Hank. Cervical Disc Disease Management When Surgical Treatment is NOT an Option. His journey and recovery blog.

Hank was a statistic no one wanted to happen.

He is a beagle who is middle aged, lazy and overweight. He also spends his time outdoors with a hyperactive over exuberant nut case of a brother, Moe. Moe has everything going for him. He is active, lean, muscular, and full of energy. This lifestyle has made him a powerhouse, it has also made him a liability to his brother, fat, old, slothy Hank.

Moe, Caleb, Hank

Hank was found laying on his side unable to stand, move, or walk on a Friday afternoon. He was shaking, trembling, and crying in pain. His family brought him to see me on a Sunday after it was apparent he was not recovering on his own.

Now I am just like you. I heard his story, looked at his pitiful pathetic desperate self and thought, "Oh God! why did they wait to bring him in?"

This is what I saw when I entered the exam room the first time I met Hank and Caleb.
I will never forget seeing them.
I feared the worst...

I have been wearing a white coat for a while. It has provided me some important life lessons. One is to not assume or rush to judgement. Hank's family was overwhelmed with caretaking for their son, Caleb, who has spina bifada. Caleb is 8 years old and preparing for his 6th surgery this year. It was very clear very quickly that this family was taxed beyond what many of us could handle on a routine basis and now Hank was down and out. When I discussed my concerns for Hank, how he needed to be transferred immediately to a neurologist and how the optimal care for his current condition would require an MRI and decompression surgery with its $8,000 to $10,000 price tag, his family went white with anguish.

Hank was Caleb's best friend. His lifeline, and his inspiration for all of his surgeries. At every surgery Caleb carried in a stuffed version of his beloved Hank to keep him company.

My bright idea of publicly posting Hank's condition in an effort to gain social media assistance to cover some, or all, of Hanks medical costs was abandoned when Caleb's mom quietly mentioned that they already had a GoFund me site set up to help pay for Caleb's next surgery. How could I ask for help with Hank's medical needs when Caleb's were in competition for those dollars? There was no way I was going to ask, or beg, for help and have it cost Caleb. So I did what I believed was the only option left. I took Hank's case on as my own. No advertising, no reimbursement, no discussion of anything except to say to his mom "You worry about Caleb and yourself, and I will worry about Hank."

And so it was. After two nights in the clinic Hank came home with me. I arrived at home late Wednesday evening with a paralyzed Hank and an almost absent ambivalent husband who now expects that I take the critical cases home with me. A few minutes of basic technician training and my husband was enlisted in Hank's care and understanding that verbal protests would only damage our relationship and fail at discouraging my maternal veterinary compulsions.

After 14 days with us, including a week of almost completely sleepless nights because Hank refused to sleep on a dog bed at the end of our bed, and would only stop crying, whining and bellowing when I put him in our bed. Which is a ridiculously dangerous place to be because who wants a paralyzed dog to fall out of bed? AND he is peeing and pooping at unforeseen intervals.

Hank required 24/7 care. Multiple baths at 2 am because had to go to the bathroom, multiple times getting up to try to figure out if the whimpering and discontent meant he needed something like, perhaps,, food?, water?, pain medication?, to go outside?, to sit up?, to get more attention?, to see the cat who believed she also belonged on the bed?, to cool him off?, warm him up?, etc. etc. There is no exception to these pups being an intensive amount of work with an unknown amount of recovery time.

There were days I went to work exhausted and cranky. There were nights my husband hated me for inflicting these restless nights upon our bedroom. And, there were the endless questions of whether this was all for naught? Would he ever get better? Would his family take him back? Would that be best for Hank? What would the rest of Hank's life look like? Would he relapse in a week? A month? A year? Would he recover the next time?

Here is Hank's YouTube diary.

There are a few critical things I hope that everyone leaves this blog with;

1. These cases are difficult.

2. There is no rule book for time and prognosis.

3. These cases need affordable options provided to clients,

4. Never surrender hope.

5. Or let anyone steal your faith.

6. These cases deserve an opportunity to provide and offer the fertile ground of miracles a chance. If any vet tells to you surrender your hope IF YOU DON'T have a couple grand available immediately walk out and find another vet. 

7. Managing pain is possible, and these cases have a chance at recovery. Hank was trembling and panting for a week in discomfort. It was hard to watch, and I tried very hard to keep him as comfortable as possible, BUT, I did not out him in a drug induced coma. 

8. We got through it together! Me, Hank, my husband, and the staff at the clinic. Provide a supportive network or encouraging helpful people. Death is not an option I considered. I understand this is on a case by case basis, BUT, I was prepared for a cart and a dog who needed help for as long as Hank needed help.

What does Hanks future hold? I am not sure. He is home with his family. We talk often and we will continue to do so. Caleb has his next surgery next week. Our best wishes and thoughts are with him. We have faith,,,, sometimes that is enough.

Caleb comes to visit Hank, day 3.

Hank and his family day 10

There is a whole lot more information on IVDD on my other blogs. Please visit them. I think they answer every question I have ever had on managing this disease.

Hank goes home, day 17

IVDD. The Days Immediately Following the Diagnosis.

IVDD. Dr Kelcourse's Advice.

IVDD. A Tale Of Two Outcomes.

If you have a pet in need, or a pet question you would like to ask, please find the helpful people at Pawbly.com. It is a free and open community for anyone and everyone who loves pets.

I am also available via Facebook, Twitter @FreePetAdvice, and YouTube. 

The Year Of Year Around Care, Transparency, and Accessibility. How Jarrettsville Vet Will Redefine Exceptional Patient Care.

2016 was a banner year for us at Jarrettsville Vet. It was really the first year we started to both think and act way outside of the traditional veterinary clinic box.

We were always a little different. Something I embraced a long time ago. I wasn't cut from the cloth of everyone else and I have learned the very hard and painful way that I could be exactly who I felt compelled to be without fear of castigation and shame as long as I stayed true to who I had always dreamt I wanted to be. At some point you grow out of the ability to force yourself into a mold you foolishly think others believe you should fit into. It is a combination of maturity meets exhaustion when you just cannot be at peace with yourself any longer. Last year was the year I really gave up trying to do anything else except help animals. Last year was a banner year because of this. All of that sweating the small stuff of being responsible for payroll, bills, and overhead gets, well,,, old. It inhibits your freedom to be creative, to live beyond possessions and when you are a dreamer at heart it is a parasite on your vision.

In 2016 we helped rescue, tame, care for, vaccinate, spay/neuter and find amazing homes for over 60 cats. We also helped about a dozen dogs. It was a sincere pleasure and delight to see emaciated, frightened parasite and disease ridden skeletons blossom into jubilant healthy joyful love bugs, and then head off into a life of their own. It happened over, and over, and over. So much so that many of us actually didn't recognize them when they returned to be spayed and neutered. 

We also opened the kennel up to any pet who needed shelter on the hottest, or, coldest days of the year. We helped feral cats in snow storms, homeless pets from freezing in cars, and even a chicken who forgot to shed feathers in the Spring versus the Fall. Did the pragmatic vet in me whisper about fear of staff being bitten by unknown pets? Yes. Did I worry about giving up paid tenant space to a poor homeless kid? Yes. Did I secretly fear that some random uncared for pet might cause a disease outbreak? Sure I did. But at the end of the day, and at the closure of 2016, I know that my heart, and the hearts of the staff who work so hard to help every pet we take care of, believe the purpose of JVC is to "always be kind." We live it.

This year also marked the beginning of our JVC Food Pantry. The simple extension of providing vet care and shelter without cost to those who need it, also now extends to feeding those who do not have the means to buy food. 

We also had a work shop day to make outdoor cat shelters. Thanks to the incredible generosity of our friends at Gemmill Plumbing, Heating and Air Conditioning we made a dozen  cat houses (that got snatched up in less than 24 hours) for the cats who do not have a warm inside bed to share with their humans. The shelters were offered to anyone who needed them for the suggested donation cost of $7.00. We provided them for free if this was not affordable. (PS please visit the Gemmill's and send a big Thank You!). It was such a resounding success that we are doing it again this Thursday.

This year our Spring Yard Sale was a huge success too! We raised about $2,000 from vendor donations and friends who donated every thing imaginable. Our Pets With Santa also raised about $2500 for the Good Sam Fund. Two fundraisers provided food, lodging, feral cat care, homeless pet assistance, and a litany of good deeds.

Did I ever imagine that every single pet need would be covered by our community pitching in to help? Well, it far surpassed my wildest dreams! I thought I would just end up doing a whole lot of pro bono work to fulfill the presumed endless need, but, it turned out the outpouring of support far outnumbered the need.

Simple things like posting our Price Guide. Putting our transparency where our mouth is provided proof that we have no hidden agenda other than to be the place that your pet is provided the best care at the most affordable prices. It is what I would want if I was the person sitting and waiting in the exam room. I would want to know that my worries would be treated with respect, fairness and dignity. There are endless options as long as the team approach remains focused on helping your pet. Where there is love there are options to help preserve and protect this bond.

So what is new for us in 2017? Well there is a lot!

We are going to be offering Pet Savings Plans to help spread out the yearly costs of pet care. We are going to provide options to preventatives. You can choose the "Easy Preventative Plan" the "Most Affordable Preventative Plan" or, the "Preferred Preventative Plan". We will even send you reminders for them, AND, we will show you what the online pharmacy charge for the same preventative is. (Look out Progressive Insurance,, Move over Flo!)

We are offering new services, new client options for goods and services and we are going to do it with credibility and integrity. The heart and soul are complimentary and always included.

Accessibility has been a key factor in our ability to help our clients. If you need us you can find us anytime via a Facebook message, a question on Pawbly.com (free!), or, coming in late Spring via our app. I also widely publish my email address for all clients. If you don't have it call me and ask for it. It is on every receipt and end of examination Pet Report Card.

What else is there to do? Well, I am going to move mountains, break ceilings, and shatter myths about veterinary medicine. If there is one veterinary demon left to slay it is that I am not going to stop until every pet has a home, every creature has a warm bed, a full belly and a loving hand to share their life with. How can I do this? I am going to keep finding ways to end the ridiculous practice of economic euthanasia. What is economic euthanasia? It is the veterinary profession's way of saying "the only option for you is to euthanize your pet because we can't offer you more affordable options." It is the sequela of abandonment of where this profession came from and legal sheltering of pets still only being considered as "property". We can do better. I am going to challenge the profession to see the shame and the betrayal in this term.

For anyone who might not be confident in the ability to have faith that the new year won't bring positive changes I invite you to stick close, find us, and watch what can happen when you don't care about anything else except building positive change. Is it possible? Yes, if you believe and you dare to be different. Here's to 2017!

Related blogs;

Price Guide 2016

Economic Euthanasia

What is Pawbly?

Pet Savings Plan, JVC Plan For Clients with Financial Constraints

Jarrettsville Vet Pet Food Pantry

Borrowing Battery Juice

Wellness Plans and Savings Plans, and Surprises

What do you think? Is change in veterinary care possible? Is it something you think needs to happen? If you have a voice for better pet care please share it.

If you can help a pet in need please find us at Pawbly.com. It is a free open online community dedicated to helping pets and their people.

I am also on Facebook, Twitter, YouTube and at the clinic helping every wet nose and furry friend.

The Turtle and the Unicorn

It's a matter of perception, like everything else. I could tag it more appropriately as obsession, but then the compulsion aspect would kick in and I would be compelled to fix it. So I'll call it a habit.

I am addicted to goals. A junkie of to-do lists, action packed days, and chaos to meet the ocean of needful souls popping up everywhere around me. Like all of us I perpetuate these on both a micro and macro scale. I set up a complex set of tasks to achieve them and I chew away like a crack headed beaver nibbling my own way to building the Taj Mahal. I suppose I would have to pick out the words of "driven, determined and dreamer" should I be reduced to a tag line on a head stone. It is who I am.

When I decided I was going to go to veterinary school about 25 years ago, after having just graduated college in a field with an available job pool of about two options I knew I had a long and unlikely attainable road ahead of me. My resolution to the dilemma; I vowed to only read veterinary textbooks until I got into vet school. Every available second of my other life was dedicated to building my own knowledge base through a book.

When I decided to become an entrepreneur I cancelled my subscriptions to Martha Stewart, Country Living, and my last guilty pleasure: Elle. It hurt bad. I did after all attend a military academy and those 14 years of being a drag queen stuck in khakis left me yearning for red nails and manicured eye brows.

Religiously and doggedly I pine cover to cover through Inc, FastCompany, and Entrepreneur. Month after month. Year after year. If the turtle was ever intended to win the race it will be another decade at another attempt to force an action into a plan that is so slow in evolving everyone else mocks or gives up on you. My legacy left to my own devices and obsession and maybe some intangible dream that only I believe in?

Beta tests, hunches, risk and personal sacrifice. They are all here in tiny specks of a life threaded on a compulsion and a new day to try once more to build something, do something, and be something no one else sees as possible, plausible, or profitable.

The next time you pass by some obsessive compulsive ask them if they need a water break? Or a hand? They might just be Sisyphus pushing their imaginary self-imposed boulder up their own hill of dreams.


To all of the dreams that might have been unanswered and overlooked.. here's looking at you kids.

Queen, our latest case.
Foreign body, EPI, and cachexia.
Happy ending to follow soon.

Weasely. From cast away and deformed.. to rock star and unstoppable.

Paisely, who came to us from the Humane Society with severe mammary enlargement that was ulcerated, painful, and might have been the cause for being euthanized. After a finger biting failed attempt at a spay we could not do she found her happy ever after with out friend Jenn. Here she is on day one with us, and 8 months later: perfect.

Mumford, rescued by Jewel's House Animal Sanctuary in DC from NYC, he has come from this photo to a happy (almost perfectly healthy) very grateful miracle.

His shelter photo.

Arrival at the clinic.

Jarrettsville vet photo 4 days after arrival.

Poppy, a feral kitten full of lice with her ulna broken and sticking out of her leg. Miraculously her leg is healing and she is walking on it. 

Poppy at arrival

today

One of the almost 70 kittens and cats JVC helped in 2016... about a dozen last ditch dog cases.. and a team of people who believe that anything is possible.

Starting small, helping every single soul we meet.. it is the reality of this dreamer and the best way we can inspire the big dreams and the unicorns.

Who am I? Well, the dreamer, the do-gooder, and the glass half way.. well,, we already established all of this.

I am a small animal veterinarian in Harford County Maryland. You can find me at the clinic, Jarrettsville Veterinary Center, on YouTube, on Twitter @FreePetAdvice, and if you have a pet question, or, are a pet person please join us at Pawbly.com. 

Tips To Avoid A Trip To The Vet.

Daily there is a call, an online request, a pet parent at the door who has found themselves in a perilous pet predicament that they were not prepared for. It is unrelenting and exhausting. Worst of all it is in so many cases; they are avoidable.

Magpie

In an effort to ebb the tide I have assembled a short list of common avoidable pet health care issues.

As a small incentive I added associated costs for avoiding them and what you might expect to pay if you end up at the emergency clinic.

Brush teeth daily. Cost to client, FREE, cost to resolve when they are at stage 4 can range from $800 at my clinic to $2,000 (plus) at a specialists office. Not to mention the damage a diseased mouth does to the heart, kidneys, and overall health. 

Wren

Eat a good nutritious wholesome food. If your pet is predisposed to obesity, disease, and any other ailment by their breed or genetics then diet is a key element to avoiding the worsening or exacerbating an underlying predisposition or disease process. You are what you eat, and, you get what you pay for. These are inescapable. The expensive prescription diets are, well, of course, expensive, but so is intensive care for a diabetic coma, heart failure, kidney disease, and a multitude of other conditions. It is my firm belief that we make up for poor diversification in breeding by diet and exercise. We will willingly pay $2,000 for a giant round lab puppy, then balk at the joint prescription diet they need daily to preserve their ambulatory function after they blow both knees.

Wren

Get lots of sleep. Dogs and cats have this concept mastered. We have some important lessons to learn from them. Try to go to bed tired, clear headed and exchanging whispers of adoration. Stress does awful insidious unraveling of our core functions. Not to mention obsessive compulsive disorders, incessant chewing, and needful whining, pacing, or nocturnal activity. Free!

Wren

Lots of interesting nose grabbing exercise. What do I mean by this? Let your dog be a dog. Sniff, tug, play, hide, walks that are adventurous AND at their own pace and destination. Let them explore the world. The best exercise is the one that is fun. Stop walking the path everyone before you has forged. Go off leash! Get dirty! Embrace the flavors of the season. Heck, go ahead and roll in it! Free!

Charlie and Jekyl

Ideal body weight and muscle mass. Avoid lots of the diseases and disease processes that obesity predisposes your pet to. Indoor cats need exercise and I warn about poor quality free feeding of dry kibble. Few of us maintain healthy eating habits at the "all you can eat" buffet bar. Try feeding a high quality canned food for breakfast and dinner. For an average indoor cat this is about 3/4 of a 5 oz can twice a day with 1/4 cup of high quality dry kibble as a "scavenger hunt" snack. For dogs I recommend they be fed twice daily a vet recommended food. Again, make it fun, earned, palatable and intentioned. Make it part of your daily morning and evening regimen. Clean the bowl and monitor poor intake as a means of health status. Diabetes, thyroid issues, cancer, joint problems,, gosh the list is long and expensive. Crazy expensive and often debilitating to life threatening, if not, severely life impacting.

Wren

Basic parasite prevention. For my part of the world this includes fleas, ticks, heartworm, and intestinal parasite preventatives. For less than $20 a month you can protect and prevent a flurry of health insults that not only threaten your pets health and safety but also your own. Heartworm treatment costs up to $2500, intestinal parasites can lead to life threatening gi conditions, and more kittens die of fleas than almost anything else. Tragic and completely preventable.

Charleston

Spay and neuter your dog by 1 year old (7 months for cats). For the few poorly bred, hyperinbred, cancer prominent breeds they may benefit from sterilization at 18 months. Most pets were acquired to be companions. Spay and neuter. Avoid unwanted pet over population and behavior issues. Cost of pyometra surgery at an emergency clinic can be > $2500. Pyometra blog.

Chloe and Cooper. Two divine miracles!

Obedience and socialization. What would happen to you if you were not able to care for your pet AND your pet refuses to allow anyone else near it? Obedience is NOT about submission to humans. Rather it is enjoyment with sharing life with them. Be kind, compassionate and teach those around you to enjoy and love life. Not fear it. Too many pets are euthanized due to behavior issues that stem from not being adequately socialized.

Wren

Microchips save lives every single day. If you want the most affordable way to get one see a vaccine clinic, shelter, or rescue. They are obtainable for about $25 in many places. The statistics on finding your pet (cats predominantly) after they are lost is abysmal.

Start a savings plan for the unforeseeable accidents ahead. Wellness plans are not in the consumers best interests. Avoid them. Purchase pet insurance instead. Or, best yet. Put away $40 a month in a pet emergency fund. You will thank yourself later. Average emergency visits for trauma alone are in the thousands of dollars. Accidents happen, be prepared. Many are treatable with the help of an emergency plan and resources in place.

Poppy

Have a great vet who knows how much you love your pet and be there for each other. Here are my tips on how to get something for nothing from your vet. At our clinic there is an answer for every situation and dilemma. Find a vet who will help you in both the good times and bad. 

Stop smoking. It is killing everyone in your home. Your feline family first. Smoking shortens everyone's life. Please quit for your kids, two and four legged. 

Basic hygiene and grooming. This includes petting, brushing/combing/brushing teeth every single day. The most beautiful and luxuriously coated cats are those who are loved, caressed, and kept matt free, flea and tick free and groomed by their family. Your fingers can feel the grit of flea dirt, the hair bunched in the armpits, behind the ears, around the face, and base of tail, etc.. The simple act of petting your pet is the single best indicator of their overall health. Train your hands to be the best instrument a vet has. And, at the same time you are reinforcing the love and trust every pet longs for. A sore spot, a wet spot, a decrease in muscle mass are all vital clues in identifying a problem at its infancy.

Magpie

Do you have any tips you think I forgot to mention? Please add them as a comment.  I look forward to hearing them.

If you have a pet question or concern please find me on Pawbly.com. I am also on Twitter @FreePetAdvice, YouTube, Facebook at Jarrettsville Vet, and in the clinic seeing appointments.

Please always be kind.

Law Suits and Veterinary Medicine. What To Do When The Courtroom Comes Calling.

This blog was written with the help of a few friends. Two are lawyers, one a veterinary malpractice attorney.  These two dear friends also urged me to not publish this. It is "too personal and could  paint me in a precarious light." I have grappled with this for weeks. If you want to be anyone of merit you have to be true to who you are and go beyond what others will. I have had two brushes with the legal side of veterinary medical practice. Both were cases where I put my neck out to help a pet and their family and both were times that that family tried to make me responsible for their pets misfortune. 

**I must provide a disclaimer to remind everyone that I am NOT an attorney. Please seek an attorney  for assistance should you find yourself in the cross hairs of a legal dispute.

In an effort to help calm my nerves my husband reported that he had done a little research and the "average veterinary practice is served with a lawsuit once in every three years." Based on my 10 year veterinary tenure I would say that I am one lawsuit short of the average. Two suits in 10 years is two more than I would like to have faced. Both are behind me, and both have left me a little smarter, a little thicker skinned, and more determined than ever to help other vets when their 36 months run out.

Here is some of what I have learned when the suits meet the scrubs;

• You cannot tip toe through life trying to remain unscathed and off the radar. Pets are, and continue to become, integral parts of the family. With emotional attachment comes the responsibility to provide for both our patients and our clients. That, and,,, 

• We live in a crazy litigious society. No escaping it, but, please try not to become it.

• Be prepared for stormy weather. There are many wonderful glorious days of slaying illness, thwarting cancer, and soothing disease ridden pets so that they can live to see another day and with each bucolic day break lurks a thunderstorm somewhere on the horizon. It is life. There is good and, therefore, there has to be bad. Embrace both, they are life in its entirety.

• You will feel the problem cases coming. As soon as you do hit the medical record and start shoring up the records to cover your ass. If your handwriting is like the rest of us take a few moments away from the constant barrage of phone calls, barking dogs, and pestering people and sit down to read your record. Think about where the holes are. Fill in as much detail as possible.

• Relive every single detail of every interaction about the case and write it down as soon as you remember it. I walked around everyday with a notebook to jot down things I had forgotten, or neglected to tell my lawyer. I then sat down and assembled the whole case from day 1 to the final blow over a weekend. I drafted a 10 page recount complete with timeline, thoughts, and perceptions. I also provided guidance to my lawyer about my clients that I thought might possibly be relevant.

• Re-living and writing all of this was both painful and cathartic. I could put it on paper and walk away. Getting those interviews, meetings, documents, and thoughts out of my head and  in someone else's hands was the only time I could get some small degree of normalcy back.

• Never ever lie. That's the stuff that will get your butt nailed. You will in all likelihood have to swear on it in court. Start with the truth the whole truth and stick with it.

• Keep your trap shut. Once a client starts circling over head it is best to not try to minimize the damages by offering more fuel for their fodder. Shut up and get legal counsel.

• When the State Medical Board comes knocking take the same advice. They, in my experience, are gathering information to use against you. They expect you to talk but they will use it against you and they have the unfortunate ability of taking it out of context when you have no way of proving otherwise. "Yes" and "No" answers will serve you best. Should I ever have to face this again I will be using technology to my advantage. Get your lawyer on Skype, use Meerkat, or video tape the entire proceeding. For my case there were gross egregious errors and the guy who took my interview mysteriously disappeared to never be seen, or held accountable, again. I know it sounds ridiculous, but that is exactly what happened.

• Take the advice you give your new associates. When a challenge of a new unknown case raises the little hairs on the back of your neck, and you think that you cannot face the challenge, nor succeed, jump in anyway. Never let fear, doubt, or insecurity halt your ability to heal and help others. That is what we are trained to do. Do it, live it, and jump in!

• Never back down from a case that needs you and has no other option. In the end tis better to have tried and failed than to have never tried at all.

• Don't walk away and leave a patient to suffer because you allowed your fear and insecurities to govern your ability.

• Be prepared. Expect every amazing, devoted client who you believe trusts and cares about you as you cared for their pet to stab you in the back. It happens, that's why lawyers make so much more money than we do.

•  Don't be stupid enough to believe your demeanor and generous time provide compensation when a client gets pissed off. 

• Do have an exit strategy. For the day, the week, the month, and this career. Sometimes a light at the end of any tunnel is enough to keep trucking ahead. Even through the worst of times.

• Walk into every situation with a best and worse case scenario. Have a plan for each. We do this for every patient we see. Learn to do it for yourself.

• Never surrender your voice or your purpose. The State Medical Boards, the courts, the community can beat you up and strip you of years of your blood, sweat and tears, but in the end you walk away alone. In the end it only matters that you walk away alive and proud of the little tiny moments no one saw, paid for, or wrote Thank-You cards for. There is not one veterinarian who hasn't made another life better. 

• Protect yourself. Hire people who are versed, experienced, and prepared to go the distance. This includes your staff, your associates, your accountants, and your legal advisers.

• Relinquish the reins to those you hire to protect you, and to those who will care for and protect you while you cannot stand alone. Only greed, arrogance, and grossly negligent immaturity will destroy a career. 

• Go to sleep at night with a clear conscious, whatever that costs you. Write a check and settle when a court case looms ahead. 

• Break it down to simple unbiased mathematics. Hard and soft costs accumulate quickly. Disease doesn't choose a one year old puppy as a personal vendetta to a life just begun. How many times have we seen that? Life isn't fair. Step out of your emotional anger and apply science and math to a problem. 

• When the storm recedes and there is an the end, (there is always an end), you have to be able to face yourself tomorrow. 

• There is a winner and a loser. Money can buy you better odds, but ultimately fate, luck, and timing decide the narrow margins. Just accept that. 

• Don't undersell your day to day health and blood pressure. Try to take a few steps back, see both sides, and be the rational person in the room of people who lack both the desire to have a clear conscious and a moral compass. Somehow lawyers can be bipolar, vicious and blood sucking and still smile at both sides of the gallery with equal conviction and genuine probity. It is the antithesis of a veterinarian. If Themis holds a scale blindfolded there is a lawyer on one side and a vet on the other. Find a lawyer as opposite as you are to provide some semblance of balance. For my case it required a short bearded man with a devilish smile, witty sense of sarcasm, and a heavy hand delivered in a slow calm slicing hand shake.

• Call the AVMA and have PLIT insurance. Notify them of every potential case. Get a team in place before the letters, lawyers, and subpoenas arrive. Remember that your PLIT appointed lawyer works for a company, not you. They are there to protect you but are paid and must remain employed by someone else. I  think that in 10 years I have called them 6 times to alert them of the potential of a suit. I am sure my folder isn't the thickest in their office, but I may be the most proactive client they have. Oddly, I still only pay $69 a year for them to answer my paranoid phone calls.

• There are battles where no one wins. There are fights that cost you more than green backs. Lawyers will be paid, you will lose time and money and the case will close. Let go of being angry. Don't swap one bad emotional crutch for another. 

Get out alive. Preferably not bitter and hating your fellow man. We have a legacy of humility, generosity and compassion to live up to. Leave the ugly stuff to the lawyers. I recommend you find one who is the yin to your yang now. The clock is ticking. Have you had your 36 month case yet?

Related blogs;

Working and Living the the Land of Liability.

We Don't See You. How Vets became biased and lost our clients in the process.

Fear and Guilt. Why these won't help your pet get better, and why our pets are smarter than we are.

Compassion Fatigue.

There has to be Mercy Before Money.

Weasely

Footnote;
It has been many months since I had my last brush with the long arm. I remain a bit bitter and biased and convinced the vets with  friends in influential and politically flirtatious positions avoid being placed in the spotlight, or questioned when complaints are filed. It is a seriously flawed secretive system. As with much of veterinary medicine is archaic and severely lacking jurisprudence legitimacy. Any legit constitutional lawyer would laugh at our Lord of the Flies self governed veterinary judicial circus. I take great comfort in being reprimanded for not offering euthanasia to a 5 month old puppy with treatable injuries who I had treated, was subsequently blackmailed (by both the MD State Board and owner) to return and refused to. Turns out you can kill a cat with an arrow and still keep your license. Laughable,  ridiculous, and inane.

Stand up for what you believe and never let fear of reprisal abandon your compassion.

Dunkin

Find me at the clinic, Jarrettsville Vet, on Facebook, Twitter, YouTube, or providing free vet advice on Pawbly.com.