydney in for me to see and I would try to get an opinion or answer from her about the concerns she was here to present me, but I could never get her take on them. It was an incredibly difficult position to try to be a health practitioner. It’s not like it isn’t difficult enough to try to understand your patient’s problems when they don’t speak. Try to unwrap the puzzle of a patient’s problem when they don’t speak and their caregiver is just the middle man messenger. Very difficult. Add to that your patient being brought to you for “old age issues” as reported to me from Mrs. Stompf who was told “to go to the Vet and tell her that Sydney is having “old age issues””.
I listened carefully, observed even more carefully, because sometimes I have to gather my most important clues from my patients by looking and not so much listening. I tried to probe Mrs. Stompf as to what those “old age issues” might be? She told me her husband had expressed concerns over the following; sleeps a lot, increased urination, sight and hearing loss. Oh, and she brought us a fecal. I questioned and probed for more clues, and came up empty handed. I then performed a very thorough examination on Sydney. I sat down with a very concerned and distraught mom. I told her that I thought some blood work and urine might help us figure out what might be going on with Sydney. I knew that she had some concerns about how much all of the diagnostics that I wanted to do would cost. I also knew that even at this point in our conversation Mr. Stompf was talking through his mouthpiece wife. We agreed that we could get a preliminary health picture with a basic blood profile. I tried to be very clear that I was here to help not only Sydney but also Sydney’s mom, take care of Sydney. My gut told me that Mr. Stompf did not want to pursue too much with Sydney. But I felt compelled to offer some assistance to Mrs. Stompf and I believed that some of his clinical signs may have a medical origin.
Sydney’s blood work revealed kidney disease which explained the increased urination. I tried to offer some suggestions for the treatment of kidney disease, and also offer some encouragement to Mrs. Stompf. She was cuddling Sydney stronger than ever, starting to sob, and holding back some burning questions and concerns. As I began to wrap up my dialogue and description of the disease, its process, and possible treatment plans she broke down. I understood that it was too much for her to take in, and she was too overwhelmed to comprehend the next step. I gave her a hug and told her we could continue our discussion on Monday. In hind sight, I think she went home to ask her husband what to do next.
She returned on Monday with “my husband thinks it is time to euthanize Sydney.” My heart sank. I didn’t want to give up on Sydney. He sat in her elbow on her arm as scared and consistent as he ever was. He was eating, drinking (alright maybe too much), urinating and defecating as he always had, and loving his over-clinging mom as much as ever. How could I assess his quality of life if it was just as it had always been? How could I interject anything if I couldn’t get the appropriate permission from his care giver? How could I ask his mom to go against her husband?
 I told her that we could try something to make him more comfortable, (it was also reported to me that he was pacing and circling and this was upsetting everyone). I knew it was a shot in the dark, but I told her that I was here to help them both with every step of Sydney’s care, and I told her to call me anytime.

One week later Mrs. Stompf came in to put her beloved companion Sydney down. She wanted to have his ashes returned to her. I am left feeling a deep sense of despair over her loss. I know how much she needed Sydney, and I know how much her heart most be hurting her over his loss. She is in my thoughts, and I carry her devotion to both her husband and her pet with me. Few of us will ever feel as cared for, loved, and devoted to as her Sydney was.

1 comment:

  1. You obviously provide good care to the pets who see you. And your kindness and caring extended to this dog's mom is very touching.