When I Get Lost.

 

Alvin. A true example of how much we adore our pets. His story here

The most obvious place to start when you are lost is back at the beginning. Therefore, I go here.. Back.. Back to the place I last remembered knowing my way. Having a direction. A footprinted fossil. That old place to call "start here."

It is all I know to do when the map has been lost, the sherpa abandons, and the world reminds you that you are merely a speck. A tidbit of dust. A fleeting, insignificant blip on a timeline too immense to even contemplate comprehension. Me, the bag of aging flesh with so much determined compassion that even this reality is dismissed.

Retracing my steps as I attempt to resurrect my direction, (albeit a direction with accoutrements like “purpose” and “fulfillment”), I remind myself cautiously that I know, admit, publicly, that I have never chosen the easy path and I am fraught with a conscious empathy that propels me. This small character flaw is a burden. At times it has led to compulsion, but along that path I was moving in a  direction I believed in, and with it I had always gotten to somewhere. After a few decades of kinetic acceleration the directions have become more cumbersome. The world seems to close in, and be far less welcoming. Age, has privileges which lessen the compulsion for manners, but, you pay for that in diminishing opportunities. Gravity clutches your intentions and suffocates them into mortality. You can't get to the previously proposed destinations with the same vigor nor timeframe, but you don’t give a damn, so it all balances out in the end. Problem remains there just isn't a calendar with a timer counting down to designate END, so you plug away hoping it isn't aimless, fruitless, and depressing as hell.

Garfield. The reason in everything that I am and who I still dream of being.
His story here.

Maybe it's mid-life? Maybe it's inertia calling my bones to pivot? Maybe it’s the reflection of those around me nesting and preparing for a hibernation I'm not prepared for?

The conundrum remains. I am lost and searching. Fueled by frustration and losing a voice in the mass of bigger fish this world has to fry. My little cause lost in earthquakes, tsunamis, wildfires, and genocides in Africa, Gaza, and Howler monkeys falling from the skies over global warming induced desiccations. How do these compare with the with blocked cats, pyometras, and nasopharnygeal polyp looksies being fined out of emergency care? I don't know, I lost my map. 

There isn’t a megaphone big enough to hold my tune next to that cacophony of desperation the rest of the world is grieving. Yet, my plight, my purpose and my internal quest for recognition and empathy in animal welfare and companion animal needs remains as steadfast as ever.

The lost part was also my beginning. No one goes to vet school to change the world. It’s a futile fight in a world of humble hardworking blue collars. Purpose exists in heartbeats for utilitarian use. Sure, dogs and cats have gained a bit of status with their handbags, service vests, and bedfellow pampering, but, vet school, is equal parts food and pushing the limits of biology and financial cushions. I went to vet school with an agenda. I went to attain credentials to argue with bigger guns than the fodder could muster. A worldwide awakening of public opinion ripe for disruption. My hope was to be a pioneer on the frontier of acceptance that the pets we call family could earn some status that provided rights and consequences when infringed upon. Cruelty comes in many forms but the worst is the mass cover-up with just how poorly these beasts are treated, and how little value their lives hold for the food supply to remain cheap and domestic. No one likes to see suffering. The Styrofoam and plastic wrap allow it to be bacon versus Babe. Dogs and cats aren’t much better off. They are considered property in the eyes of the law. Replacement value for your four legged furry kid is about $100. Pain and suffering if they are killed or tortured are unlikely in the lobbying world of minimized liability the vetmed profession defends. We, the collective veterinary profession, lure out incredible medical advancements and opportunities out one side of our mouth when we recommend MRI’s, stem cell therapies, cloning, or organ transplants and protect liability with "property" status out the other. It is an unsustainable mixed message against a public so bound to their companions. We provide some pets month long stays in ICU's and chemotherapies with price tags now hovering around $50,000 and up. While others are bred to be mute lab-rat beagles. Compliance their greatest asset, yet doomed to die unnamed. The Auschwitz inhabitants of our day. We offer. We profit, and we refer to our own knowing price tags that begin at 10k lie ahead. We admonish when parents aren't prepared and yet we defer responsibility when heartbreak is delivered. We, the lowly GP's, always offer “economic euthanasia” as a mandatory treatment therapy option. We offer this to make our clients feel empowered and compassionate as the last true gesture of kindness to alleviate suffering we hardly ever have firmly diagnosed, nor been specialized to treat in its maximum effectiveness. We know you will get another pet. We also know it is much cheaper to replace than treat. We did this. We are responsible for that mathematical reality, yet, we judge and castigate when it happens. We are even so egotistically privileged that we feel good about recommending euthanasia as a benefit to our treatable yet priced out of affordable options within the bullet points of acceptable treatment options that we have now made this a lucrative part of the profession. (And people wonder why the profession is plagued by self help via iatrogenic euthanasia?). We kill ourselves as an option to seeking compassionate resolution to unanswerable dilemmas.

Pickles and Geisha. Rescued by a client who cuddles them like they are the most precious lives anyone of us has ever been privileged enough to be entrusted to protect. 

There are veterinarians so fed up with the anger of negotiating between need and availability, options and finances, or the endemic corporate structures of avoiding on call and surgery, they can either head back to training to specialize, expose themselves to most often kind side of medicine; in home euthanasia, where your clients always speak nicely to you and show gratitude or wash out and switch professions.

There is no map for this place. This crossroads of incongruities. This place where we have to be human in places of lost humanity. The place where greed greets celebrity. Kindness is annihilated by power hungry egos. It is dizzying to know where to go at times. It is harsh to look in the mirror and ask yourself if you can dissect the problem  from the solution when you know you live within both as a matter of necessity and survival.  

I'm still fighting. Fighting to refrain from accepting the self protective blank faced indifference that permits clients who can't pay to be turned away with some excuse about everything being “their fault.” Or, the litigious liability paranoia that defends our patients as being replaceable within the big scheme.

Sparky. Rescued within minutes of being euthanized, and hours after his owner surrendered him.
His owner was told he would be given less than a day to be rescued as the shelter did not have enough space to keep him longer than that.
That smile says it all. 

I don't know if I will ever find that yellow brick road. Or, the map I had predicted so long ago that would lead me to tranquility. Or, even my self-proclaimed Utopia of purpose driven bliss. Maybe mankind is so inherently flawed these just aren't possible? But, maybe, just maybe my path lies right here at my feet. The inherent perfection of the pets I call my companions. The wet noses of the patients I know to be my purpose. These beloved companions who love so completely and unconditionally they inspire me to keep marching on.

Lil D. Rescued from an online ad. Transferred to her foster mom in the WalMart parking lot.
22 toes (2 shy of the world record) and now living her best life in a home she confidently calls her own.

Where did I leave that torch and megaphone?

Cooper. Waiting for me to leave

The Cost Of Hope

 Hope. When there is everything, and nothing, there is still hope.

Hope, for me in vetmed, is all of those blocked cats who never see a chance at help
because we may it too expensive.

A long time ago there was a girl who was afraid. Of all of the things she was this one thing dominated. It was what propelled her, crippled her, and reminded her. It was the beast she lay victim to for all of the days. It was the affliction her mother had and her mother before her. It was everything and nothing. It was, and it was what she let it be. 

It was like this for a very long time. A lifetime, and then, a lifetime more. 

Mom in her barn for her first antique sale.
She was beamingly happy, can't you tell?

It took a long time to recognize the part of her she didn’t have to be. She knew that there had to be more to this journey. The one she woke up to everyday to repeat the whole pattern again. But when you carry a beast so big, and so heavy, for so long, it is hard to raise your eyes above it. Maybe fear is the antidote to hope? she thought. And, maybe hope was the cure for her fear? And with that it began; the daily ritual of pulling her bootstraps up and raising her chin above the horizon, just to see if maybe out there somewhere there was another option to her fear. Maybe there was a place she could leave it? Just to rest its weary head for a while. Maybe, it was as tired of her as she was of it? Maybe, they could exist without each other? The shell without the cortex. The cure without the disease. Maybe, if she could grow big enough and strong enough, she could outgrow its need for her, and with all things that persist long enough, her need for it? Maybe? Just maybe?

What happens is that time works its magic on you and you grow comfortable with even the most horrible. You get used to each other to a degree that makes it hard to coexist without each other, even when the other half is a cancer stealing you from yourself. A bad marriage arranged on the most horrific of terms. Life is like that. It will kill you if you let it. Leach you to anemia just to see what the reserve tank has in it. Medicine, the art of molecular life in the grips of another life, the host with its many moving parts all required to work in tandem even when they have opposing agendas, is just like this. A dance, a tango set to a music you cannot always chose. You try to lead but you know the tempo might change and there may be feet stepped on as you tip-toe across the floor. 

Isn’t life like this for all of us? The calculations of actions you make silently within to try to make it through life with as little turmoil, pain, and scarring as possible. At what point do we learn that if you don’t have one side of the coin its impossible to know the other. Maybe with age there is wisdom and the ability to excise the fear so you can live with just the hope?

Outer Banks. Duck

Today is Mother’s Day. The day that we all celebrate the origin of our existence on the double X chromosome in our own DNA. For me, 5/14 is the day my mother died. On this day at 4:14 pm in a little stone house not too far from my own, my mom took her last breath. I say this as it marks a date, impermeable, and in-excisable. The pivot point to which the calendar resets, and a life without another starts. I say this because that day changed so much within me. There is a book to write about her, and her impact upon me. A book that sits waiting for the time and the distance to write it without it eating me up. Consuming me like the fear that swallowed her and kept her trapped within.

Today I remind myself that there is life after another life passes on. I cannot call her gone. She is never gone. She is here all around me reminding me to always have hope. To always see the beauty and the joy in the life that exists even if you have a difficult time seeing through the tears. Today I talk about hope.

Today I opened my eyes before the sun came up. The sky crept from black to the darkest of blue. A grey-washed out kind of blue. Smeared in its blurry shadows. Quiet, heavy, and slumbered with a fog that keeps all of the earth’s tiny souls safe in their beds. The first rays of sunshine wake up the world and to this awakening the first chirp can be heard. It is my time to be alone and feel as if the world will remind me that I am never really solitary. One little chirp. Just a call in the almost-darkness to awaken the rest. I turn on my Merlin app, and start to record. I now know that this tiny rooster call is an American Robin. Maybe being afraid, and trying to replace it with hope is about seeing the bravery in the darkest of places and still singing?

The potting shed. Mom and Diedra's boys

I made a video the other week about all of the clients I see who come to me having to lay their pet to rest after disease, and age, and all of the many afflictions that life can wear you down from. They always ask me the same thing, without fail; they ask, “this must be the hardest thing that you have to do as a veterinarian?” And I always reply the same way… “No. You loved your pet so much that you made them a part of your family. They were loved every moment of their lives. How lucky they are for that, and I know they are so grateful to have been yours.” That is the hope in the face of fear. That is the beauty in the face of death. Maybe losing someone you love is about remembering the hope they brought you every day you were together?

With hope springs gratitude eternal. Is there anything we wouldn’t give for that?

Happy Mother’s Day to you all. (regardless of what your chromosomes or current children roster looks like)..

The first icy drink of Summer. A mojito from our mint patch.
Diedra, mom and me.

And P.S. go out and foster, adopt, and live life with someone else… pets count as kids these days,, so we are all moms here. Maybe there is life outside of the one you are living right now where hope springs eternal? And, maybe its time to go look for it? Let’s all look for hope in the love that reminds us we are all mothers. 

P.S. I write about all of the issues that being me brings. I know that I am not alone and I hope (there's that word again), that others hear me and know that they aren't alone either.

Hope. Stealing, Losing and Resurrection. How the fate of veterinary medicine hinges on hope.

Fighter. Maybe not a "prized fighter," but, none the less, fighter. This is my job.

Driving home last night it hit me. I fight. This is what I wake up, diligently-doggedly do all the day long, and then attempt to subdue myself out of each night. And, I do this every-single-day.

It's exhausting, don't get me wrong. I'm sure that there wasn't some detour along my life-path where I made a conscious decision to become this person. Live this life. But, alas, it is the one I recognize as my own now and I wonder if I am alone? I suspect I am not. There is great angst in always being cortisol-intoxicated to fight the next brawl in the next room. Junkie-syringe slasher style. This is the stuff ER doctors, race-car drivers, Navy Seals, and inner Baltimore City high school teachers are cut from.

Many vets are compelled into vet school to be that healer of furred affections. I took it a step further. I started to advocate, demonstrate and change the way I lived my life because of how I saw the world treating, or rather, more aptly, mistreating, animals. I couldn't live to save some of them, the "pets" and eat the rest. Or, wear the others. Ask the moms at my clinic who have chickens, cows, goats, or pigs as "pets" if they can eat them? Resoundingly the answer has become "NO!"

The fighter evolved. She grew. She came from that place where you recognize all living beings are looking for the same things. A place to belong. A family to love them, and a day full of liberty and freedom within the world around them. At our most basic level we all want to be free to live our life as our soul tells us to.

The fighter in me has molded the doctor I became. The person who sees each patient who walks in as an independent life worth saving. An integral part of some persons life that is incomplete, emptier, and less valuable without them.

When I started to fight for more than I was, more than I needed, and more than I had to, I realized that the most important part of that fight was the hope it gave to others. I realized that where I saw a fight they saw a chance. A glimmer that it was not all as hopeless as they feared and they didn't have to surrender in desperation to avoid their companions suffering.

Hope is abundant and yet it isn't shared enough. Why? Why wouldn't we give away the few things we veterinarians have in our over-abundant, yet too often over priced tool box for free? Like confetti? Why aren't we casting it like raindrops? Why isn't every single case started from this place? This mantra;?

I will fight for your pet,
and,
I will not steal, squelch, or dismiss hope, ever!

Why doesn't every healthcare decision start here? Universal investment at ground zero.

Now I know the pessimists out there, the jaded, angry, and lost are going to balk at my over optimistic view. They are going to lash out the defensive, dismissive banter about why this isn't realistic! Or, why it isn't even responsible. God forbid they even throw out some legal crap about liability in the face of unethical moral conduct.

So, to all of them here's my real-life professional advice to this beaten, broken, angry, over abundantly suicidal profession. We aren't God. We have to get off our power tripped judgmental pedestal. For ourselves and our patients sake we have got to stop being so brash and burnt that we spread that pessimism like a plague. We are all the same, each of us is a practitioner. There isn't one person who knows everything. None of us have some magical crystal ball that miraculously tells the future. We cannot spew a diagnosis to our clients who so often come to us with few, if any, resources for the diagnostics they need, like a magic 8 ball. We, more often, and too many more times than we want to admit it, we just don't know. We don't know what's at the core of our patients issues more often than not.. And, if we don't know the diagnosis why are we even speculating the treatment options, never mind their associated costs? Why, because we think we know. We think we know better than the parents who love them. And, erroneously, we think we are liable and/or responsible for these. We aren't. We are supposed to be honest. We are supposed to be advocates for our patients. We would all be better off if we were just verbally and emotionally open, honest, and humble about the depths with which we do not know. We are also supposed to protect the public who shares this community with these patients, but, these are exceptionally rare cases. Stop using fear as bait. Stop telling our clients all the stuff our lack of diagnostics can't rule out. Be honest. Treat people like the loving parents they inherently have to be if they are going to walk in your door and ask for help.

We would also benefit if we all allowed hope back in to live in medicine. If we all fought for it we wouldn't be killing ourselves off in numbers 3 times higher than the next statistic of the next most depressed profession. We wouldn't be emotionally bankrupt and our debts wouldn't be mounting. Our guesses are too often incorrect, assuredly without being medically sound, and these cost lives. It burns souls, and can destroy the lives of those people who call upon us for help.

When my Jekyll-pup was diagnosed with prostate cancer, one of the most deadly types a dog can encounter, I sought and bought hope in bundles. I specifically sought out an oncologist who doesn't carry a medical bag with rationed  portions. I sat down with her on day one of our journey to help my pup with an agenda. I needed to feel like I had  teammate on my wrestling squad. I also knew that I needed a map to start our journey. A place to begin, and a speculative place (or places) to stop. I knew I could, would, and even was ok with visiting crazy-town along the way. Crazy-town for a vet like me is that place where the stuff no one else conjures as 'acceptable for a pets quality of life' resides. I was concocting up novel surgeries to re-route the urethra around that pestiferous prostate. I could rebuild him, make him better, stronger, (not faster? maybe?) then he was before. I had the technology to build the first bionic beagle! I knew I had this fighter in me who wasn't going to surrender my beagle without a knock-down-drag-out fight! I knew I needed help with navigating myself away from crazy-town. My oncologist, Dr Jeglum, helped me stay hopeful while not going all Oscar Goldman and Dr Rudy Wells. We agreed to keep trying as long as Jekyll needed us to. We wouldn't stop at the conventional. We would try every option, every possible combination and therapy. I was hoping for more time, which I got 9 months of, while buying hope in bundles I bought time in months. I needed these to get me through his passing. I needed him to be living while I was fighting and then I needed to be able to go on without him at least feeling as if I had done everything I could for him.

People pay for hope. It is a valuable commodity and a religious tenet. Whole civilizations were started there.

What I see far more often is people who have been dismissed, over looked and cheated of options. Options that have hope intimately anchored to them.

Why???!!! Why would we ever NOT give options? Are we so lazy, so jaded, so indifferent that we can't take the extra time to sit down, look into our patients eyes, see the soul of a fellow being as still fighting for their life and their time in the sun of this planet we call home? They still have a life to live. A soft patch of grass to submit to. A warm purring tune to play on our laps. A day to make better for the human that adores them.

I see the cases that other vets have denied hope for. I see the cases no one else took time or interest in fighting for and in them I found the reason to keep going.

Where it has brought me is to this place, driving home, where I want to exchange the fighting gloves for the surgical gloves. The place where tears of pet parents change from inability to accept fate to hope filled possibility. We all want to face life, our mortality and the lives our days have accumulated into as this, Hope.

Never steal the hope. It is the single greatest gift we can give.


This week brought me two crying clients.

One was Joey's mom. Joey passed away this week. I had been taking care of him, his diabetes, his urinary stones, and his omnipresent smile for a year. He was built of defective parts. They eventually quit on him, but, he never quit being joyful. His mom told me, as we were talking about how far he had progressed into multiple diseases with little hopeful outcome that she trusted me because I was "the first person who spoke to her, not at her." She loved her Joey and I know that as I write this she  is at her home missing him. She has had 5 strokes over the last year and Joey was her only constant companion. She had to let him go and I know it is hurting her immensely right now, and will for the rest of her life.

The second case was Spencer. He is 12 years old. A lab. Most labs are lucky if they see a dozen years. His years had brought him painful joints, diabetes and blindness. He also had a huge ugly, awful death smelling tumor on his wrist. Someone had decided he wasn't worth options. The tumor grew, as tumors will. It got so big it couldn't feed itself, so, it started rupturing and dying. Dead carcass is fetid smelling. You can actually be alive with dead tissue hanging, falling and breaking off of you.. This is what his tumor, on his wrist, was doing as he stumbled his way along.. wagging, lab-fashion the whole way.

His mom was hysterical when I proposed we remove it. "No one ever told me it was possible." She was a new client. New that evening. Spencer was not a good surgical candidate, but,, this was his only hope. We were either going to save him from his tumor, or, euthanize him because of it. She told me that "this was the first time anyone had given her hope for him."

Here are his post op photos;

Here is his story.. in video time.

I cannot save every life, in fact, every life I see, help, embrace, will be lost. We all die. I have to tell every client this. That at some point in our journey the road will end. There is always death. But along the rest of this road there is love and with love there is always  hope.

If you are a pet parent and your companion is struggling there are ALWAYS OPTIONS! ALWAYS! And please never lose hope. You can lose everything else in life... hope is given away. Relinquished, and no one can take it from you unless you surrender it.

If you need pet help please reach out to me at Pawbly.com. It is free for all to use. If you have a pet story you would like to share please add it to our collection.

I am also available at Jarrettsville Vet and YouTube.