Friday, December 4, 2020

The Blacktop Divide. How Vet Med was redefined in a pandemic.

 Nine months in and I still haven’t figured out the knocking on windows etiquette. 

I spend an inordinate amount of time these days amidst the middle (maybe? Hopefully? Dare I even hope?), of this pandemic in my veterinary clinic parking lot knocking on windows. I am not comfortable here. Too many people pulling in 5 minutes late (or more) for their appointments, going too fast, and congestion at every corner. The struggle to talk through masks, after I pound on the window to release them from their cell phone meets carbon dioxide trance, is real. I am also repeatedly finding myself in too many arguments about even putting the mask on. It has gotten so bad we have put laminated warning signs on the back of our patient record clipboards. 


The protocol is that if you walk up to a car, or client, without a mask on you just raise the clipboard up to your face so they can read the “mask required.” (It has very small (almost invisible) emojis adjacent with a poop face and a finger for staff motivation). 


The real fear of the black topped front office is losing a pet in the transfer to the staff. (Because we all know that if something awful can happen it will.) We have had this happen multiple times. One escapee had us spending three long desperate days and nights searching woods, roads and back yards fearing the whole time that they would be hit by a car in the interim. The other had the entire staff running down our busy two-lane road (where the speed limit is always pressed at 50 mph) to persuade a full on running dog to come back to the rioted crowds chasing it. I wasn’t sure which I was more petrified to see happen, the dog flattened, the staff tossed like road kill salad, or the owners meltdown within the whole endeavor. Or,, that even within the confines of our parking lot, entrance, and exit, that a pet will be run over, bitten, attacked or misplaced in the clutter of chaos as we do more and more outside. The parking lot has become our catch-all. The check-in and check-out point. The collection of pet information and the (thankfully dissipating) point of hostility contact place for the non-mask wearing amendment protestors. I had no previous emotional designation for my parking lot, and, yet, now within this pandemic year it has become an extension of my profit-making square footage assessment. I have invested as much into it this year it as I have my front lobby in years past. It is my first impression, my (by far) most dangerous spot on the property, and the new battlefield for healthcare provisions. Truth be told my hate for the asphalt grows daily as this pandemic grinds on.



The parking lot has been upgraded; glossed over, restriped, labeled by parking spot number to help identify where to find our patients, and as the months drag into winter we are adding portable heaters. I am proposing to also add check-in microphones, the sort of modern-day drive-in movie theatre comms system. All we seem to be missing is the jovial spirit of short skirts, knee-high tube socks and the roller skates. 


We have benches outside that allows for a change of scenery as people to wait to be seen, albeit used based on weather permitting. It allows some refuge from the confines of a car that can last a few hours at our busiest times. We also have a considered how to more easily implement the check in and out procedure. Phone lines are blowing up at record breaking unprecedented numbers. Our call volume is about 1800 calls a day. Which is up from about 300. It is significantly more than two receptionists can handle over 12 hours. The attempts to remain a place where people feel welcomed and well cared for is immensely more challenging while trying to maintain social distancing and public isolation. Removing the in-person examinations where the pet parent and veterinarian, and veterinary staff can exchange patient concerns in real time and together is nothing but detrimental to the overall patient care. As I have lost the ability to share my examination findings together, like showing a parent their pet’s degree of dental disease, eye issues, body and muscle condition changes, every little detail my eyes have been trained to look for and identify, is lost. It becomes reduced to a bullet list of items lacking the relative personal expression of invested concerns on a report card sent back out to the parking lot. Or, a summary phone call.


We are fortunate enough to have a little house that accompanies the veterinary clinic, grooming and boarding facility, and, the 5 acres of land it all resides on. The house has never been used as a part of our veterinary services. It has for the last 50 plus years just been a domicile for rent. This year it has become an integral part of the personal approach to the care we used to pride ourselves for having given each case. In this oddly distancing time of self-protective warnings the house has given us two things many other practices don’t have; a indoor bathroom, and, a place for quiet peaceful passage. My septic system for the small family it was built to support now holds a reservoir for dozens of people a day. I have fingers crossed every day that it can manage the load, same as the rest of us. And, I wonder how do I renovate it to resemble the facility at Ravens stadium? The house has also served as our last tiny vestige of compassionate centered care for the euthanasia’s. Since the beginning of the curbside COVID service discussions I knew that I could not remove this last piece of humanitarian kindness. How others justified, (and perhaps my bottom has not been met yet and I will have to eat these words?), and permit only drop off services for euthanasia’s I don’t know? I have been that person so consumed in grief, while desperate to hold on for every last second as I say goodbye to my family member. Doing that as a ‘drop off’ service, well, I could never forgive myself for that. Nor could I ever look that person in the eye again and proclaim myself as compassionate. The clinic house is our one last sanctuary for providing the intimate care we all came to this place for. The most meaningful moments of my vet life during a pandemic have been there. Taking that last good-bye, those final moments, and reducing it to a drop off service puts us all in a place that undermines all we have collectively prided ourselves as. This pandemic has already taken so much; it can’t take this. Even if I have to gown up in hazmat gear to be there, I will. I can’t surrender this last place of empathy.


I find it jarring how much the place I practice has changed within the world around us changing. That piece of ever engulfing black top has been the divide between the clinic still bustling with activity and yet absent from the people I share these patients with, and that little house where we say goodbye and still remain human.


People are tired, worried, and fed up. I am with them. Everything is thought out, measured, weighed on a risk-based analysis, and the duration that feels omnipresent along with annually recurring in its resplendence. 



I wake up every morning wishing this looming veil of fear would be eradicated. Yet, I know disease doesn’t work like that. It does what it wants. It takes it’s time on a calendar that is intangible, mysterious and elusive. That’s the single thing driving me the closest to the brink of breaking. The unknown. Looming over me day to day and unending in its grip. 

My closed clinic doors. My masked face, and my painful hesitance to hug the client crying beside me as they say goodbye to another loved one in a time where companionship is scarce and fleeting. 


Yesterday I had to help a 2 pound kitten into the only peace she has available after her previous 4 months of struggling to survive. She was one of those few neophyte patients who has failed to thrive. Her mom has dedicated the last 4 months and thousands and thousands of dollars to multiple specialists across the eastern seaboard to help her get over her too many ailments. She passed away in her mom’s sobbing arms, desperate to fight another moment with a poking prodding vet who hurts. We cried together. The injustice of it all. The finality to a time with so many already to mark its passing. That kitten, (her name was Honey), fought so hard. She was destined to fail by some minute failure of her tiny bodies’ creation, or lack thereof. All I could do was say how sorry I was. What I wanted to do was hug her and her mom as firmly and re-assuredly as she was being held and cry together over the loss that was so painful and unfair. That, this personal grief met by self-protective perimeter defense is carried every day. It is an elephant that is dying on top of me. The degree of suffering is transcending every moment of everyone’s life. Like it or not. Deny it or not. 


The parking lot is just my tangible, dangerous reminder of how much distance we have lost in our taking care of each other during this pandemic. 


While I am not going to attempt to list all of the challenges COVID has brought to us as a veterinary clinic I would like to remind everyone that we are all in this storm together. Paddling in the dark, not sure which direction to go, desperate to hold on as the weather unpredictably rages around us. And, yet we aren’t really truly alone. It just feels like it amid the isolation of a parking lot which seems to feel like the best way to stay safely afloat. Being kind isn’t an act of exclusion., The challenge is maintaining it as inclusion amid the chaos of the unknowing. 


If you would like to learn more about veterinary medicine you can follow me here, at my blog KMDVM.blogspot.com, or my clinics website JarrettsvilleVet.com, or, our Facebook page Jarrettsville Vet Center.


I also have a YouTube channel, and the best place for free pet centered advice at Pawbly.com.



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