You Can't Help Them All

Be kind. 
Be compassionate. 
Be full of grace. 
Give as much as they ask for. More if you can.
...and,,,
Let there always be hope.

Let there always be hope.

I wrote this on my way to work as a fleeting reminder. My daily affirmation masked as inspiration.

Driving to the clinic knowing I am already overbooked, and will be understaffed due to this, I needed a little self proclaimed pep talk. I knew I had 5 patients waiting for me for their surgeries. Five beloved companions who were left by their families, families who would worry all day, and 5 pets reliant on me to get safely onto, and, off of,  the surgery table and be better off for it. I go to this head space every morning, every transit to work, every-single day to affirm and re-affirm the focus. I cement the purpose internally. I reiterate to myself that imposter syndrome is real, and 20 years of practice probably has earned me the right to admonish it. Perhaps after another 20 I can boast this as abolished, but not today. After the surgeries are done I will have to face the onslaught of same day fit in requests to be seen for every ailment and emergency imaginable. I am Atlas, at least I feel as if I am her, as I drive to the asylum. I love what I do, the purpose that I possess, but the days are insane chaos. They run into each other. A bleeding ombre of one-into-the-next until I have to take pause to remember which day it is. I have done this to myself, albeit driven by the best of intentions. 

Yesterday I euthanized two cats a wall apart who were double booked within the same appointment time. It had been an oversight perpetuated by desperate pleas from the clients to be seen as soon as we could. A request that takes precedence and makes my ability to partition empathy in a calm manner with a sympathetic ear and papal hand into their appropriate and necessary compartments impossible. I left last night feeling as if I failed both cats and their parents due the chaos that surrounded their poor timing and punctuated time table placement. On the worst of all days for these patients and their families I am now left feeling as if I fell short of my own expectations for this, the most sacred of all provisions, while searching for their names on the tip of my tongue. Hoping my respects didn't fall short of their due value.

"I have become an ER." 

It is the next prophecy that slips into my thoughts. I hadn't planned to. The staff reminded me that we needed to. Our clients made us this, not me. We are simply available, respected, and affordable. The market will build as much as it will shape what it bears,, and so my legacy as the small hometown vet is marred into a title I never sought. Another crown upon the head that wears enough hats already.

I repeat it again;

We will help. 

You have to be brave enough to ask, generous to give back, and put your pet first. Just like we are going to do.

We get a phone call a day, (maybe 10 more), where someone from elsewhere is in need of immediate assistance. We take every call. We carry the burden of every plight. It affects us. We willingly listen and feel compelled to help.

I am told all the time; " you cannot save them all." I refuse to listen. What is the purpose in being reminded that their are limits on compassion? On hope? On attempts at kindness? I can. I can at least try. Why can't we just start there?

What I have learned is that the next action after that spark, plea, cry of desperation is a link in a bigger picture. The piece in a lifelong, worldwide puzzle of how you fit, hope to influence, the global network of all that is possible, or may follow. I don't have to save them all, I have to be hear to help them all. almost always this small action leads the course for a cataclysmic meiosis of magic. hope, life, and passion live in these moments. they are influential, life changing, powerful beyond money, fame, and possessions. they are the nucleus of humanity. the greatest gift man is given is our ability to build reflections of our most precious moments and store them for future incentive. this is the power of medicine and our companions place within our lives. It is why i am a veterinarian whose single mission is to save them all, and ourselves as the collateral preservation to it. 

Being comfortable with the chaos is my newest challenge. Is it possible to find that place where I accept it and welcome it with open arms?

I spoke to a practice owner in Texas who told me; "we give whatever they need and ask about payment later." I have held these words as my incentive. She owns an ER. Who in this day does that? How can I be so kind and let her words carry me for the next 2 decades?

I will try to be brave. I will try. I can do that again, today.

Walking Away. Can Empty Handed Be More Painful Than Heavy Hearted?

Walking away. 

For those of us who choose to travel abroad with the hope of helping, do something meaningful, and, influence an unjust reality, it is deeply painful to have to walk away empty handed. 

I wanted, upon my return home, to feel as if I had done more. Make a more meaningful impact.  I quite honestly want to take them ALL away. Pack up every little face I saw, all of those fearful eyes, bowed defeated heads, and hungry souls, and stuff them into my carry-on luggage and just head west. Cross the landscapes of the safe Nato countries skirting the western borders. Hop that big pond with our own 747 and fly the coop Big-time-America style. Just bust outta Ukraine and be done. Dust on our heels, blue skies ahead. It’s the only real tangible hope for them. The only way I can stop the suffering and save their lives. And I can’t. I don’t accept inability nor denial. It is not in my vocabulary. I didn’t go so far away to just bear witness. I went to change fates. Move trajectories make happy endings from a war. It didn’t happen. I feel defeated and guilty for departing. For leaving them behind. Abandoned and in the same predicament I found them. 

I hadn't traveled this far, 5,000 miles from home, with three days of traveling into Ukraine to see Droog shelters massively overcrowded 500 head count, and just witness the problems there. No, I came to influence them. Surely I couldn't solve many, maybe a tiny pet on a tiny scale, but, I wanted to try. Me and my ever present operative word, TRY. It just doesn't feel like enough right now. Isn't always enough,, but, it is sometimes all you have.

Two Ukrainian rescued dogs out for the evening walk.
I miss them every single day.

For more on the Ukraine trip please see my previous blogs.

The Common Goal

There is no argument that the focus of everyone's immense efforts here is the animals. 

Me, and the compound kitty, Mitsi.. I do LOVE her!

To have such a strong common goal is the only way this many craggy, crazy people, all deprived of sleep, food, warm comfortable beds and all of the amenities associated with running water, AND, being from all corners of the UK, (and me the single American), could coexist together for weeks on end. Life here is complicated, and full of tragedies. People are trying to live normal lives, but, it is obvious that isn't possible here. Because of the poor living conditions, the overarching fear of air raids, bombs, and all of the insecurities war can present it is difficult to lose your way if you don't have a common goal and purpose. It is the glue that keeps us cohesive. If we didn't have this I am sure all of the ragged edges of all of the hardships would crack us. I am also sure that I am the person who fits in the least here. (I think I am proud of that.)

The depth and width of the pet dilemma that is here is oceanic. Mind boggling. This is a country that has very few frivolities. Dogs roam. Cats roam. People trudge in ratty clothes, and everyone sweeps bent over, scoliosis, kyphosis, nose to the dirt, sweep, sweep, sweep. An old country, old people, old stories of war, a country of tales of having been claimed by others, broken away from them, the castaway step-child and the weight of the world with whom you never know who you will saluting to lives here. These people have so much to manage already that the pets, the kind animals, are stepped over and passed by. To be honest there is probably no way to even begin to suggest an end to this mess. As the war drags on the problems deepen, intensify and coalesce. The lesion this began as has become a metastatic cancer of a wound that never received adequate treatment to begin with. How do we try to end the plight of these animals when we started at accepted indifference?

The animals here, at the compound I stay at, were all extracted (the term they all use) from the streets and abandoned shelters after they lost their residencies to the bombs that their homes became Russian targets of. They are all scarred. Some with obvious wounds, others with anxiety based fear so deeply embedded you don't want to know the source, or, excise the reason. You just assess, be kind, exude confident optimism and take small steps one heartbeat at a time. I am a fixer. I am wired to examine, dissect, treat, cure, and claim victory. here, each of these must be set aside. Reduced, and simplified to simply what I can do in the right here, presently, now. I will go mad, abandon the cause if I try to practice medicine like I do in my well controlled, everything accessible home. There are almost no spayed or neutered animals here. I assume with every tragic life threatening ailment that they come to me with they are also passing it forward to the half dozen offspring within them. Great, the problem multiples as I gaze upon it. There is no end. No finishing point.

The dogs here at the compound came from a shelter in Alexandria Ukraine. The shelter before the war used to run with a capacity of about 40 dogs and cats. When the war hit the numbers surged to 400. When the staff could no longer manage the animals and the war they reduced the care to feeding alone. No cleaning and no exercising. When the threat of further invasions and insecurities presented the shelter staff had to make an even more perilous decision. They opened the cage doors so the pets would not be left to starve. The group when in weeks ago to find many of the animals set free from their cages. The scene they came upon was about 150 animals alive the rest in some form of eaten. It is what we would all be faced with if 5 weeks went by without food or water. The weak, gentle and submissive were not who were left to rescue. Most of these dogs are German Shepherds. All are thin, matted, and apprehensive of humans. this is what war looks like. The war of abandoning human kindness and compassion. It is the face of people we should never be reduced to become. It is also why I am here.

I wonder if as the days pass that I won’t grow more indifferent to this place then desiring to stay and help? It is the same dilemma I face at home as a veterinarian. Do I give up as others have to save my fragile soul, or provide it with barricades shrouded in tattered clothes and fight on?

The Announcement.

Two weeks ago I broke it to my husband. I confessed that I wanted to go to the Ukraine, and do something. Something meaningful. Something needed. Something impactful. I had reached the place where I couldn't tolerate myself as an idle observer any longer. I didn’t want to feel helpless, mute, and privileged on the sidelines. Be the American so comfortable that other peoples issues didn’t take space, or deserve time to contemplate. The world is a mess more often because people sit by quietly and let it pass. How can so many people just watch? How do you not put yourself in their shoes and act? It is what oppressed victimizes. It is why oppressing persists. People let it. Specifically other people who know it to be such.

My husband reacted the way anyone who loves someone else would. He resisted. He challenged me to not put myself in the danger that wasn’t mine to defend. He reminded me how dangerous the life of the people over there is. How my life has obligations here, at home. I help the animals at my home. There is legitimacy and purpose here. And yet I still felt like a hypocrite; complaining about the atrocities to humanity because of the actions of a bully who needed to be punished. I was picking sides. I always do. I always root for the underdog. Vote for the newbie, never the incumbent. Where there is power there is too often corruption. Let that power last long enough and the rot of greed, arrogance, and entitlement metastasizes. Putin has become a plight. People are dying in war crimes while the USA strategizes how to help and not look obvious. We fear reprisal more than we fear the shame of watching it happen to others.

My husband texted me the worst thing anyone could have said to me; “you aren’t ready for this.” His less offensive doctrine to “I won’t let you.” The former incited a fire the latter would have laughed at. He knew from my long list of accomplishments that were never mine to proclaim for myself, that the last thing you tell me to not do is the first thing I will prove can be done. A source of pride that has cost me decades of doing something I never had my heart in to begin with. I have college degrees I never wanted based simply upon a threatening dare.

Telling me I am not ready? Like there was a university degree program I missed? Needed a certificate for? What the…? Ready? Who is ever ready to defend their belief of good should prevail over bad? A clergyman? Ready to travel? Yes. Ready to help animals? Umm? Always, yes? Ready to land near a war zone? Maybe..?

As composed as I could sound I replied, “I would rather die doing something I believe in, then wait for cancer to come find me and die with a list of things I wish I had done.”

I broke the news to the clinic a few days ago. The majority of the staff understand this. They understand me. They are supportive and inquisitive.

They cheer, and beam with enthusiasm. ‘Aren’t you excited? Are you scared?” always these two questions and always in tandem.

I still struggle and pause with a reply. I am a terrible liar. Worse I am hesitant to be transparent. It just doesn’t play back as plausible out loud.

I am not excited, nor, afraid. I am compelled. It is the most honest way to describe it. I'm not maniacally obsessed to go someplace people are fleeing from. I am not an adrenaline junkie who loves skydiving and roller coasters (I wouldn’t be brave enough for either), but, I am needed, and I can go. I have the passport, the vaccine card, the skillset and the experience to be gone for long periods of time, alone, far away, and perform a task. They need me, I can help, so, I am going. That’s all. Remove the emotional burdens of feelings,, maybe that’s my key? The autopilot every vet goes to when you do a surgery. You just go,,, one little step at a time. Push the emotions, all of them, to the back of your mind and jump in, do it.

My day to day life as a veterinarian in private practice is a bar maids soaked towel of feelings. Drowning, quick sand feelings. Feel a lot for the abused, neglected dying kitten, then try to swallow the feelings of intense hurt when a client talks down to you as the person “who does what they tell me they want me to do.” (Insert euthanize a pet that doesn’t fit their lifestyle any longer). Too often these scenarios are both the same case. People can kill you with their cruelty. Feelings hurt as much as they heal. We don’t get to choose how they are handed to you. Going away to a place I have never been to help animals without clients to tell me how I am supposed to treat them is bliss. The cruelty of war, the neglect of all human kindness being a luxury war wont permit is bare bones medicine. That’s adrenaline that feeds the soul. that’s where I want to be. At least for a little while. That’s compelling.

I am booking tickets tomorrow for Northeastern Romania. I will leave next week. There is a small group of people there already. They travel daily into the Ukraine to help move out the animals left behind. I will be there to help in anyway I can. I will post more as the journey unfolds. It is takes two days to travel. We stay in a makeshift warehouse kept warm by space heaters. There is no running water, bare bones electric and a narrow window that these abandoned starving animals have to find safety. Hundreds of dogs and cats have been extracted and taken back into Romania into an ever growing city of portable shelters. It is a humanitarian crisis of epic proportions. Unlike a natural disaster which strikes and then vanishes after it passes through this has no end in sight. This just compounds the need and direness.

The Futility Of It All. How Futility Fuels Empathetic Activism.

Serafina. Her story here 

The futility of it all is ubiquitous if you sit and think about any of it for longer than a moment. This appears to be true because just about everything imaginable can fall into the futility category. Just take a minute and think about a few examples.. You might  have to take a few steps back,, narrow, or widen, the focus, but, it's true.

Or, so I fear most days.

You will die,,, there's a big one. What the heck does it all matter if that is the final thought? Eat more cake. Watch more t.v.. Buy that expensive purse. Live larger, or, live longer,,, (which is it?). Can you do both? Isn't it all futile if a nuke lands in your back yard tomorrow?

It's futile to deny it.. All of it will end. Someday.

But, wait a minute, what about our pets? Those little delightful beings that drive us to do almost everything we so willingly have to do. Like waking  up early on those precious few days off, cleaning (yes, this includes diarrhea and vomit on the living room rug at 2 am, and, hair in every corner of every room). And, don't have to do.. like putting on a pretty dress for our eat-in dinner date together. I swear that my home lives by the motto: "I work hard so my cat doesn't have to." But, is all of this futile? My precious short time with them? My deep adoration toward them? Am I alone in this singular thought that NO! It isn't! They are my life,, certainly that can't be futile? Can it?

Pawbly is the place I chose to put my excess futile efforts outside of my too often also arguably already futile vet practice. (Futility meets its maker on an even larger scale. Yipppeee!). I can't follow any current vet practice ownership model. They have all become too calculating on how to make more money, how to lure more client visits, manage your practice better so it is more efficient AND more profitable. Listen to the experts, embrace the real facts that some people just shouldn't have a pet if they cannot afford them.. we after all are vets, we know everything,,, we should decide who lives and dies and who deserves companionship... yeah, I'm not this person... it's futile for me to try.

Poe. His story here.

There are endless debates about the futility of vet medicine. It is jarring to think about how futile that whole long four years of vet school is as the foundation of ice cream is to its banana creme sundae of my daily futile veterinary life. At least that's what it feels like in this profession on some days. Do you know how many times a day that I have to plead for a patient because I am certain that their treatment will NOT be futile? Or, how many times I have to look at an animal knowing I cannot alter the path they are on already because life as they know it is futile at this juncture. Never mind the even more futile and heart crushing cases that I can intervene on behalf of and SAVE but aren't given the chance to! Yes, I feel like my life, whole veterinary existence, is futile far too often.

For many clients the futility of their pets medical options might be financial constraints, personal issues that preclude ability to preform the treatment or an intervention task needed, or, the awful reality that life is replaceable, expendable, an economic equation, perhaps not just the current status of their health but perhaps their entire existence, and the utter lack of seeing our life as a reflection of others. That's when futility makes this veterinary life almost impossible to bear any longer.

Fripp and Storm. My puppies. Their story here.

The problem as I see it is that whatever I might know, or want to utilize to assist or intervene on behalf of, dish and dole to those who find me, and the importance of life as I see it, is futile when that patients care, or ability to access it is decided by someone lacking the ability to see their life as anything more than, well you know already; futile.

Can you see the dilemma?

The face. The cases you never forget.

It's not the ending of a life at its end from some debilitating destructively devastating disease that rips you to shreds. It's the ending a life at its most vulnerable time of needing me, the vet, to intervene for them and being unable to that makes it all feel futile. Hence, Pawbly. Try to offer more help to more people and deliver it to them for free, (which by the way it most certainly isn't).

Storm. His first appearance here.

It hits me pretty hard on occasion. This dance between navigating selfish decisions, suffering, economics, and easy street to avoid feeling anything. Then the smack in the face of futility wakes me. Pets are at the mercy of people too often. People are governed by motives I cannot always alter. People don't want to be decided for, and far too often they can't see their pets, their dilemmas and their place in altering courses like I can. Futile to try to convince, futile to push, plead, beg, and not permitted to coerce,,, futile.

Serafina.. futility at its best.

Going into every pet related situation as a veterinarian with my automatic assumption that my clients, (I say "my" because I do have invested ownership in them,, I know most other vets say 'the' (always pay attention to grammar,,, imperative of these is the choice of the noun. "Mine" is non-binary, we are all safe with "mine" ,,, use it, mean it, small soapbox diversion ended now),  is setting me up for problems, inevitably. There is this invisible line that seasoned vets learn to nimbly maneuver. Act like the patients best friend if the client can pay, send them to specialists, offer best practice medicine, charge premium for all of it, or, act like the bearer of compassionate euthanasia as their next best option if they can't. Appear to care, but decide who is worthy of our time and expertise based on financial ability first, deem the remaining as futility cases otherwise. Doesn't work for the patient all the time does it? What if I tried to always side with what was best for my patient? Albeit I might be biased, and, I might possess a more tempered professionally honed medical lens to decide who is and isn't likely to live a little longer. What if I just decided that I was my patients advocate and stuck to my guns about it regardless of the finances? Seems easier to tip-toe through this way with a client who might just think that medicine, my whole purpose is just futility dressed up in a white coat. Well, not so fast. I know many a financially sound client who uses a date, age, disease, length of  expected treatment plan, and even degree of personal involvement in said treatment plan, who opts to get another pet as this one doesn't meet their "acceptability" standard any longer. That argument, that plea to intervene on the patients behalf, leaves me with a patient of my own to try to rehome (which oddly has been easier than I assumed), or, a furious client because I am "not honoring their wishes." (Umm, does the pet have a wish? Can I ask? please?).

My Fripp. Found in a box on the side of the road.
If that almost didn't kill her a week in the shelter for her mandatory hold period almost did.

In a deep conversation with the smartest, most successful person I know, the topic of my pet project Pawbly came up. In one second of air sucking despair he gave it to me. The complete futility in the ridiculousness of a business that even a philanthropist would balk at as they dis-considered it. There it was, the perspective of extending compassionate for free care gone, evaporated, scoffed at. Futility Be Mine.

Futile efforts to herd the vacuum.

How interdependent are we all on each other? That's the question I often ask myself as the dog and cat mom to my family. Beauty, in all its intricate delicacy fades. Love herself is futile if you don't jump in and let yourself be brave enough to surrender to it. Be courageous enough to have your heart broken. Willingly. That's the aphrodisiac to futility. There is futility in caring. It will fall away from your fingertips. Leave you. And, yet I stand here stethoscope ready for the next set of futile feet to patter in or fall upon my compassionate driven threshold.

Poe

I wander in futility for the opportunity to be met by that every so often occasion where intervention matters, recognized or not. That one little soul who meanders in to my clinic, or, my website, and is able to depart better than they arrived. That one play that shifts the deck in their favor. The win in a sea of losses. The sheer joyful moment where what I have chosen to do with my life matters. The admission that this moment exists outside of every moment of every day where my beloved companions; Charlie, Storm, Fripp, Wren, Jitterbug, Oriole, and Magpie reside. That place where butterflies are air suspended floating winged fairies. Frogs are coins leaping in a fountain, and a new glorious sunrise is at the end of every nap. That omnipresent yearning where bellies are always anxiously awaiting the next treat in the many forms they find them, and nestling fur remains snuggled close the my laying legs with a reassuring resting fingertips to remind them they are safe here. It is the life I choose, futile amongst the otherwise.

Serafina

As for my largest futile effort, Pawbly, it still matters to me. This wanderlust idea that a place I created can transform a culture into acceptance that we got a few things wrong in our fear to protect our profitability. The futileness in believing that pets matter more then the dictionary portrays them as. That they are our beloved family. Our furred little ones. The idea that our lives are meaningful to each other, and worth the heartbreak the loss will cost us. That believing you can continue to try is worth the heart you wear on your white coated lapel. Profitable or not it's futile to try to take it with you.

The futility is in the trying to get through life without pain, disappointment, or solitude. The futility is denying  that empathy and love solves them all.

Anyone want a feral cat?
Sure,, meet Muffins, one of our JVC kitties.

Here's to endless practicing in futility! The bitter disappointment to futility's attempts to sway my little chips into its magnanimous suit of armor.

And proving myself wrong. That none of this is futile. It's futile to try.

Taking Frippie home.

Related Blogs;

Find What Breaks Your Heart. Why I do what I do in my veterinary practice.

Borrowing Battery Juice. How I utilize the lack of compassion I see too much of as a source of strength.

Affordable Options Are Everyone's Right. Difficult cases, expensive care and how I manage the tenuous cases that present.

The Turtle and the Unicorn. Entrepreneurialism in Veterinary Medicine. My way.

The Year of Year Around Care. Transparency in Jarrettsville Veterinary Center. How we changed the face of our practice to benefit our patients.

If you are interested in help for your pet and don't know where to go please find us here at Pawbly.com. It is a free online community dedicated to educating and inspiring pet people everywhere. It is free to use and open to everyone.

I can also be found at Jarrettsville Vet in Harford County Maryland. Visit our Facebook page here, or see our online Price Guide at our website jarrettsvillevet.com

The Rabbit Hole. When Supply Outnumbers Demand, and Free Isn't Incentive Enough.

When it comes to pets there is an endless supply of "free" replacements available. Endless. There is NEVER a time where the shelves are clear at the shelter. There are multiple rescues within a 30 minute drive that have upwards of 500 cats available (begging for homes) under their roofs for adoption. The numbers are staggering, the supply unyielding and the consequences too often unimaginable.

At the present time cats are FREE and, with a FREE gift (for the holidays) at the local shelter. It is becoming a fairly common practice for high volume shelters to offer "free pets" in the busy and overcrowded periods. For example: The Spring kitten explosion. The housing of hoarder interventions. The days after the holidays when people deposit unwanted pets for vacation plans, new pets, and company visiting. Free is a wonderful marketing tool. BUT what happens if you can't even give them away? At the shelter they are advertising and including "a present as an extra bonus" incentive?!. (face palm). This is part of the problem. It is not an easy problem to solve, BUT, it has to be addressed. The best answers to overcrowding, over populated pets likely lie within all of society. But the brunt of it is shouldered by the shelters and rescues. They are after all the catch all for the castaways, forgottens, abandoned, and lost. They NEED to exist. You are not going to change these. People die, lose their homes, cannot afford to care anymore, etc, etc. Shelters and rescues NEED to exist for the pets no one wants, and those who are missing. Pets deserve a chance to find their own (old or new) family. BUT relegating them to "free" may not be our best way to preserve their safety and value?

Luna.
Rescued from the  shelter,, loving life at JVC

If the replacement value is so low and the supply so great this only leaves an emotional tie to keep the system running. The debate over emotional bonds between pets and their people is undeniable. If you haven't had your heart stolen by a purr, a wag, a nuzzle, or the unyielding unconditional love of a pet you haven't let your heart open long enough to enjoy the most wonderful part of sharing a life with the love of a companion.

Pets own us. They do with each moment we get to spend with them. The emotional ties have evolved into bestowing of names, personalized beds, blankets, and bowls, monthly treat deliveries and a market that grows faster than (almost) any other. It is so lucrative and strong that venture capital is pouring into it every-single-day.

Mouse. Abandoned three times. Then he met us.
Turns out he is deaf and a dog.
Embrace who you are and there is someone for everyone.

For those of us in the shelters, who know these unwanted cast-aways it is a tough acceptance that giving them away to the wrong people is worth the chance of euthanasia to reduce in shelter numbers. If people can't, or won't, invest in their pets care are they good parents? Are we setting everyone up for disaster and disappointment. After all no pet is really "free". They will need basic care this will inevitably include veterinary care, and this might even be more expensive than "free". It is a real-life dilemma that I don't have any other answer to than "anything is better than dead. I think?"

The Roaring Pet Market, Forbes article. Here

The Littles.. Stuart and Falcon.
Rescued from the shelter where they couldn't shake their upper respiratory infection.
They needed love, time, antibiotics, and antivirals.
Some cases are easy and some remind you why it takes 4 years to get through vet school.

If you have any questions or comments please find me on Twitter at @FreePetAdvice, or ask me any pet question for free at Pawbly.com I am also at the clinic Jarrettsville Veterinary Center in Jarrettsville Maryland. 

Rescue Economics. When the Expense Costs You Your Ability To Care.

Annie

Lately I am finding myself questioning the grey lines between the black and white. The definitive Yes's and No's. The right and the wrong gets blurry and hard to decide. The more I see the more I try to tip-toe and spare all around me. It is not the life of bliss and skipping through fields of daisies. This is real-life death and despair, and shit, it sucks sometimes.

Not too long ago a fellow rescue friend vehemently argued with me that it was "excessive that a cat dental could cost $400." She refused to listen to all that goes into those dentals and how anesthesia, doctor time and expertise, and the degree of care and responsibility that we invest into them influences the clients final cost. She is a rescue volunteer who has helped hundreds of cats over many decades whom I respect but, I fear that her perception of the overwhelming need has diluted her recognition of what "ideal care" is. It isn't hard to get to this place when the assembly line of TNR's disfigures your ability to recognize optimal or acceptable and has replaced it with quick, cheap and processed. She also has never had to stand witness to the stress, fear, and deep anxiety that riddles every surgeon who has to be dentist, anesthesiologist, veterinarian and humanitarian. When you lose the individual in providing for the masses you are losing the trees for the forest..

Another uber rescue wizard Facebook friend posted this.. it reminded me once again about how much we have to do and how difficult it can be when there are bean counters in the ranks.

I am appalled by a private message I received by a "Facebook friend" about the little chihuahua family, Annie and her puppies from the Houston shelter in Texas I rescued.

I was first just going to ignore this message and un-friend her and not let it get to me since everyone is entitled to their own opinion. I am not even sure how she ended up as one of my friends if she doesn't have the passion of compassion for animals since I am pretty selective whose friend request I accept.

But my blood is boiling by what she said:

"Why would you spend so much money on these dogs in Texas where so many dogs in your area that need rescue? You could have saved 20 dogs for the amount you are wasting on these."
WASTING??????? I am WASTING money on rescuing dogs????

First of all, every penny I have spent and continue to spend in the rescue of a dog is never WASTED and very well INVESTED as every needful soul is worth saving. NO dog ever deserves to be in a shelter confused why they are there and why their life would be at jeopardy and could end at any given moment.

This little family had no control over their situation that ended them up there, nor had they control over being sick and miserable. They didn't ask to be there, trust me.
We put them there! Ignorant people who won't get their dogs fixed and turn the blind eye to the neighbor who breeds dogs in their back yard. If everyone would spay and neuter their dogs and take responsibility, this little family wouldn't have ended up there.

Statistics:
Spaying and neutering makes a big difference: Just one unaltered female dog and her offspring can produce 67,000 puppies in only six years. In seven years, one female cat and her offspring can produce an incredible 370,000 kittens! 8 Million dogs and cats enter shelters in the U.S. each year. More than 1/2 won't make it out alive.

I can't save them all, but I made a difference in the life of little Annie and her puppies. I can only focus on the "Starfish Story" and keep saving one at a time.

My dear Facebook friend: "You tell this little family they are NOT WORTH saving by WASTING money on them." I can't. I will do everything and anything to save them, with much blood, sweat and so many tears, and every Dollar that is needed.

I am not going to unfriend you with the hopes that you will follow their rescue journey and see the joy and pride they give me, and everyone involved with their rescue, and everyone who supports animal rescue and enjoys following these precious souls. And the love and joy they will give and receive by the families who will adopt them is the biggest reward. That to me is PRICELESS and that is why I continue what I do!!!!!!

As we always say in rescue, "we have lost our minds but found our souls" but I wouldn't have it any other way.
heart emoticon

Annie and her puppies

No one can argue that there is a forest of need and a million trees being overlooked. But, God, don't let me finish this journey not seeing those eyes, that warm nose, giving that little soul a hug and telling them how much they are loved. 

This is Paisely. She was surrendered with her sisters at the local shelter. She was not spayed, she was kept in a cage, and sent to us as a last ditch effort to help her presumptive rare medical condition. After three vets, vaccines, anesthesia, and one misfortune after another she was found to be pregnant. She is the epitome of the faces of our broken humanity. The overlooked, minimized, and disposed of. She is now with a foster mom who loves her and will be there for her. She is the forest and the trees and all of the faces that compassion beholds.

Please join me in helping pet people all over the world by joining the free online pet platform dedicated to educating and inspiring by providing free information and assistance. Pawbly.com is all about pets and the people who love them.

I can also be found in the vet hospital, mostly kissing pets. Meet me anytime at Jarrettsville Vet in Jarrettsville Maryland, I am also on Twitter @FreePetAdvice. 

My Veterinary Rescue Shaming and The Frank-Starling Law.

Warning: This blog o' mine can become my sounding board. My vessel to vent. And, yes my therapy couch as I continue to try to keep my chin up and press on... I share my experiences, thoughts, and yes, even my stumbles along this journey as a way to grow, learn, and provide my burgeoning heart of emotional baggage a place to rest.

My Magpie. 

We live in a competitive consumer driven society. Subsequently there is intense contentious debate about pricing in veterinary medicine. I have added my own thoughts, and I do recognize that many people believe that the veterinary profession is pricing our clients out of their ability to care for their pets/our patients. I hear it all too often from an angry, frustrated, desperate finger pointed harsh protest about "excessive cost of care" and" how this is the reason for the current state of pet welfare."

None of us want to be humiliated or felt as if we have been taken advantage of. It is an emotion encountered when you allow yourself to be vulnerable and/or wear your emotions on your sleeve. It is a common characteristic for those of us who choose a profession in healthcare.

In medicine we call it "shaming."

After a decade in private practice, lots and lots of pro bono work (which I used to take great pride in and even boast about) for both clients, rescues, and rescue volunteers, and now I am feeling lost. The rescue people I hoped both appreciated and needed my skills are seeking care "at their regular vet" (what am I chopped liver?), or complaining about my excessive "regular costs." I now see why it is so common for other vets to just say "No" when asked for free/discounted care.

The trick to keeping yourself adequately armored from shame, guilt and humiliation is to be just far enough from the situation as to appear resistant to the emotional tactics employed when the dilemma presents.  I am seemingly unable to embrace or accept this concept.

Magpie relaxes after a hard day of relaxing.

The clinic I own has been or become the veterinary care provider to a few local rescues. We provide whatever care needed and provide our vet services for free and all goods at cost. It is the best deal I could even propose to provide.

As a practice owner it always appears that the need exceeds the ability to help everyone who asks. How do you manage this fact on a day to day basis? I think that most vets just start saying "No" because they feel they have to. If we cannot meet the need why even start? Rescues and shelters therefore believe vets have turned their backs on what the foundation of our profession stands for.

My current debacle is trying to remain interested in helping these rescues simply for my own peace of mind. The expectation of accolades or appreciation is being crushed by recent events.

My Joe and Wren

"Give me your clinic time and discounts but I'm taking my personal pets elsewhere."

Winter snow day 2016, Jekyll and Charleston. Both rescues..

Situation Number 1;

RV 1 (Rescue Volunteer 1);  "Hello, yes, I'm calling to get a refill of the xx medication for my dog."

Me; "OK, please hold, while we check your file." short pause on hold. "Umm, Ms. T, it seems we forwarded your pets records to another clinic? Is that correct?" (I swear I should know better by now than to answer my own phone lines..)

RV 1; "Yes, I don't come to your clinic anymore because the wait time to see the vet is too long. But I haven't been to the new vet yet and I don't want to pay them an office visit if I can get it from you guys now."

Me; "So you are telling me that you want to continue to bring rescue dogs here, but you don't want to wait while we take care of other rescue dogs? And now we are supposed to provide medications because it will save you money and from having to go to your new vet?"
Angry click and multiple Facebook berated comments about how we are all about the money follow. Along with an apology from the rescue founder when she caught wind of it.

Magpie proof reads

Situation Number 2;
How about answering to the rescue founders who bring their pets to other clinics who never help the rescue pets in need. That's a hard one to accept. Would it be so hurtful if their own vet participated in the spay/neuter clinics we do? Maybe not?

The reason I sleep in, Wren under the blankets, Oriole provides cover.

Situation Number 3;
Open letter from a personal friend and devoted long time rescue employee;
"Dear Veterinarians of the World,
I'd like to make a request. Until you work very faithfully and with utmost dedication at a rescue or a shelter, can you please not bad mouth ALL shelters and rescues ever? I find this very (very, very, very, very, EXPLICITLY...) frustrating.
We don't live in an ideal world. We're just trying to save lives.
heart emoticon,

PS. I absolutely LOVE all of the vets I know personally. It's the vets I hear about 2nd and 3rd hand who seem to criticize rescues and shelters the most. I'd love to have a conversation with anyone who thinks negatively of rescues or shelters...." XXXtech

Reply from another fellow RV (rescue volunteer);
"Really? How can you not think there is a problem with vet pricing, please 350.00-400.00 for a feline dental? I'm sorry if that isn't excessive , I don't know what is. Societal problem, no it's not a societal problem, not everyone has the means to put out that kind of money for routine care let alone if one of them gets sick. Most don't. You are doing a wonderful service to the community and the animals and don't ever forget how phenomenal you are, we need more people like you who dedicate their lives to the welfare of these animals and you should never let their ignorant comments affect the outstanding job rescues and shelters such as XXX does."

(personal note to self,, stop answering my clinics phones and reading posts on social media)

Me;
"We need to talk about this rant! If you can figure out a way to keep your cat quiet and still while I clean their teeth I would be happy to shave $150 off that price. It's not excessive. I promise. If you and the rest of the world would kindly start brushing your pets teeth twice a day society won't have an excessively expensive pet dental problem. I am sad to see this."

RV
"No rant, just my opinion, and I will never be convinced that that price is justified. Maybe $200, but 350-400, please. this was my opinion that 350-400 for a dental is overpriced. I'm not comparing them to XXX's care, I've worked too many spay/neuter clinics to compare; by all means the quality of care is far superior at the vet than what you get at the shelter, but sorry, this is my opinion and we can agree to disagree if you'd like."


Me;
"You are welcome at the clinic anytime. I would be happy to show you where the cost goes. In many cases the old adage "you get what you pay for" applies. If I could provide it cheaper I would. We can agree to disagree and I will do my very best to not give up on providing excellent care at affordable prices even to the wonderful rescue people who seem to sometimes not appreciate it. Perhaps some will not believe me when I say this, but, if done correctly by someone trained to do it, a dental needs to have anesthesia, should absolutely have iv fluids, nerve blocks, and dental X-rays. Extractions if needed, and most dentals (I would say 70% plus) need them have to be done by a trained vet. Then a cleaning and polishing. The fastest dental is about an hour. There is absolutely no way this can happen for less than $300. If you want it to be a profitable clinic it starts at $400. I am sure there are people who balk at the extra price of non GMO fair trade organic food. Do I understand why it costs more? Yes, because I care to invest the time and attention in understand how my actions impact the world I live in. If you can find a $200 dental I promise I can find numerous short cuts that are detrimental to your pets health and safety. Being an educated and compassionate consumer takes work and a kind heart.

I am trying to be a vet who helps everyone and supports rescue. I care deeply about the people of XXX and those in my community. I hate to see all of the nastiness and division between us. I wish you all well in your efforts to help animals."

XXXtech reply;
This conversation has definitely taken a turn from what I originally intended. I'm with Dr. Magnifico. The costs are justified at full service vet clinics. They have staff to pay, overhead to think about, and they offer quality service. While rescues need to think about these things, we're at least lucky to raise money for necessary expenses through generous supporters. Veterinarians do not have that luxury. Often times at a low-cost clinic, certain things aren't done to save time and money. This isn't ideal, but sometimes it's the only option the animal/caretaker has and, in those instances, it's better than having the animal euthanized because a full service vet can't be afforded.
I see both sides of the coin. We do the best we can for our rescue animals, and also people in the community who cannot afford higher prices. On a personal note, I prefer to take my own pets to vet clinics for exams and certain procedures because I know that there's often a higher level of quality care that is offered.
I am lucky though in that I can utilize certain services at the rescue like low-cost bloodwork or at cost medicines. That's why having so many animals is at least feasible. Many people don't have this nice perk, so vet care can be quite costly.

Me;
I'm sorry XXXtech I know this wasn't what you intended the post to become. But it is important that we all talk to each other openly and honestly. It would have been very easy to walk away from this conversation and silently swear to myself to never help the ungrateful critics who ask for it. Alienating myself from those I know are trying to help animals in need just feeds the problem. I don't want to be part of the angry other side. So I struggle remain a part of the solution and see the good in all people. In rescue, veterinary medicine, and life this is a huge challenge.

Jekyll reminds me to keep a healthy perspective on life.

I had to do what I often find myself doing more often, I had to walk away. Leave the battle that was only going to divide us. I have to pull up my passionate opinions, roots, let go of the connections that cause pain, try to reinforce my insulation in a healthy manner, and not carry a burden that will only prevent me from that next furry face who needs me as much as I need them.

In the end I still struggle. I don't propose to know what the right answer for everyone else is. I know that I have to focus on the furry faces I am here to provide for. I cannot ask, look, expect, or even hope to get anything from anyone else. Shame, I have it, we all do, it is why we became vets, I just can't chose my path based on it. My heart is still on my sleeve, it always has been, always will be, and in the end I think it is the best part of me.. broken, bruised, resilient, over burgeoning, over taxed, and over abundant. For those of you who are in this boat with me remember the Frank-Starling Law, our hearts can increase their volume when there is an increased load. (Personal note; all of my cats are named after bird species. Next cat; 'Starling').

There are lots of us struggling with this shame on every side. The immensely over burdening need, the responsibility of every rescue/person/vet trying to save every pet and asking each other everyday to extend our necks, our pockets, our hearts, and give away another piece of ourselves. There is an avalanche of need. A tsunami of shaming.

Worst for me the rescues, the people I most closely bear my soul to, work tirelessly for and try to help above and beyond every other request, berate and remind me that if I am fragile, sensitive, wear my heart on my sleeve, or let someone, they can humiliate, hurt, and castigate publicly. It feels as if this is going to drive me to either turning a blind eye, or succumbing to the compassion fatigue that hides like a shadow behind every corner.

How can the one group of people that are supposed to most closely understand the burden of my heavy heart turn on me? I don't know. But, there is probably enough blame to burn down every compassionate effort and then we will still have to remind each other why we do what we do.

Magpie.
Found as a kitten with a broken ankle and adopted by us from the rescue above.
She is one of the lights of my life and why anything else matters.

End footnote; Judgments, criticism and and cruelty can be kept to yourself, I have enough that I provide myself, and, am still trying to find a place to stow them.

Related articles on Vet Shaming; Coping With Vet Shaming, Andy Roark, DVM, MS

My related blogs;

Economic Euthanasia

Carry Each Others Burdens.

The Profitability of Drive-Thru Euthanasia Clinics.

Can Veterinary Care Evolve With Our Clients?

Compassion Fatigue.

There Has To Be Mercy Before Money.

Never Surrender Your Voice.

What Are You Building?

Making Vet Care More Accessible.

Blog Update; March 2017. It has been a year exactly since this was written. Both rescues mentioned above have closed. Perhaps it wasn't the right relationship for any of us? JVC is now assisting three other TNR rescues. It is an amazing group of women who are as invested in patient care as we are. I think we finally found our perfect match!!

I considered removing my rants above, but, I think it is important to remain honest, even in the vulnerable frustrating times. They are inevitable, but they are survivable. They cause us to reflect, analyze and ultimately grow. They also forced me to be open, honest and make some hard decisions. If we cannot work together we cannot ultimately achieve our goal of helping animals.

Make a new furry faced friend every day

Please join me on Pawbly.com. Pawbly is an open free community based pet information exchange network.

If you  would like to discuss your pets care in person I am available for appointments at Jarrettsville Veterinary Center in Jarrettsville Maryland. JVC is open 7 days a week. JVC publishes our prices every year. The 2016 Price Guide can be found here.

I am also on Twitter @FreePetAdvice.