To Harry, The Best Cat Ever.

 "Harry was the best cat ever."

We ended the day, today, the last day of the year, on this.

Harry was a 16 year old debonair, distinguished, dark tabby dying from kidney failure, and all of the myriad of afflictions it brings with it. Kidney failure brings you a cascade of  collaterals. You are hungry, but too nauseous to eat. You are frail, but still want to try to jump up on the counter because in your kitty brain you are still a total badass, yet unable to gain any air. You are thirsty, drain the water bowl dry, pee out the buckets in piles voluminous and dehydrating, only to walk to the water bowl again, and again, to have the thirst never quenched and the march to the box never cease. You become tired from the anguish of your starving muscles from the anemia in your bones inability to replenish the red blood cells that let your muscles do your bidding. You fail in tiny stumbles until there is no wind left in the sails. Harry, well, Harry was the husbands cat, and the husband was in the car, to distraught to come inside to share in the goodbye.

Today was the last day I will be a veterinarian in 2023. Do I remember my fist day of 2023? No, but I will always remember today.

"Harry was the best cat I have ever had. I am 88 years old, and Harry was it." 

Harry's mom was short, quiet, smiling, gentle and full of pleasantries of gratitude that he was here with all of us, and loved. She held him for a moment, bent over to whisper that "you are the best cat ever," then kissed his forehead, and gave him a solid scratch under his chin. Harry was curled up, too tired to be afraid of the vets office. We stood nearby waiting for them to have their last moments together. Harry's mom wasn't remorseful about the days he didn't have left. When Harry was sleeping she looked at us and smiled. There weren't tears, nor fretful second guesses of hesitation. She said thank you to every staff member and left us with a laugh to replace the tears with her wisdom brought perspective. She told us how she had been coming to JVC for over 30 years. She told me that she first walked into JVC as a veterinary sales rep. She met Dr Wilson and knew immediately that this was the only vet clinic she would bring her pets to. She said that over all of these years this place was still full of love, and hope and kindness.

We shared stories about how Harry had found them, how they had found each other, and how much they all loved each other. 

Today was December 31st, walk-in appointments were from 1-3, an Harry was the caboose on the end of the year. The last patient I saw. The last person I shared the day with over the lifetime of a loved family member they would grieve and miss for years to come.

I had decided to open for Christmas eve, and New Years eve for the clients whose pets wouldn't make it the 12 hours ER wait, or the 24 hour closed day pause. For the patients like Harry. To be there on their last day is as meaningful, or maybe more so, on their last than it is on their first. The honor of being able to say goodbye to someone so loved they mark our life with stories that give our purpose placement. That was Harry.

As we all toast a glass to a year ahead I take a few moments to feel the weight and the gratitude that sharing little piece's of our most beloved companions brings. How can we walk forward with anticipation and joy if we don't remember what the past has brought us, or taken away. There is never a full cup without the vessels promise of empty and the chance to fill the cup again and start another day with the memories that made us who we are and how lucky we are to have been here. 

I set out to be a veterinarian all those many years ago to be a part of these stories. The happy ones, the sad ones, but most importantly the ones that remind us who we are when we put our whole selves out there to live every moment of the life we are given.

Rex, adopted 24 hours ago from a local shelter by one of our technicians.
The face of second chances and a better year ahead.
For Auld Lang Syne

Here's to you Harry, and your parents, thank you for being a part of every day that I get to live the best job ever. 

Raffles, my adventurous one

How Did We Get Here? The intersection of veterinary medicines needs and the professions gains.

I have tried to hold on, to not lose faith. I know I am not alone. I used to believe, heck, know emphatically, that every veterinarian came into this profession with the same common goal. We all came here because we loved animals in such a compulsory way that we would endure decades of schooling to help them in whatever capacity we could. We were pragmatic in knowing we could not always bend fate by sheer hopeful will, nor cure where disease had overtaken, but every so often some little wet nose would be saved by the hard work of our hands and the training of our mind. Vetmed was about this for all of us. Wealth from collecting and consolidating, or, fragmenting and focusing, well that was for the other white coats and their heart transplants and cancer ports. We vets were a humble, gritty, salt of the earth bunch. Quiet, yet trustworthy. Never a white coat spared for vanities sake. We were smelly, dirty, and proud of the badges of barn dust and species feathers we pinned in our caps. We boasted about having to be very skilled to fix a patient who didn't speak their ailments. We helped every patient who came our way. Each and every one of them, owned, beloved, lost, frail, unnamed, or otherwise was seen our duty, and our reputation on the line if we didn't at least try. We fostered compassion with every act of empathy. We were never too busy to be a beacon of hope in a world of cruelty. We were old souls that passed on our pearls of the profession from our weathered hands and thrifty resourcefulness to fresh faces of the next generations. We stood for the common man and their house pets inherent nucleus of the families whole. I set out to go to vet school to be this person. I bought my practice to perpetuate this long sought after lifestyle. I came into vetmed with all of this as our collective credo. The torch of quiet kindness for the sake of all the souls of the world we live within made vetmed the most honorable profession of them all. Without exception we were all cut, fashioned, and trained from this.  

Raffles. My Beloved kitty

I used to believe all veterinarians came here for this. The preservation of purpose. Perhaps we still graduate as this fledgling of hope and goodness, but, somewhere along the way the elevation of the status to pets being the glue and marrow of our all too complicated lives became so valuable it was extort-able, things changed. These voiceless, beloved to the point of needed beyond replacement value pets became fodder for greed. At some point it became permissible and acceptable to go to vet school at a price point the market could not support. With the incurring hundred of thousands of dollars of vet school debt, the corporate take over of the practices and the limitless, unregulated increasingly escalating cost of care, the professions barrage of whispered reminders that we are worth the six figures we command, the idea of being the one who cares for all as the oath we all took got lost. The profits soared, the costs climbed and the divide between the cans and the cannots grew in never before seen numbers. It became acceptable to place blame. It became permissible to deny care. It became excusable to turn the most needy away as we lacked the time, the willingness, and the empathy for them to make it worth our while. I don't know when that first denial to help because it was no longer profitable to even try happened, but it is now a systemic plague that has killed millions. We are part of this even if we can justify to myriad of reasons why. There is a shortage of veterinarians, and a squabble of people throwing obscene amounts of money at them, making it feasible by charging exorbitant amounts of money to feed the machine, and perpetuate the profession. We were once the place where all are welcome, all are cared for, and now we are the profession of the wealthy, or good luck finding help among the masses in the same boat as you are. I am going to tell all of those nameless, overlooked, dismissed and forgotten, broken hearted pet parents who have met the face of economic driven pet care that they are right. It is now very much about the money. If you are a person who loves their pets as family, spends most of your day insuring that your pets are comfortable and happy beyond the ability to provide the same for yourself than you have either learned this lesson, or will soon. If you are a pet parent who will need to hear the estimate for the cost of your pets care, and then have to negotiate for a higher credit limit to provide it, let's say you do not have $6,000 on hand for a 2 am ER visit, then you need to begin to plan for the ugly that lies ahead. Most vet professionals would insert a strong recommendation to get pet insurance. I will not. While I realize that the future of healthcare for your pet is not foreseeable to most, it is helpful to have some kind of financial plan. The hitch here is that you will not have access to this at 2 am when the deposit is required. You have to have an emergency fund of at least $2,000 and you have to be prepared before that fateful night happens, and you need to have insurance.

My Storm and Frippie.

I came into vetmed when every patient was given options to make them feel better. I came here when "tincture of time" and a pennies on the dollar analgesic plan was the norm. I came here at a time when vetmed didn't have access to the diagnostics, the specialists, or the corporate ownership and we saved more lives in spite of them. I came here when every pet parent was given equal access to our time, our talents and our unquestionable integrity. While it wasn't perfect, it served the patients with equal concern for their family. It came with generous hope, and unmitigated compassion. It was a time when euthanasia was only offered to spare an untreatable pet a suffering death. When equipment was purchased to save lives not bolster share holder dividends and entice/dazzle new talent acquisitions. We paid at point of sale, and never conceived of buying by marketing and passing the purchase price to clients in packages tied to services they couldn't opt out of. We were independent, privately owned, and working for the community who knew us by more than our credentialled monograms. We were faithful, devoted, and supportive of each other in a home-town baked-apple-pie way. I came here to pass the torch my predecessors granted me. Somewhere along the way we all decided we liked stuff, nest eggs, and the chasing of wealth more than the ability to be kind to all. We, the huge collective chasing the American Dream, we, all bought into this. We are all going to be reminded of it every time a life lies in the balance. What would you do if you were in our shoes? How many times do people tell me that they couldn't do my job because they would want to save them all? Where does the ability to chase the American Dream, profit upon the fruits of your labors, and the quest to get as much as you can meet the empathy needed to save the companions we call our lifes joy?

What Your Pet Wants For Christmas

In the heart of Macy's department store for the month of December rests a large red Santa's mailbox. It is nestled between the racks of clothes, flanked by flocked evergreen trees, and it is always easy to find as it is the center of the crowd in the middle of the first floor. I visit it each year as a reminder of how magical this time of year is to the little kids in all of us. The front mail door swings open with its traditional metal hinge melody so often it sounds like part of the caroling. Children, of every size, from every corner of the world, congregate here to mail their present list to Santa. Although I have never slipped an envelope into its red belly, I stop and watch as the other kids do. For each time that door is pulled open and the mouth of the North Pole is summoned to answer a request, I wish for that kid to know that the magic is always here. Not in a store, but in the hope of a wish put to paper. The feeling of anticipation that whatever you ask for might be provided. If you take pause, and allow yourself to be the witness to another's joyful excitement you will quickly be reminded about how sweet the gesture of writing a list and sending it to make-believe-land is. You can stand as an onlooker to this little spot of letters, wishes, dreams, and love and just lose the rest of the bustling patrons elbowing by. I always wonder what those letters hold. How many are asking for a toy, a doll, a childhood keepsake to mark the year in the timeline of a life that grows up. How many are for such basic wishes that no child should ever have to ask for. Food, clothing, a home to feel safe in. How many hold wishes like mine always did; a pony, a puppy, a bunny. Something alive for me to cuddle and keep safe. Some little life to love and be needed for.

How do you do a thoracocentesis?
One of our rescue kittens getting treated by my team.
Giggles are always on the schedule.

These days my life revolves around the little lives my home calls its heart. I have 5 cats, and two dogs, and I will admit with 100% honesty that I spend every day asking myself if I have fulfilled all of the items that they would have penned in their letter to Santa. They always have the basic needs of a cat or dog at their toes. The basic is food and water, a warm place to sleep every night, but the wishes meant for Santa's ears, they are the items that I ask myself if I am providing.

So I thought that this year I will share what I think my pets would ask for, should Santa remind them that their Nice days outnumber the Naughty.

Wren is the cat I call my beloved. She is the first one I go looking for at bedtime if she isn't already purring at the top of my pillow. She is aging, and less finicky. Less likely to call out in alarm when she hasn't gotten her way. She lets the kittens plow past her and grumps with the expiration of an old soul who hasn't got time for shenanigans anymore. She is wise, adored and Queen. She bows to no one, and puts up with even less. This year we got her a heating mat that has 10 settings, (she prefers 3), and we set it for 12 hours. She also likes her water changed daily. We keep a glass by the bed, and she prefers options even in this. It is more likely that she will drink from my overnight water glass, a tiptoe at a time to scoop it from the glass to her tongue. Even in this we share everything. (I know not to drink past bedtime). She prefers fresh plants in winter. It's too cold to go out for a green nibble. Reminding the housekeeping staff to bow to her as they pass. 

Wren

She has a window sill of her own. Packed with a bed and blankets. A perch to see the sunrise, and then set, and monitor the critters of her kingdom. For cats, every single one of them, this perception that they are the apex predator, the indisputable badass of their kingdom, is paramount. Every cat needs to feel they are free to make choices. Free to have opinions, and able to execute commands at whim. Finding your place in your own home when you are their servant is the key to an equitable, honest, and amicable life. Your cat always needs to feel that they are in charge, and this will not be threatened. It is part of the reason that there is a critical mass threshold for multi-cat homes. That one extra cat too many that tilts the apple cart and leads to marking territory, cat fights, and stress in the multi-cat home. She is the constant comfort for all of my days. The one who purrs when she sees me. Takes delight in me just being near. She is the epitome of why we all sacrifice so much for the pets we call family. 

Birdie

My two rabies quarantine kittens; Raffles (short for the state bird of Pennsylvania; the Ruffed Grouse), and Birdie, (the state bird of New York; the Eastern Bluebird), are wild, crazy, pure kitten energy rambunctious. These days my husband is retired. The two kittens follow him like ducklings, always underfoot. They grew up with the puppies, Frippie and Storm, and seemed to imprint on them as much as us humans, so they follow the dogs in and out for the am pee and the before bed bathroom. Unlike the dogs who stay wherever we are, they decide if it's time to come, or go, and beckon their wishes with long drawn out meows fit for drama soap operas of the B-rated variety. My husband stands near the door and opens it slowly for the kittens to come and go, based on which side of the door they scream from. He will stand their like a doorman and say, "I do this all day," with a prideful subservience only a parent could admit to. Their new favorite fancy is feathers. My dear friend Kim gave us a handful of her peacocks plumage and they have systematically disemboweled each frond. The confetti of a killer spread across the living room floor. Life for a kitten is easier, as long as it is quiet, safe and has ample food. They make the simplest things fun. You just need to remember their energy threshold requires they come in pairs.

Raffles

The dogs; Fripp and Storm. Two peas in the pod who could not exist without each other, even though they are so different. There is a firm two dog rule in this house. Two dogs to keep each other company. Two to play so hard during the day that they sleep well enough through the night, so their already exhausted mom can go to sleep as soon as she gets home from work. This couldn't work if they didn't have each other. Their Christmas list to Santa would very likely include a wish for the other. They are this couple. They would only ask for more time. More time together to go on long walks. Walks where they lead and decide which trail to follow. Time to find that ever elusive squirrel and finally make peace with the pursuit. More steak dinners. Fewer vacations for their parents that involve planes or trains. The kind of vacations we take with cars allow them to go, therefore they prefer these. They are family and they expect every family vacation will include them. They are greeted every morning by a whisper of a "hello" that allows them to jump on the bed and curl up on our pillows. They insist that bedtime follow the same principles. Every day begins and ends with a bed in the bedroom and a wish for a peaceful night of dreaming about the adventures of tomorrow. These house fellows of ours never want for more than time together. It is the most sincere wish for Santa anyone of us could ever desire.

Storm and Frippie

Here's to wishing all of you a very Merry Christmas and a holiday season where all of your time is loved and treasured with the family you call yours.

Pets With Santa 2023

If you need some hints on what your pet might want this Christmas, think about these;

- a place to call home. So many pets die in shelters, and so many others still live in horrific conditions breeding the puppies of the internet sales ads.

- a person to remind them that they are loved. We all deserve this.

- the gentle acknowledgement that they are the most beloved being in the world.

- a warm place to sleep.

- a collar (dog only) AND a microchip that says "you are mine" (and the appropriate contact information).

- a place of their own. We all need a place that is exclusively ours. A bed, a perch, a cage, a corner, a space.. a bathtub and a vanity (if you are me).

- current vaccines for the appropriate place you live. Nothing, no one, not one living being should die from a preventable disease. Watching a pet die from parvovirus, rabies, a pyometra, the list is exhaustive, the mental pain, and the enduring heartbreak these bring, is avoidable. Why are we still begging for this?

- spayed, neutered, and putting the life of your pet above all else. (Breeding them puts their lives at risk, and we already have too many unwanted pets in the world).

- a walk everyday that is just for you, (I am talking to your dog, but, I know lots of cats who love being outside safely. Maybe consider a walk with them too). We don't walk a dog to go from point A to point B, we walk them so they can get out, stretch their legs, employ their nose to investigate a world of scents we can only imagine. Let your dog do the walking, just be the chaperone.

- a catnip station, toys, water fountain and feathers. How about indoor cat grass year around. What does your cat love to get their claws into? Do you think your cat feels like they are a guest in their own home, or do they think that you are?

- photos on the wall, the mantel, the wallet, all of the places where terms of endearment lie. Doesn't everyone have their screensaver set to their pet?

- cats need lots of choices for litterboxes. If you have four floors in your home, and your cat has access to each of them a litter box on each is a sign that they are welcome. Also, choices are important. What if your cat is afraid to get in the box with the lid, or can't quite manage to jump on the top to gain access? Think about your cat aging, and struggling with the joints? Who wants to debate a painful poo?

- dogs come in every shape, size, and demeanor. Some are highly social others just want mom and dad, and don't need anyone else. Maybe a gift of learning to allow others to have value is a way to ensure that your pet has options outside of you and your life. Dogs are just like people. Aren't we each our own individuals?

- remind your pets that they are the most important part of everyday. Say "good morning!" Say "I love you!" Or, say, "you are the most beautiful girl in the world!" it doesn't matter what you tell them, but acknowledge them every time you see them. There will never be another life who loves you so devotingly. 

Spend some time thinking about how lucky you are to have your pets. How lucky are we to have each other. 

Happy holidays to all of us who love the pets we devote our lives to.

I want to hear about your pets list to Santa. What would they wish for?

Cheeto,, another broken kitten who needs us..
He will have half of his tail amputated tomorrow.
He came to us with multiple injuries,, and his story continues.
He is loved and he reminds us of our purpose.

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.