My Christmas Wish

Some people are just building a body of work. The getting up day after day to repeat the same tasks for the same boss. Punching the same clock. A small cog in a bigger wheel that they cannot identify their own importance, or the meaning of it, within. Day, after day. Weeks on end, until at some point you realize that the novel within you lacks a central character you can relate to, or, even root for. There is that someday where you realize that there is more behind you than in front, and you are at the intersection of what's left to do, vs., what is left that you want to do?

Others are just trying to find work. Find someplace to pay the bills and disregard the purpose, the passion, the place of belonging that maybe a job can bring. 

Sadie.
The most influential patient of my veterinary career.

Then there’s me; plodding along trying to build an empire. Filling my days with little wet-nosed lives that have already given so much. Filling my life with the people of Jarrettsville Vet who share this passion and purpose and expanding upon them, so that it touches everybody in our community from its core. I am also trying to convince the rest of my profession to feel the power and the addiction in the purpose we all came here seeking. Ask yourself if you became the Ebenezer when not so long ago you just wanted to help the Tiny Tim?

Every year at this time my husband asks me what I want for Christmas. I'm 5 decades into this passage, and I can say with 100% honesty that it's not wishing or wanting more. I simply feel so grateful and lucky for what I already have. Right here and now, this is it. I worked my whole life to get here. I am not waiting until retirement to live. Or go out and live. It's within everyday already. As far as the season of giving,, well, I just tell him; I don't want one more thing, that is a thing.  Nothing. Not one smidgen of a particle of an article that was intended to be gifted. Not one more thing to dust, to pass on, to leave behind, or, wonder how much of a carbon footprint it carries?

The wealth of love

This year the wish is to pay everything forward. All of the intangible things that spread peace, joy and kindness. Veterinarians, the whole lot of us in vetmed, forget, overlook, under appreciate how impactful and meaningful the power of kindness and compassion is. These don't cost any of us anything. These change lives exponentially. They hold more power than our diagnostics, injections, and medications. These save more lives than all of the tools in our medicine locker do. 

Now, I am not a person who lives in a tiny, shabby, debilitated make-shift hut. I have not come to the place where I shun all belongings. Meditate in a trance-like chant to find a higher inner awareness seeking permission elsewhere. I have traveled the world and seen far too many families suffering in poverty, corruption, greed and desperation. Living in a home constructed out of piled wooden shipping crates. Or, an assemblages of tarps. Rooms partitioned by shower curtains. Dirt floors, no provisions to allow for windows utilizing a portable camping stove with its assigned two pots forced to feed 5 or more mouths. Homes that wouldn't pass for junk are required to be the shelter for the heart of its inhabitants. I have heat, insulation, cable tv, food in the fridge, a pool, and the happiest, spoiled, blissfully unaware pets. There are rugs underfoot. Artwork on every wall. Bins of rotating holiday decor to embellish the upholstered furniture. It is a rich life. There is excess here. I admit it, and I am eternally grateful. For as long as it might last. Wealth, all of it, in all of its many forms, is fleeting and fragile. Wealth that is tangible, liquid, asset-based, is transient.

River, who is as excited to see me as I am her.
She, and her mom, are some of my dearest friends.

Yesterday on the NYC subway a middle aged heavily sweat-shirted man broadcasted that this year he was asking for generosity. He had lost family in the 911 massacre. He had served in the Army. He was suffering from PTSD, on the streets, and begging for food. A man next to him quietly and shyly handed him a burger-sized, wax paper wrapped sandwich. "My wife made this for me. I hope it helps." That simple, impromptu, two second exchange made everyone on the train smile. It was accepted with gratitude and a firm handshake of "thank-you Man." The train stopped not one second later and we all got off feeling like a little bit of the holiday season happened with all of us to witness. 

That is my wish. Pass on a small act of kindness. Avoid the door-busters. The stocking stuffers. The swag, and the stuff, and the things. Take great joy in what is already around you. The life you have built. The people you share it with. Think about how rich you already are. Want for nothing more than the possibility of this being all there is left to do and still being the most blessed person you could ever be. 

Autumn and I stealing a snuggle and a kiss with Otis.
He was at the clinic for his first puppy visit.
How many others do this on routine appointments? Why not?

This year I hope that I can refuse all the gifts. My hope is that I can convince others that there is nothing more to accumulate. I want nothing other than paying it forward. Is it possible to keep paying it forward until there is no one left who still can't recognize the treasures underfoot. I hope that they still give of themselves to enrich someone else's life and that they feel that the gesture pays back 10 fold over in return. Wealth in the truest form of pandemic proportions.

This year, as one fades into a new, Jarrettsville Vet is going to take on a new challenge. We are going to empower ourselves, every staff member, to find that sense of financial freedom and the independence it brings so that maybe by the time they all hit the same number of tree rings that I have they feel just satiated gratitude irrespective of Santa denoting you naughty or nice. You never have freedom unless you have this. It doesn't have to be millions. It only has to be enough to keep you from making choices based on the influence of need. It is why I feel so strongly that the debt we carry denies us the ethical integrity to put our patients first in every decision we make.

Sadie. Captivated by the temptation of another treat.

Nothing matters more than having the freedom to make your own choices. The sense of being healthy enough to pick your own path. Even if no one else wants to emulate or follow. The passion of your purpose to make other lives better, and the financial freedom to never feel you have to sacrifice any of these to etch out your own survival. Veterinarians forget that they hold such power. The power to bend lives, influence, albeit determine survival and outcomes of the lives those companions hold together. I never lose sight of this. I never deny hope, or miracles, or chances, or financial freedom for this to determine fate almost more than any other influence. Of all of the callings that going to vet school answered for me, it was this one reason more than any of the others. I think that lots of vets go to vet school because of the impenetrable bond we have with animals. Me, well, I was never going to surrender the power of protecting my beloved pets to not being able to afford to get them well, or at least try. I was never going to be stuck, trapped, tortured in not being able to keep them safe, healthy, and pain-free. Some women stay in relationships for all sorts of victimizable reasons. Me, I can give up everything else in this world, but, I will never lose the peace of mind that I never have to let go unless there is nothing else that can be done. That is power. That is what being rich beyond compare brings you. That is a Christmas wish that has nothing to do with things. That's the gift I want to give back. That is when you change lives.

Storm. Rescue,, a dobie with ears and a tail!
She is the cutest!

What is your holiday wish this year? What are your New Year goals? How much of them just rely on giving vs getting, and why?

Oh, and let's not forget,,, go adopt a life. Start 2024 with the most incredible way to pay anything forward. Go save someone. Foster, adopt, read a book to the shelter animals. Take them for a walk. Come to Jarrettsville Vet with your whole heart on your sleeve and just give. 

Critical Mass

Critical mass. 

I am fixated with the concept of where that fulcrum lies between viable critical mass and the surrendering of life. In medicine, vetmed very specifically, we are trained to inspect and dissect down to the point of recognition of this place of fate. We learn to listen to a patients history. We perform a thorough examination and then recommend the appropriate diagnostics to solidify our presumptive diagnosis. All of this from a patient who cannot speak and often doesn't want you poking/prodding/palpating them. We have to be the doctor of every department and we have to stay on a budget. How any times am I expected to diagnose and identify without any of the diagnostics I need to be more certain? How many times can I beg and plea for mercy for the patient to be given some small chance at recovery when all their owners want to know is where is that critical mass point and will it be cheap enough and easy enough to allow passage of better days ahead? It will make you mad if you let it. It is why there is this protective parable preached to us about not being judgmental, and, not caring about your patient more than the owner does. Not recognizing the face for more than a number in a day of many. It is why we band together like refugees in a village of emotionally fueled hostiles. There is not one day where we aren't vividly reminded why life is so slippery and precious as why it is so wretchedly, painfully hard.

Rudy. Rescued from Texas. So absolutely, adorably perfect.

It is the fated search of critical mass in a life of fearful brevity.

There is a place in all lives where that one cell too many costs the whole. One atom too few, one tiny piece of sand hits the pile below and all of fate is doomed. The fulcrum, the pivot point and the place where you cannot force, intervene, and bend the will of the ghost that comes calling you home. In vetmed I look for this place with endless relentless persistence always hoping I can outsmart and out will the critical mass headed toward my efforts being futile.

My beloved Raffles.
Rescued as a kitten, forced to serve a 4 month quarantine for rabies.
We will never love all cats fully enough to permit even the most basic vaccine.

This place, the tiniest of differences between that one moment soon enough, and the next, where it is too late, is where I stay stuck in my cause. The place where I seem to hyperfocus, stare down, and too often get stuck. The place I think I owe in recognition to both my clients and my patients. The place I fear I will both not recognize, nor admonish. In vetmed we are expected to intuitively know this place when we arrive, articulate its magnitude, and spare all parties involved the futility, the suffering and the premonition to save both dollars and disappointments. We are expected to know it all, and then dictate a fate that fits the hands that pay the invoice.

How many times have I overstepped this place? Tripped over the threshold and found myself falling into the end before I knew it?

Minnie. One of my WHY's

For my mom I knew we had lost her battle for her life, and all that that carried, when she was lifted from her wheelchair to the scale at her oncologists office and the numbers read 74. 74 pounds was not recoverable. She could not come back from here. She would not be able to regain her body mass. She would never walk again. The ability to stand up, blaze her trail to independence and freedom from all of the decisions that would soon follow was gone. Extinct. She was destined for death and there was no point in hoping, praying, wishing or cajoling anything further.

Me and mom.

For my best friend Havah it was 31. The day she called me as I was driving to work. The one place we shared everything our veterinary lives brought us. The one place that solidified us as sisters, the fairytale of vet med and all the magical moments, and this was our road sign to never being together again. She was going in one direction that I couldn’t accompany her. She had yet another mri the day before and her headache culprit lay in 31 metastatic  lesions within her skull. This conversion was the place everything collapsed around. For five years she had never wavered in her conviction to win her breast cancer battle. This was her Normandy. Her foxhole was exposed and her enemy was mounting its last attack to claim its host. It was the first time her voice cracked and her fire diminished to a spark of planning a legacy she could no longer add a chapter to. 31 was the count we knew we had lost each other and all of the many things we depended on each other to carry. We had to go the rest alone. I had to try to imagine being a veterinarian without her. She was the soulmate to my passion and the guard to my heart being safely nestled in some semblance of sanity simply because we both knew what it took to survive this profession and neither one of us would ever leave the other wounded soldier behind. She was my Forrest and I her Bette Midler Beaches. I had always banked on us going out like Thelma and Louise and now here we were having to decide how one could finalize a life still with so much left to write while I, the other, the one being left behind, knew it would never be happy ever after.

Havah and my mom. Halloween, maybe 1999.

The cases at the clinic walk in like a revolving cattle drive. Every 30 minutes the door deposits another sick, helpless cat or dog at my feet. I have 30 minutes to find that pivot point. Identify the underlying triangle that permits one side to slip into the abyss and recognize it for its power, while the other allows me to flex my medical prowess and save this life. The scant 30 minutes to identify which side of the fulcrum we are resting upon. How many of those once in a lifetime lives, those irreplaceable companions can I sleuth into being classified as savable before that last determining grain of sand slips into terminal. Can I see it for its critical mass of yet to be undetermined in its fate and push the tide back to sea? Where is that place of my endeavors can still matter and fate has claimed its next hostage for keeping.

Grizzly and Bear. Two patients I adore.

I play this game in my head with every life I see.

You don’t know you are strategically laying out your chess pieces until you try to pause from the game. Until you try to push yourself out of your chair so you can look at the board from above. How little your pieces influence the greater part of the landscape. How many pieces you can lose to protect the king as the queen does all the heavy lifting. Where is that moment that the game tips?

You don’t realize how much the tiny shuffles of all those pawns in front of you influence the outcome until the critical mass of your life’s work sit beside someone else on the opposite side of the table.

You don’t realize how much you’ve lost until you have to contemplate surrendering the whole endeavor.

Vetmed tries to measure loss in inches of acceptable intestinal resection as a way of predicting functional abilities. How many abdominal exploraties have I opened up to see lengths of black gut leaching into both sides of healthy adjacent tissue? How many times have I had to call a parent to guess, propose and confess the critical mass being lost already? That game. This duel of sizing up my opponent to try to mercifully protect my patient is the battle I obsess over.

It is the battle to not feel to pessimistic to the power of hope. It is the battle to not be so egocentrically dictated that I presume failure while dismissing miraculous chances. It is the most egregious aspect of vetmed. This insidiously absurd power that one life can be replaced. It’s mark left to be rewritten by another. Vetmed needs a slap in the face to wake up its indifference for another patient to follow. We need to see each individual as its own unique and meaningful life. So influential in its existence that it enriches our own beyond replaceable measure. We need to be ever vigilant in our inspection of mass that we seek purpose in saving and protecting rather than measuring and abandoning.

500 dogs. 500 dogs kept in 80 cages. Broog shelter in Ukraine was a war camp. A place where all were trapped in a hell that lived smack dab in the middle of a country under siege trapped by a war none could flee from. This is my ptsd. The place I go back to as a yarn of tangled intentions to distract from the weights and measure of assigning critical mass. The place of chaos to remind me that my decisions, as honorable as they may be are still just wished cast to the clouds as I grip the grass below. Yet we all still wake up to another day of discovery and hope the compassion can out weigh the mass. That the tiny grains of moments collect into magic wishes of perpetuity for the next generations to reminisce about.

The dogs from Droog, The group in one of the open spaces

I am beginning to recognize that I cannot stay focused on the end. The place where there is less, and it is slipping away. I can only stay grateful in the present, and all of the joy here, the rest will find me, someday, regardless.

The profitability of Asclepius

I recognize that my veterinary clinic; Jarrettsville Vet, is succeeding because we are not following in the ever increasing footsteps of the rest of the parade of hospitals around us. I recognize that as we remain independent and committed to our patients and the people who call them family, others, in ever growing numbers, are becoming financially focused institutions. Under their guise of care people are being targeted for manipulation as they are held emotionally hostage for their pets care as the commodity. It is obvious that as so many other veterinary clinics fall into corporate, conglomerate hands, focused solely and singularly on profits, the wave of supportive leadership to make this happen is the keeping of the guards to allow passage of currency. The veterinarians are the backbone of every veterinary practice. The engine that keeps the machine allowed to run. They hold such power, permit the profession to promulgate, and, now more than ever before in our history, they are in such short supply that we are begging for more of them to find our unanswered want ads. 

Given away at just a few days old someone took mercy.
Often the littlest lives need the most compassion.

With any great demand comes innovation, competition and incentives. The ability to find a veterinarian in any of the traditional ways has become impossible. You cannot place an ad in the local, state, or country publications and get even one response. You can try to recruit from the veterinary colleges, but you will be met by large corporately run HR banks with their platoon of jesters who now recruit students at the freshman level as "ambassadors" who are paid to promote their hospitals and essentially own the student upon graduation. As with all choke hold demand there is great profit in finding that unicorn. So gives rise to recruiters. 

 Today I received an email from one. Here's how that exchange unfolded.

Good afternoon Dr. Magnifico, 

I am sorry you have not had good luck with recruiters in the past. I try very hard to be transparent and have never been accused of being unethical. I have been a veterinary recruiter for 30 years and love the industry and what I do.

I have attached the document that explains how we work and associated fees.

Looking forward to hearing back from you.

Gwen

The contract is as follows;

Contingency Retained Recruiting

Off-site identifying, sourcing, and recruiting

Off-site telephone interviewing

One year replacement guarantee

Fee: 33.5% of first year annual compensation of each candidate hired. To begin process, sign agreement

and pay retainer of $3,900.00. Retainer is deducted from invoice of candidate placed. Only one retainer is

required per year, regardless of how many open positions we are recruiting for at the same time.

Fee is calculated at offer and acceptance of candidate chosen and is due in full within 5 (five) days of receipt of

invoice. Payment is due upon verbal offer and acceptance. If payment is not made on time as agreed, billing

fees, interest, and late fees can be incurred.

Retainer

Retainer is non-refundable. In the event Client hires someone outside of VetProCentral services, the

retainer is available to use on any placement within one year from date we are notified that the original position

has been filled.

Details – fine print is always necessary!

Signed contract and retainer are required to begin the search. Retainer is non-refundable. Signed contract

and retainer are required to begin the search. Retainer is non-refundable. In today’s market, we strive to offer a

superb candidate experience as well as meeting client’s expectations. With that, a streamlined hiring process is

essential when entertaining the best candidates available. We have adopted the 2/5/5 premise to achieve those

goals. What does that mean? With permission from the candidate, we will present them to you for consideration

after the initial phone interview with a VetProCentral team member. To follow, we expect a decision from our

client to either move forward with a candidate or pass within two days of submission. Thereafter, an interview

via zoom or on-site is to be scheduled within five days. Following a decision within five days of the on-site or

zoom interview, a second interview is to be scheduled or an offer will be extended. This hiring tactic is used to

give you a competitive edge against other practices. Our goal is not to rush our clients to an offer, but simply to

move the interview process forward and ensure we do not miss out on excellent candidates as they wait in the

interview pipeline.

Replacement Guarantee

Each Candidate placement is guaranteed. In the event a recruited and subsequently hired candidate is

terminated for cause during the first year of employment, VetProCentral will replace candidate at no charge to

Client. Guarantee follows title of person placed and location. The guarantee set forth in this paragraph will be

void in the following circumstances: (a) Client chooses not to replace the candidate; (b) Client decides to

promote from within to replace the candidate; (c) candidate is under contract for one year, and the contract is

determined not to be renewable by either party, prior to year-end or (d) the candidate is moved from one Client

location to another.

My response;

Jesus Christ. I would have to euthanize half of my patients to increase fees enough in the other half to pay for this. 

Insane. 

When you hear about the cost of care for veterinary care going up and the subsequent loss of access to care because of this, and, all of the pet adoring parents who will never get another pet again because they cannot afford to, please recognize your part in the landscape that vetmed has turned into. 

I just think it’s super important that we all share that responsibility. 

You are either a part of the solution or a part of the problem. 

May there someday be empathy for compassionate care again. 

This is disgusting. 

Krista. 

Earl, one of our rescues on his last day with us. He was adopted by one of our most beloved friends.
Here's to living the best life ever!

It will come to a place where this is really all, and only, about the money. Where only the rich can have pets, and only the richer care for them. There is a tipping point, a continent of opportunity for those with an entrepreneurial spirit to propel them, and a whole devastatingly destructive tidal wave of culpability to follow. If independently run veterinary practices continue to sell out to corporately managed investors at the rate they are the price for care, the salaries paid to do their bidding, and the death toll of those treatable cases will continue to rise. Who among us doesn't want to be paid more? Who among us wants to work harder, see more cases, and try to hold the line for ethical care at affordable prices against a wave that grows bigger, hungrier and more powerful? 

My adorable Seraphina. My muse, my salutation salvation, and my Why.

There is a cost for each decision all of us in vetmed make? I am bombarded by it every day. Today a person drove 11 hours to see me. He was afraid to go anywhere. Afraid his cat is going to die from a treatable disease that no one else wants to help him with. Eleven hours away I had to tell him that his cat was not treatable, savable, and that all he feared was about to unfold. I told him this for $500. The cost of an exam, blood work, xrays, radiologist reviewed, fluids, appetite stimulant, antibiotic, and a steroid as our last Hail Mary attempt to make whatever time she has left as pain free and peaceful as able.

I know he drove by hundreds of clinics who would have given him the same advice, for about the same price. I also know he drove by hundreds of ER's who would have told him he needed $4,000 to get started on his journey of futility and not been honest with him. He would have felt shamed in not being able to afford the list of recommended line items to punt his cats diagnosis to a specialist, in network, of course. 

Daisy. Getting ready for her dental.

I wonder if my end in vetmed will be left with me as the only DVM name on our shingle? 

There is a price for high wages. A cost to only providing care to the elite, the wealthy and the expected annual salary of $200,000 per vet and the 33% of that it would cost to be able to procure a vet from this agency. Veterinarians out in the world looking for employment hold great leverage and power. They expect sign on bonuses of over $50,000, annual pay of over $150,000, and every other benefit imaginable. While I recognize the great healing powers of all veterinarians, I also recognize that no where in any recruiter flyer, corporate descriptor, and "about us" website section is only about quality of care, work-life balance and income. There is not one single word, inuendo, or iota of responsibility with regard to the reason we all came here. There is no hint of caring, compassion, or the incredible magnetic force that is caring for these pets who hold our hearts, and now wallets hostage to the web of greed that we are engulfed within. There is no mention of how fulfilling, inspiring, and impactful it is  to save the life of a companion that ties another human to wanting to stay within humanity. The gift that I receive day in and day out in saving the savable lives, showing compassion to those I cannot, and never denying that there is hope for each one of us in even the darkest of days is the elixir to all of our collective miseries.

When will vetmed, and the powers who hold them in check, become honest about transparency with these influences? What I will call cost of culpability, be called out? When will moral integrity with all things that fall within the net of vetmed reign supreme again? When will the tipping points of treatable tip back from profitable? When will we all wake up from this catastrophic speeding train and recognize we burned every bridge as we transited to indifference?

From Wikipedia; culpability;

The concept of culpability is intimately tied up with notions of agency, freedom, and free will. All are commonly held to be necessary, but not sufficient, conditions for culpability.

A person is culpable if they cause a negative event and
(1) the act was intentional;
(2) the act and its consequences could have been controlled (i.e., the agent knew the likely consequences, the agent was not coerced, and the agent overcame hurdles to make the event happen); and
(3) the person provided no excuse or justification for the actions.^[2]

Every decision that I make as a veterinarian, a practice owner, and a human being, has influences on others. The meekest being the most obviously influenced. If I even entertained the idea of signing this contract with this, or any of the other recruiters, I have to pass on the expense to the patients I came here to care for. Period. The idea that the profits of the clinic not being passed down to the staff as unpaid wages is not present at this clinic where we post our prices, wear our hearts on our sleeves, and never shame based on financial limitations. We also are not afraid to try to save a life, even when we need to cut diagnostics to do so. We are honest in our mission, purpose, and compassion. It is not a tagline to infer trust that we simply break when you are not profitable to our business.

It is wonderful to have the newest, brightest, shiniest, fanciest, modern pieces of equipment, but if you can only utilize on a tiny segment of the patients who need them it is a detrimental restrictive asset. It is a choice to be the Bower bird and not the Asclepius we were trained to be.

Rio. My heart lies here. In the stories of these lives and the memories of a life rich beyond the measure of societies currency.

It's time to be honest again about why we are here. If you are a product of a sign-on bonus that compelled you to have to turn treatable patients away, and you told yourself that pets are a privilege, and that these patients with their treatable ailments, are "not your problem" because the CFO at your employers office will not permit you to try to find an affordable answer, then the issue with integrity lies at your feet. We are all responsible to help the animals who come to us in every capacity we are able.

One of the four blind puppies we have helped to rescue.
These are the reason we came here. Why this profession will always be more than a recruiters ability to sell, market and negotiate.

For more on this please follow this blog. Please find the real-life cases on my YouTube channel and follow along with us in our day-to-day lives on our Facebook page.

Remember we are all here together. We all came into vetmed for the same reasons. None of us will grow rich on saying no, denying chances, and killing for the profits that bankrolled the guys who never have to get their hands dirty. Who's side are you on? 

Goodnight Gwen. God bless all those tiny creatures who are still out there in need, and the souls who still find their lives valuable enough to see the miracles in the chances of just being kind without a balance sheet.