I have this terrible affliction.. It's a bibliophile thing... like obsessive. There is the smell,, the musty, powdery ashen parchment.. it's intoxicating just a tactile feast. Then you get the extra added bonus of that wealth of adventure, knowledge, and escaping story desire and it's euphoria I cannot resist.
When it comes to the challenging moments of my life, those little bumps along the way that cause me to trudge and shuffle, I turn to the poetry flavored feminist written chorus columnist-seasoned manifestos.
This is my new go-to;
This little green wonder is my hard copy to Gloria Gaynors anthem,,, you know the one; "I will survive," every jilted girls hashtag for getting over being disposed of. But, as with all personal rites of passage you customize a little. Accessorize, monogram, throw in a few extra expletives, drop an F-U to the waning fist pumping moments, spare a tissue drop a threat and a promise save yourself a wrinkle and rehydration requirements.Salt stains after all.
So, I buy a book I think can add a bit of stiffness to my tired bowing back, and then I spice it up.. just to taste,, as a former sailor I find starching, corner creases, a gigline, and a potty mouth help immensely.
Here is my edited version of an almost perfect book from the start;
Medicine, veterinary medicine especially is fraught with insecurity, imposter syndrome paralysis, fear, suicide, and getting through the day, never mind safely to retirement takes grit, courage, dedication and a strong overwhelming sense of purpose. For me it has been a series of challenges so incredibly devastating I have learned to fight for what I believe in every single case every single day. I also stay true to one thing above all else, my own path. So, if you need a little bolster of conviction buy yourself the outline of the story you are walking (or stumbling and trudging) toward your journeys happy ever after add indelible adjectives and your own sparkle, whatever it takes to get out alive and still like you best of all on the other side.
That's Brave Enough for us all.
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Hello Erin, As a veterinary practice owner I want to sincerely apologize for this. I cannot say that I know, or even remotely understand this?, but, I am sorry that you left feeling penalized and punished at one of the saddest moments of any pet parents life. If I can help I am here. Again, I am so sorry for your loss and frustration. Sincerely Krista.
Nashville
Starting a conversation with an apology is about as common for me as "hello." A few years ago there was an outpouring of articles all proclaiming how over used and detrimental apologies were especially passing from the lips of females. It was heavily marketed that apologies as a preamble masked submission, leading to shame, and that women in all places and positions, especially those in leadership positions, were being throttled to abandon. I spent years pouring over these articles, catching myself constantly to pull those three little words back in each time they slipped out, while beating myself up for the deference apologizing for everything brought me. And yet, I still apologize often. Way too often.
The opening paragraph above is a private message I left Erin, on Nextdoor.com just a few days ago. Sad as it is, it is true that I am so prolific in apologies I even send them to strangers. Stranger or not, with this apology I meant every word I was delivering.
Apologies fall like confetti daily in my veterinary life. I apologize for the small and insignificant just as much as I do the grand,, and everything in between. Failures of the staff, the facility, the limits of human abilities, the boundaries of my soul-sucking emotional requests, the anger every so often a person seems to need to explosively purge at the clinic, as they are, after all my responsibility and I take ownership of them even if they don't recognize them. For me, as a veterinarian, and especially the veterinary practice owner, there are a boat load of fully justifiable reasons to extend a word of apology as ubiquitously as raindrops.
"I'm sorry we were running late today. I appreciate your patience."
"I'm sorry that I don't have better news," always the case of providing some death sentence diagnosis to a parent unprepared for the bombshell I just provided.
"I'm sorry but we don't provide walk-in euthanasia services." (Cause ya know, everyone should be able to decide last minute that "it's time" without the assistance of a doctor to consult. Which always elicits hostile accusations of us "not caring that their pet is suffering!" Somehow that is our fault too. These are only pets we haven't seen in years, or, pets we have never seen. I always want to reply, "would you call your pediatrician and request; "Hey! my kids suffering, it's time for goodbye" and NOT expect to be questioned?). (where is that fire headed emoji?).
"I'm sorry but I cannot take the 4 kittens you just found in your backyard." (Personal note the clinic has 5 cats in need of homes presently, and, we used to take in kittens to help adopt to homes and in the last year 4 were "returned",,, what the &@*&!).
"I'm sorry but we don't have overnight staffing to keep your critically sick, eminently dying pet, you WILL have to go to the ER, or take them home." (people you cannot leave your pet here to die alone, right?).
"I'm sorry but your dog is so frightened by restraint we cannot safely hold them. We will need to reschedule another time when we can provide pre-examination sedation." Also usually met with incredulous judgmental angst, as if we were the party who failed to provide the conditioning needed to do a nail trim safely? Odd how so many clients know they cannot trim their own GSD's nails at home, and yet get angry that we can't either. Even more disturbing is how many people prefer the staff be injured as long as the nails can be trimmed, right now!.
As you can see from the examples the apologies range from introductory opening statements to help shoulder the burden of the disappointment about to follow,, "I'm sorry, but, I can't..." To the "I'm sorry, but, I won't." To the most common; "I'm sorry for your loss." It is a Santa-sized sack of apologies to be plated and served daily.
They all work, even if their pallor and place varies so enormously. What other prelude would be appropriate?
But let's get back to my apology to the stranger, Erin.
Social media reaches into the tiniest corners of every community. It is undeniably powerful and in a matter of seconds a social media post can reach millions of people and cause lives to change irreversibly. If you own a business it can be the death of you. Literally.
I am a champion of social media. I have (albeit unforeseeable) found overnight notoriety through the power of an emotionally charged video that struck a nerve with not just me, but bitter burnt pet parents the world (although lets be honest, overwhelmingly just the USA). Instant fame has been found by many a social media post, some good, much otherwise.
One of the burgeoning eruptive social media sources of the last few years is Nextdoor.com. Nextdoor groups people based on location. There are multiple daily posts by my local community members looking for advice on all sort of things, like services. For instance "nanny needed," a newly diagnosed patient in need of a need of "orthopedic surgeon recommendations for hip surgery," or, notifications like "hound dog loose" replete with photos, times, and pet descriptions. It has also been the place for bad services experiences to be vented publicly, back yard crier style. If you own a small community based business Nextdoor is a potential hotbed of agony.
Here is the original post from Erin, to whom all of my apologizing to a stranger was about;
"New Vet Wanted"
We had to put our sweet boy down last month... pancreatic cancer. We spent a few thousand at XXX XXXX Animal Hospital during his treatment. The day we Euthanized him.... our original quote was $330 which was euthanasia and private cremation. Once they realized that we wanted to stay with our dog during euthanasia... they upped the charge to $390, They actually charge $60 more for you to be present while your dog is being put to sleep!!!! I have NEVER been more disgusted in my life. Our receipt actually says “Euthanasia—owner present”. Their prices are exorbitant almost extortion like.... I stayed with the practice while our Nashville was being treated there but I will never use that practice again now that he is gone. Looking for a reasonably priced, non price gouging bc of “ the neighborhood” compassionate veterinary practice.
In the very exhaustive list of things that you just don't do in veterinary medicine screwing up a euthanasia is at the top of my list. Think you can't possibly screw this up? Let me give you my resume of them.
1. You put the wrong tag on the wrong body. Yep, not requesting the proper cremation (say the parents wanted the ashes back and you didn't tag it appropriately. Yep! really really bad).
2. The process doesn't go smoothly. Yep! happens. Death is not an easy ask most often. Our bodies are wired to keep breathing, and beating no matter how much drugs you provide. Or, they gasp for air as their bodies fight to give up. Not the last impression you want a family to have.
3. It is a busy, frantic day at the clinic and you (hard as you try) cannot get into the family waiting for you to be calm, patient and generous, as you secretly worry about the pet you are trying to save from death next door. I often think we need to have "euthanasia only" hours to avoid the chaos our general practice life throws us into.
4. People are people. Some know what to expect and know you, so there is not so much chit-chat to exchange. Others think they know what they need for their pet and then lose it last minute. (I once had a parent start CPR on their dog as I was injecting the euthanasia solution).
If you mess up a euthanasia the 10 previous years of anything you ever did for that pet gets flushed. Along with that scar you leave on your (previous) clients heart goes the devastating word of mouth they will share with every loved one they know.
So to every well intentioned Fortune 500 seeking femme fatale out there attempting to ascend that ice sheer under that omnipresent glass ceiling i apologize for my prolific apologies. I woefully fear (apology again), that I have set us back a few centuries..
For my place in vet med empathy is about apologizing for fate that few can outwit and outplay. I cannot undue the fact that all of my patients will die. Many of them too soon despite the best of care, the most adoring of parents and the miracles of modern medicine, but, I can apologize for the failures of not being able to spare them the grief of loss. I never surrender anything here, just remind them that kindness comes in many forms and a bow clad apology is one.
Where did this practice go so wrong? They forgot that giving an estimate over the phone sets you up for big problems. Every case is case based, and an estimate is "estimating." Although less is always met without fued, more is a set up for angry torches at your front door. I try very hard to not provide estimates. For the cases of pay in advance euthanasia services they pay up front (if they want to) and I eat the overages if it happens.. (avoid the torches whenever possible).
You also never forget, no matter how crazy busy the rest of the clinic is at the time, that these last few moments of a life you cared for matter just as much, maybe even more, than all of the rest. Stop, embrace, say you are sorry for their loss, and be empathetic!
Erin's response; Wow... thank you so so so very much for such a kind and beautiful message. I knew that I was paying exorbitant prices at XXXX during his treatment but I was committed to just staying with them till the end. If I had known that would have happened, I would have switched earlier. It’s shameful that it happened and they seemed to have lost touch with human and animal compassion and are just about money. One person commented that it’s about staffing and that is why they charge extra but in my opinion when it’s an end of life situation, money should not play a part , only compassion. What practice do you own? Thank you again for taking the time in your busy schedule to reach out to me. It is most appreciated and speaks volumes.
Here is Erin's description of why the price was different because she was present;
My daughter called them after the fact and was told it was for the catheter that was placed. Owner present.... catheter placed. No owner present... no catheter placed. I was a tech for 10 years. The vet that I worked for never placed a catheter because it’s unnecessary. You can give the dog an IM shot of Acepromazine. That will take about 10 minutes to make them sleepy and gives the family private time to say goodbye and then the vet comes in and gives the final euthanasia injection. I asked for sedation from the tech first who questioned my request then when the vet came in, I had to ask her again. They were actually going to give a wide awake dog the euthanasia injection through the IV! I had to ask the vet (a second time) for sedation. She obliged but then gave him the sedation IV. He went from wide awake to dropping like a sack of potatoes in front of my distraught family. The vet then said “I’ll give you some time now”. I looked at her and said “Well you might as well give him the final injection now”. I feel like that peaceful 10 minutes to say goodbye to him was stolen from us. I have called several hospitals (like 5 or 6) to discuss their euthanasia policies and all have said that charging for owner present is disgusting. Some said placing a catheter is unnecessary, some said that they place a catheter but do an IM sedation injection first. The whole situation was horrible and completely in poor taste.
If the reason they place a catheter is because they want to make sure they get the vein then why don’t they do it if you are not present for Euthanasia. That says to me that they are more concerned about getting the vein while in front of the family and not for the sake of the dog. If you are not present , no catheter is placed. That says to me that it is not about the comfort of the dog but for the comfort of the vet trying to find a vein in front of the owners. Plus , they still take your dog “in the back” to place the catheter... it should be done with the family present. Going “in the back” is scary for the dog... they still have to shave him and stick him with a needle to place the catheter. What if you could not afford that additional $60 but WANT to be present? Is that an “oh well, sucks for you” situation??!! And what happens to the dog? Does a sick, scared dog go in a kennel until they have time to euthanize? Do they just jam a needle with euthanasia solution into your wide awake dog? I’m thoroughly disgusted.
As a practice owner I understand that time is money. BUT, as a human being driven by the love of a pet I would never think of performing a euthanasia in a different manner because the owner is present. Why would there be a difference in how you handle the euthanasia? I know the answer I know why most vets place a catheter before. I know why vets act one way in front of clients, and hence practice differently in front of clients, but, for me, there is no difference. You could be a fly on the wall of any part of my clinic and the treatment is the same. I will tell you that " I am sorry," and that you "were loved." In some cases it is an animal that was never granted "pet" or "owned" status, but that doesn't mean they weren't loved, if only by me, for that moment in time we were together. How do you work for? Me, its the pets, my patients, 24/7/365.
Here is the story that Erin wanted me to share.
This was sent to me today. I teared up. 😢 Pls excuse the cuss words... How your vet sees euthanasia..... So, you bring me this puppy - she kisses my face, devours the cookies I offer, and our friendship starts. Several visits later, he starts to learn where all the cookie jars are in the clinic, and that lady in the white coat, well she’s okay.... Fast forward many visits later, now I am in love with your dog and your whole family because, well, you are just really really good people and I have not only watched that pup turn into a really sweet family member, but I got to watch the kids grow every year and be a very small part of your journey. Remember that time she ate your teenage daughter’s thong underwear? 😝😝😝 yeah we all had a good laugh over that once surgery was done and she was recovered. Your daughter probably never forgave me for bagging that up and showing the whole fam-jam when they came to pick her up from the clinic. So many adventures, so little time..... And here we are, fifteen or so odd years later, having to say goodbye. He’s got heart disease and I can’t fix it anymore. She’s got cancer and there is no cure. He has arthritis and the meds just aren’t working. I want her to live forever for you. I want that so badly it hurts. I feel like I have failed him and you when I have run out of options to keep them, and you, comfortable and happy. So now it’s time, and I am supposed to be professional. Objective. I am the doctor. Calm. Cool. Collected. Always under control. *&$# that. I have known you and her for a third of my life, and most of my professional career. But I keep it together. My superhuman amazing technicians have put the catheter in. My support staff from reception to assistants have done all the paperwork. Trust me they may not show it but their hearts are breaking for you. They have been there. They know. And they know you and care about you too. And I have the needle in the pocket of my white coat. The same pocket that was always full of treats for him. I take a deep yoga breath and come into the room. Gotta stay strong now....... She’s giving me that sweet look she always does, the one that is followed by puppy kisses and a glance at the cookie jar. But she is too weak now. She is ready. You are not. I am not. But this shit has to happen because we love her too much to let her suffer. She would keep going as long as we asked her too. But we can’t ask her to anymore. It’s not fair to her. I wish our human hearts could be so giving all the time. I wish I could be the person my dog thinks I am. I wish I wish i wish I could find a way for them to live forever. But I don’t have those magical powers. I am just a vet. So we kiss him back, not much left of his body that still works, but that old tail wags, just enough that I lose my shit on the inside but I try not to cry. Gotta stay strong. Her body relaxes, she is in your arms and your are sobbing. Another family has lost one of its most cherished members. I put my stethoscope to her heart to make sure it has stopped but she is held so tight to your chest that maybe that is your heart I hear pounding or maybe it’s mine and all the blood rushing through my ears as I try so so so hard not to turn into a blubbering mess. Confirmed, he has passed. You lay him gently on the table and we hug tightly as you go to leave. The door closes behind you and I don’t know if you hear this, but I sob hysterically into your pets ear. She is gone, he will be missed, and you have to face what I know will be one of the hardest parts of today. Entering that house and they are not there to greet you. Please know that I know how you feel. As you leave the clinic I just wish with every fibre of my being that you never had to face that. I wish they could live forever. And please know, I am so grateful that I was a small part of your journey. Love always, Your vet.
We all want to be this veterinarian. It costs us something to be her. Vulnerable, fragile, and emotional. It is not a big ask, but, remember in the same breathe, at the same moment for one person that we are expected to be this person, in the next room over there is a person with a cat they say they only feed, "it's not theirs" who has a very treatable condition and wants you to treat for free because if you don't "you're a cold hearted bitch." Do you know which one you are supposed to be for which room? There are many reasons the suicide rate in medicine is what it is.
This blog is dedicated to Nashville,,, and Erin.
Erin's story and Nashville's photos are posted with her permission.
Taking A Stand And Facing Consequences. What Would You Do If You Were Asked To Euthanize A Pet You Didn't Believe Was Ready to Die? How often do you think it happens? I know most vets euthanize anytime asked. Why? Because if you dont you get labeled as "uncaring."
More on Jarrettsville Veterinary Center here.. JVC is a place where compassion comes first. Compassion towards our patients is paramount. We are kind, generous, and never allow financial constraints to dictate access to care. If you would like to know more about the topics I discuss here please find me on Pawbly.com. It is free to use and open to everyone who loves pets. Pawbly.com is designed to help educate, inform and inspire pet people everywhere. We have just added our "storylines" section to help people share their own pets experiences and to help others learn from them. Please also consider joining if you have experiences to share and pet support to lend.
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"I have such great news! .... My mom found a home for the cats!"
It is a tough ask; pitching two adult cats to anyone. People adopt babies. Cute fluffy new babies. Teenagers, well, teenagers are a hard tough sell. And yet it happens; life, and it's unforeseeable twists and turns leaves us in a place with pets we are not sure we can care for any longer. None of us want to feel as if our own life is so fragile, so uncontrollable, or, so unpredictable that we are one bad decision, or, phone call away from bankruptcy, homelessness, etc.. But, these things can, and do, happen. People get a twist in the road of life that derails them. They find this place where they are no longer able, or willing (in some cases), to support their pets. What happens to them, our companions we brought into our lives, should we ever find ourselves here? In my life, and this line of work these stories end up as preludes to these dilemmas too often.
A few years ago a house fire threatened to leave a client and his 42 cats looking for new living arrangement options. (Yes, 42!). He began collecting cats as a rescue effort. One or two here or there, a litter became four litters, and 7 years later his 4 bedroom home included 10 to 20 cats in each bedroom. The litter box management alone left everyone smelling like sewage. The house couldn't be kept up. Random pieces of appliances began to fail and he feared letting anyone in to fix anything as the cats would literally be out of the bag. He began using a hot plate, and a kitchen fire happened. Thankfully no one was hurt, but he realized his cats were almost public knowledge, and if this happened he knew his whole life would come under county scrutiny.
This is a man who loves his cats.. Like many hoarders he has more than he can care for and he also believes that surrendering any of them places them at a far greater risk then their current situation where they are overcrowded, underfed, and lacking in basic medical care.
He fears the public more than he can see his participation in the denial of the affection and health to his cats that they so obviously needed. He always believed that his life was managing fine, and his cats are happy because he loved them.
After years of trying to help him and his cats with multiple attempts to spay and neuter everyone (which never happened because the few we couldn't catch were too feral to trap), I realized he didn't really want a population neutral home. He wanted more cats. Kittens to be precise. Kittens made him feel needed. They were so small, vulnerable and often so sick. They needed him to nurse them back to health (because they all were after all unhealthy and always sick), he had concoctions for every ailment. He began to resist spaying the girls because he wanted "to focus on the boys," and, "most were related and they wouldn't mate if they are related, so I didn't have to worry." I spent years begging and pleading him to start considering adopting out some by letting us find homes for the youngest, the friendliest, the ones we knew other families would adopt. But, he would never even consider letting even one go. Not one kitten. Not one feral adult. They all had names given to them as soon as they were born. He knew who was whose grandparents, siblings, aunts, and uncles, etc. This was his family. He loved them more than he could see what that love was costing them.
After 10 years of seeing bad decline into criminally negligent and mentally incompetent I was broken to resolve that I was merely a spectator watching his cats die more tragic deaths than the parents before them had. The problem over the years had gotten bigger, and more alarming and he just wasn't seeing it. A few timid cats turned into 40 plus (although I suspect the number is 70 plus) indoor cats with severe emaciation, respiratory failures, illnesses that can only be explained due to massive overcrowding, inability to manage basic sanitation, and starvation due to dental disease that left the cats unable to eat and dying to in the process. I gave up my ability to believe that I could make his cats lives better. I realized I was just flaming the fires of an inferno and watching cats die more excruciating deaths than I could intervene on. My last straw was a dozen plus cats who starved to death from stomatitis. A cat with stomatitis has inflamed gums that causes such severe mouth pain they can't eat although they are desperately hungry. One emaciated fire mouthed cat after another showed up. Each so sick they couldn't fight the stranger they knew everyone to be. So weak and yet afraid to eat they gave up and willingly died in a corner of a cage that offered no reprieve.
Any person who hoards is already a difficult person to relate to. There is always a lack of trust, there is always a degree of denial that often turns into defensive denial coated anger, and there is always a helpless life hanging in between.
I got to the point where I knew I wasn't helping anyone. I was just prolonging and participating in their and my own suffering. I didn't want to continue to be an accomplice to his feral cat breeding side show circus any longer. I explained that the conditions had gotten to a point where they were no longer manageable, that I felt as if I was complicit in this, all of the death, the disease, the perpetual continuum of it all, and I couldn't live with it any longer. I tried again, and in vain, one last time to be the advocate for his cats who he dedicated every minute of his life to.
At the end of my attempt to open his eyes to the state of despair his cats were living in I landed the ultimatum. Either he got help, or I would report him to the county animal control officers.
Helpless is a place for the meek to hide in. Helpless and hog tied as a bystander is torture beyond forgiveness. I was the enabler watching disaster strike over and over again.
I never saw him again.
Over the next few months the local shelter received 5 hoarding cases. Each case had between 20 to 80 cats. All were thin, sick, and covered in fleas and feces. I would estimate that less than 5% of these ever found a home. Most were too wild to be adopted. Some ended up in barn colonies. Others just died of fear.
It is impossible for me to tell you the worst way to die? It is impossible for me to say there is anyway for a happy ending in these cases. It is also impossible for me to understand people. Veterinarians seek animals to fulfill our healing purpose, people we distrust amongst our dislike.
I grapple with the fact that I ever made anything better for these cats who deserved a life of so much more. I still ask myself if they were better off with quick death from someone who doesn't care about them, versus the slow death they got from someone who does? There was no happy ending, I just got out, and, even in this I wonder if it was the right thing to do?
"I have such great news! .... My mom found a home for the cats!" Jenn, my office manager, relayed the seconds ago phone call as she came bounding into my office.
The excitement in her face was obvious. The relief was inflected in her tearfully bubbly words.
We had spent much of that morning, and previous few mornings, discussing this dilemma of the impending eviction. The eminent need for a home for two older cats whose long time clients were moving to a smaller apartment and not taking them. We, the collective of us who manage the vet practice, had decided many many years ago that if we wanted to run a family-oriented veterinary clinic then we had to stick to our words. Be more than a trademark tag-line and actually stand by it. We aren't going to say that we "treat your pets like family" and then not really treat them like our family. So, we do. We offer payment options, free boarding, intervention care and emergency care to our patients when the pet parents need it. In the past this has included; emergency boarding for family emergencies, the automobile accidents heart attacks, deaths and even domestic abuse and inclement weather needs. If needed we even do it pro bono. We have never put profits above compassion, nor, pitted purses against pet care. We stand by our patients at their best AND worst days and most dire times of need.
We had also learned the very hard learned lesson that if you give someone an easy out they never truly take responsibility, and they hardly ever follow through with their end of the bargain. People who abandon/surrender pets already have an emotional disconnect, or, they are so far removed from financial ability that follow through won't matter. In 15 years I have only had one surrender I ever felt right about. (See Cole's story here). The rest were clients who had a history of disposable lives the unloaded (often obviously un-remorsefully and un-apathetically onto anyone else who would take them. Once you surrender in (many places) you are forever blacklisted from adopting again. Shelters, rescues, and yes, even us, won't adopt out to you again. Ever. (How can we?)
This particular family were losing their home. It was something we had known was likely for months. We had been in constant contact with the family to get as much social media saturation as possible. Just that morning Jenn had told me that she was scheduled to visit the home to take an in home video of the cats (as one of them was very shy and wouldn't film well at the clinic). She had planned her weekend around this home visit. We all know how hard it is to place adult cats, especially shy reluctant cats. When I asked how the visit had gone she told me that they had cancelled it.
"Don't they understand how hard this is going to be? How we really need to find them homes before bringing them here to live at the clinic."
We have taken two other pairs of cats into the vet clinic over this last year. Our current number of in clinic cats stands at 6. All older, all tough sells to find homes for. One pair came from a family who had developed allergies. The other from a family who just didn't want them any longer then the 10 years they had already had them. One of these cats had gotten so depressed, fearful and withdrawn that we feared he would die from the stress and anxiety our busy chaotic clinic landed him within. I had almost gone as far as placing a feeding tube to force feed him. Cats bond very closely to their owners. Even if they aren't a lovey-dovey lap cat they know who their caretakers are and they adapt to their home with a dependence not seen in other species. When their world changes many of them cannot handle the insecurity. They withdraw, they stop eating, they stop grooming, their depression can kill them. Even when they don't appear to love and need human companionship they die without their people.
"No, she cancelled over the weekend, and that was before her mom had called her to say that she had found a home for them."
"Do you know her mom?" I asked.
"No,"
"Call the shelter. I will bet you a thousand dollars she is just going to bring them there."
...."WHAT! Are you kidding!!??" Jubilation transitioned into shocked perplexity and angered pause.
"No, I'm not. I have never known her mom to be a nice person. She had a sweet cat named Feather, the only time or attention she ever gave that cat was letting her follow her to the mailbox every day. She was never allowed inside and she was never more than a cat., and she also never says anything nice about anyone, her daughter especially. Call the shelter, give them a heads up."
The next day the shelter called to say the cats had been picked up by Animal Control. The mom had requested they be euthanized. She had expressed that they were better off dead, something about being concerned that they would be "abused if adopted to the wrong people."
Now, I have to pause here. I have to stop here because as hard as it is to believe I hear this a lot. Too often. It bleeds into this paranoia, the same paranoia that precludes a person from finding homes for his 42 cats who are dying slow deaths around him, in his home. He firmly believes that all of his cats, whom he loves and will admit to repeatedly loving, are better off with him than anywhere else. He is blind to their suffering. Distrustful of everyone else in the world. Which also included me, the one vet who would allow him to drop off any sick cat at any inconvenient time, AND, not force him to pay when clearly he had no ability to afford anything.. Even I was threat so intense that I had to be cut out. The same paranoia that allows people to believe death is a better place than chance when you dump them into societies mercy.
The lack of trust in medicine, in compassion, in humanity has been one of the hardest pills to swallow.
The shelter called to ask for medical records to be transferred to them for these two adult cats that we had just been told Mom had found a home for. I interrupted. I have such great news! .... My mom found a home for the cats!
"Who dropped them off?"
"Mrs. MOM did" they replied.
"Well, she isn't the owner!" I exclaimed. I was excited to have caught them before the euthanasia filled needle did. Before they were lost in an overcrowded shelter. Maybe, I thought, if I could show that these weren't the MOMs cats we could get them into a better place for their second chance?
The rest of the day included multiple phone calls to the shelter staff to promise me that they wouldn't euthanize the cats, the Animal Control Officer to explain the whole situation and urge him to go and speak to the cats real mom in person, and the vet clinic staff, just in case someone came packing and angry. We have had to go on lock down before, get restraining orders, and do emergency shelter recons before. You put everyone on alert when shit like this happens.
When I was on the phone with the Animal Control Officer I begged him to go to the cats home in person. "I'm afraid her mom lied to her. We have offered to help to find homes for the cats, give them a foster home, all so they wouldn't have to be surrendered, which was what she told us all along she feared the most. That sending them to the shelter where they could be euthanized if they were too scared to be adopted might be their fate. Please go! I just can't imagine she would do this, or knowingly let her mom do this? And, please give her my cell phone number. She can call me anytime. We will help her and her cats."
The next day the shelter called back requesting records. She, the cats real pet parent mom we have known so well,, hugged thousands of times, cried with over the loss of her pets, shared holiday cards with, loved more than any other person/client/friend/and even more than family had signed them over to the shelter. Their fates, as the shelter will openly admit to, are open, can be decided to be terminated at any time (because surrendering allows immediate euthanasia), and I am devastated beyond words.
I do not understand people.
Why would you not trust us more than the shelter that can/will/might kill your unadoptable/stressedout/abandoned-and-petrified cat?
It is impossible for me to tell you whats the worst way to die? It is impossible for me to say there is anyway for a happy ending. It is also impossible for me to understand people.
It is increasingly more impossible for me to not judge people as I try to dissect into the comprehensible these non-sensible pieces. I live in a profession where people decide their companions fates. I live in a world that I still willingly invest my heart and soul in, and I live in a world where even those pet parents who I think/feel/believe will fight and die for their pets don't.
And I'll be damned maybe, but, I sure don't understand them. The hoarders are killing their cats with selfish abusive neglect they cannot see, and, the disposers pass on a problem to let their guilt succumb to freedom knowing full well they can be, and often times are, euthanized. Because in the world of shelter medicine surrender allows anyone to decide at anytime whatever fate they want to deliver.
The pets, these defenseless deeply emotionally attached to us regardless of how atrociously we treat them, well, they deserve better.
I spent the night trying to figure out how I could be so wrong about her? Her obvious love for them?
Do I call her and try to unravel this? Do I secretly go get them and hope that I never see her again?
The next day Jenn called. "The Humane Society called. They are full, they want to know if we will take them?"
This is where the soul of every vet/every rescuer/every humane is decided. The little pieces. The incremental stories that your life gets entwined in and the facing of the fact that you do care more, you always have, and that's what makes you who you are. For me, the little fired-up vet who looks at every one of her patients as HER patient, HER family. I will never abandon you, or fight for you, without or without your parents.
"yes."
Here is the video of us picking up the cats. Meet our new JVC kitties;
Here's my video of how these cases affect me;
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Fighter. Maybe not a "prized fighter," but, none the less, fighter. This is my job.
Driving home last night it hit me. I fight. This is what I wake up, diligently-doggedly do all the day long, and then attempt to subdue myself out of each night. And, I do this every-single-day.
It's exhausting, don't get me wrong. I'm sure that there wasn't some detour along my life-path where I made a conscious decision to become this person. Live this life. But, alas, it is the one I recognize as my own now and I wonder if I am alone? I suspect I am not. There is great angst in always being cortisol-intoxicated to fight the next brawl in the next room. Junkie-syringe slasher style. This is the stuff ER doctors, race-car drivers, Navy Seals, and inner Baltimore City high school teachers are cut from.
Many vets are compelled into vet school to be that healer of furred affections. I took it a step further. I started to advocate, demonstrate and change the way I lived my life because of how I saw the world treating, or rather, more aptly, mistreating, animals. I couldn't live to save some of them, the "pets" and eat the rest. Or, wear the others. Ask the moms at my clinic who have chickens, cows, goats, or pigs as "pets" if they can eat them? Resoundingly the answer has become "NO!"
The fighter evolved. She grew. She came from that place where you recognize all living beings are looking for the same things. A place to belong. A family to love them, and a day full of liberty and freedom within the world around them. At our most basic level we all want to be free to live our life as our soul tells us to.
The fighter in me has molded the doctor I became. The person who sees each patient who walks in as an independent life worth saving. An integral part of some persons life that is incomplete, emptier, and less valuable without them.
When I started to fight for more than I was, more than I needed, and more than I had to, I realized that the most important part of that fight was the hope it gave to others. I realized that where I saw a fight they saw a chance. A glimmer that it was not all as hopeless as they feared and they didn't have to surrender in desperation to avoid their companions suffering.
Hope is abundant and yet it isn't shared enough. Why? Why wouldn't we give away the few things we veterinarians have in our over-abundant, yet too often over priced tool box for free? Like confetti? Why aren't we casting it like raindrops? Why isn't every single case started from this place? This mantra;?
I will fight for your pet,
and,
I will not steal, squelch, or dismiss hope, ever!
Why doesn't every healthcare decision start here? Universal investment at ground zero.
Now I know the pessimists out there, the jaded, angry, and lost are going to balk at my over optimistic view. They are going to lash out the defensive, dismissive banter about why this isn't realistic! Or, why it isn't even responsible. God forbid they even throw out some legal crap about liability in the face of unethical moral conduct.
So, to all of them here's my real-life professional advice to this beaten, broken, angry, over abundantly suicidal profession. We aren't God. We have to get off our power tripped judgmental pedestal. For ourselves and our patients sake we have got to stop being so brash and burnt that we spread that pessimism like a plague. We are all the same, each of us is a practitioner. There isn't one person who knows everything. None of us have some magical crystal ball that miraculously tells the future. We cannot spew a diagnosis to our clients who so often come to us with few, if any, resources for the diagnostics they need, like a magic 8 ball. We, more often, and too many more times than we want to admit it, we just don't know. We don't know what's at the core of our patients issues more often than not.. And, if we don't know the diagnosis why are we even speculating the treatment options, never mind their associated costs? Why, because we think we know. We think we know better than the parents who love them. And, erroneously, we think we are liable and/or responsible for these. We aren't. We are supposed to be honest. We are supposed to be advocates for our patients. We would all be better off if we were just verbally and emotionally open, honest, and humble about the depths with which we do not know. We are also supposed to protect the public who shares this community with these patients, but, these are exceptionally rare cases. Stop using fear as bait. Stop telling our clients all the stuff our lack of diagnostics can't rule out. Be honest. Treat people like the loving parents they inherently have to be if they are going to walk in your door and ask for help.
We would also benefit if we all allowed hope back in to live in medicine. If we all fought for it we wouldn't be killing ourselves off in numbers 3 times higher than the next statistic of the next most depressed profession. We wouldn't be emotionally bankrupt and our debts wouldn't be mounting. Our guesses are too often incorrect, assuredly without being medically sound, and these cost lives. It burns souls, and can destroy the lives of those people who call upon us for help.
When my Jekyll-pup was diagnosed with prostate cancer, one of the most deadly types a dog can encounter, I sought and bought hope in bundles. I specifically sought out an oncologist who doesn't carry a medical bag with rationed portions. I sat down with her on day one of our journey to help my pup with an agenda. I needed to feel like I had teammate on my wrestling squad. I also knew that I needed a map to start our journey. A place to begin, and a speculative place (or places) to stop. I knew I could, would, and even was ok with visiting crazy-town along the way. Crazy-town for a vet like me is that place where the stuff no one else conjures as 'acceptable for a pets quality of life' resides. I was concocting up novel surgeries to re-route the urethra around that pestiferous prostate. I could rebuild him, make him better, stronger, (not faster? maybe?) then he was before. I had the technology to build the first bionic beagle! I knew I had this fighter in me who wasn't going to surrender my beagle without a knock-down-drag-out fight! I knew I needed help with navigating myself away from crazy-town. My oncologist, Dr Jeglum, helped me stay hopeful while not going all Oscar Goldman and Dr Rudy Wells. We agreed to keep trying as long as Jekyll needed us to. We wouldn't stop at the conventional. We would try every option, every possible combination and therapy. I was hoping for more time, which I got 9 months of, while buying hope in bundles I bought time in months. I needed these to get me through his passing. I needed him to be living while I was fighting and then I needed to be able to go on without him at least feeling as if I had done everything I could for him.
People pay for hope. It is a valuable commodity and a religious tenet. Whole civilizations were started there.
What I see far more often is people who have been dismissed, over looked and cheated of options. Options that have hope intimately anchored to them.
Why???!!! Why would we ever NOT give options? Are we so lazy, so jaded, so indifferent that we can't take the extra time to sit down, look into our patients eyes, see the soul of a fellow being as still fighting for their life and their time in the sun of this planet we call home? They still have a life to live. A soft patch of grass to submit to. A warm purring tune to play on our laps. A day to make better for the human that adores them.
I see the cases that other vets have denied hope for. I see the cases no one else took time or interest in fighting for and in them I found the reason to keep going.
Where it has brought me is to this place, driving home, where I want to exchange the fighting gloves for the surgical gloves. The place where tears of pet parents change from inability to accept fate to hope filled possibility. We all want to face life, our mortality and the lives our days have accumulated into as this, Hope.
Never steal the hope. It is the single greatest gift we can give.
This week brought me two crying clients.
One was Joey's mom. Joey passed away this week. I had been taking care of him, his diabetes, his urinary stones, and his omnipresent smile for a year. He was built of defective parts. They eventually quit on him, but, he never quit being joyful. His mom told me, as we were talking about how far he had progressed into multiple diseases with little hopeful outcome that she trusted me because I was "the first person who spoke to her, not at her." She loved her Joey and I know that as I write this she is at her home missing him. She has had 5 strokes over the last year and Joey was her only constant companion. She had to let him go and I know it is hurting her immensely right now, and will for the rest of her life.
The second case was Spencer. He is 12 years old. A lab. Most labs are lucky if they see a dozen years. His years had brought him painful joints, diabetes and blindness. He also had a huge ugly, awful death smelling tumor on his wrist. Someone had decided he wasn't worth options. The tumor grew, as tumors will. It got so big it couldn't feed itself, so, it started rupturing and dying. Dead carcass is fetid smelling. You can actually be alive with dead tissue hanging, falling and breaking off of you.. This is what his tumor, on his wrist, was doing as he stumbled his way along.. wagging, lab-fashion the whole way.
His mom was hysterical when I proposed we remove it. "No one ever told me it was possible." She was a new client. New that evening. Spencer was not a good surgical candidate, but,, this was his only hope. We were either going to save him from his tumor, or, euthanize him because of it. She told me that "this was the first time anyone had given her hope for him."
Here are his post op photos;
Here is his story.. in video time.
I cannot save every life, in fact, every life I see, help, embrace, will be lost. We all die. I have to tell every client this. That at some point in our journey the road will end. There is always death. But along the rest of this road there is love and with love there is always hope.
If you are a pet parent and your companion is struggling there are ALWAYS OPTIONS! ALWAYS! And please never lose hope. You can lose everything else in life... hope is given away. Relinquished, and no one can take it from you unless you surrender it.
If you need pet help please reach out to me at Pawbly.com. It is free for all to use. If you have a pet story you would like to share please add it to our collection.
I am also available at Jarrettsville Vet and YouTube.
Growing up isn't always what we hope it will be. For some there are hidden dangers in being in a relationship. For some the cost can be so great you have to give up everything to try to protect the ones you love. Love can cost us many things, most wonderful, some compromise, but the currency should never be fear, and the price should never include abuse, trauma, your life, or, the lives of those you love.... Domestic abuse and violence affects an estimated 10 million people in the US every year.
When I was in vet school my mentor and adviser, who was one of the most generous and kind people I have ever met, talked to me about the social services project he wanted to create and make universal. He wanted vets in the area (this was rural south-western Virginia) to help offer his version of "one health care." A place where all aspects of family care could be found under one roof. Can you imagine bringing your toddler, self and pets to a place where everyone could have their medical AND emotional needs met by a group of people all dedicated to helping the entire family unit? Having your teeth cleaned as your toddler got their vaccines, and, your cat and dog had their nails trimmed and ears cleaned? It is possible, although logistically cumbersome. He also wanted this healthcare utopia to offer housing for emergencies too, more specifically, domestic abuse safe housing. He remains a visionary and an inspiration.
Although I have yet to find a human healthcare network willing to co-op with my noisy veterinary medical care abode, I do carry his vision forward and offer JVC as a safe harbor sanctuary whenever we are asked. I don't make the offer publicly as that would defeat the purpose of offering a free safe place to hang out or hide if everyone knew about it and wasn't being kept secret from the people it is here to protect and shelter. But, we do, and we have, and this is one family who we were able to help.
This is the picture of joyous reunion. This pup stayed with us, hidden in the kennel for weeks while his mom left her home to move into a women's shelter. Most shelters won't allow pets. Few take whole families. He was kept safe, loved, and hidden by us while mom took her life back. He was visited daily by the men and women of the domestic abuse coalition who helped this mom and her kids find a safe place as they moved out of their dangerous home. It was a group effort. We are honored to have been a part of it.
Support, understanding, acceptance, and yes, even active advocacy can come wrapped in unusual packages in the most mundane of places. A vet hospital for instance. This is what a safe harbor looks like. It is the place around the corner. The place you visit daily and have no idea is housing a dog as her mom tries to find a women's shelter for herself, and her kids.
This is the place that protects the four legged kids of the family who data shows often see the beginning of the abuse and are used a pawns in the terrorizing and torture to keep the spouses fearful and compliant. An abusive house can be a death sentence for pets. The stress, the neglect, the manipulation, and the role they play in control are often hidden, unrecognized and silent. Kids with marks on their bodies, changes in their behaviors, and the scrutiny of a social school system trained to identify problems and mandated to report them are far more visible. Pets, well, pets can be hidden. Pets in homes with abuse and violence are at great risk, and people stay just to protect them because they fear they will lose the ones they love most, the only family member who might truly love them unconditionally and they fear what fate would befall them if they were left behind. The abused need their family and cannot abandon them, kids and pets equally.
Here's one report analysis;
"In households with a history of domestic abuse, pets can be a complicating factor. Not only are pets likely to be the target of abuse, but people who are the victims of abuse often refuse to seek shelter for fear of abandoning their pets.
The statistics are grim: Seventy-one percent of pet-owning women who go to abuse shelters reported that their abuser had injured, maimed, threatened or killed pets, according to the National Coalition Against Domestic Violence. And as many as 40 percent of abused women stayed in an abusive home because they refused to leave their pets behind."
What would you do? Would you leave a relationship without your kids? Your pets? Where would you go if you couldn't take them?
Jarrettsville Vet is a safe harbor. It is a place we built to save the little pieces of a life in progress. The place where honest advice, fair transparent prices and assistance in the best and worst days is available. It is also the place where a food pantry is kept for those in need locally. Food, litter, pet supplies, etc., are collected daily in our clinic and then brought to the local food pantry to be distributed monthly to those in need. There is always a line, it is always a huge number of families, and the pet supplies are too often the first items sought, and the first section to be cleaned bare. Food and litter are in such high demand that the large bags are broken into smaller portions to try to meet the need. This food and supplies are yet another of our safe harbors for those not under our roof.
This is the face of gratitude. A pup who has a mom who loves him, and a society to protect them both.
Serving the public isn't just about providing care to paying customers. Serving them includes opening your heart and home just a little bit wider than you have to. Being brave enough to know that you were simply lucky enough to have not needed a place like this when you were 20. Lucky enough to live in a place with protection to those whose voices lie quietly hushed in the dark corners of a world too full of judgement, blame and criticism. Lucky is about being courageous enough to ask for help and imagine a different ending where "happy" is foreseeable, and, not just a fairy tale ending other people get to live.
For anyone out there fearing for their own life, their dependents safety, and the terrible turmoil of not knowing where to go, or who to reach out to, there is help. We are so blessed to live in a country where anger, abuse, and manipulation for control, fear, and power is not accepted as a womans/pets/childs/persons place.
Be the voice for others who can't chose. Be the protective parent. If your pet needs safe keeping we are here to help. We will also assist in finding a safe place for the rest of your family. This is who we are, a safe harbor.
A very big thank you to all of you out there who help the voices hidden and huddled.
What else does JVC do?
Cat shelters in the fall. We collect donated supplies to make outdoor safe, warm shelters for the cats who do not have warm homes to winter over in.. (a separate subject for another day). Here is a video on Making Cat Shelters.
I call myself a mom.. I have had many children.. All were mine to bring into my world, and too many have been lost along the way. A mom is a person who dedicates their lives to the rearing of others. I qualify. I mother. I rear. It counts regardless of skin tone or degree of lacking alopecia.
My kids all have been four legged and furred. They were, are, and will remain, my everything, my world.
Me, Charlie and Storm
To say this is to be honest. To live this has been the greatest gift. The loss the hardest to ever try to live through.
My pup Jekyll. I miss him everyday.
It was exactly what propelled me into veterinary medicine. The force that drove me to study, sacrifice and the proudest moment yet; to accept that medical license and finally start being the girl I had always dreamt I would become. Veterinary college graduation was the culmination of a long heart driven journey. When your path is so narrow, your vision so focused, and your goal so precise you forego or forget everything along the periphery. You lose, or rather sacrifice, many other aspects of yourself along the way. It is the cost and the price for a big prize.
I didn't always have a singular calling. I had many visions of following the artistic coercion. To dance, to draw, to write. My truest passion lies in these. The longing to drown in color. Speak in landscapes, and captivate in portraits. I was the visual kind of autistic child. I was also the product of a parent and a society that measured worth by productive net income. There is a small part of me that would have never allowed myself the freedom to be the artist. To surrender a life dedicated to helping other lives for the pleasure of just expressing and sharing joy. I keep that girl quiet inside of me, but, she is still the persona who wears the pants of my soul. She is the caged bird I wouldn't let myself frolic in. She is selfish, frivolous, undervalued and less vital to the word she lives in. She is kept quiet for reasons I have a harder time justifying.
I was called to vet medicine from the passionate seduction of art because it is difficult to be immersed and devoted to both. But, like every mom we make sacrifices for our kids and suppress the self for their time with us.
The loss of them, the family I have known and loved along these many years, has been more than I can describe. The pain, the visceral sense of loss and loneliness when their presence is no longer palpable has been the most devastating moments of this life. No matter how long it has been, how far removed I have become from them I still long for them to return. I still reel with anxiety that it wasn't the right thing to do. Did I let them go to soon? Were there options left to try? Something I missed? For as many times, almost daily, that I have to confess to a client that I fear the case is lost, the battle too stacked against us, I still can't forgive myself for giving up on my kids. I decided but I still question if it was ever really their time? It is the consequence to loving so much, and having to decide when to say goodbye. They can both be a curse.
I have to say I never walked away feeling as if I had been selfish, or waited too long, or even whether or not I made the right decision. I still know it had to come to saying goodbye, but, I didn't know that exact moment. The year, maybe, the month possibly, the day, perhaps,, but that single moment of farewell.. well, I never come to terms with the moment of adieu.. I know it wasn't the right thing to give up on them. To ever give up. To not wait out another miracle another day from now. You can buy, beg, or bury yourself in a minute, but a day longer was never mine to squander or spare.
There is me, the veterinarian mom,, who has to analyze, judge, decide, quantify, and bear responsibility for the first and last steps of her kids lives, and then there is me, the veterinary mom to the patients I hold so dear. I have a tough enough time consoling myself in that last few steps of a life, never mind the steps for those clients to have to navigate it on their own. How can I make it easier for them if I can't offer the same for me?
How I have wished that I could be that all knowing god. The one who walks into the exam room, places the hand on the dying and says something so powerful it can suck up the grief and the doubt and fill the room with peaceful permission embraced in the arms of the better place we are promised to be delivered to.
I never know what to say. I never know how to not internalize that patients suffering to knit it into something soothing and consoling. Like an embrace you dolefully succumb to.
I fear I say stupid things, like, "I'm sorry." For whatever good that does anyone, but, sorry?, which I am genuinely. Is that enough?
Or, I mutter that I "know how impossibly difficult this is".. which I do.. does that help? Is it relevant? Comforting?
Can't I just be quiet? Collect the last moments of the color, the breath, the rhythmic pulses of the lungs pulling me into their struggle? There isn't any courage or bravery nor any point in trying to deny them.
There is no right place to say goodbye. It always comes too soon. No right time. We are never prepared. There isn't any argument I haven't had, nor, game I wouldn't play with either the white winged good angel or the red leather horned bad one that I wouldn't have considered? It was not a place for decorum or grace. It was ugly and full of anger as I questioned my failed attempts to buy more time. More good days lost in each other.
There are people who are truly gifted at being the guide as the after life acquires the present. People who can softly encourage the fear to be greeted with acceptance and even desire. Convince us that the next place is kinder, gentler, and more welcoming than this one. I'm not sure if it is congruent to be a healer, a fighter of the preservation of life and the giver of death via a quiet syringe of sleep. I haven't come to terms with how to fiercely be the former, the girl I forced to submit my own calling to be the artist, and the girl who trained to be disciplined, methodical, and follow a scientific approach to every problem, AND, then be the priestess providing last rights when the high command calls.
You can get stuck in trying to define, refine and serve a purpose inside and out of yourself,,, never mind the figuring out how to deliver the request to seek the end of suffering.
I fumble, a lot. Internally and verbally. It's the price a veterinarian pays when your quest to wear the coat turns you into a warrior for saving lives in a society with disposable values.
Here is a video of my dear friend Kim, talking about her recent experience with me, at the clinic when she had to say goodbye to her beloved Gracey. Kim also works at our local funeral home so she adds a perfect insight to loss and how we manage the passing of the lives important to ours.
It's been years of beating myself up over euthanasia's. Not knowing what to say, what not to say. How to act. Wanting to melt into a pile of tears with every grieving pet parent I sit next to as they say goodbye to their own beloved. Relive the pain of my own goodbyes as they begin theirs. I understand. I really do.
I can offer empathy. Genuine heart felt empathy. But I cannot say that every request for passing that I am asked for is with selfless merit, nor, internal conflict with the consequences of denial. I am truly lucky to know such wonderful generous loving people in my practice. People who helped me grieve my own losses. People who shared their impossible goodbyes with enough trust to allow me to be present. But, I long for a day when euthanasia isn't an option. I think I have come to this. To that place where pets all die of old age, disease we cannot cure and a place in our hearts that is empty after they are no longer with us. What else is the option? Economic euthanasia? Convenience euthanasia? Depopulation euthanasia? They all exist as the counter to our ability to decide another life. The lives of my kids, and others who never knew the love of a mom.
To all of you out there facing, or having faced the loss of your beloved pets I offer this small piece of advice.. Find someone who you connect with. It's ok to give yourself the time to grieve, however you want to. Follow the guidance of your heart. It will never deceive you. Every right decision lies in that place.
And to all my absent kids, wherever you are, your mom loves you. She will see you again someday.
For more information on anything and everything pet related please ask us for free at Pawbly.com.
Thank you for reading and sharing your life with the companions who remind us why life is worth working so hard to keep them in the lifestyle they have grown accustomed to.
