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Friday, August 11, 2017

Transcendent Care. Investing in Internal Conflict

At some point the actual practicing of veterinary medicine becomes about the "other people" in your life.

Sadie,, my touchstone.
It is less so about the never ending revolving bills to pay, the pressures to meet some internal expectation and stop feeling like you live the model life of "imposter syndrome", it is about making others feel more connected to their pets by way of your ability to make them feel at ease with their pets care. It is about other peoples feelings towards their family and the role you play in that.

I call it the "transcendence period." I have transcended out of my own insecurities as my primary motivating factor, (although the fear of failure, embracing of human fault, and ever persistent nagging to know more, do more, and be more all lurk behind a gossamer curtain just off of stage left in the periphery of my every interaction), I have learned to live with them more peacefully and not let them guide my once too tentative footsteps forward in a direction intended to simply help others.

Charlotte, my girl. Rescued from the local Harford County Humane Society
PTSD, aka post traumatic stress disorder, is often pinned to warriors. The hero's who have returned from wars fought outside of our safe arms length sent home to deal with memories they were supposed to intuitively file away forever neatly after getting back home. I think I suffer and struggle with internal conflict much the same way? My own sort of deep inner hidden nidus I am not supposed to provide a name, a voice, nor a syndrome to. It is the plight of intensity meets introvert. There is not a vet alive who isn't to some degree an introvert. We like to study late at night, often all night, after all. We like to dig, pick, scrutinize and cast questions in the hopes an answer will appear and stick. It is detective work with mute victims... we are introverts at heart. We also place ridiculous unattainable expectations on ourselves. We loathe failure and defeat. We loathe it so much we learn how to posture ourselves so that we minimize how often we have to face it. We don't say much out loud, we hardly show our cards, and we worst of all don't extend ourselves into personal relationships with our clients, never mind our patients. We expect more than we can deliver and we criticize ourselves for both as some sort of Escher-type circuitous maze.

Like every lifelong challenge at some point you either slay the beast, surrender to it and await the next one to yield it's foreboding head, or you lay your sword down and walk away white flag flying high. I am not sure you can acquiesce in a healthy manner to any conflict other way than to choose option three. If you can walk away feeling empowered by doing so you transcend.

Chester, so sick she was almost given up on.
She was an 'easy' case.. she just needed time and antibiotics.
She needs a home.
The cure for my obsessive compulsive determination to not succumb to the shadows is to reinvest my efforts and joy back into the thing I can't quite escape.. my love-hate relationship with vet med. The choice, and the success in that choice, relies on investing wisely and accepting good with bad on equal merit and not forgetting the patient is the cause as you often fumble along.

Invest in the cases that need you. Not the easy ones AND not the quick pay out ones. Don't swim in the shallow end of puppy visits. Jump into the ones that have the longest list of unfavorable criteria. The cases no one else wants to touch because they are afraid to. Intervene on your patients behalf even if the pay out has no guarantees. You will find yourself and your salvation in these cases. Every vet knows that there is more to medicine than money. The soul of medicines cure lies in these cases. The quest for Indiana Jones celebrity is fueled by little triumphs inside the person you doubted you could ever become.

Invest in the other people in your life. The two legged, the four legged, the needy ones. The ones you can make a real and meaningful difference for.

Ari, diabetic, effervescent, incorrigible, and unstoppable.
Unapologetically independent, adoptable.
Interview a veterinarian, a practitioner, a person from any profession who has mastered their craft and still keeps on punching the clock why they keep on showing up to work long after their retirement age is automatically approved and most will tell you that they transcended into the period of work life that is no longer work. It is the part of not sitting still because your participation brings value to others. It is the recognition and responsibility a greater good by giving of self and keeping the parts of life that you savor and treasure as special occasions. Visiting a Caribbean island to lie carefree in the sand is a treat, contributing to others lives is reward.. living on that island gets boring when you lose purpose. When you get to that place of your job being much more than the means to a paycheck you realize that you keep showing up to give time to others because those others provide us our needful purpose. We do it for others as much as for ourselves. It is a transcendence to work being purpose, and the others who keep us reinvesting.

To learn more about my journey please follow this blog. To learn more about pets and pet care please follow my YouTube channel. If you have a pet question, are a pet lover, or think that you would like to contribute to helping other pets across all socio-economic borders please join us at Pawbly.com. It is a free question and answer site dedicated to educating, empowering and inspiring pet people the world over.

I am also on Twitter @FreePetAdvice,, and punching a clock for the shear love of wet noses everyday at Jarrettsville Vet,, the greatest little vet clinic in the solar system.  And for the best Facebook page take a lookie over here at Jarrettsville Vet Facebook.

Siya



Thursday, August 3, 2017

Atlas and Somebody named Chester

I too often feel compelled to shoulder the burden of someone else's problem. To carry the weight of the worlds problems on my shoulder as if I am Atlas standing on the sea, desperate to hold the world above my breaking back and planted feet. It is the obligation of an emotionally driven anthropomorphic veterinarian living in the world of a plethora of disposable pets. 



There are pets who come to you in desperate, dying need. Pets that so often have been overlooked a thousand times before. I cannot ever explain, or even pardon, how, or why, people are so preoccupied with their lives, the daily grind of meeting others expectations, and not taking a second to shelter another less fortunate life.

Templeton. Rescued from the Harford County Humane Society in June 2017

For me it is the single greatest joy in being a vet. The tales of triumph in a life lost, alone, and mistaken as negligible. For me, it is the answer to the "why" of every single question.

Medicine, like every other discipline, at some point becomes repetitious. The cases blend into a muddy mass of numbers. The cold heartless statistics that begin to dictate decisions that used to be analyzed by diagnosis meets treatment plan. The medicine resides in the cure of disease, not replacement of a healthier substitute.

Volunteering at the shelter with Terri, shelter technician, discussing a tail trauma case.

"Are you saying that you want to try to treat her?" Long pause... hallowed silence.

"Yes, of course. She has a treatable disease. Let's try to treat her." I replied to the head shelter technician.

"I am never sure if you are serious? None of the other vets want to treat. She's so sick." Continued silence in the room of four other technicians.

"I am always serious. There is always a chance. If you are ok with me taking her back to the clinic, I'll take care of her."

Smiles erupt from the crowd.

Her name is Chester. She was very sick at arrival to the shelter. She was very thin, frantic to not be held, and blowing thick yellow snot from her nose everywhere.

Chester
To the analytical minds before me she is a disease vector with a long road ahead. She is unvaccinated, unspayed, and an unknown with too many questionable variables. To me she is Chester. To my training as a veterinarian she is more than somebody else's problem in a sea of problems, she is Chester. I do not see the forest for the trees, she is somebody. More importantly, she is somebody I can help. She is a cat with a severe respiratory problem who needs immediate intervention and medical care. She is what I do every single day. A list of clinical signs and treatment options that I can quickly list, exclude, narrow, refine and treat. I can also do it affordably and without justification to a client questioning motives, prognosis, and value versus expense.

Dory, rescued with paralyzed back legs from a spinal fracture.

On the many days it feels like I am a tiny boat adrift in a violent storm I am too small and insignificant to survive I look at the faces of the pets at my home, in my clinic, and even at the overwhelmed, over abundantly in need shelter pets and I remember to change my perception and focus my perspective and see each individual as a somebody. Her name is Chester. She is getting stronger, and happier, and healthier. She needs me, she needs to be seen, and I can help her. It is the reason to all of the "why's" and the answer to all of the weight of the world on my shoulders. I don't need to be Atlas, and she doesn't have to be perfect, we just have to see each other as somebody with value.

Pickles, one of the many bottle babies we have every Summer.
Here is what Chester had done;
We placed her in quarantine with food, water, bed, litter box and a hiding box if she wants to retreat from the clamorous, aromatic bouquet that a vet hospital presents. It can be a scary place for a cat who has spent her whole life hiding in bushes.
1. Feline leukemia and feline immunodeficiency virus test. Both negative. Cost $40
2. Fluid therapy. Depending on overall hydration status and severity of her condition, intravenous at $80 a day, or subcutaneous at $25 a day.
3. Antibiotics. Critical to improvement, costs range from $10 to $60 for a two week course.
4. Eating! She has to be eating. We force fed her on the days she wouldn't eat. Prescription high calorie canned food that can be liquefied and syringe fed at about $5 a can, or a feeding tube if severe at a cost of $100-300, or find a food she likes after offering a lot of options. Turns of Chester is a dry kitten food fan.
5. Get her breathing, fast! We use a nebulizer and steroid drops in each nostril to open them up. Labor intensive but cheap. We use a nebulizer made for humans and steroid drops typically used for the eyes. Pediatric sterile saline drops in the nostril (1-2 drops per nostril) can also help open them up.
6. Keep her warm, weigh her daily, monitor for progression of disease, be prepared to alter her treatment plan and don't forget there is a cat under the snot. She needs vaccines, deworming, preventatives, and affection. She is a whole package. My job is to get her to be well enough and trusting enough to get a home.



The true measure of a practitioner is not in what your analytical mind tells you to be cautious of, it is fundamentally in your perception of life and the value it holds to one tree in a forest of others. It is how you view life and not how easy it is to replace it.

Our first trip to volunteer at the Harford County Humane Society.
We each came home with a pet.
Except me, I cam home with two pigs.


Wilbur,, adopted from the Harford County Humane Society
 If you would like to chat with me about your pets health, ailments, behavior, cost of care, or are a pet lover yourself and want to help other pets please join me on Pawbly.com. We are an open community dedicated to helping pets around the world by educating, empowering and inspiring each other. It is free to use and open to all animal friends.

Charlotte and Wilbur
I am also on Twitter, Facebook, and at the clinic at JarrettsvilleVet.com

Or on YouTube! Lots of videos on patients care with prices and options to discuss with your vet.