Saturday, November 23, 2013

The Reality of Veterinary Medicine

As most of you know, I recently switched jobs from a day practice and now work in a 24 hour hospital as an Emergency Veterinarian.  I absolutely LOVE this aspect/side of vet med, and I wouldn't (and don't) want to do anything else... ever (like every other vet, I am a type-A overachieving work-a-colic). However, there are moments when I am hit with the reality of what my job REALLY is, and I wanted to take a moment and share with everyone my experience, especially in light of the recent media regarding vet med.

I walked into work this evening at 5:45pm ready for my overnight shift, and felt like I was walking into a room of chaos. I took a moment just to evaluate my surroundings and see where I could jump in and help.  What I realized was: 1) there was nothing for me to do, and 2) the hospital at that moment was the reality of vet med.
*I would like everyone now to really try and picture what I am about to describe. For my vet friends, this won't seem out of the ordinary... in fact, this is probably every day. For those that are not vets, it will give you insight into what YOUR vet REALLY does... it is not all happy healthy puppies and kittens... actually... it is UNCOMMONLY puppies and kittens...*

Sitting in the back on one of the treatment tables was a cardboard coffin with a 5 month old puppy in it, waiting to be picked up by its owner. This puppy had passed away during a neuter. Come to find out during surgery, that the puppy had several congenital abnormalities that were hidden from pre-op bloodwork and physical exam (every precaution to make sure anesthesia and surgery is as safe as possible), and only discovered during surgery, causing the puppy not to wake up after anesthesia. Any veterinarian will tell you that a neuter is one of the simplest surgeries that we do. We could do it in our sleep. However, unseen complications happen, and there is nothing that anyone could have done to prevent this from happening. This was an unhealthy puppy that was not going to live a long and happy life, it would have gotten very sick and died at a very young age. However, the veterinarian that performed the surgery was devastated. This was the first time this had ever happened to this veterinarian in 5 years of practice... 5 years and countless surgeries. Put yourself in this vet's shoes for a moment: You just lost someone's baby under anesthesia for a surgery that YOU recommended. Colleagues and even your own head tell you - This was not my fault. There was nothing that I, or anyone could have done. This happens to everyone. But your heart only feels pain and guilt and anguish for a life lost and your failure, and an inability to serve the purpose that you were put on this Earth to do: HEAL. Now comes the hard part (I know, like everything else isn't hard enough!). You now have to get on the phone and call the owner of that puppy and tell them what happened. You get to break the news to mom, dad, and their son (the person the puppy was bought for) that their best friend is gone. You get to tell someone who is excited about playing fetch and running around in the yard, you get to tell them, I am so sorry, but your dog is dead. It puts a knot in your stomach and chest that nothing else can. It makes you sick and hurt to the deepest part of your soul. You hurt for the owners, for the puppy. You hurt because you caused PAIN.

In this same moment there is a dog and owner in a room with another doctor. This dog has been unwilling to eat and unable to keep anything down for the past WEEK... and oh yea, the dog ate a cactus a little over a week ago.  The poor dog is so sick and painful it won't let the doctor feel it's belly. Xrays were taken and revealed three cactus needles stabbing through the dog's small intestines causing a perforating foreign body. the doctor explained to the owner that the only way to even give the dog a chance to live is emergency surgery and gave an estimate for the $1500 surgery and a 50/50 prognosis. The owner's response? Anger. Saying things to the veterinarian like: How could she be so cold and insensitive? She only wants money. If she REALLY cared about the dog, she would do the surgery for free. But no, she doesn't care and is a terrible, cold hearted, unfeeling, horrid person who is MAKING her kill her dog when the dog COULD be saved if she would just stop being such a money grubbing Scrooge. I ask again, put yourself in the vet's shoes. You have a dog that you know for the past WEEK has sat at home, starving, in pain, with a fever, feeling horrible and puking its guts up as three needles stab through it's intestines. And what did the owner do? nothing. You know the dog is suffering, but you can potentially help and save it's life! But what will the owner let you do? nothing. You know that had the owner brought the dog in right after it ate the cactus you could have used the scope and gotten the needles out for about $400. But they waited A WEEK. And according to the owner, this is all your fault. Her dog is going to die because of you. Talk about feeling powerless! You can't even defend yourself! Your response. "I know this is a difficult situation, and I am so sorry." But at the end of it all, you are the one that has to inject in the hot pink euthanasia juice knowing you have the skills and abilities to save this dog's life, and instead, you must end it.

The final scenario that was occurring was an older dog that suddenly started limping on one of his legs. The owners thought, oh he must have arthritis, we will take him in and get some meds and he will be fine. The vet had already taken xrays before I got there and saw the bone cancer that was covering this dog's humerus. Again, put yourself in the doctor's position. You now have to tell someone that their best friend of 10+ years has cancer. The big C. Their options are either 1) amputate the limb, 2) very short term pain management (days) or 3) euthanize right now. You have to shatter their world and make people cry. You cannot offer any relief aside from euthanasia, which is no relief at all for the family. You get to be the bringer of bad news.

All of this occurred at 5:45pm... AFTER an entire day that started at 8am, with even more cases similar to these. This was one 15 minute section of time in a 10 hour long work day. No wonder veterinary medicine suffers from the highest suicide rate and highest addiction rate of any other profession. No wonder all veterinarians at some point suffer from what is called "compassion fatigue". Unfortunately, the majority of people do not understand this about our profession. I cannot tell you how many times people have said to me, "oh you must LOVE your job! You get to play with puppies and kittens all day! Though, I bet it is hard when you occasionally have to euthanize something." I just nod, and smile. What they don't know is that I am thinking - yes, it is very hard. Those THREE patients I euthanized in the past 30 minutes were very hard (which happened on my overnight shift tonight).

I appreciate you if you made it this far!! All I am trying to do is help people to realize what the reality of vet med is... and what it is not. We are NOT in it for the money. We recommend tests and vaccines because we had 8 years of schooling that taught us what was best for your pet. We are overworked, emotionally drained, compassion fatigued, under appreciated/respected, and SEVERELY underpaid for what we do (because no amount of money is worth what we go through on a daily basis, *and side note, average salary for a veterinarian is $45,000/year and average student loan debt is over $150,000 :)* ). Yet, we wake up every morning and devote our life to your pets. We love them as if they are our own, we cry over them when they don't make it, we work long hours and stay late working and reading to learn and try to figure out why your pet is sick. We talk to them like they are people and love them even when they try to bite us. We deliver pain, hurt, bad news, and encounter countless situations that we have no control over throughout our entire day. Our reward is internal... it is knowing that at the end of every day we have done everything that we can to the very best of our abilities for every patient we have touched, even if that means ending their suffering.

Thanks for reading :)
Lindsey Lane Verlander, DVM