The Hardest Days.

The hardest days are lived in snapshots.

Frozen moments of the day that solidify, remain indelible, and scar. 

I have collected mountains of them. Held them in my arms like a clutch of kittens too fragile to walk away from and too demanding to dismiss. I know they are the villains to my story that makes the read worthwhile, but when away and alone I sit and wonder if I need to be so burdened by them. How can I extract the color without bleaching the meaning they must hold for me to carry them for so long?

The past few weeks have been vibrant and jarring. The color that propels heartrates into arrythmias.

I live within the proverb; intentions matter. I also suffocate screaming for merciful reprieve because these two words are so impactful. Within these intentions you are left to question motives at every movement. Veterinary medicine is a quagmire of bipolar extremes. Emotionally charged, diabolically opposing, with violently swinging requests of the pet care spectrum you often cannot foresee. What gives a family the gift of a graceful, peaceful passage, also leaves the other owner with a disposable/replaceable burden they simply want eradicated. The purveyor of these passings is too often  given a heavy burden. Or, what one family wants and will fight for another will dispose of without whim or wait. I have been bullied, berated and threatened for caring too much, and too little. Never have I euthanized a treatable pet without fighting to give them every chance, at no cost, which somehow vilified me even more. I have been dumped for an easier practitioner who works on an upfront-pay-and-I'll-remain-mute basis because I dared to open my mouth to attempt to defend a pets life. I have been threatened when I refused to be a part of a pets undoing unjustly. And with each I remind myself "that no good deed" often comes with punishment, however unintended, and unwarranted. I have also come to realize that a dignified end of life death is often a merciful act. But, dare I try to be the inspector of this intention, question the reason, and the tables will swiftly turn from humble request to angry accusations. How is it my place, my duty, and my obligation to question who dies and when? 

I am often asked if euthanasia's are the toughest part of my job, (I have written about this before), and no, when I am being asked this it is always at the hand of someone who loves so deeply they see beyond themselves. A euthanasia request for a pet that hasn't seen a vet in years and is suffering from a treatable condition they still don't want to try to treat, yeah, that's soul-sucking. A euthanasia request because it's cheaper to buy a new one than deal with the old one, yeah, that's a cancer you never recover from. This is my life. The one I chose. The one I fought so hard for.

For the pet owner (emphasis on owner for this is the only title that provides such privilege), the mere perception that I would ever question their intentions or motives can/has unleashed raw anger and threats of questioning your own compassionate humanity. On the flip side there are so many euthanasia's I have declined for fearing my thinly skinned heart could not bear witness, nor survivors remorse, from the act. I believe that for almost all of us veterinarians our internal parting words for excusing these acts, even when we cannot understand, nor agree with the motive(s), are; "if not us, who?" For within these requests there is always a pet, this piece of property, that will be/can be abandoned, tortured, hurt, or dropped to be surrendered at the shelter for the same request. If an owner wants it to be done, it will be done. Just as all property can be disposed of. No law, shame, or unjust reason will change this. So it happens, almost always, that these pets can leave by my hand with me telling them softly that they mattered and they are seen. I, in every goodbye, steal a moment for myself to say that they are everything that holds value and they are loved. I can at least always give them that. And then pardon myself in silent solidarity later. 

Euthanasia, in vetmed is the Medusa of intentions. I am the Master of my own acceptance that I am confident in my own intentions, I will never be everything to everyone. I have grown into an adult who rarely cares anymore if I am liked. I am not mute and I insist on this being married to my intentions.

This week brought us two families who tragically had to say goodbye to two pets within the same day, two days apart. When I admit that this has never happened before in my 18 years of practice I cannot believe it happened two days in a row. How is it that luck never translates to lottery tickets? I had been asked if I would do both dogs at the same visit? A way to condense the pain into a more efficient way to let one dog say goodbye to the other before we said goodbye to him? Thankfully we both agreed this would be too difficult on our hearts.

I have done double euthanasia's on two other occasions. Both were excruciating. After each I promised myself I wouldn't/couldn't do this again. The grief around these always leaves me reeling. I feel twisted in my intentions, and guilty in considering to deny it. How can I be a veterinarian who knows there needs to an end to a suffering we cannot avoid, and not feel a stab of feeling selfish within considering how to address and face this request. Euthanasia's however hard, can't ever be about me I reminded my inner gooey-yolk of a heart.

The first double euthanasia was two old black labs. They were 13 years old brothers, struggling to remain ambulatory. They had great difficulty getting up and walking more than a few steps without collapsing in pain. They lived on a sprawling, verdant bucolic farm and their quality of life was significantly impacted. The owner was not able to get one of them in the car, never mind two, so I agreed to come to the house. When I arrived they saw me approaching, and as if by some divine interventional miracle managed enough energy to get up from the front porch and run a half a mile in different directions. I followed the slower one to the west, sunset in my eyes, dragging my medical bag to the edge of the property to find him solo. I knew then that I had made a significant rookie mistake; coming alone, agreeing to do this in the first place and a massive miscalculation on time, ability to drag a deceased 80 pound dog back to the house and then repeat the process on the other. I too had not planned for how I was going to get them into my car. (Have we ever talked about the physics of dead weight being much heavier than alive? Someone has to have done a research paper on this?). The logistics, inability to walk so far, bring dogs back from so far and the emotional turmoil about how to make this horrible day less horrible for a pet parent who couldn't/wouldn't help me with this was traumatizing to all of us. Pets, all animals, all living beings, seem to sense goodbyes, and regardless of how warranted they are, they react. The reserve of adrenaline to preserve their life defies all diagnostics and prognostic indicators. The primitive call to get up and run even when you know you are no longer viable to evade allows bodies to defy biology and physiology. I can tell myself every moment of my professional, and personal life that I am here to relieve suffering, but yes, the desperate plea of those pitifully sad eyes looking at you as you send them away can hurt so bad you cannot find solace in the present, nor your intentions.

The second double pet euthanasia was a long time client who battled a many-years long breast cancer battle. When she went into remission after a year of treatment she bought herself a Corgi puppy. She had set that as her accomplishment prize and she wanted to be well enough to take on another Corgi. Her original Corgi was about 3 years old by now. Young enough for a sibling and sweet enough to allow one without bitterness or jealousy. She wanted to be sure she would be well enough to care for both of them. Almost 8 years passed and her battle reappeared and raged again. In a matter of a few short months she lost all of her body weight, her hair and her spicy wit. When she elected hospice her last wish was for her dogs to be with her in her casket. She made an appointment with me to ask me if I would be there for her in this request as I had been there with her in all of the rest of her pets lives. I struggled with this request so deeply and profoundly that it almost broke me. Truly, it was the single most wrenching thing to be asked. I was this woman's trusted veterinarian for almost 12 years. She valued my compassionate care for her dogs, and knew that I cared for her as I cared for them.  We had been a team for all that was our lives with her most beloved companions and she had one more request for me to assist her with. She wanted the four of us to be together to say goodbye to her dogs that she could no longer take care of. I spent hours almost begging her to see if we could find them a place to go together. She was convinced that they would be neglected, mistreated, or unable to build a new life without her. She wanted to be present at their departure and she wanted them to be with her as she was laid to rest. It was one of the most emotionally gutting moments. How do I put all of my love, attention and energy into one euthanasia and then within moments try to muster it all genuinely for the other? I had flashbacks of being at the county shelter where the pets would be lined up as if in a genocide to clear the cages. One, after another, after another, Void of the dignity that ending a life turned into out right killing should be made of. It was the longest, most brutal, most conflicting experience. A few months later their mom passed away at home from metastatic breast cancer, I hope they are all together on a couch feeling like their family of love has enough belly rubs and wiggle-butt endearments to make the after life as magnificent as we all hope it to be.

These last weeks I have averaged about 3 euthanasia's a day. We joke that euthanasia requests always uptick in the days before major holidays, (Thanksgiving for the win), with all of the family arriving and the incontinent pet being the main incentive. Or the days before Summer vacation departure when you cannot come to terms with the emotional trauma of leaving a sick pet in someone else's care, or the inner turmoil of cancelling the trip because you expected they wouldn't have lived this long when you booked it 6-8 months ago. Or the back to school chaos and the days that you have to go back to work, the kids will be away all day and the luxury of constant care via Summers timetable. 

Last week a very old, very poorly looking lab came calling for help. She could barely walk or lift her head. She was labored, exhausted and sporting a severely distended belly of fluid. Within a few minutes I had confirmed what my fears told me. She was bleeding internally and there were only two options and a stopwatch timer to decide them within. She was dying in front of us and we either needed to get her on the surgery table immediately or euthanasize her now before she died imminently.

The response is universally the same. A tidal wave of tears, and a few moments to talk amongst the family to decide. They decided to let her go but only after they called the kids to come say goodbye. What ensued was two girls under age 6 bawling and screaming in agonal grief. The girls insisted on being present, a decision I feel very strongly is not theirs to decide, and subsequent hatred toward the veterinarian who was "killing" their dog. I was yelled at, thrown fists at, and made to feel like the most horrible human on the planet, which to this day, and likely every day of their lives I will be referred to as. How else can they process their heart break? How would I have been any different at their age? Why do we have to let our little kids see things that aren't going to be anything other than devastatingly painful?

And why do my shoulders have to be so broad as my heart grows so hypertrophied, thin, big and bulging with the responsibility I cannot always accept as kind?

Why if I am so convinced about the inherent holiness of my intentions do my convictions question my motives?

Ok, I know this one was a tough one,, so for all of us who need a reminder.,,, Here are some photos of my week and why I still love being who I am and doing what I do,, and how often one bleeds its color into the other,,, my ombre life.

Seraphina,, my beloved cat waiting for me to get back in my desk chair.

Winnie takes a quick nap while waiting for more treats during her puppy visit.

One of my favorite faces,, this is Goose. He always makes me feel like being a veterinarian is the highest honor possible.

Josie getting ready to go home after her spay.

These two are my giggles in my day., This is Lydia and Grace holding our beloved Hamilton.
If a clinic has a soul it is the reflection of the people who make all we do possible

Penny,, and her worried face. Beagles are my favorite breed but the lack the badge of courage,, which they make up for in adorable-ness. She was here for a 2 second visit and a hug from her mom.

The most challenging internal medicine case of my career is crowned by this little one. This is Snickers.. the most loved pup you will ever find. 

I write about the life I live. Complicated, conflicted and full of purpose. For more please search a topic and see what 10 years of blogging and 18 years of practice yields.