Diary of a Real-Life Veterinarian: February 2022

Saturday, February 19, 2022

The Measure

The measure, (of really anything right?), is too often based on "success". But who gets to decide what that is? Who decides that measuring stick has increments other than dollar signs? Why is our society so fixated, obsessed, with money? The success measured by profits and the magnitude of the beast that the business is based upon. So often I wonder if people are really happy behind that? So often I wonder if the whole damned world needs a smack in the face about success with respect to where success, and hence, happiness lies?

At some point enough is more than you need and the result is finding meaning within the days after financial security.

The clinic has become so busy that I have to repeatedly stop, look for, and find myself. Days become so chaotic, hectic, and fervor-ed that I have to remind myself to breathe. Step away, take a breath, maybe even take a sip of water, and, ask myself if I have peed yet today? I have to do this... actually consciously tell myself to STOP. I have to repeatedly ask myself if I still remember why I am here? I have to force myself to take pause,,, Re-center, refocus, and renew the hopes, dreams, and aspirations that got me to right here. In the chaos.

Kitten pile.
5 of the 54 we helped re-home from a dire hoarding situation.

Here is a veterinarian. Here is a 7 day a week veterinary clinic with a heart so big people travel from miles away to be a part of our mission. The marrow of our purpose. Here is 12 hour days packed with more cases than the day can contain. If I can't help them they too often don't get help. There are industry wide whispers about seeking and maintaining a "work-life balance" but the reality is that the advice easier to dish from afar than it is to swallow. The reality that I hoped for this. I got exactly what I asked for.

I got here because I love pets more than my compassion for humans could convince me to study medicine for the sheer bliss of helping a human who already had a death wish provided. People are complicated. They like complicated. Pets, animals in every species, are easy. Life, liberty, freedom, and no false bravado or pretense for personal gain at your expense. The simplicity of their lives, as little and seemingly insignificant as they seem, are splendidly beautiful in their quest to live in the moments they are given. Their fears are only in their losses, never their greedy gains. Humans make life hard, painful, burdensome. There are angles, trust issues, and acquisition/preservation of gains to contemplate. Pets, no they never steal your heart and break it for less than you were willing to invest. They fill it without asking what's in it for them. They define, and eternally exemplify, unconditional love.

There is an endless sea of veterinary need. For those of us who take personal pride in the feeling of being needed, even desired or sought after in the professional sphere the ego boost can be invigorating. The problem lies within the minutes between the chaos. I get lost here too often. I can't find my footing and with that I lose my compass.

One of the Motel 5, 2022edition of the Good Sam rescues

So many days, (I would say the vast majority), go like this:

I start the day driving to work heart pounding. Cortisol surging through my veins. Every inch of them. Heart beating out of my chest. The drumbeat reminder that the day looms before me. Taking deep slow breaths and trying to replace my current overwhelmingly dismal mindset with some podcast of light jovial banter. Half of my days are filled with surgeries. These are the days that cause the deepest despairing and yearning. "Lord, just let them all live through the day and be better off for my scalpels precision." I absolutely say something this corny and pathetic. I obsess over these patients. Their predicaments. Their necessary, life changing surgical interventions at my hand. The cases that only have me as their only life saving options. The much heavier burdens to bear; the routine spays that can bleed out behind your back after you thought they were sewed up nicely and left to warm up and revive. The routines will break you. The adverse outcomes you never saw coming. Never mind the pet parents who debate, doubt, and despair over these "routine surgeries" and whether the risk of anesthesia is worth the lack of heat cycles they will have to endure. People worry about their pets in degrees that I both identify with, and break my back over fearful burden with. For all of those clients that fret, I promise I fret with you. I am hiding in the bushes these days. Passing cases anytime I can to a boarded surgeon, internist, cardio specialist. I pass the buck at every chance possible in the hopes that these patients are better served elsewhere. The measure of success is in outcomes, not deposit slips.

For these days, these fearful-filled stress like you cannot imagine, days, I know every patient that I will see. I compartmentalize them. If hope and well-wishes could motivate fate I expect I am blessed and flush. It also makes the weight of the elephant on my shoulders mammoth sized. Remember the days when pets were just "pets"? The kind that lived in a box outside? On a chain. Yeah, I don't either. I know the pets that have names as endearing as the well thought out collar and matching onesie they had custom made for them. I know these pets, my patients, and I know that they are just exactly like my own. Family. Irreplaceable. The most important part of our human days are the pets we share them with. They don't just fill our home space, they define our happiness, well-being, and place of belonging. It is the kind of clientele I attracted. Hoped for. Wished into existence and fought for. Heart on my sleeve, berating the profession that so vehemently wants to protect the "pets = property" legal designation as they promote their personal professions of "pets = family" worthy of kidney transplants, chemo and costs of care tipping the bar of elaborate weddings and lifesavings. Smiling out both sides of our faces.

Two of the 54 from last years Good Sam endeavor.

My patients, the ones who land on my surgery day, they are much more than a name, an age, a species and a problem. They are my lifeblood. My responsibility. My only obligation for that period the anesthesia is running and the heartbeat is defining the rhythm of the moments. They are my mammoth to carry to the other side safely.

The measure for me is really simple. Your pet is one of the greatest gifts ever given to us. A personal treasure beyond weight, or measure. That value is unmeasurable. Hence, my mammoth, and my dilemma.

You see my challenge. How do I stay true to my belief that every pet is someone's bedrock, and, not let that become a mammoth that puts so much pressure on me I hyperventilate on the drive into the office?

Clarke.

I am successful. Profitable, but yet still so burdened. I wonder if they are inseparable? Does one only come without the other?

Yes. I think so. For me. For my measuring stick. For the kind of success that I am interested in.

Oaken. May they all be as beloved as he.

Maybe I need to be asking myself about contentment. If that is measurable?

The Mistakes Veterinarians Live that Make Us Paranoid. Or Kill Us.

This is a blog about the journey. There is not a destination. Nor, is there a typical audience. Just a diary into the ethos to cast out the inner musings and hope they find a place to settle outside of my soul.

Each entry is a step to a place that like every other will have an ending. Its the little fragments of time I steal away to peel myself from the arduous work that is my life's joy and legacy.

My crew, Storm, Frippie, Charleston

Good Commercials Are Sold With A Smile You Never See

Did you know the secret to selling something with only audio is to be smiling as you record?

Did you know that a smile can be heard?

Have you tried it? That smile is transcendent. It influences. Motivates. Sells.

Don't we all have to pitch ourselves every single day to someone?

Veterinary medicine is no different.

Simba. One of the 54 cats we helped last year from one home.

My job is to understand and translate my mute patient and sell their needs to their parents. Smiling while I sell, albeit the way a ventriloquist does, is the art behind the successful veterinary care sell.

I more appropriately I call it the 'building of trust to the point where the pitch is simplified to a permission versus a negotiation'.

Basil One of 5 cats we took after the owners were evicted from a motel.,
He is safe with us now, but looking for a home.

I am a terrible salesperson. All that nonsense of fluff, fake veneers, and smoky mirrors is exhausting. I am a failure as a phony. I know this. I have had to rely on my genuine compassion to build a clientele willing to entrust their pets care in my hands. Just be me and try to remember to smile every so often. Not too much teeth or arm twisting. Keep the common goal in mind. We all have to be here with the same agenda and the same endpoint. Not an easy task or small hopeful wish.

It's not just lip service. I back it up with skin in the game. I make deals. If needed I will make deals that the house loses on.

Sadie. The most influential patient in my career.
She was my defining moment. My pivot point.

I give stuff away daily. It's the glitter in my vanilla day. It is the thing I love, take greatest delight in, every single day.

Sound crazy? Counter intuitive? Maybe its the easiest way to sell my genuine belief in always putting the patient first.

Saffie. Clinic cat.
Adopted and returned 3 times.
And still loved.

Here's an example.

Miss Phillips was elderly. Small, demure, crumpled and lacking any color in her dense weighty coat. Grey stringy hair, grey overstuffed winter coat, and grey sweatpants. She was seated on the long wide wooden bench in the exam room. Composed, quiet and clutching her coat sleeves enveloping her oversized market bag I think she used as a purse. She was quiet, withdrawn and weathered. She struggled with the weight of the 7 decades she had been alive. She needed help getting into our building. The staff led her into the exam room as they carried her petite dog-sized cat carrier for her. She was soft spoken and easily overlooked. She was a new client with a cat to be seen for a spay. This is the information I am given as I walk into the exam room. "New client, new patient. Cat needs to be spayed." No other information available. Blank slate. Not my favorite place to begin.

Seraphina.
Queen of everything

I say "hello" and start collecting pieces to finish the canvas. "This is Lilly. She is about a year old. She is not spayed." That's all I have. I look up at Ms Phillips. She has no emotion. She doesn't move an inch on the bench. Nestled into her winter coat seemingly swallowing her in its over abundant quilting.

"So, she has never been to the vet before?" I ask.

"No." Volley and serve and still no emotion to guide me on where this is going to end up.

"She is here to start her vaccines and be spayed. Correct?" I repeat. Ms Phillips is not giving me any information willingly. This is going to be a Q&A discussion. I slow down. Mirror her pace and attitude as much as I am able.

I take a minute to look at her again. Switch gears from Lilly to her. "Did you drive here?"

"No, I don't drive."

"Oh," I reply. A sigh of relief washes over me. "Who brought you?"

"My friend drives me."

"Do you have other pets?"

"No."

"No other cats?" Part of my job is sizing people up. Finding common ground whilst understanding the degree to which they invite these pets into their lives. That, and I just had a sense of "cat lady" lingering. Building a relationship to help a pet for their entire life and not this one and done visit. I try to remember to smile inside my inquiries. Add a smile, slow my pace, she seems very nice. I can see myself, someday, in her.

"There is a cat. (long pause).... She is not mine. I let her inside when it is cold. I just had her at the ER over the weekend. She had a respiratory infection. It cost me $300, so now I cannot afford to much for todays exam. I am not allowed to have more than one cat."

And there it was. The shell was cracked. She spilled the beans in just a few sentences and a change of perspective.

We spoke for a few more minutes. She told me that she was renting her house. She was not allowed pets, but her landlords were going to let her keep Lilly as long as she was spayed and vetted. She was here, at my clinic, because we were the most affordable outside of the rescues and non-profits that had a 6 month plus spay/neuter wait time.

"You let this other cat into your home where she sleeps at night. You feed her and now you pay for her to go to a vet clinic, and yet she isn't yours?"

All of a sudden one cat that she couldn't afford was two.

"What is going to happen when she has kittens?"

And with this question the look on Ms. Phillips face fell to the ground. It hadn't occurred to her. This reality where her good deeds put her in a predicament she couldn't manage.

We decided together that she would leave Lilly with us at the clinic. Her friend graciously ok'd bringing her back tomorrow with the other cat, Kitty. I would spay both the next day, and she could pay me back as she could. To save financial resources that she truly didn't have we would cut out the optional items like pre-op blood work. The exchange and change of plans had taken almost 20 minutes of our allotted 30. It had included being honest with who we are. It also included asking for help from the driving friend via a flip phone she dialed to her friend parked in the lot outside, too far for Ms. Phillips to walk again.

The next day I met Kitty. Small, slender, matted and peppered with grit in her coat from the flea dirt. Underweight, under muscled, overlooked and discarded like soo many cats in our community. She was gentle, confident, and melted with any small inkling of affection. She was so grateful for a warm place and a kind heart that she surrendered and collapsed into your arms soaking it all in.

Ms Phillips called later in the day checking on how the two cats did with their spay surgeries. "Fine," I replied. I had estimated Kitty to be about 4-6 years old. She was too sweet to be overlooked anymore. I asked her if she would like us to try to find her a home of her own. I never know if I can persuade others to see the kindness in an all black cat who isn't a kitten, but, she was not a feral cat and she needed a break. Ms. Phillips agreed once again that she couldn't have two cats at her home.

Over the phone (no car to drive and sign papers, remember), she authorized Kitty to stay with us as we tried to find her a home.

You know what happened? Another miracle. Seems so crazy the way miracles find us when we give more than we have to, and offer more than the house makes money on. Ms. Phillips got brave! She went to her landlords and put her cards on the table. She told them that she loved these two cats! That with a little help she was going to take care of them and she asked for permission to have TWO!

They said YES!