The months within the abyss never clarified the question. Was the sense of abandonment worse than the sense of loss?
Twenty five years later I still can't find the answer. All those many years ago, when I was the new bride with the husband asking for divorce I couldn't answer this question for myself. Would it have been better/easier if I had been grieving over his casket. Widowed, alone, and yet everyone would know my story without me actually having to mutter the words aloud. Sparing me the humiliation that his truth held. I could have had a life again. Someday. Sure, I would have lived in the shadow of our wedded life contracting so fast. Being so fresh and small then wiped away cleanly. The nuptials of a black holed loss. Our life together compressed with so much into so little. A proverb of a marriage story. Just a few sentences; we came, we tied the knot, we died. The End. But, nope. Me, my marriage, this story, had to have mystery. Intrigue. Substantial tabloid worthy dirt to smear with shame, horror, judges and public notices. Mine had to have an arrest. A secret charge for child endangerment. A pregnant teenager. A mother of same said pregnant teenager who called our house aghast at the thought her daughter was capable of complicit consent.
He had left before. But, he always came back. When he left for good I realized he had only come back as some sense of pity. Imagine that. He pitied me, and I was the one with the clean record. Nothing more than guilt kept him. After a few weeks not even that was enough. That's a slap in the face with a reminder to listen the next time. Listen to what people tell you. Not only to what you want to believe you hear. I hadn't heard him the first time. I hadn't wanted to.
While you watch other married couples around you treat their spouses far worse than you know you ever treated your ex the truth remains that they never left each other and yours did. Yours did it in everyway to make it feel soo atrocious you lost your own identity in the mire.
All these decades later I am not grateful for the time my ex-husband and I had together. I am still fuming from the way he left. What shit came out of that departure. My dogs and cats, the dozen plus little lives that I have lost within this same time frame, well, I am still searching my insides for those little pieces they took with them from the weight of their loss. I miss every precious moment of everyday I had with each of them.
Frippie in the poppies. (Poppies seem appropriate, right?)
At a continuing education conference a few years ago. Three of us sat cross-legged on the carpeted floor, all hoping that it didn't have as many germs as we knew it likely did, eating our bagged lunches. I, always the oldest of the group of my vet school classmates, had by this time, owned my own vet clinic for about 17 years. They, they were 10 years younger and about 14 years shy of my ownership anniversary. New to the game, still optimistic in making all of the pieces fit, sat and talked about motherhood, toddlers and juniors of their own, and finding that elusive balance to it all. Me, I ate. I know better than to offer unwanted, pessimistic advice or lessons. They had loads of questions about bookkeeping, scheduling of staff, adequate staff to veterinarian ratios, payrates. Marketing, websites, inventory buying power, and cases that seemed too odd to be real. Their questions required minimal time to answer. They were most inquisitive about our internal slush fund, its use and my unwaivering dedication to treating every patient who crossed our threshold. They asked many questions. The one that I had learned and they had yet to feel first hand was that one lesson that time makes truest.
"What's the hardest thing you have been through so far in owning your clinic?"
"Heartbreak. The cases can be difficult. The acceptance of life just not being fair. But, the hardest part above all, without question, is the staff. They will break your heart. You won't see it coming. You won't be prepared for it when it happens to you. You will question everything."
Its bereavement in shades of grey.
Frippie, cold Sunday at home.
The stickiness of this, my own veterinary clinic, is the same glue trap of my existence. There is such great emotional depth here that it is impossible for it to not bleed into every other moment of our lives. It is the same canvas that paints a families portrait. Dysfunctional, adoptive, ugly with infighting at times, yet still all coming together in times of disaster, trauma, and need. We are that bunch. Proud as I am to have them all home for supper, each with children of their own. This clinic, our veterinary hospital, has weathered storms. Tragic deaths. Departures from unforeseen epidemics. Boyfriends, babies, and ambulances. Waves of changing tides, yet still trying to stay the same course. I have to be the one to leave this time. Abandon the web in the hopes it doesn't force exodus to those that remain behind. If I can logically see myself as the common denominator to all of this then maybe the problems solution remains in the crossing out, cancelling of the common thread? Afterall, excision is curative in so many other cases.
Storm, also never sure of much.
"What do you want to do?" My husband sat quietly across from me. Worried about not being there for me as much as saying the wrong thing.
"I just want to be a veterinarian, and still have a little time left for the rest of the life we amassed." Our house, now finally done. The cats and dogs all healthy enough to not leave me counting days, and pills and obsessing over calories in, weight loss out, and the pennies in the 'good day' versus 'bad day' jar to help measure the quality of life scale.
"What are you most worried about?" He loves to live here. In the doubting-Thomas shoes. The red spiked tail and pitchfork always at the ready in his back pocket.
"I am always to blame." You cannot feel anything other than this. The imposter friend. The imposter boss. Never truly a part of the group. Never in on the inside scoop. The pulse of the practice. Always aloft in the crows nest looking for a speck of dry land, or, the iceberg. Sure both are there re-plotting their courses to intercept yours. The sweeping line leading to the bullseye dead-center on your radar screen. Game Over. You know you will go down with the ship. They won't save a seat on the lifeboat for you. They never even counted you into the articles.
I left the conversation with my business partner/spouse/wise old owl that he is, with this. "I understand now why Dr S and Dr L just walked away from their practices. They had no other way out. They hadn't become different people. They just couldn't stay trapped within their own prison any longer." I am not sure he heard me. It wasn't a nugget of information for him anyway.
In the end you will find yourself alone. Life will remind you periodically to get comfortable with this. It will remind you to be at home in your own heart. That people will tell you who they are. It's up to you to listen. They will come, and go, and try to come back again. You might not be the same person the second time around. It's up to them to listen to that person too.
Serfina
Me, well, the animals, the pets I adore, the places I always invested my whole heart within, well, they never broke me. They might have stolen my heart. Sent me into grieving as violently as anything else ever dared to, but they never broke my heart in a text message or email. Humans, they are the glue trap you will chew your own arm off to get away from. They are the ones you have to become at home with indifference over. There are people who come and go. They don't have a calling card to notify. They have a history of half hearted attempts. Broken wings. Fledglings who keep flying to a different nest, but, never set up a home. Well wishes and bon voyage. What else can you do?
It has taken me forever to learn this. I am never the person to leave. There are cobwebs on every facet of my existence. I don't know if I am the wiser or the poorer for this. I just know I am still here. Roots, legacy and epitaph intact.
This is a blog written in response to a meeting I had with a group (I'll call them Joey's Group) getting lots of attention in both the private arena of veterinary medicine and the many veterinary groups where vets seek shelter from the too often cruel world we live in. Pet parents who feel their pets suffered at the hands of their veterinarians are growing angry to the point of building support groups centered around their pets injustice. I contacted them to try to understand their feelings and thoughts as well as try to understand their advice on how to resolve the injustices they feel are occurring. I also feel that I align with their pain more often than the vet forums my profession has created. I love my pets like they are children. My life is devoted to them. Losing them is an unbearably painful experience. Trying to imagine how that grief would change when I believed my pets loss was due to malpractice would probably make that pain morph into anger fueled by seeking retribution just so they could hurt a little bit as much as I was. This group wants more accountability, more legal means to seek compensation, and license consequences much harder and easier to obtain than presently found in the veterinary leadership. These members are hurt, angry, and now organized and seeking vengeance. Here is my attempt to introduce the difficulty that being a practicing veterinarian in this climate presents. This blog is not to chose sides, it is to attempt to inform based on my life's experiences.
Our annual vet clinic Pets With Santa photo
I love my pets more than anyone could imagine. I also know that when it comes to that time of losing them it can cripple you. I have felt as so many of us do; that no one can understand my grief, my loss, and that only I can feel my palpably paralyzing pain and suffering. What do we do when the grief is so consuming? We either fall into ourselves as the introvert and hole up with the hopelessness so it drowns us in despair that feels too suffocating to begin to contemplate addressing, or, we lash out. We use our anger to fuel the pain of the grief that we know we must do something about, but, don’t want to lay up all emotional over. Putting that grief to something that makes a difference, fuels a purpose that gives that life you miss so tragically meaning, well, that’s the harder, longer more arduous path.
I wish that I could tell you I consistently chose the last. Unfortunately, I am a mom who has tragically and utterly bereft with grief in losing my two beagles, and my dear diabetic cat who (almost) broke me. To make their death even more bitterly corrosive I feel that I can only blame myself for their passing. I am after all a veterinarian, shouldn’t I above all others be able to make miracles happen? Isn’t that the reason I went into vet school to begin with? I dedicated my life to them, my career, every tiny tidbit of my professional knowledge base just so that when the time came that I needed all of those tools, resources, pearls of knowledge, I could bestow all of it into some cumulative tsunami of healing re-genesis. My kids, my dear beagles, cats, (and yes, two potbellied pigs), were, and, should have lived forever because I have spent every moment of my life to make that so.
My Storm. Who saved who? Rescued before minutes before euthanasia. He had just been surrendered to a NC shelter who was about to kill him as they all evacuated an impending hurricane.
Of course, life is that elusive magical thing that only insures one other thing; death. We are all going to die. That inescapable ending looms for all of us, even those of us who deny it.
What do we all have in common? How do we start to understand why I react, or not, so differently than you? We all love our companions as our own family. We allow ourselves to be vulnerable. It destroys us when that leads to heart break. My dearest friend lost his mom and his dog within 4 months of each other. What hit him harder? His dog, he confessed. I just last week lost my mom after a swift devastating 6-month battle with breast cancer. I have also lost numerous dogs, cats, pigs, and although each one reduced me to a puddle of emotional waterfalls, but my moms’ passing lingers in a different way. I can’t even quantify one versus the other, but, where grieving fatigue burdened by responsibility pain struck me with the pets, I am angry-furious about her loss. It is a different kind of anger that I didn’t have with my pets. Why is that? Well, because in my mom’s case I wasn’t in charge of medical care. Her medical team (all 20 or so of them) smiled, held her hand and then went on their merry way to their next patient. They gave paltry advice in dribbles of meaningless drops, and in the end, they failed her a million times over. She died in pain because it was the only way to treat her relentless and excruciating pain effectively. Palliative care was an afterthought. I say that because for 5 months her biggest single request was help with paralyzing pain. Always too little too late. I blame them not for her cancer, but for her suffering. I have lived a life as a practitioner never exchanging one for the other. Palliative care is as much apart of every treatment package as antibiotics and vaccines. They are interwoven, interdependent and unwaveringly provided upon each other. Diagnostic tests, referrals, care in all forms and fashions ALWAYS comes with the patient’s comfort placed first and foremost. Her doctors wanted tests with answers before focusing on her pain. When asked what she desired most she would reply every single time with the same singular answer; "help with the pain." They got all of their tests, (which took forever as she suffered), and she was only pain free for the two weeks before her death. Furious, unethical, malpractice. She, and all patients, deserve better. So, you see I understand loss and grief, and yes, blame too. Where do I go with this? I make my decisions as a veterinarian with an open honest heart. I remember with each patient that my job is to serve them, my furried calling, (the puppies, kittens are the ones that break you). You see as veterinarians we have to serve multiple parties. Too often I have to make an immediate on the spot and under great duress choice about loyalties. In some cases these cannot always be to serve my clients, the people holding the leash as their motives are not as transparent. Human motives are complicated, sticky, and it makes me incredibly vulnerable to try to unravel theirs as I try to focus on unraveling my patient’s needs. Add to the burden of paying clients seeking care that is not always putting patient needs first, I also have to answer to public health threats and law mandated requirements. I truly have to decide who outranks whom. Do I put the patient first (my heart always does), the government public health requirements (ever worried about whether your life is in danger because you might have been bitten by a rabid animal? What about the four year old kid that was?), or, the client who is abusive and threatens you if you don't give them what they want? (Ever gone to court to get a restraining order on them because you really fear they will show up and unload an automatic weapon on the whole lot of us?).
I want to end my moms story with a few thoughts. I went with her to every appointment. I brought every concern to their attention. I asked my mom at every interaction “what her goals were?” I never, ever let them lose sight of her in their process. I have a very clear conscious about what my intervening on her behalf brought us. She is not me. I fight. She wanted to be comfortable. Do I wish I had mettled with her medication plan? Yes, I would have adjusted it every 3 days when it failed to deliver. I would have put my license in jeopardy as they were unwilling to do with theirs, (I suppose?). But she would have passed away sooner, which would have been my choice, it wasn’t hers. I have to forgive for the things I cannot change. I am working on it.
My pups. My life.
There is a bond we have with our pets that elevates them to children, best friends, companions we fear we cannot exist without. That’s what all we have in common, you, the pet parent, and me, the veterinarian. That love, devotion and companionship drives us to madness, feeling broken, shattered unable to go on without them. It is loss at its most intense and we try to replace that loss with suffering elsewhere. We try to blame. I live it, I know it, and I also know why I do it. But, I also know what it is like to live a life as a veterinarian who feels vulnerable because I am a human. I make mistakes, assumptions, and I am asked to be someone I am not too often. I am not everyone to every case. Human medicine is built upon referrals. Clear defined lines in the sand with boundaries. My mom was shuffled to the point of being a patient under numerous specialties; oncology, surgery, nephrology, general medicine, and even mental health. She was not my mom for those few minutes in their office that she waited weeks for, no, she a time slot and a quick visit, then shuffled to the next hat in the next specialty. All of that fractured care meant not one of her medical team was personally invested. That’s what veterinarians never hope to be, and yet, pressures dictate we must too often.
My Fripp. The girl who reminded me I could forgive, move on, and love again.
Perhaps this all sounds foreign to you? Let me try to explain how different it is to be a veterinarian in a humans world. This is how your vet sees you and your companion in a time of medical need;
•Established client-doctor relationships. Does your vet, or this vet caring for your pet, know you? How can I if time hasn’t provided the luxury or history? I am incredibly blessed now to have been at my practice for 15 years. The first five were painfully rough. I wasn’t the vet they were used to. I wasn’t the old charismatic-charming-congenially and perpetually smiling guy they had know for over 3 decades. I was the newbie. Which pretty much equates to "worthless". Having the advantage of knowing your clients allows the assumptions (the deadliest part of this profession) to be a little more palatable. For example on an almost constant basis I know based on previous experience how each particular client values their pet(s). I adjust my internal and external patient plan based on this.
•Value is influential. I suspect that based on knowing and being a part of Joey’s audience, it was the most influential factor. If your veterinarian had known what the value your companion brings to your life it would have, (might have?), changed everything? If your pet is your life tell your vet. Ask for "gold standard" of care. Make it public knowledge that your pets life is of paramount importance to you. You may assume that everyone feels this way about their pets. That everyone thinks the sun rises and sets on their whiskered wet nose, but, believe me they don’t. Here’s what you don’t know. Loads of people do not love their pet as much as you and I do, or, even a tiny fraction as much as you do. Or, they have struggles in their lives you cannot imagine, nor perhaps even relate to. If I know I cannot be the Jack-of-all-trades to every patient don’t I also know that I cannot be the vet to all people? Should my absolute requirement to keep my business alive, which is also the lifeline to my staff, influence who I am for them? Do I take on cases I know I want no part of? Can I afford to do that? Decades ago it was expected that every vet take on every case and you that you adapt to the clients needs and demands, and, you do it without judgement or personal reflection. The vet I bought my practice from was beloved. I had shoes impossible to fill. I was lucky enough to not need the same degree of financial stability most other new practice owners, and, new graduates, need. I got rid of (yes, harsh term but true), about 30% of his clients because trying to be who they needed me to be was going to kill me, or, at least bankrupt me emotionally to the point I would have to kill myself (in some degree) or walk away from the part of me I had worked forever to manifest. He was the vet to everyone regardless of what that meant to the patient. He had clients who wanted to euthanize because it was cheaper to "just buy a new one." And so he did that. I am not second guessing his decisions, I am merely saying I couldn't do what he did for the reasons he did them. He never lost a client, I never euthanize a treatable patient. There is the right vet for you out there. I wasn’t the right one for part of the population he called his own. Maybe it would be helpful for every client to know their vet as much as they love their pet before disaster strikes? Understanding a pet’s emergency warrants a referral to an emergency facility. Understanding that they don’t know you, or your companion warrants a willing ready and able compromise that you are going to pay twice as much at the ER as you will almost any other general veterinary practice. Being honest implies a degree of humility that all sides are arguing for more of.
•Money decides almost every case. There is almost no pet insurance in this country. Humans can walk into any ER at any time with any condition and they must be treated. Not so in vet med. You walk in and you are expected to pay. I can tell you that most clients decide patient care (even for their most beloved companions) based on price point. If you have a price point you are obligated to state it up front. If you don’t have budgetary limits go to a referral hospital at every occasion that your pet is not acting perfectly normal. It may not seem intuitive but let’s use human medicine as the example. Asking your GP to see you when you are vomiting/diarrhea blood, or poorly responsive, or purple, labored breathing, weak, unstable, etc., is ludicrous. You know, at least I hope you know, that every single human medicine receptionist and answering service in the country starts with “if you are having a life-threatening emergency please hang up and go to the ER” statement. For all of the veterinary audience expecting human grade care go to the ER, not your vet, at the onset of an emergency. You will absolutely need immediate access to funds. These days you should expect an upfront deposit of, up to, and perhaps significantly more than, $5,000 available on credit cards or in cash. Do you have that if it is 2 am on a Sunday morning? The expectation that your companion is your life and we veterinarians are all about the money leaves us no place to move forward cohesively or productively. This is the dilemma vets face every single minute. Invested and devoted pet parents want the highest standard of care, but, they cannot, or too often, will not, pay for it. Try being everyone at every price point to strangers. It’s a landmine field of fear-based existence. It is one of the many reasons we have the suicide rate we do.
•Blame the other guy. The best way to understand who is to blame is to accept that we are all party to the case at hand. The rest of the hurtful banter is fuel for litigation. Where most victims feel that they had no party in the disastrous consequences that unfolded I can say from experience that losing a pet is not always unavoidable, but, if all parties were respectful, kind, patient and willing to listen the outcomes don’t need to scar everyone indefinitely. Medicine costs money to access and provide. I often have clients come to me with an open admission of having “$50 only" for care. The exam at my clinic is $45. Can anyone really expect a treatment plan for $5? Yes, they indeed do. Where others would say it is impossible, I would add it is my ethical obligation to try. In all cases of a client with a pet in need every patient is seen. After that an open honest conversation is had. The truly compassionate people will listen. The others get angry. Here is how these real-life cases unfold. For $45 dollars I perform a thorough physical examination. I am obligated to give my honest assessment. I rarely know the diagnosis by an exam alone. I then offer my diagnostic plan and proposed treatment options. A list of all of these are made with the appropriate cost estimates for each. If everything needs to be declined we focus on the treatment options. If all else fails, i.e. we cannot find a friend to help financially, we construct the best plan possible based on the options at hand. I will write a script to be filled at a big box store, or, donate to the cause myself, or, use funds from our Good Samaritan Fund, or start a social media campaign (with permission of course), or even offer to have the pet surrendered if the cost of care and, or, follow up care is believed to be too great. What often happens? A client gets irate. I hear things like, “I am all about the money.” Which I clearly am not if I let them come in the door with only $50. Or, worst of all, “I would rather have him dead than with anyone else.” Well, doesn’t that let me know how invested you are in your companions life? Those are the people I know I cannot help. The anger will kill us all. It makes it hard for me to like what I do, hard for me to remember where my allegiances lie, and hard for me to find that common ground. Anger will be the death of medicine. Not malpractice, not mistakes, liability or standard of care. Anger. You cannot love and let anger rule. Think this isn't really true? Meet Mufasa. He is at my clinic now. More on him here.
•Mistakes happen. People aren’t prepared for the emergencies that present. (That is the clients fault, right?). They aren’t prepared to make on the spot hard decisions which have to be made because pets aren’t people and the ER cannot provide care without consent. (Which we should add would also influence your ability to euthanize when you feel "it's time"). My mom, well, I wish she had this option. Suffering is something that should only be saved for the human who elects it for themselves. We've already discussed how people are expected to know things they cannot know; like whether you love your pet above all things. Whether you can care for a sick, debilitated animal, and whether you will walk away from telling the vet “to do anything and everything possible” and not feel like your vet profited from your pets ending in suffering. Who makes these mistakes? Are they all based on assumptions with unrealistic expectations influencing a vet to offer any and all possible treatments, even if they think your pet is going to die anyway? There is a consequence to every action and decision. Isn’t it more honest to say that both parties are responsible for a pets care and eventual outcome. Vets love to use the line “if you cannot afford a pet you shouldn’t have one.” Or, “having a pet is a responsibility, not a right.” Both are so offensive they drive a wedge of hatred into our clients we ask to trust us. Both are so counterproductive to both sides we must abandon them.
•Resilience. Why are the vets so cold and callous? Well, because life, our ability to survive, and I use the tag line all the time, “we all have to get out of this alive,” depends on our own resilience. Try euthanizing a treatable puppy because its owner knows its cheaper to euthanize than treat, and that puppy has about a $50 value to them. What would you do? Let’s add the fact that if that owner tells you to euthanize you have two choices, euthanize and harden your heart so you don’t have nightmares for the rest of your life, or, say no, and imagine it being drowned in the bathtub at their home. Which by the way is legal, and/or at least almost impossible to prosecute. Most vets know the death at their hands is far more humane, so we do it. How do you feel about our life choices now? Oh, and for all of you delusional Polly-Annas out there, I always, (ALWAYS!) offer to take the pet myself. Want to know how many people take me up on that offer? Less than 20%. They are offended. That makes them feel like they are a shitty person. They would rather have a dead pet than feel responsible.
•Abilities. Do you know how hard, like impossible it is to be the Jack of all trades? How can you be the master of any while you are trying to wear all of them? This expectation is unrealistic. A good vet will try to dabble only to be able to recognize when it is time to refer to a specialist. Think there isn’t a can of worms with that? You would be wrong. Many clients will become irate at the mention of a referral. Why would I dare assume that they can afford that!? If I can’t fix it, then, it isn’t going to be fixed (thanks for the pressure). Or, (and this is the excuse I most commonly get) “Doc, I trust you. I don’t know them. I don’t want to bring Fluffy anywhere else.” To which I always reply, “thanks, but we are here to do what’s best for Fluffy. She will be better served by someone who only focuses on this particular ailment.” What I really want to say is, “you are setting us all up for disappointment, despair, and an unhappy ending.” I would guess that 75% of the time people won’t go to a referral. At least on the first visit and recommendation. I can get a client to go about 50% after the third request for a cardiology consult.. that’s usually three years later. Not the optimal time to intervene on a heart condition. And yet, still I am so grateful they finally are willing to go I would never elucidate that disappointment. Think a human GP would do a heart assessment on you because, well, ya know, you know her and it is so much more convenient to not have to make another appointment or waste a trip elsewhere. NOPE!
People are hard. Pets, the whole driving force that veterinarians chose to work harder, make less money and deal with grief that drives a suicide rate every single pet loving person should be compelled to act on behalf of, are easy. Pets will not give you a false sense of security. They won’t take their grief and use it against you. They won’t blame you for loving them, although they aren’t always understanding of i.v. catheter placements, nail trims, and restraint. They are pure live in the moment unconditional love. They are why clients, heck even ourselves go a little crazy on the grief scale bereavement.
After all that spilling my guts to you, ranting about how incredibly hard my job is, how I am routinely set up to fail, asked to do impossible things and then expected to be a whole, fulfilled person on top of that, where do I go now? I am brutally honest. I fess up. I make hard calls. I clearly know that I am in the profession I have always wanted to be in. I treat people fairly. I love unconditionally (patients absolutely, people I am trying). I do not judge. I assume everyone loves their pets as much as I love mine. If they don’t they need to find a vet that suits them. I say no, a lot, and I stand by it. I don’t do convenience euthanasia’s. I don’t turn away clients who need me. I am transparent, honest and accessible. (Want to see for yourself? Go to my YouTube channel, my blog KMDVM.blogspot.com, or Pawbly.com to see real-life cases with costs of care included.) I stand by my patients every time they need me. I call the authorities on neglect cases, and I stick my neck out for pets every single time. It has cost me huge. I will walk away still liking how I am, even if others don’t.
What is my job now?
•Forgive. I have to know that I always did the best I could. It was never able to be perfect, but perhaps the flaws remind me that it was real. I got to live it. The textures added the uniqueness and that was what made it recognizable to me as my own.
•Let go so I can love again. Jumping back into another companion has always been fraught with too much scrutiny to make it easy. The one truly amazing part of my profession is that the more I put myself out there to help the more disastrous cases I place myself in the path of, (the moth to the flame), the more lives I learn I could make a meaningful change to. Hiding as the introvert so my grief, fear, anxiety and depression wallow over me leaves me just there. I may not be able to see out of this place when I am in it, but, damn I hate only knowing that landscape. Go to a rescue, hug another pet just for the sake of feeling their warmth. Jump back in. you will never be ready so don’t wait for that stop on the road of life. Try. You may fail, but the real magic only happens in the risk taking of trying.
•Not forget the whole reason I came to this place. The joy my kids bring to my life and the perspective I have to chose are those that tell me my life still has purpose. If I allow myself to stray from who I came here to be, allow the pain and loss to define me how is that a memory worth preserving. Action is an admirable quality. Putting someone before you is unconditional love, and remembering that forgiveness is the peace gained from a life well lived if only how it brightened others is the real magic to a perfect love story that never lasted long enough no matter how you tried to preserve it.
To the vets out there still assuming, still wondering about the expectations of our clients we don’t know well enough to dare to guess, and to those of us struggling with not being perfect at every avenue of medicine, I want to remind us all that we know who we are. Why we came here. You have to get out of this alive. For me, that is doing more than I have to. Being braver than I think I can be. Jumping back in when the lunacies of life pop-up in front of you, and yes, helping every furried creature that crosses my path. I cannot save them all but I am damned sure never going to stop trying. I have to take only myself to my grave, I darn sure don’t want to spend eternity with her still being angry that I didn’t try, and still like and respect myself along that long road to my coffin.
Here’s my advice for Joeys members;
1.Interview your vet beforehand. Tell them who you are, how you feel about your pet and what you are willing to do for them. Put that in your pets (all of them) medical records.
2.Expect a bigger bill when an emergency strikes. Also expect to be sent to an ER. Be prepared for both of these and be grateful for both.
3.Go interview the ER. If you are unhappy with them interview others. Here’s a pearl; go to a veterinary teaching hospital at any and all times possible. They are exceptional in all areas of companion care. You will never get better service or a more reasonable fee.
4.Avoid corporate veterinary care if you are financially restrained. They are, in general, less willing to work with clients who need help with cost of care.
5.Have available credit for emergencies. They will happen so you should be prepared.
6.Ask to record every moment of every conversation with the vet (write down their name(s) and vet staff (names). If they are recording you, which most are, then you should be granted the same. If they decline write every word of every conversation down. Leave a copy with them as you leave. Paper trails matter more than any other piece of legal fodder. Sign the copy of the account and make a copy for them in their presence. If they deny a copy make a note.
7.Ask for a copy of the medical record upon your departure from the clinic. If they do not have it ready ask them how long it will take? Tell them you are making a note of their response and return on the day and time they say it will be ready. If they decline make a note ask them if they would like a copy of your notes? Sign and date with time. (note longer than two days is unacceptable by most board standards, unless the patient is still present for care).
8.Never leave your pet behind if you don’t feel confident about it. Stay at the hospital. Tell them you are staying. Be a pest. Not rude, but your pet, like my mom was, is your responsibility.
9.If you aren’t comfortable there move to another place. I am not the vet for everyone, I don’t even want to try to be. Its ok to admit that.
10.Have a follow up plan for each visit. If they aren’t telling you what to watch out for, and what to do about it, then you don’t have a follow up plan. Ask for it is writing. Every vet, like every descent doctor, has you leaving with a written plan. Accountability only follows reputability.
11.For the crowd holding torches remember the anger and threats breed more of the same. Transparency is two-way, honesty is the same. I know that vet med lacks transparency. It is our greatest fatal flaw. It sets us up for unrealistic expectations. Lacking honesty is a grave sucker. No one goes through life happily if they aren’t honest. You cannot demand others have ethics or honesty. So, we are left only to be the example.
Want to know how is the center of every decision, action, and motive I have? Here it is.
Who are you here to be? And whose hand of loyalty do you hold? For veterinarians these are too often a difficult questions to answer.
If you would like to know more about my side of the exam table please find me at the following;
Pawbly.com. It is a place for all pet people to exchange information to benefit pets worldwide. It is free to use. We are always looking for credible, reputable pet care experts to offer advice, and we welcome people posting their pets stories so that others may benefit from them.
My blog can be found at KMDVM.blogspot.com. It is called “Real-Life of a Veterinarian” and that’s exactly what it is.
Grieving has consequences. Serious, mind numbing, life paralyzing consequences. I call it the collateral damage to loving so much it hurts too bad to consider ever doing it again. Grieving is the yin to the deep love of living that is its yang.
I get it. I really, really, do! I know what grieving is. How hard it is to get through once you get pulled into it. I know what loving costs.
Me and my beloved Jekyll, at the oncologists office.
As a veterinarian I see pet loss and grieving daily. It is the painful sunset consequence to every jubilant new puppy and kitten exam we get to share. Where there is a beginning for these new bundles there is also often a decade or more of rich, deep love that at some point meets it end. That goodbye can cost more than anyone signs up for when they go to bring home their new companion. Saying goodbye often causes a forever farewell for many pet parents. I fear too often that their grief often comes with an ultimatum for never grieving again.
Overwhelmingly I get three responses when my clients lay to rest their last pet...
1. "We want to travel."
2. "They are too expensive."
3. "I never want to feel this heartbreak again. It's too much."
Do you wonder how many people say this to me? A LOT. I have started to classify them, and by "them" I include all people who have to say adieu to their beloved pets, into two categories.
Number one. My category. The place where sharing our lives with pets is our purpose. The people who can't imagine, nor have ever dared, to not have a pet in our life. The people who can't live, won't live, wouldn't even try to imagine living without a pet in their life. I am this person. I grieve but I get back in the saddle. Again. And, Again. It never gets easier to grieve the next time. Even with all my practice.
Number Two; everyone else.
.
Whenever I fear one of these reasons I always find it is almost impossible for me to answer these without clarifying who I am and what my life looks like.
Lewes Beach, delaware. My last vacation with my dying pup.
I LOVE to travel. In fact as I pen this I am on a train to NYC and then onto Boston. It is a 5 day jaunt. My three pups are with my parents. I am incredibly lucky to have parents who tolerate two puppies who most of the time act like deranged lunatics on an endless sugar high. The puppies love being there, and my parents love the puppy antics they entertain them with. We are a pet centered family. We all share each others pets and they share each others homes. If you aren't as lucky as I am to have family or friends share custody there are other options like Rover.com, or a boarding facility like my clinic runs. If you are a person who thinks that long term boarding, frequent boarding or even day trips are needed start acclimating your pup as soon as you get them. Make boarding a "normal" activity. Ask if you can start with a day or two a week and work up to overnights. Also get to know the boarding staff. They (we sure do) will send you daily photos, updates and help make their vacation as much fun as yours. If these don't work share your home with a pet sitter, or your pet can stay at doggie camp while you are away. If finances are tight a staycation, or working vacation are options. In some cases you can even bring your pet with you, although this might be too stressful for some pets. I have clients who chose to travel by motor home so their pets can be with them at all times.
The expense, well, all living creatures need appropriate health care, food, shelter, and these take financial resources. If you think that the emotional trade off has a financial restriction I can't argue with you, you just don't get it. There is no price for the love, devotion, and companionship they give for free. If you live within a tight budget, or need to budget for emergencies consider pet insurance, have an emergency pet fund, and find a vet like us who will help you with payment options if they are needed. Money doesn't have to be a defining limitation to loving a pet, but with all responsibilities that are willingly, consciously entered upon please don't adopt a companion if you cannot adequately compensate for them. I am not the veterinarian to preach about "don't have one if you cannot afford them," I am the veterinarian who will tell you from experience that the wealthiest clients don't necessarily make the most devoted parents. I will also adamantly state that caring for a pet with limited funds is possible. It takes a team approach. It takes honesty on the part of the parents. It takes openness, truthful discussions, devoted emotional investment that you share with the veterinarian, don't be angry at the vet, don't try to coerce, lie, threaten, manipulate, it will cost your pet and break the walls of trust that allow compromise to happen. I have managed difficult cases on a shoe string. It also takes a veterinarian willing to work with a budget and compromise. Not every vet does, and it is important to establish this very early on in the relationship.
Neutering Storm..
I can say this. There is a yin to grieving. There is a sunrise on the other side. There is a peaceful awakening when you open your life again to loving someone. There is also immense joy in opening your heart back up to another soul living in the today and joyful in the delight of the moment. Mourning often robs you of this. A distraction, a life to share, and a new place to build a future on is often the only thing that heals me.
I am a slave to loving my cats and dogs. It is an addiction like no other. I miss them painfully when I am away on vacation. But I am bursting with glee when they reunite with me. I mourn them when they pass on with a grief many non-pet people don't relate to, and I go on with another hopeful friend awaiting me somewhere. They are my constant source of hope and love. I still vacation, grieve them when they are gone, and invest in the care I owe them as my family.
I often tell people that I feel as if my life has been lived in chapters. Some were defined by places I lived, the events that occurred around them, but, most were overwhelmingly defined by my companions, the dogs, cats, and pigs who shared each place in time with me. They are the foundation to my life's story. The place markers, the main characters, and often the support system to get through.
Storm and Fripp.
As I lost Jekyll I gained two desperate disposed of souls who needed me almost as much as I needed them. If you have it to give cast it like seeds, watch them grow around you. It is what life means as it matters.
This is the balance to loss, living and loving again, for as long as this life will allow me.
For more information on pet loss and grieving please see my other blogs on this subject here;
Thank you for reading and sharing your life with the companions who remind us why life is worth working so hard to keep them in the lifestyle they have grown accustomed to.
Death. It is unavoidable.. Un-avoidable!. In my veterinary day to day practice I see death most often creeping in like an insidious pestilence. The end,, that precipice place right before life meets forever absent, well that place, where I am mired now, that place sucks,, bad.
Your life and the way you see it, the lens you see everything through, changes. It has too, you have to filter out the clutter, minimize the distractions, focus on the living left to do. Life here at the transition out of it is like a vacuum, a quiet, lonely, absent, dark void.
I was one of those overprotective, hovering, helicopter moms. I have a beagle after all. You let those beagles out of your sight and off they go, into the clear blue yonder, nose to the ground, running, ears flapping in the wind their heels kick up. Beagles live on short leashes, or in kennels, or anchored to a pack and a leader. They make bad decisions if left untethered. Truth is they don 't know any better. It's genetics screaming at their primitive primal brain imprisoned by a nose that must follow where the trail lies, the bunnies are, and the adventure is certainly awaiting. They can't help it. They are a body enslaved to a nose they cannot turn off, nor ignore. I am that mom to a kid possessed, called, beckoned, reckoned to be elsewhere (except when the dinner bell rings or it is raining...beagles are bog avoiding babies in the rain). I am also the mom who keeps tabs,, makes sure they know where their kids are at all times.. I should say, was, I was that mom.
Now I am a mom with a kid on a short timetable. Weeks, maybe months, but damned unlikely to be a enough months to amount to a year. Life changes when the calendar gets to pages, single digits, pieces of a lunar fluctuation, or, "this might be the last time we get to..." thoughts. My wishes for him have changed, come full circle. I want him to run, play, be the boy his beagleness calls him to be. We go for long walks, unleashed, unmonitored. He gets lost in being the boy with the nose in the dirt. We live without consequences in the wild. To die on the trail, possessed and unfettered by a disease that is eating him up from the inside, and backside out. If he passes while doing what he loves, being who he has always been, kicking up the scent he is intoxicated by, tracking his shadows and howling for their surrender I will be at rest with the unfair, unjust hand he was dealt. We all want our pets to die peacefully, in their sleep, oblivious to pain, in their beds at home. Me, for my hellion child, I want it to be living the life he was most fulfilled by. Running in the woods, being caught up in the moment and living the life of the boy he has always been, unleashed, undying, and blissfully euphorically purposeful.
P.S. I have to post this after Jekyll's passing. It was not completed in time to see his paw prints on my doorstep any longer.
I can tell you all that he got to be the beagle he was up until his last moments with us. He was loved, on his rolling hills of lush green and endless possibilities always calling him yonder.
P.S. Jekyll passed away August 26, 2018. I miss him everyday. I honestly didn't know how I would, or could go on.... but I did.. and I'm still grateful for everyday together.
For more on Jekyll, his disease, my struggle to get through it, and what the other side looks like, please follow this blog. Or you can find me answering questions for free on Pawbly.com, or, sharing cases, and living life helping other companions at my Jarrettsville Vet Facebook page, or on my YouTube channel.
Veteran territory. I have been here before. The wound is soo deep it seems fresh, draining, life threatening. Death has been to visit me before. We haven't come to terms with each others presence, nor purpose. IT is still an unwelcome intruder. Albeit, ominous and undeniable, still IT calls, I collude, and yet, IT always wins, as I feign fractured and defeated. Again, and, again.
Our pets never live long enough. You can try to push the limits of pet-mortality with purchasing a parrot,, get yourself a good chance at a millennia, but dogs, if you stay mainstream canine, are lucky to see their teenage years, incredibly blessed if they hit two decades, and if you like to go big, or even "giant" you may not ever see double digits together.
I have learned that my heart can barely handle this pain every 10 years. I need, want, choose, hope, pray, beg, for a decade of longevity. Turns out my track record reflects this. "The older I get, the smaller my pets get." It is a hard-learned trade secret to try to spare me the loss every 5 years, or so, and it allows me to be able to carry them when their winter starts to wither and their bones can no longer support their ambulatory requirements.
The last few years has marred me with the loss of two beagles; Jekyll (just last month), and Savannah, a few years ago.
It took me weeks to get out of the grey fog I was flailing in with Savannah's loss. I just couldn't get out of the programmed repetitive daily motion I had become so accustomed to. The getting up at all times of the night. The managing her hysteria, messes, and failing functions. Undoing the habitual duties she set into my daily life took time. All the while desperate to go back to that place of interrupted sleep that her deprived mania brought just to have her back with me. But her loss was explainable, excusable, sensible. She had made it to 16. A ripe old age. A respectable age for any dog. She could be grieved but not denied a silver lining sentiment for surpassing the acceptable tenure. I could complain that her loss hurt, but I couldn't expect sympathy that she hadn't been afforded a long loving life.
Savannah
Jekyll, my most recent loss, another beagle, passed away at 8. He got cheated. I have anger lining that grief. Bitter shards to embalm him in. Seething pain to intern him with. Dust to damnation. A cursed cruel loss.
jek
The pit of my grief with his death lies here. The time frame cut too tragically short. The agony of desperate attempts to buy another "good" day for him. The exhaustion in losing the big battle. The responsibility I feel as having been the ultimate master of his destiny and purveyor of his curtain call. It is a terribly painful place to be. The ultimate responsibility can leave you with the lifetime of despair in second guessing and brow beating every previous decision. Sad couldn't begin to capture my angry bitterness. Except to mar it with also feeling responsible. That little fact made it crushing to swallow, impossible to move on, and fraught with such self doubting so that no piece of me was big enough to reassemble.
The days after his passing were simply about getting up, getting dressed, crying in the car to work, choking on grief and visible despair , all the while attempting to trudge into a day I dreaded facing. It also brought me back to why. The why of this profession? The immense magnitude of the responsibility we carry. The joy and the pain and the immeasurable grief it brings when you build a life around another.
The why we let them into our homes and hearts? The why we incorporate them into all parts of our lives? The why it is so easy to love them and yet so impossibly hard to lose them?
The why is the reason for everything we do as a parent and a veterinarian. It is important to always remember the WHY's?
I can love this pup, let him go knowing life too often works in its unfair ways, and not be ashamed, embarrassed or surprised when it repeats itself in my clients lives. If you can't feel a loss you cannot love. They are inseparable. It is what makes a vet a real person in the right profession for the right reasons.
I know this. I believe this. The tough part is living this when my own heart is shattered after losing the little one I loved so completely. It is grieving. Understandably. Grieving without withdrawal from ever opening your heart again is what I believe to be the most devastating part of pet loss. This is where I spend time talking to clients. It is normal to grieve. Grieve, however you need to, for you. Take time for yourself. Make a place to memorialize your pets life. A place to know you can go to to tell them how much you miss and love them. Live in the memories of your time together. But, try to not blame yourself. Try not to get stuck here. I know it is hard. I spent weeks here feeling like I, me the great powerful veterinary healer, could surely have saved my beloved boy. I had time, financial resources, access to the best specialists. Every tool to make him survive even the worst disease. It didn't happen, He left too soon. I lost him. I failed him.
Me and Jek at the oncologist's office.
That was exactly how I felt. Can you imagine how everyone else who doesn't have a decade of being a doctor, a clinic at their disposal, an Army of specialists, a bank account dedicated to dog care feels?
We will all lose a love because life always meets death. But giving up on loving again, ever having a pet again, that's where the real tragedy for me is.
So many clients give up after their pet dies. I think they feel it is too painful to go through again, or, like me they feel as if they will never find another pet who fills the shoes, measures up to the caliber of loyal/obedient/dedicated/wonderful there pet did. It is natural to not want to feel awful again. But not feel again? That's a loss that costs more than any heart should endure.
You cannot go through life living it if you try to not feel it,, good, bad and everything in between.
We all write the chapters of our own book. My book, each deep rich chapter of it has always been delineated and defined by the four legged family who made the tapestry the vivid, meaningful experience it was. The many homes, the varied geography, assorted jobs, were all the background that set my stage for each chapter whose central characters were always the dogs, cats, and pigs who made this life colorful and rich. They were, and are, the most important and meaningful pieces of the life I created and treasure. Some took up hundreds of pages. Some saw me through decades of questions trying to create the adult the kid was dreaming of. Some were short poems, a life too little, too fragile and too small to last past a haiku on an abbreviated page. But I am a richer, wiser, more content and accomplished thanks to their acceptance, love and wisdom.
You would think that with all of these chapters, all of the times I have been through loving and losing them that I would be better at grieving? My previous practice would make perfect assembly line efficiency of recovery? Yeah, not so much. I still invest whole heart immersed, drown in despair with loss, and trudge ugly through getting over it. Practice has not made perfect, unless that perfect implies pitiful.
The loss of Jekyll and Savannah took me weeks, months, longer/forever, to come to terms with. I will never "get over them." They were too monumental for that. All I wanted from myself when getting through their loss was to not give up. It was all I could hope for. They were loved. (I can say that with total conviction). There are millions (millions) of equally deserving (I can say that with complete honesty also) who never know a kind hand. I still have that to give. I may be broken and hurt, but I can still be kind to a furry face. I have to think beyond me. Society, civilization rests on this. It does transcend past human to human. Anyone who has ever loved a pet knows that. The world is better for all of us because we can love each other, regardless of size, shape, color, claws, fur, or fins. Love that is compassion is the key to life. All life and all living. This is what I believe, and remind myself of when reeling in loss.
Here's what happened to me after Jekyll passed away. I cried a lot, for days, weeks. I told the people around me that while I appreciated their sympathy I couldn't talk about it at work. I had to stay busy and focused around the grief.
After two weeks I started trying to put my toes back in the water. I started looking at the pets in the shelters and at the local rescues. None of them were Jekyll. None of them pulled me into compulsion to step forward for them to come home with me. None of them were Jekyll. I was looking for that face. That smile. Those ears. Some tiny resemblance to jar me into adoption and out of affliction. I realized that obviously I wasn't really ready. I wanted to be ready. I just wasn't. I started spending loads of time with Charleston, my other dog. The left behind dog while we were all so focused on Jekyll. He had been neglected while Jek took so much of my time to monitor, treat, and obsess on. I owed him help in his grieving to. He was as heart broken as I was. We went on lots of walks, changed the room around. Got new toys. A little distracting helps pets adjust to a different routine and life. He got quiet and withdrawn. He missed his instigator and boisterous beagle brother. He was always the shadow behind that dynamic personality. He never saw his own sunshine without Jekyll pointing the way.
Charlie was depressed.. But, he seemed more than withdrawn. He seemed deflated.. Vet mode mom kicked in (although it felt like paranoid vet mom). What would I do if he was dying too? Charlie's blood work revealed a low thyroid. I put him on medication to see if this would help resolve his lethargy, depression and sadness. It helped quite a lot. He started to wag again.
The next set of events changed everything. It added a new chapter and pulled me out of isolation and despair. A hurricane hit. Storm landed. (more on him soon). Hurricane Florence lands.
I added two very sick puppies within 3 weeks. We needed each other. I remembered I had a purpose outside sadness. I am alive again with them. I can go on. Being needed and loved helped me remember to start writing the next chapter, again. I was pulled out of grief by two sick puppies. I reinvested my energy into them, constructive caring, versus my grief soaked couch. Charlie, well it took about a week to realize they were residents, but when he could no longer ignore their incesant chew-bite instigation, he started to play. Within two weeks we stopped his thyroid meds (there is no medical study to back this, but its true). Charlie, and I, were back with the living.
I wasn't ready. I have no idea how long we will get together. But the time with them is far better than the wallowing in despair. We need each other, all of us. Loneliness is the gateway to despair and my puppies are waiting for me at home.
To all of those out there drowning in grief I hear you. I know. There is a way out. Reinvest your whole self in a pet. They need you as much as you need them. You can help each other to the shore. I send you all love and support.
For more information on who Jarrettsville Veterinary Center is please visit our Facebook page, or our website.
If you have a pet question or a story about your pet to share so we can start to help others who might be in the same situation you are (or were), please visit us at Pawbly.com. It is free to use and open to everyone.
.jpg)
