How Rich Is Too Rich?

The question I often ask is; How rich is too rich?

There isn't is there? Isn't that what we are all expected to say?

"You go get whatever you can. Build your empire. Have it all." It is the country's theme song.

..until you see what this breeds. In vetmed, one of the newest frontiers to wealth, (who saw that coming?), there is no limit. The price point to everything is escalating. It seems to have no boundaries, just an endless horizon.

Dixie. 141 pound St Bernard with a 5 pound pyometra emergency that was $6,000 at the ER.
Our community posted her story and raised all of the funds to pay for her surgery.
She is alive because enough people cared to make it happen.

Twenty years ago I graduated from vet school. The vet school was nestled in a rural, deep mountain, poverty stricken area. The small animal practice I used for my own pets was in the very rough, country, mountainous landscape of deep Western Virginia.  I was a fourth year vet student in need of a tape worm medication for my elusive, reclusive, outdoor-escape-artist had found it in her heart to deposit flecks of white undulating larva on my bedspread that morning. I called, asked politely for the medication and was told to come down shortly to pick it up. The vet clinic was a bustling, wood-walled, throw back to 1970, the early edition. Orange counter, long ago broken glass partition and a matronly woman long absent from etiquette class restrictions handed me the tiny envelope of praziquantal. "Fifty-nine cents." she said when I asked for my cats medication.

I stood at the check out window dumbfounded and paralyzed. Surely she had gotten this incorrect?

"What? (long odd college student perplexed shock). "How can that be?"

She didn't look up at me. She sat multitasking the phone ringing, the busy waiting room. She was as sick of college students as the rest of the full-time residents in this mega-college stuck in the mountains.

I persisted. "Isn't there at least a dispensing fee?" Here I was arguing the best example of poorly managed vet practices. She wasn't amused. 

"Don't you understand that your salary is a reflection of this sale? That the only way we can bring the earnings of veterinarians up from exchanging chickens for pet care is by adding a dispensing fee to all of the medications you sell?"

"It's still 59 cents." 

I rifled through the change in my wallet and produced 2 quarters and a dime. "Keep the change." (Put it toward your 401K, I whispered. Smart-ass senior vet student one arm fisted protest in the air as I departed. Slightly proud of my college student frugal gain.

Scooter. Dying when he arrived. We managed him in the hospital on a diagnostic restricted plan. He is thriving now. His parents just needed help in managing his care. Help can come in the form of listening, donating time, asking for medications from the manufacturer reps, and just basic medicine.
He is 3 years old. He deserved this chance. He is a purring, biscuit making miracle. The first time I met him I fell in love. Every moment with him was an investment in my self worth. He reaffirmed my dedication. There is no price for that.

I bought Jarrettsville Vet a year later. It was a win-win for both parties. I am eternally grateful to have bought a clinic from someone who wanted it to keep its heart and soul alive. It was passed on to me to be its guardian. I truly feel that way. There was a decade of catching us up to speed on basic goods and services and the cost and value of them. I remember cat neuters being $15. They were real down and dirty raw bones. I was proud of that. Getting a Tom off the streets to help curb the tide of unwanted kittens was my singular goal. Profitability would have to come from another aisle.

Yesterday the neuter for Bo, a 7 month old male tuxedo cat was $187. It included being intubated, on general anesthesia, pain medication, a local anesthetic block, post op fluids, and an antibiotic (his siblings all have upper respiratory infections and he sneezed twice after his neuter). I am still really proud of that price. I don't know of any other for profit clinic that even considers turning on isoflurane for under $300. He was pain-free and given 5 star care. He had a well trained surgical technician with him the whole time. Further he was cuddled and loved from drop off to pick up. 

The standard of care for all pets has consistently gotten higher. The prices we demand for this has also increased. The blossoming of specialty care, the multitude of avenues that pet parents have available to them for their pets has also become accessible. There are specialty hospitals for dialysis, transplants and the equivalents to the most costly aspects of human medical interventions. It is truly astounding what your rescue cats and dogs have in the way of medical care, if you can pay for it. There are specialists topping 7 figures. It is not uncommon for a pets care to be over $20,000 at a specialty referral center. Whilst our portfolio of options for care have grown, our compassion for feeling ethically obligated to provide universal care has not. I would add that the perception of offering care to all simply because we can has diminished to a shockingly scant level. There is a pervasive feeling of pets being better off dead than lowering our profit margins to assist in their chances to survive. (And lets all be real honest here, those young cats survive against all odds with the most horrific injuries. Don't we all remember the meme about a cat broken in a million pieces and a paper bag? 

The vet school teaching of this goes something like; "Put a broken cat in a paper bag and forget about it for a few weeks and it will heal." After 20 years of practicing "save them all" medicine, I will tell you that it is true. The ones who die do so because of parasite anemia, bombarding of infectious disease, and a very very few from congenital defects. Of these the congenital defects are the only ones who should be dying. Modern medicine doesn't need its fancy modern frills to save the others. Heck, they may not even need medicine. They just need someone to care enough to help.

We are living in a time and place that breeds more selfish indifference. It is as deadly as anything else modern times will ever face. Every single human being needs to be asking themselves what every single veterinarian does with every case that we see.

My kitty Raffles. My constant, at home reminder of who I am.

Is this life worth saving? Is the question about why we shouldn't ever more than the money we need to encourage ourselves to answer this question with kindness and compassion in our hearts? And, what does this answer say about humanity and our part within it? 

Wealth, well, I suppose we all have our own definition for this. Me, well, I am just as wealthy as I was when the cost of a dewormer was 59 cents. I just didn't realize it until now. 

I was only poor when I saw the glass half empty. The really sick kitten as "replaceable" and "unwanted." I was only poor when I let the world remind me that this vulnerable soul of mine was for sale for a salary of someone else's profitability.

Shouldn't we all be asking the same questions? Isn't too rich that place where your ability to have an ethical compass is lost? I think that too many people in vetmed, and most professions, have lost their ability to be inherently wealthy by virtue.

Seraphina. The rest of my everything