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Friday, 21 March 2008

Unnecessary suffering.

This week has been one of the hardest.

When you are hurting inside there is nowhere for a vet to hide.

No desk to sit behind, no computer screen or client sales.

A new face every ten minutes, a new emotional dilemma, criticism from your boss again, no time to eat, people counting on you to finish operations you barely have time to begin.

In order to stop the meltdown I have developed an emotional shell, life's too short to deal with this sort of crap. When clients make unreasonable demands and ask questions they already know the answer to, I say nothing. When no-one is willing to speak up and defend themselves during a battering from management I step forward.

I am holding it together.

Until by some cruel twist of fate, Molly Watkins is brought into my consulting room. Molly is a fourteen year old cat. She has lost the vision in her left eye and has poor use of her right fore limb and right hind limb. It is very likely that she has a left sided lesion in her brain. Molly is an old cat and I warn the owners that she might have a brain tumour.

Molly gets worse the next day and they decide to have her put to sleep.

Mr Watkins insists that their seven year old son be present whilst I give the injection.

'You've got to learn that things die son.' He tells him.

But soon the young boy is wailing, not because he is upset over the loss of his pet but because his own mother is crying and visibly distressed.

The sound they make is unbearable.

I can count the number of times my mother has cried in front of me on one hand. I remember each and every time, even from when I was a young child because it always breaks my heart. When I think of the number of times she has been my shoulder to cry on for various trivial matters and how painful this must have been for her too it makes me feel ashamed.

This week I have heard that soft but painful sound she tries so hard to keep from me twice.

Her sister has been diagnosed with a brain tumour.


'I don't know how you can do this job.' Mr Watkins says to me.

Ironically, as he watches my eyes fill with tears he looks strangely satisfied to see that perhaps sometimes I can't.

I want to scream at him, 'I don't know how you can call yourself a parent!'

But I say nothing because that is part of doing my job.

Friday, 14 March 2008

Too late.

Charlie is a large un-neutered Tom cat. I have seen him twice for cat bite infections.

Both times I have told his owner, Mrs Withers that neutering might help prevent the fights.

I have also told her that Charlie's life style is more likely to cause him to stray and get hit by a car.

Charlie is also far more likely to contract the feline immunodeficiency virus, FIV or 'cat aids'. The virus is spread amongst cats through bite wounds and it is also sexually transmited.

But Mrs Withers did not take my advice.

Charlie didn't get better from his latest war wounds and I suggested we check that his immune system was not at fault by testing him for cat aids.

Charlie tested positive.

Charlie would have to be neutered and kept in doors to prevent him infecting more cats, eventually he would not get better. Mrs Withers asked me to put Charlie to sleep.

She asked me if she could have ashes back.

Ironic that she would be prepared to pay £100 for Charlie's private cremation, approximately twice the cost of a simple neutering operation that could have saved his life.

Sadly I don't think Charlie will be the only victim here and I hate to think of the number of cats he might have infected during his short life.

When clients tell me they want to allow their female cats to have a litter of kittens, I urge them to think twice before letting the local tom cat near, you just don't know what they might be carrying.

Wednesday, 5 March 2008

Losing my footing.

The recent criticism of how I like to practise has taken it's toll and I have found myself stumbling through my work this week.

I missed a simple diagnosis today whilst another more experienced vet picked it up with ease in the blink of an eye.

If I am asked by a colleague how to manage a case I immediately ask about the clients financial situation rather than conjuring up my usual list of tests. I am more guarded and unwilling to commit to an answer.

I am left wondering whether I was really any good in the first place?

I feel fragile and unsure.

Worse still I am questioning my own judgement.

It won't be long before I'll be handing out the antibiotics like smarties and give up running any diagnostic tests at all.

I used to have a strong instinct that would usually lead me in the right direction with a case but now I just feel empty.

I have lost my way.

I only hope it's not too late to find my way home again.

Tuesday, 4 March 2008

The secret pet.

Tall, taught, athletic, well muscled, aloof and unattainable.

The mens all eight high performance rowing team strut passed. Their closely fitting Lycra emphasising every inch of their perfectly toned torsos and much, much more..

Do they look left at the boat house?

No.

Do they look right at the river?

No.

Do they look down at those beneath them?

No.

I smile, hoping to catch the attention of the biggest of the bunch who I have spoken to on one occasion.

He ignores me. They continue on in silence.

But I am not intimidated.

'How's Timmy the tortoise?' I ask him loudly and pointedly.

There is a delay of approximately ten seconds, they are not the sharpest bunch.

Finally the words sink in.

Then all eight roar with laughter.

Vengeance is sweet.

He really should have thought twice before his drunken confession to LittleVet about his love for his secret pet Timmy, currently hibernating under his staircase.

Sunday, 2 March 2008

He loves me, he loves me not?

My colleague has developed a small crush on one of her clients.

'The only problem is that he is so into his dog that I'm finding it quite a turn off.' She tells me.

'It's like it's his kid or something.' She continues.

I explain to her that the attraction is likely to be mutual.

'How do you know that?' She asks.

'Because he thinks that as a vet you will automatically love his dog too and therefore by showing a keen interest in his dog he will be gaining your affection.'

Having recently dated a man with a dog I speak from experience. We only went on two dates but during that period he asked me to examine his dog four times under fairly false pretences.

'If you like him, you must never let on that when you look at his dog you only see a dog, from now on his dog must be very special dog to you too.'

'I don't like him that much.' She replied. 'If he had a cat then we might have something to work with.'

Saturday, 1 March 2008

Dumbing it down.

I have been told by my employer that an ever increasing number of people are complaining about the cost of my investigations and veterinary care.

Since these so-called complaints have not been written, neither recorded nor recalled I cannot defend myself.

A recent study suggests that if a veterinary surgery is not receiving more that two complaints a week, they are not charging enough.

There are two paths a veterinary surgeon can decide to take throughout their career.

The first is the easy, path of least resistance. Antibiotics or steroids, minimal investigation, pattern recognition and presumptive diagnosis. Minimal effort. This will work in 80 % of cases but 20% of the time a vital diagnosis will be missed and the patient and owner will be let down.

The second is evidence based medicine. This involves a logical, methodical approach and recognition that A+B does not always equal C. It involves more effort and time which comes at a cost and there will be times when the animal just gets better by itself despite a £400 bill. But there are also times when it will save a life.

I have chosen my path and I will stick to it because I believe in providing the best quality care for my patients. I refuse to dumb down. The reason my investigations are more costly than they were four years ago is simply because I am a better clinician than I was four years ago and therefore able to provide a more thorough service. I do not purposely subject animals to procedures that are un-necessary for financial gain. I will carefully assess what is required in each case and ultimately I receive no share of the profit.

If my path is the wrong one then why do many members of staff who know how I like to approach my cases choose to bring their animals to see me?

Despite the hard work I continue to put in and the dedication I have for each and every one of my patients, I have never received a single word of praise from my employer and this recent criticism for which there is no proof is a sad attempt to knock my confidence. A sad attempt because at times it can feel quite threatening for those who have always chosen the path of least resistance to watch others mop up the mess they leave behind. To watch others who are younger and greedy for knowledge pick up a diagnosis they missed. How very English to attempt to stamp out the flame before it burns too brightly rather than nurture and respect it.

Perhaps it's time for me to tread my path elsewhere.

Somewhere I will feel appreciated rather than undervalued and demoralised just when I felt I was reaching the top of my game.