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Sunday, January 23, 2022

No one should ever have to choose. When we, the practice owners, cover the cost of care for employee pets.

I was on a veterinary hospital owners FB page the other day. While there a veterinarian practice owner posed a question to the group. It was essentially a long drawn out description about an employee with a specific patient ailment which led to the question; 

When should the veterinary practice help a staff member with the care of their own personal pet?

I was a little taken back by the responses. Most, (I am sure they are classified as "well managed" aka the varsity letter for "highly profitable"), clinics had some long verbose lawyer-ey written up explanation for what discounts staff get and when these apply. It was all very cut-dry-to-the-letter. It was sadly indifferent and cold. In essence there was an algorithm set up in advance to "assist" with very anemic access. A discount is given, but a yearly cap was also applied. In essence, for most veterinary hospital employees who can barely cover their own housing and food costs it would never be enough to help in a bad case of any pets ailments.

Bica gets a hug of reassurance.

I read the feed, chewed on it all night, and the next day replied with the following;

"Why do we set our staff up to fail? What the hell is this "accountability over compassion" crap. The culture breeds indifference and neglect and yet we spend every professional moment trying to harbor the exact opposite with our clients? We know what we pay our staff and we know they cant afford the care we expect our clients to bestow upon their own pets and it is incongruous." (,,and I wonder why other vets don't like me,, ugh, Krista. Shut up more often, or, at least try).

Every staff member at my clinic JVC is treated like family. Yes, we are dysfunctional, and, yes, we are imperfect, but when I take you on as a staff member I help you take care of your own family. In return we all collectively take care of the patients in need within our sphere of influence. 

Kissing my Seraphina goodnight.

If your staff can't afford to care for their pets at your practice I challenge you to think about whether you are a part of the problem that separates the ultra rich from who you are? Telling me that you cannot afford to pay them what they need to to protect and care for their family indicates that you either take too  much off the till, don't charge enough for your goods and services, or, you have lost your way in a profession built upon an oath to serve.


And as soon as I had finished this article I make the mistake of perusing Facebook;

Here's what I found one of my family-staff-members had posted.


..to which multiple other staff members; (you know the same ones I just called "family" above write the following;

"very true"

"I feel this"

"Yes! That's why I'm broke and happy. lol. No more pushing myself too hard." (she quit a few months ago.

"truth"


...and I wonder why so many other vets sell to corporate? Why not cash in and dump your family? 

Rio. I live, and, live for this smile!

I am almost two decades into this profession. It has not been an easy road. But, I think that above all else is the fact that no matter how hard you try, how much you invest of yourselves, people look out for themselves first. I am at peace with this, even as I try everyday to convince them to help those who need us desperately, without judgement for the sake of being true to our purpose and mission. As I try to unite them in one small walk of faith into a place of putting others always before ourselves.

My end of Summer 2021 family photo

I wrote a truly pathetic self-pity blog a few weeks ago about how tender my feelings have become. I believe that the more I convince myself to hold onto this somewhat delusional dream of being a practice owner who still cares much more than she profits, that I could inspire a whole team to do the same. That is the hardest pill to swallow... that it might be contagious for a short time, the desperate case of the day timeframe, but, it might not have legs long enough and strong enough to endure. it wont be the heartbreak of losing cases that I turned away, or declined to help, I never did that, it was the investment in others that never got returned. its the fair weathered friends who will always see you as just their boss. The person who is the unwanted guest at the party. The enemy. The person who makes more money than you do, who profits from the labors and yet cant ever be one of the group. That's the hardest part. Just being lonely and still trying to stay the course of what you think is the right thing to do.

This profession, this place that I hold, leaves me constantly questioning. Who am I? What do I want to be remembered as? And, how can I shape the world, and my little community in a positive way? Even if it isn't always sunshine, rainbows and easily recognized?


If anyone, truly, anyone comes and asks for help we need to remember the following;

First, that is is our calling. Our chosen profession. The place where being needed is also being depended upon. You can't have one without the other.

Instead of being annoyed at the pet parent, the situation, the road to however they got here, we just remember there is a soul in need. We focus on that. 

We offer help in all of its forms. medically, emotionally and, yes, in some cases financially.

As it always is we start at, and end at compassion. The value resides here, and very often the cost of care can be managed adequately so that we all feel we didn't fail our pets from there.

And lastly, it is imperative to every human who loves a pet companion for them to feel hope. If we take away this whether it be in the form of excess cost, lack of access, or apparent indifference to their plight, we lose our ability to keep the staff who keeps us viable and capable. 

Give more than you have to and expect nothing in return is a good motto to live by.

The good life as modeled by my dog Storm



Saturday, January 22, 2022

Everyone Is NOT Welcome Here. When Do I Close The Door To Bad Clients?

While I recognize that this is prejudice, I also recognize my own limitations. 

I mean isn't that fair? Didn't the Supreme Court decide who could, or, didn't have to, bake cakes? Why not have my cake, and eat it too? (The degree to which cake defines acceptable social tolerance is alarming, isn't it?).

Seraphina. She is adamant that you will hold her.

I would like to believe that I am the person who accepts all; lovingly, unconditionally, and without the harsh judgement that divides, alienates, and perpetuates. BUT, it turns out I am after all the person who yields death, AND, therefore, I feel I deserve reprieve and definition to my latitudes.

No one enters my realm unless they love their pet. in itself this offers a huge range of persons. those that love so much they cannot bear goodbye. those that love so blindly that cannot see the path of despair they reap. those that love so much they will not permit one ounce of struggle...the list goes on.

My Charleston. Second chemo session.
passed away 10/21/21

If you aren't sure what I am referring too, let me explain the polar end of loving so much..

The woman with the elderly cat with the facial mass. She found me after visiting a dozen other vets. Two of them specialty clinics with all of the options available for every disease and ailment imaginable. These are the pinnacles of exceptional care and treatment options. She had been told by every single person before meeting me. They all told her that the mass on the face of her cat was so advanced that it was no longer curable. There were no surgeries, no medications, and unfortunately this cat was so debilitated that not even oncology had any suggestions. Cancer is often like this. It can cause such devastation that at some point we should seek merciful end of days, versus, fighting for an ending that leaves no hope for any quality of life. What was best for this cat? Simply helping this woman understand what lay ahead for both of them. She refused to see what all of the rest of us were telling her. She refused so vehemently she became angry. Argumentative, accusatory, and nasty. I kept repeating to her that I was on her side. Her cats side. They are not, or at least did not, have to be separate sides. She couldn't see it. She did not believe us. Any of us. None of us should have to suffer. This cat was comatose and suffering. Now for all of you who are as incensed by this as I was, there were measures in play to help. Animal Control was on her case before she came to me. Another vet before me had reported her. It is incredibly difficult to force euthanasia on anyone seeking care for their pet. Hospice is an option for all of us. But, just like all of us it requires acceptance of dying. My mom couldn't see her own cancer killing her. I get it.


The woman with the mass that took the life of the patient. What about the client who brings in the happy, active dog with the softball sized mass that is bleeding, necrotic and seriously problematic for both his quality of life and his family. Bandages cannot contain masses of this size and severity. They only go away when taken off. Nothing (alright, to be honest, almost, nothing hurts my heart like euthanizing a mass because I don't have a chance to save the patient from it. (Veterinary pearl of advice; don't wait to do surgery on a mass that will never go away without surgical intervention. Take it off  asap!) Ask me how many old dogs with yucky masses I have taken off and had them live years, yes, years, after. See Spencer's story).

The hoarder who loves kittens so much she cannot spay. Ugh. This one drives you to question humanity at its core. The most egregious hoarders that I have tried to help have been compassionate enough to see the respiratory infections, the lethargy, the signs of illness, but, they are resistant to spaying and neutering the whole colony. Why? Well, they don't want to admit it, but, the core of the hoarding is the feeling of purpose and feeling needed. (Every veterinary professional can identify. It is why we are all here.) If there are kittens you are needed. If the cats are sick you are needed. It is an impossible cycle to stop. They will go adopt new kittens if the colony is sterilized. It makes you crazy to see the cycle of dying, disease and suffering be promulgated due to mental illness. Cats need to have kennel licenses required by law. It is the only way to curb the tide for this situation.

The old man with the lifeless chihuahua who cannot put him down,, even as he is agonal. The times when an elderly, (it has happened twice, and always been very elderly), man cradling his dying dog and refusing to let go. There is obvious suffering, and still, they cannot let go. Who do I advocate for? Who do I work/serve? There are times I do not know.

....at least there is some salvation with them,, some bedrock of a foundation that helps me justify the end,, at least they were loved..

The people who give up at the first sign of hardship to spare suffering.. . There are cases that wag, wiggle, and delight into the clinic. Most are here for routine examinations. Every blue (black?) moon these patients are attached to clients who perceive something I do not. They feel their pet is unhappy. Struggling in some unidentifiable fashion, and, therefore needs to be put down. I reel on these cases. I offer free everything: diagnostics, exams, drugs, every pain medication in the arsenal, even taking custody of him. These, yes, absolutely these cases are what ruin me. I have had two clients, both men mid 40's, yell at me. Threaten me, and yes, even charge my via the State Board, that "I work for them." Get so angry and unhinged you fear for your safety. They, (my perception) seem more about the control of it all. The embarrassment of being challenged. Called out. Questioned. That they resort to anger, outrage and threats. One I will never forget is Chuck the dachshund. When Chuck walked into the clinic he bounded toward the treat jar at the front desk. He sat, waited patiently with the drool running down the sides of his mouth, and gulped up three treats the receptionists gleefully delivered. He was euthanized because they were going to have it so even if it meant dropping off at the shelter to have it done by someone who primarily euthanizes via a cardiac stick and doesn't know him. He would be afraid there. He was loved here. I hugged him, cuddled him in my arms, and cried. I made it as full of love as I ever did for my own pets. He was mine in that moment. He was the most beloved dog who ever lived. They weren't going to watch. They told me so as a weapon to remind me that they were so hurt by the loss they couldn't watch. I can't put into words the hate that burned inside of me at that moment. I whispered in his ear as he fell asleep that I loved him, and I hope he returns to pee on them every day of the rest of their lives. Let Chuck be the karma I couldn't deliver in person. 

Did I have to do this? Put Chuck down? No, of course I could have declined. I have done so only to have the Sheriff be called out to witness the dog being shot in the backyard tied to a tree. 

(Middle finger salute to that idiot who ever said "what ever doesn't kill you makes you stronger.")

Like it or not, the minute you threaten me is the same second my claws come out. Yesterday I screamed back into the phone to a woman who was insistent to tell me that "she has friends who do not like me!" It was a dagger she thought would hurt me. She wanted to hurt me because I was forcing her to wear a mask in the clinic. I very loudly told her that "I truly didn't care what anyone thought of me." I am over that manipulative crap. These two guys, gone for good. Hip-hip.. I definitely don't work for them.

Jitterbug. My beloved cat. Passed away September 2021

The wise old veterinarians before me would tell me that it is not my place to judge. While at the macroscopic this might be best for mankind, it is not the reality of the world I am trying to stay alive within. 

Diedra, always a smile.
Me, claws at the ready, yet still looking for the next adventure/challenge

Can you love too much? No, I don't think so, but, you can love so much that you are blind to the other person/soul/being/dependent in the relationship. You can love so much that it is destructive to the others around you. You can love so much that there is no other perspective to influence decisions. If that includes your health care provider they cannot do their job with the best interests of the patient first. I also cannot survive with a compassionate spirit to guide me. 

End Note;

This blog is about the lives I meet and the struggles I face as a veterinarian. It's about the endless questions that I grapple with everyday as I try to find my way. I can say that I am trying to stay true to who I am, and why I chose this profession. But in reality I am just trying to keep that little girl who always dreamed she would grow up be a veterinarian, in the face of the harsh realities the adult me has to manage, alive.

Friday, January 21, 2022

Hello 2022, Whatcha Got Up Your Sleeve?

It's the dawning of a New Year, and, hope springs eternal, again!

(yada, yada).. as we all try to shake loose of this pandemic. Time to look back as I plan ahead. 

Or, as I feel is more realistic.., what couldn't go right from here?


So, here it goes,, pen to paper, heart on my sleeve, best attempt at optimism to carry me through another year. (Roaring 20's comin' round again?)


I want to open this new year full of old hopes and new dreams.... 

This year I am making some lofty goals. It's a combination of feeling obligated to make resolutions for a brighter future, and, be reminded about the bleak recent past.

Here's the dilemma..

I have this nagging lingering insecurity that I am going to find my dear friend Havahs' fate. She died in 2020 at 47. She was also a veterinarian, and a veterinary practice owner. She had two kids under 10. Or, my mom who died at 74 thinking she still had another 74 years left to get her dress rehearsal right. They both died too young. They both thought they had more time. Turns out life will hand you a shit sandwich and then watch you die trying to accept it. I prefer to not have any of this nonsense. I much prefer to die old, tired, contented and meeting that new book of the afterlife with a smile of gratitude and the look of the cat who swallowed the canary glee on my face. I hope to get away with everything as I accomplish more than imaginable. Maybe that’s not relatable to anyone? Maybe, in your opinion 47, and 74, are ripe old ages and there are too many people on this planet anyway? But, if COVID has driven home one thing it is that life is short, fleeting, unpredictable, and disposable. A bug/virus can rule the world and keep us hostage while it permeates every corner of every human life. Fear shouldn’t be the only motivator, but it makes a damn good coach.

There isn't much that my life is without. I seem to have so much that I wonder where it all belongs at times? It's a comfortable nest of fluff and fodder that I made for myself. Just enough dogs (two, and they are inseparably happy together), three house cats (and they have found a way of avoiding each other just enough to no longer have cat fights), my two clinic cats (Seraphina, she's famous, (see my Jarrettsville Vet Facebook page if you don't believe me) and Oreo, her ever devoted side-kick), and, the amazing group of people who keep the inner soul of the vet clinic burning bright. I seriously fear that way too many vet hospital owners claim success based on the thunderous magic of their worker bees who keep their practices alive. It's tragic and pervasive. I don't subscribe to it. I might pick the paint colors, and pay the mortgage but JVC is the magical kingdom of hope and miracles because of it's people. I have just enough, and yet there is this relentless nagging that I can do more. Maybe not for me, but others. That place where inner calling supersedes personal preferences to the laurels and my nest they lie upon.


I was talking to an old friend who now hosts a podcast on "successful veterinary practices" (of which JVC seemed to qualify based on metrics that remain mysterious to me). He asked me how the pandemic had changed the way I manage the clinic? I told him that I will never be the same on the other side of it. Early on, when the world was closing down to a hide-away halt, I told myself that no matter how bad this pandemic got I was not going to be the person who failed JVC. I am the third owner of a place that has survived and served its community for over 80 years. I have their legacy to carry and preserve. If that meant I would have to sleep on a cot, work any hour of the day needed, answer every call for help regardless of its severity, I would. I was prepared to be the vet of one against the pandemic of all. Whatever it required I would not let this clinic fall or fail. I was not going to succumb to the fear. The virus might claim me, and I might be one of those little ones in the litter of parvo pups where you are the single one who will survive. I had seen infectious disease wipe out populations before. I knew this villain, but, I wasn't hiding and surrendering. At this same time my mother was bedridden at her home battling a demon of her own. She lost her battle to cancer quickly in the beginning months of this world wide quarantine and fear. Her fear wasn't all she had to shoulder, she focused on the worlds of panic, tucked herself away, and gave up without ever fighting. It was the darkest hours of my life, without question.


Through that loss the clinic chugged along. In the beginning we lost some staff due to personal preferences about exposure and family obligations. As our numbers dwindled so to did the demands for routine care. It was a symbiotic relationship that made life manageable. But through these early days I had this burdened heart that was unshakable. Fear. Dread. Despair lurking. I got through it reminding myself that "to each beginning there is an end." One step, one day at a time. Breathe. Be brave. It's all I could do. 2020 took two lives very close to me. 2021 was the mourning dark veil of a still life still frozen in COVID paralysis.


At a vet conference mid Summer 2021, mid pandemic, I met with other female practice owners. We were all grateful for a get-away, and, we were all exhausted. Most of us qualified as 'burnt out,' I was charred. What I wasn't expecting was how much their attitudes about their practices had changed because of COVID. All, and I do mean all, were once (pre-COVID) worried about how the new corporate ownership would affect their staff. Two years prior I would have said that this was the biggest and most significant factor swaying practice owners to not sell to corporate. That concern had evaporated. Their viewpoint now was exactly what the corporate acquisitioners wanted to hear; "I'm too tired, too broken, and too frustrated/fed up to care anymore about anyone else. I just want out."

I never got there, but, I understand how others did. Had I been forced to run the clinic solo I am not sure I wouldn't have crumbled. I know of one veterinarian who lost 9 of her 11 vets in the first few months of COVID. They left for many reasons, but, they also left her largely incapable of meeting the demand. When I asked her how she did it she replied that the techs did everything. She stayed in surgical scrubs all day and the techs did everything else. It was now 9 months later and she was selling. Her team had abandoned her in her darkest hours of need. 


The backside of this pandemic has left me feeling relieved of a burdened heart that couldn't have taken much more. Where early on the demand for services was so great we were stretched thin to meet them, now we are anxious for its departure. COVID vaccines are available to anyone who wants them. Where I had feared people would be putting themselves at significant risk to stay employed with us, they now had options to protect themselves more than the mask and PPE's, (which make medicine inherently more difficult to patients who cannot talk to you), could. If a staff member had gotten exposed at work, brought that home and infected others, and anyone had died along the way the guilt would have crippled me. I was out of that self-imposed fearful scenario by end of 2021. The burden was now solely and singularly on them.  I could go back to being grateful for their help and not burdened by the fear of their presence.

Maybe being able to forge your path from the end is a good way to not be hesitant or afraid of the now? Maybe as I live everyday with such a constant reminder of what we are all going to lose from living through this, is a way to be more free to make huge mistakes, take huge risks, and live without caring about what others judge, call, label or even think about me.


I can say with a full belly of castigation that almost everyone who is anyone in vet med thinks I am an awful person. From the vet side my colleagues hate me. Yep, hate. Such a cruel word. I am not on twitter anymore and I cannot use the Facebook peer pages without at least one veterinarian trying to berate, bully and intimidate me into hiding in shame. I am outspoken. I remain this way. And it compels my every move in vet med. We, this profession, have failed so many pet parents whose lives revolve around their companions. The prices, expectations, and yes, our own interactions with pet parents is decaying. Vets don't seem to care as much as we believe we portray ourselves to the public. Too often in this, my own clinic, if I try to be vegetarian I am faced with the same shaming and ridicule. As if this life choice is insignificant and banal. And this is from people I actually care about. As I try to be kind to all animals I have staff members insulting me and mocking me. That hurts. I remind myself of this as I try, (operative word), try, to be respectful that others have different opinions. Even opinions on COVID vaccinations. I have had to accept that they may get sick, or even die, and it was their choice. I can almost accept this, except for one small thing, that person could infect another person who might not survive. So I try to be respectful of civil liberties and freedoms in the face of vulnerable defenselessness and yet I struggle to elevate them to the place of pride and dependency they hold.

I have done all I can do as a leader in a small town with a vet clinic that has no equal. We are the sum of all of our parts and yet we are still here facing another year of undoubted challenges with unknown obstacles and a big heart on our sleeve which I will be the first to say is our biggest strength for our greatest chances at success.

We survived the pandemic. What has it done to me? I suppose it will take 2022 to see? 

We were so lucky.

That fact has brought me back to being able to set goals. Make wishes. Be at peace.


What had gotten us here? I think it was just being true to who we are. Not being reluctant to be genuine. And staying there for them in both of our darkest hours.

How do these fit into this book of my life? My singular narrative?

I am left with feeling that they are the root of everything in life. 

Here's to all of us finding a new dawn in a new year, and the hopes that dreams are still possible on the other side of gratitude that we are all still here.