Thursday, October 20, 2016

The Misperception of An Outspoken Vet.

OK, so I have provided apologies before. I probably do it too often? Some ridiculous effort to provide a piece of genuine empathy to my audience and still seek permission to keep on chatting. Maybe it is a silly way to divert assertion of a strong voice or soften the edges while I deliver a punch? Or, perhaps it is even a trace of manipulation or deference for a spirit I don't always suppress?

So here I go again....

I am sorry if this  offends anyone. It is not the intention. Let me start there.

Everyday I question what I am doing and why? I have to provide a list of reasons to my internal self-check consciousness mechanism as I invest more time in what might end up as a completely futile effort. These moments of self-reflection are tidbits of a fractured To-Do list meets overwhelmed workaholic. I accept it as my own doing and dissect so as to provide justification to keep on repeating my self fulling prophecy. Here is a good example of my internal conflict meets slightly scattered over tired practice owner/vet/mom/wife.

Person with box walks into clinic. (Always a bad sign).
I over hear the following between vet tech and box holder; "He's not mine. I don't want him."
Said vet tech finds me to report; "Tiny kitten, head wound, quiet, barely moving found 4 hours ago. She wants us to take it. Can we please just take it and tell her to go?" I know full well this is a plea for two things:
  1. Tech wants to get box carrier out of office ASAP. It is closing time and she knows the argument is a lost cause.
  2. Kitten is in bad shape. 
Internal dialogue unfolds something like this: "Crap. Here I go again."

I walk out to meet said box holder. She repeats same story. "I found this kitten in my yard under a bush with flies on it. It isn't mine. I don't want it. So I brought it here. I figur'd you'd take it?"

How do I answer this?

"He's pretty close to dying isn't he?" She takes advantage of the lull in the conversation as losing leverage and adds a smear of additional pity to the plea.

"Well, maybe if you didn't wait 4 hours?" I mutter, knowing I had lost the battle at the arrival. I add insult to injury.. and peak in the box. Cursory exam; 2 week old kitten with swollen head, poorly responsive, dehydrated, who is dying in front of me. If I don't take him right now and help him right now I know he will die. I know this.

"What are you going to do if I don't take him?" Answer is not going to keep kitten alive. And the most idiotic thing to leave my lips follows, "I am not a shelter."
Yes, we take him.

Swollen head, abscess,
and fly eggs (will be maggots in about 2 hours).
I cannot win.. I just have to find acceptable decisions so I still want to wake up tomorrow and relive the hamster wheel meets Groundhog day life I am trapped within.

Sounds bleak, huh?

Well, I don't think its bleak. I think it is my real-life. How can I title this little public journal and not be honest?

Maybe the whole freakin problem is lack of honesty? Or, in my case, too much honesty?

Maybe it is the culture of whining and blaming and not stating our true feelings?


And maybe I am tired? I can be tired? We all get tired.. but remember that little internal inquiring voice? Yes, I listen to her. Too often I even argue with  her.

I understand I got myself into all of this. I am not asking for anyone's sympathies. I am not even asking for your understanding. I think I am only asking myself to be true to my vision. To not be swayed by others lack of interest, failure to find common goals, and indifference to the plight of others that I am trying to assuage and ameliorate.



Although my blogs and articles get some attention they also leave me open to explaining myself. Truth be told, I feel the conversations are fuel to perpetuate important topics. But like all people we get defensive and protective of unsolicited opinion.


And then my strong voice, fierce compassion and outspoken demeanor elicit this..

Hi Krista,
XXX .. just sent me one of your recent blogs regarding your policy on costs and economic euthanasia, which I thought was AWESOME! (sic)
Hope all is well, and keep on advocating for animals.
XXXX

I should add a bit of background. The email is from a member of a vet group I belong to. I deeply respect him and believe firmly in the groups purpose and vision. We have firm common ground and a distant rapport.

Hello,
Many thanks for the email.. To be completely honest I feel as if I  am a one woman crusader against a flurry of corporate run behemoths who are slowly, insidiously taking over vet med. It is shocking to me how few people seem to be left upholding the standards of the foundation our profession was built upon. There are so many wonderfully caring hard working vets but they have been strong armed into practicing what the owner/director mandates, or, they are too driven by a bottom line, or, they are leaving and/or killing themselves.

For example, yesterday I saw two clients who were given estimates of 4x what my clinic would charge. One was a cat who needed a dental and one extraction, estimate given by  "big city practice #1" was $1000. Estimate number two, the puggle with pendulous soft tissue mass wo palpable blood vessels at base of stalk, $800-1200. Cat dental at our clinic $400 (w full pre op bw), and mass removal $200 w sedation and local block. Both clients waited months to try to save up for the service at their clinic, both left when they called me to  inquire about doing at my clinic. You understand my gripe.

My intention with  everything  I am doing  is to reduce (as much as possible) economic euthanasia. I also feel strongly that vet med is way overdue for a reality check. If we still maintained our integrity we wouldn't need transparency. But sadly I think we have lost/abandoned both. And we both know who suffers when that happens.

My clinic is my beta for what I am building Pawbly to become. It is my attempt to build something on a small scale that I can use to prove my vision and scale up to provide universal animal assistance. 

It is a lofty goal which I am determined to achieve regardless of time, effort, and  investment (well I say that now $100K in). Pawbly and my clinic are the legacy I hope to leave behind for both the veterinary community and animals around the world. I will ask for help from every person  I meet  (the plight  of an entrepreneur) and keep going alone until it finds its grass roots ground swell.

I would love to chat with any of you about my project and how it might assist with your efforts. As with my presumptive business theory to build Pawbly upon I believe that people love their pets and that there are millions of us around the world who share this common viewpoint. All we have to do now is have  one place to meet and  exchange information, animal education and infuse it with inspiration. The result is helping pets and their people live longer happier and healthier lives. I know the pitch sounds like Dr Google, but it is quite the  opposite. I know pets need their vets I just have to convince the general pop that this is still the case, and we vets need to provide a stronger, more meaningful relationship built upon trust and affordable realistic options.

Ok, off of soapbox and off to the clinic to save another wet nose.

Have a wonderful day.
Please do keep in touch, and please let me know if I can participate in any of your endeavors.
Sincerely,
krista



Hi Krista,
HSVMA has started a coalition of people devoted to working on ensuring access to veterinary care.
http://veterinarynews.dvm360.com/hsvma-announces-access-veterinary-care-coalition

From a larger perspective, I’m concerned about the tone and degree of angst in your thoughts below..,.
There is no doubt we both share valid concerns regarding whether our profession fulfills its potential in serving the needs of animals.
Its also become abundantly clear from my own journey as a vet x 30 years and from studies, that the line between compassion-advocacy-stress-burnout, can be a short one…
To be an advocate for animals, requires you ensure you remain healthy as well…



My reply;
Hello XXX,

I would love to be a part of the care coalition.  I had seen the write up in JAVMA and wanted to inquire about it. I hope to help our clients and pets in anyway I can. 

I realize that you don't know me. So perhaps I can reassure you and place my passion into perspective. I am a devoted dedicated and determined Italian. I spent 15 years in the military and at sea and if that couldn't break me nothing can. I am doing very well. But I am not giving up on helping my community and my profession. I appreciate your care and concern but I am good. I promise. And if by chance you hear that all the time and still ponder?. My cell is XXX-. 

I appreciate your prompt response and extended concern about my angst. Although I think it is more accurately described as frustration and optimism to provide a place for assistance. 

Take care 
Sincerely 
Krista


.... and with that there is silence. Maybe we don't have common goals and firm ground? And so the internal debate marches on.

.... or maybe I am passionate about something and I want to improve it? Maybe this assumption that I am so delicate AND that all of this is possible, is taken by me to be yet another older, wiser man telling me to abandon my dreams and just be a little quieter?

It seems I am always fighting. Always. Internally, externally, and with everyone... self included. Is that somehow dangerous? Is it somehow the ephemerous spirit that is the catalyst for change when some conscious frustrated person sees inequality, suffering  and injustice? Damn it I see suffering everyday that I somehow have to make a decision about. Its my decision alone.  I cannot place it on my staff. I cannot turn my back.. and yes it means there is a conscious recognition of not choosing indifference, not abandoning  that needful soul and yay! now I get to defend and justify it to others who want to impress upon  me that there 'numerous years of experience should be my guide to a happy healthy lifestyle." Which leaves me feeling like I can't win.

Ugh! I cannot/will not apologize for this. It seems it might be harder than I thought to be an outspoken unwanted advocate?... and so I decide to stay the course, not abandon hope and keep pushing on.. even if it is alone. Elicit internal pep talk; Note to others in similar plights; I get it. Few people get you. Others will disclaim your credibility, intentions, or lofty aspirations.. Keep believing in yourself. In the end that's all you really have. You have to always be ok with that.

Maybe for me being an advocate is being  a strong voice in a field of hushed mice? Maybe for me I am ok with being my professions Rosa Parks? 

.... and so I internally debate again.. sit to write, throw it all out there naked, and push on.


I am not going  to walk away from a problem I think i can influence, improve and feel compelled to do... and yes, this is a decision I have made with the understanding of what the costs may be. I am an entrepreneur! I shout it and proclaim it! I know what I am willing to throw on the craps table. I know what the house holds. What the acceptable risk is, and I know that there are a lot of blank faces I have  to walk away from. I don't have the time to explain it to you. I  don't have the energy to waste trying  to convince you. And I don't have the capital to worry about whether you approve.

I am not going to walk this path and not try. I am not going to be a part of something I know I can improve but fear the consequences of others judging me, coddling me, cajoling, or castigating. I can't and I won't. So I walk away again knowing I did the best I could and took care of everyone I could along the way. Regardless of the unsolicited, albeit well intentioned advice I seem to attract.

Footnote;
Dear friends with more years of walking in these shoes than I have added their mutual concern and inability to understand both my perspective and point. For this reason I am going to try to add a bit of clarification as to my position and,, well, yes, angst.
I am frustrated with vet med and how I believe we aren't providing care to those in need and we certainly in too many cases aren't providing affordable options when clients need them. There is huge need and very little thought about our obligation to those patients. I am frustrated to feel alone in this dilemma. When I expressed that and asked for assistance in discussing what Pawbly is about I was  met with advice to be cautious. I don't want to in anyway be told or advised to be cautious. I want to create and foster change. To innovate where there are inadequacies. To be unafraid to try. It seems like that is as outside of anyone's viewpoint. You cannot be driving change and be afraid. Perhaps the pendulum of panic over our professions suicide rate and burn out has swung so far we are afraid to innovate?


Here is how you can reach me if you have a pet in need. I am at Pawbly.com and Jarrettsville Veterinary Center in Jarrettsville Maryland. You can also follow me on Twitter @FreePetAdvice, YouTube, or on Facebook. If by chance you want to help a pet in need Please join us all on Pawbly.com. It is free to use and open to anyone anywhere who loves animals and wants to help them and their people.

16 comments:

  1. Excellent post. Bless you for your concern about your principles and the way you do business.

    There are some people who you know will never be self-aware or "enlightened" - you have no worries, you are already there. :)

    Roberta

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    1. thanks Roberta,, I am just stubborn and determined,, and unable to walk away from so much struggle and need. It fuels me and reminds me to be gracious and humble,, something I think vet med needs more of.
      My love to you, as always.
      krista

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  2. I believe in what you are doing, I share your vision, AND I can relate to ALL of your feelings. There are a lot of people who won't understand, you just CAN'T understand. There are people who don't get what having a mission is all about, because they are not mission-driven to change what isn't working, to fix what is broken. They are the ones who accept things as they are, who say "well it's always been this way, nothing we can do about it." Yes it's harder to live as the person who says "I refuse to accept that there's nothing we can do about it." On the other hand, it's equally untenable to try to live disingenuously, as one of those people who gives up before they ever tried. Or never even considered trying in the first place. So keep the faith. I am with you.

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    1. Thanks girl! As always, here's to hoping and working for the unattainable and staying untenable and smearing it in their faces when we do..(OK thats a little graphic and mean),, I only half mean it meanly.. gotta keep the sass with the pessimists circling. Love you and I am always here for you.

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  3. Dr Mag (Love your one syllable nick name),
    Your honesty, integrity and ability to be forthright even when it may entail blow back, is something that inspires me every single day.
    I work as a Veterinary Nurse (seems this is the moniker everyone has come to a consensus on) and I also work in rescue for two groups.
    My hope with this comment is to let you know, that whenever I am discouraged, at a loss for words, my ability to care has clocked out or I am just plain frustrated, I head straight to this blog.
    I know that I will not only LEARN or see something new but I am convinced that your words have had the affect of holding onto the back of my sweatshirt so I don't go over the emotional edge.
    You ARE not JUST an amazing Veterinarian, you are an example, a motivator and a darn good writer.
    I am always rewarded with encouragement, hope and above all the desire to come back after a deep breath and gave 100%.
    So thank you. Thank you for writing and sharing and giving and knowing what it is that we ALL need to hear. Pet owners and people who work in our field need to have this resource that you provide.
    The way that you talk about your staff and the pet parents (while they are frustrating) is always with love and so much compassion. Please know that without your blog I would not be the Veterinary professional that I am today. Sincerely,
    Greytmari in NC

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    1. Hello,
      Well, that is the single nicest thing anyone has ever said to me.. I am genuinely honored and graciously timid about the magnitude of the impact these blogs provide to others. Too often I feel as if they are too personal, too raw, and too conceited. When in truth all I want them to be is honest, genuine and helpful to someone else.
      How wonderful to hear about all that you do and give back. I know it gets exhausting and I know it is arduous at times but I hope that you never abandon your sense of pride in all that you give and see the miracles of what you do everyday. It takes immense heart to be a tech (yes, I am still a bit old fashioned) and still do rescue. But it proves that you live what you love and for that I hope you feel blessed and fortunate. So many people lack both the ability and the generosity to do what you do.
      Thank you for reading and for sharing your thoughts. I hope that one day I can give you the hug in person I am sending now.
      XOXO
      Krista

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    2. Your cyber hug came at the perfect moment in my crazy day! I got a bit emotional as I savored and digested your heartfelt words. To receive and accept positive feedback and acknowledgement feels fantastic! To have been an encouragement to you (even in a small way) is better than fantastic. I would call it fabulous! Thank you again for ALL that you do and for taking the time to write from your heart.
      Greytmari (Greyhounds are Greyt) in NC

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  4. "There is something in every one of you that waits and listens
    for the sound of the genuine in yourself.
    It is the only true guide you will ever have.
    And if you cannot hear it, you will all of your life
    spend your days on the ends of strings that somebody else pulls..."
    - Howard Thurman -

    The genuine in you is beautiful.

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  5. Krista - I understand where the vet who wrote to you is coming from. I too have been in practice for 30 years. I too have seen vets who pour their entire essence into helping animals, only to find themselves pulling out after a few years because they just can't do it any more. That's his only concern, I suspect. For each of us to continue to care, we need to live a balanced life ourselves - that wheel with 8 sections - work/ recreation/ family & friends/ finances/ "significant other"/ health & well-being/ spiritual & personal development/ home & physical environment. If we don't attend to all of these sections, it's likely to be unsustainable. And when you are passionate about your work, as you are, then it's easy to neglect the others in favour of work. But who am I telling? You know all this. I am just trying to explain where the other vet is coming from. He's seen people like you stumble before, and he just wants to make sure that this doesn't happen to you.
    Keep up the good work!

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    1. Thanks Pete. I do appreciate the advice from all concerned parties, even if it is unsolicited and unwarranted. It is not intended to be a blog to discourage caring, only a blog to say perhaps we need to bolster together to improve the purpose of each others lives through support of endeavors and not just fret for those overwhelmed. And perhaps we can be both?
      There have to be challenges to seek improvement and it would wonderful if there was more encouragement alongside the empathy.

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    2. Written communications like this are frustrating sometimes because it can feel like the intended message is not being transmitted clearly. Some time I will write a blog about this entire subject myself. The basic principle that I am trying to debate is this: if you look at a lifetime, how can you extract the maximal amount of caring from one person? 99% focus for 10 - 15years till they burn out? Or 70% focus with a more balanced life for 50 years? Or is burnout not inevitable - can you have 99% focus for 50 years? That's the debate. Nobody is saying you shouldn't care as much as you do, or that you should abandon your dream - quite the opposite - this is about searching for the optimal way of reaching goals - just asking questions, as much reflecting on our own situations as commenting on your own.
      But to move this forwards: how would you like your profession to help you? What would you like other veterinarians to do? What can others do to push forwards your goal of eliminating economic euthanasia from the lexicon?

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  6. I love that you actually care! Maybe if I known about JVC, I wouldn't have had to put my kitty Bella to sleep in June! But I think we'll bring our new furbabies to you! Keep fighting the good fight!

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    1. My sympathies for your Bella. We are an amazing group of dedicated vets and pet lovers. Maybe we will meet yours sometime soon? Thanks for reading.
      Krista

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  7. Krista, you are a stud. Did the kitten make it?

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    1. Thor is recovering very well.. He is growing normally, playful, and his wounds are healing.

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