There are tougher parts to this job than most people think. These are the eternal forces that pull you into and out of the ability to care. The profession calls it “compassion fatigue,” I call it surrendering your purpose. It is a fight I have every day. It is a fight I expect to have everyday as I continue to practice vet med with the public paying my way.
“I don’t know how you do it.”
“I always wanted to be a vet, until I realized I would have to do this.”
“I couldn’t do it.”
“This must be the hardest part of your job?”
I hear these weekly, and, on the really bad days, I hear them daily. The small talk, the dropped one-liners that are delivered to me as I am sending another life into the after life. They are the common conversation fillers from clients as I humanely euthanize their pet. They are the reminders of how dismal this job can be. How emotionally and mentally taxing the price is for pet care at this level as your chosen path. We tell ourselves it isn't our fault. That this task is our final act of compassion, but, the truth is we have to tell ourselves something to stomach the acrid taste of being the designated henchmen.
For the majority of clients that I see, saying good bye to their pets is a kind way to spare their loved ones further suffering and the passing is marked by overwhelming grief. For for a smaller group of people it is the only way out of a situation they can no longer manage. In either case I am always sure that this act is based on love. I have spent decades insulating myself from the other scenarios that bring euthanasia to the resolution of a pets treatment care plan. The cases who can no longer afford further care even when the condition is treatable, or, believe that the road to recovery may be too long and arduous to attempt. The disposable pets who are more affordably replaced versus ‘fixed’. The cruelty cases, the court mandated cases, the "found but don’t want cases," and the weak/dying/debilitated/desperate cases. I have somehow figured out a way out of being simply the euthanasia mother to these. It has taken stern warnings to the staff, repeated pleas to the receptionists, and a no-exception scheduling of walk-in euthanasia's. It has taken courage to stand this ground. I have been called terrible names. I have lost clients. I have been brought to the medical board, punished and chastised, and, yet I still stand firm on my position. I will not euthanize a treatable pet without offering every option imaginable, and extending myself further than is ever expected. I will not go to my retirement with blood on my hands. If, and when, I leave this profession, as I lie in my own grave I will at least like myself for standing up for my patients. It is not the path of my fore-fathers. The men who began this profession to serve the needs of their community. Veterinary medicine has changed over the last 100 years, most remarkably within the last 20. The place of our pets within our families has evolved. The desire to value our pets as family members has driven the wealth in the vet med profession and lucrative lifestyles we veterinarians can lead because of this, and, it should follow that our perspectives on these patients who allow us this should also evolve. There is a sphere of hypocrisy among our colleagues and within the leaders of the profession. The belief that we should not judge, and that we cannot maintain a healthy client base if we don't answer all of the client requests, (almost regardless of the basis of said request). These tenets have shaped us into appearing "
indifferent" as we deny care to those who are financially constrained and yet also the exemplification of absolutely devoted to their pets, while we "humanely" euthanize the cases we feel are better off dead than neglected of the care we deem "
most appropriate". All judgement calls. We readily, and, almost universally shirk emotional investment as we consistently and almost without exception buffer our own personal financial risk. We do so with the legal backing of the state veterinary boards and the national leadership. We
un-
apologetically (my least favorite over used axiom in the profession), deny based on any desire we choose. Veterinarians are emotionally scraping the bottom of an all too empty well, as we blame poor financial decisions of our creation, (if you cannot afford to go to vet school, and you cannot financially recover from that decision based on your current or projected salary whose fault is that), as we at the same time blame poor decision making on clients financial limitations whom we remind all too often need only have that pet based on
responsibility versus
rights. (My second least favorite vet med saying). It is an impossible game to play. I have learned this the hard way too. I hate myself for being the middle man between clients who don't value their pets as worthy of love, and the investment that this responsibility requires, and, then I hate myself most when I consider turning my back on a case I believe I can assist. I often sit trying to chose between which scenario I will hate myself less for. It is all about choices, and, getting out of this alive.
I am too often left with trying to discern what the hardest part of this for profession for me? I will admit it has changed over time. It has transitioned along with my courage to stay viable. Early on the hardest part was the angry and demanding owners who tried to remind me that; “I work for them, and, therefore it is my duty to fulfill their wishes to kill their pet/declaw the pet/etc.” I have bid them all adieu. I am financially secure enough to have this luxury. Truth is I have decided I could not go on like that so the financial loss was apparent either way. As I was figuring out who I was, I was realizing they didn't fit my perspective professional path. I, along with the rest of us, cannot be everything to everyone.
Then there was the period where I knew I was being tested to see if I could maintain my own choosing between doing the kind thing for my patient who had just been hit by a truck puppy and the manipulative demanding owner who wanted everything for free and then to have their puppy back. I wasn't sending her back to them. They had withheld lifesaving care I gave them for free the last time , an old yellow lab who died the most horrific death of denial of care, and it had left me heartbroken like no other case has before or since. I should have reported them, another lesson I have learned, and I hadn't fired them in time to avoid this (their new puppy to replace the dead previous lab) puppy and the truck, which the state board so firmly reminded me, that “euthanasia is a required to be offered option for every, (yes, they used the word “every”), condition.” I suspected I was going to pay for this decision when I was making it. My pocket paid a fine, but my heart did not. I still know it was the kind decision for Sadie, even if it wasn't the right decision in the state boards eyes. Sadie is alive and well almost 10 years later with a different family, (the original family tried to get the board to force me to relinquish ownership after they surrendered her due to lack of any funds to treat her. After I paid to have her fixed they sued me. The board offered to drop charges if I returned. I didn’t. They charged ahead for not offering euthanasia). You have to pick sides in life. Make hard choices. Decide whose integrity you care about most.
The hardest part for me after I earned and tested my titanium britches was the cruelty. It is the single undeniable force that breaks vets. Cruelty comes from only one side of our equation; our clients. It is the people who kill you. Chip away at your ability to remain centered on your patients and the care they need. Indifference is the dark side. The force that whispers in your ear over and over to just stop caring so much that the vulnerability leaves you marching to the fatigue that compassion can cost you.
How do I get around the cruelty? I use the tools I have at hand. I simply don’t tolerate it. I don’t turn a blind eye and I don’t ignore it. If it crosses my path, and it does, I take photos, I have frank conversations about what I am seeing, how I am documenting it and what needs to happen to keep me from reporting it. Doesn’t it seem odd that society has anti cruelty laws and yet you can euthanize for anything? I call out Animal Control to bear witness. I leave the judgement of inadequate care, neglect, cruelty in their hands. It is the job they signed up for. I am now the messenger, albeit hypervigilant, but that is part of my purpose to protect the pets I still call the love of my life.
The hardest part for me these days is the looking into their eyes, these patients who I have elevated to be the answers to cause and consequence, and asking the hard, deeply moving, philosophically governing questions. There are patients who are suffering and desperate to get better and there are others who are suffering, dying and don’t want to go on. Here is where I am finding my latest cross to bear. The part that is chipping away at my inner purpose and conviction to course.
When I can see the difference in their eyes and not be able to do anything to change it.
I will never let myself be any other kind of veterinarian than the one who shows up for her patients. Although our clients are an integral part of our ability to keep our pets healthy my love and my loyalties lie in the preservation of life and health of the cats, dogs, kittens, and puppies I pledged to serve. Not putting them first, in everything I do, is answering to the indifference that has plagued too many lives already. I entered vet med with the same single belief the rest of us do, we love animals.
If you take the time to look into their eyes they will tell you everything you need to know. I, as the practitioner also have to listen as I gaze. I have to believe what my heart and soul tell me, what so many of us know already, that they have a place in our hearts because they have a heart of their own. Isn't that everything in this lifetime worth fighting for?
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Dr. Magnifico: Your love and compassion for your patients and clients never cease to amaze me. As we have moved from one area to another, I am so thankful to finally have found the perfect vet clinic and you as it's owner. Please know that I am thankful for all that you have done for our family over the years.
ReplyDeleteI would also like to send a warm Thank You to Dr. Morgan and the rest of your staff.
With much Love and Respect, The Browns