Death Of A Lobster

 

It's said that the lobster sitting in the pot as the water gets hotter around him doesn’t recognize his own imminent impending demise. The gradual boiling of the lifeblood giving rise to a peaceful slumber, pain free. Whilst the brown pincher-ed self screams as it meets the inferno being drowned in the cauldron boiling to his final crimson curtain. I, like most veterinarians, spend a disturbing amount of time obsessing, questioning, and seeking peaceful death. We are the worlds pre-eminent experts of dying peacefully. We have more experience than any other earth bound shepherds. You, me, all of us in the companion animal side of vet med get no dress rehearsals, no free pass, no second chances at the delivering death if we cannot make it pretty. It's really a twisted request when you think about it. A conversation I have had to have too many times. How to make this passing peaceful and welcomed. Truth is the body, any and all, do not want to surrender. We have to use inordinate amounts of seriously concentrated narcotics to trick the heart, lungs and mastermind of it all; brain, into letting their primitive and archaic, hard-wired and determined to preserve at all other costs self to take pause and trip up just long enough that it cannot restart or resume. Our organs are prehistorically programmed to keep on beating, breathing, and firing even under the most intense of insults. Death isn’t supposed to be quick, easy, or pretty, no matter how much you desire it to be. Accept that. It is what has kept you alive through all of the accidents, injuries, diseases and disasters a lifetime endures.

But let's get back to my lobster.

Does anyone plan for their blushing oblivion? What about the life we live in between the here and the thereafter? Surely lots of us veterinarians do. Right? I mean how else can we euthanize one, two, or even three or four patients a day and not get smacked in the face so repeatedly that we don’t start asking ourselves if we are living the life we chose, or just living the life outside of the cauldron.

This morning I stood in the shower long enough to turn my own fleshy peach Crayola exoskeleton into a blushing burnt umber. Winter is here and I remained frozen between the day I had to face and the numbness of turning the hot water a little at a time toward scalding. There is the ocean and the fire and chasm of indecision between the two. 

If you don’t know vet med in its own current state of matter it's a hellish inferno. A secret kept so dark that it is reduced to a statistic instead of a biography. That shower for me each morning is my threshold between the two worlds. The world I sit quietly and creatively trying to exist within and the black hole vortex of the clinic which I am both immensely proud of, inherently petrified for. Because of these I am unable to break free from it. It’s a glue trap of purpose wrapped in good intentions. It is as consuming as the soaking sauna that lobster marinates within. Unless you live it it is hard to fathom. We all love what we do and hate what it does to us. We all came here with such fierce conviction to become a veterinarian that it captured us within its hopeful dreaming. And yet we all wish for the day we are independently wealthy enough to walk away, bags packed, scalpels silent, and yet knowing as we look back from our recliners that the notches in our belts had meaning and value.

Today I leave my sanctuary home to drive into work to check in on Harper, the Dalmatian who arrived so down trodden I feared for her ability to survive another few days. The dog who was so charming she smiles. Her dad was a tough nut to crack. The lobster debating his own destiny. He was intent on managing this mysterious ailment, the one who had her not eating for 5 days, on a scrawny budget. I begged to run diagnostics. They came back over 24 hours, not the 1 hour his timeframe based on budgetary constraints was based upon. I had an ultrasound and xray telling me that her gut was at an all stop. She was 2 years old. She may need an emergency surgery if my guess was obstruction. That starts at about $800. I asked him to go to the ER for overnight care. He couldn’t afford that. I asked him if she could come back to us first thing the next day. He said he wasn’t going to be able to do that. I took a long pregnant dare-I-step-here pause,, and,,, these words came out of my mouth. “What do I have to do to try to save her life?” I had already offered a payment plan. When that was refused I offered to take care of her pro bono. That was refused too.

Why did I do all of this? It was that smile. That Harper grin that I had only known for a few hours, and this gut feeling that there was a mystery to solve and a patient I could save. That nagging, gnawing knowing that this patient was not to be let go back into the ocean.

We agreed to leave her overnight. She settled into her cage as I walked out the door at 9 pm. I was fairly certain she would look much the same 11 hours later  when I could start her on i.v. fluids and wait for her blood work to return from the lab.

The next morning the fluids ran. She perked up just a little bit. Her blood work arrived from the lab mid morning. And there it was,, my answer,, Addison's disease! Of course!

TREATABLE!! Wishes of little girls dreaming to be their own James Herriott take up the bugles!

I called to report that I was fairly certain I had her diagnosis. I gave him the budget for managing this under best case scenario. We agreed to try the injection for the treatment. I told him that if we were correct on our diagnosis she would look like her old self in the next few hours. He ok’d the $200 injection of DOCP.

He came to pick her up at the end of the day. When he came in to see her she smiled, wagged and bolted toward him. We all cried. We were all so grateful for two lobsters who wouldn’t let the tide carry us into the cauldron.

 This is a profession of emotional turmoil so intoxicating it can kill you. It is a minefield of emotional decay that breeds indifference for your own survival. There are lives in the balance at every 30 minute appointment slot. It is not for the meek, or the dreamers, or the lobsters with the rubber banded pinchers outstretched.

Its been 5 days. She is back to being her happy, energetic, adorably endearing self. I, well, I am out of the shower and headed back to the frying pan clinic. Another notch in my belt.

Harper

P.S. Harper is about 40 days into her Addison's disease and doing very well. Her story has a happy ending because there is courage, determination, and an emotional investment in everyone involved with her care. We are going to save her on a tight budget. Although it is never ideal, it is exactly what her case requires. We all come to the vet with a heartful of pain, burden and extenuating circumstances. Harpers family needs Harper and I am here to help.