Sunday, April 6, 2014

I Am More Than a Veterinarian - Guest Post

I had an epiphany today. I am more than a veterinarian. I have read that when you ask a veterinarian who they are, they answer, I am a veterinarian. And I’ve thought, well of course they do. Because in our culture who you are is what you do, right? Sure, I’m a mom and a wife and a gardener and the caretaker of a menagerie of animals. Recently I’ve decided to be a runner and am training for a marathon. I’m a cheese maker, a daughter, a homeschooler, a sister, and when I have time, a damned fine cook. But if you ask me what I am, I will tell you I am a veterinarian.

And that is a logical answer. I am the owner of, and the only veterinarian of a small, rural practice. I get up 6 days/week and go to work. I spend my entire day there, usually not leaving the building nor taking a break from the time I arrive until the time I go home. I often get home at bedtime, or sometimes even after the bedtime of my kids. Some days I don’t see my kids at all while they are awake. Because I am a veterinarian. My days are full of caring for my patients. I try to keep the healthy ones healthy. I try to make the sick ones well. I spend hours every week holding the hands of my clients (literally and figuratively) while they try to work through their own issues. Sometimes the issues we work through have little to do with their pets, but that’s OK, because I am a sounding board, a psychologist, a shoulder to lean on, a hander of tissues, a cheerleader, a veterinarian. I care deeply about my patients and the people who bring them to see me. I care about them so much so that I put my own life on hold, regularly, to be there for them.

But I am not there all the time. Sometimes I have obligations outside the four walls of my office. Sometimes I need to be a parent, a wife, a patient myself. Sometimes I need to get my hair cut. Sometimes my own pets need me to drive them to a vet across the state. Sometimes I try to squeeze in a run or an exercise class. Sometimes I try to weed my garden, or visit my elderly parents, catch up with a loved, but rarely seen friend. These things get put in the small hours, squeezed in between the big picture. I miss my run 8/10 times. The weeds will win the war this summer as they have every summer before. My husband is a single parent most days and nights. I have not been involved in my children’s homeschooling this year. I don’t get to stay home with a sick, feverish child who cries for me to stay. I have a nine year old who cried, asking me if I could please work less because I am never home. I pay this price because I am a veterinarian.

I was heartbroken today to talk to a client who was angry with me for not being available to her when she had an emergency. I had a local veterinarian and two emergency clinics who could have helped her. But I was not available. Her dog suffered waiting for me. She is angry with me. I have let them all down. She and her husband had a lot of things to say to me today. And one of them was something along the lines of, “you are a veterinarian and that should be your life.” It has been my life. For the last 15 years I have been a veterinarian first, second, and mostly. But today...today I spoke words I didn’t know I would ever speak. I look this sad and angry couple in the eye, and I said, “I am not just a veterinarian. This is not my whole life. I have a husband. I have 3 children. I have a life and hobbies outside of this building. I work 6 days each week. I can not there for everyone all the time. I can not please everyone.”

I said that. You don’t know me. You don’t understand the power of those words. But I understood. Instantly. In that moment I realized. I am more than a veterinarian. I am a lot more. And the rest of me is important. To my husband, my children, my pets, my parents, my friends, my sisters. And to me. It is easy to get caught up in the needs of your clients and patients in this business. They need me. And I have gotten lost in trying to be there to fill all of their needs. 


I have lost track of all of the other hats I am supposed to be wearing. I have sacrificed the needs of the people I love the most. My clients are quick to turn on me when they feel wronged. I wasn’t there for this woman. She turned to Facebook to let my entire community know what a monster I am. My family is neglected by me on a daily basis. They have rarely complained to me and never publicly humiliated me. They love me and support me for being...well...me. Not for being a veterinarian. Because that isn’t important to them. I have spent my life defining myself as something that isn’t even important to those that mean the most to me. I realized today that I am not a veterinarian. OK, I am a veterinarian. But that is my profession, it isn’t me. So, if you see me pulling weeds, if I invite you to a dinner I cooked, if you catch me reading a book to my toddler, running on a back road, sharing a morning swim with my girls, milking my goats or out to dinner with my husband, please know. I am still a veterinarian. I still care deeply about you and your furry friend. The wellbeing of both of you is important to me. But the wellbeing of me and my family is important to me, too. And while I will probably always define myself as a veterinarian, I will be a far better one for realizing that all those other things I do are important, too.

Tuesday, April 1, 2014

Humorous interlude for neuro geeks

Paging Dr. Grumpy! 

With apologies to The Knack...

OOh, my little jerky one, my twitchy one
Coming in to see me with MY-OCLONUS

Got my work cut out for me, out for me,
Looking for the cause of your MY-OCLONUS

Never gonna stop, it won't stop
Such a twitchy one, wonder what it's from
CJD, serotonin syndrome?
MY-MY-MY ay-ay-woo!
MY-MY-MY-MY-OCLONUS

Come a little closer huh, a will ya? huh.
Lesion in your spinal cord? MY-OCLONUS!
Keeping it a mystery, gets to me
Twitching down the lengths of your THIGH-OCLONUS!
 
You may now return to your regularly scheduled time wasting :)

Saturday, March 22, 2014

Doing the best thing

Our basic training experience was an orientation class that we had very little interest in. But we didn't get to start veterinary school without sitting through this. So we sat through this.

Our friends endured a more significant basic training before heading out to Viet Nam, so we had little to complain about. But we complained....anyway.

I was nineteen. The oldest guy in the class was 40. We nicknamed him, “Gramps”. Five had masters degrees already. Most all already had at least one bachelors degree. Some had two. I had two years of undergrad under my belt. Five women had been admitted. The class was 71 men, and those 5 ladies. And the term “second class citizen” landed firmly on the ladies' backs. They had to prove they were up for the challenge. And they damn well better not quit to have babies, because that's what everyone expected.

It was 1968. The world was a tad bit different then.

We all wanted to become veterinarians. And the doctors teaching the orientation class intended to teach us what that meant. What we learned wasn't exactly what we expected it should be. These teachers were REALLY old, and we wondered why we must endure them.

Veterinary Medicine had been important for many years before we came along. Decades. A century. More. It had served the farmer, and the horseman. It did the best it could, which was considerable because a small number of truly dedicated, inventive, brilliant, adaptive men figured ways to keep horses sound and farm animals productive.

But there was that other side to our calling, the witchcraft and the charlatan too. Veterinarians were known as “Horse Doctors” The blue ointment worked better than the red one, when the only difference was the coloring agent. And some worked for the money while most others worked dedicated to helping the farmer and the animals.

The men who taught us were the men who during their lifetimes had dragged our profession into the modern world. These were the men who changed things, rid us of the charlatans and the quacks, elevated our passion into something that warranted the title profession. They improved the training, applied the ethics and enforced the ethics, and they were damn sure going to teach us to do the same. We were to inherit their baby, and they wanted us to appreciate it, protect it, perfect it.

We were going to be practicing medicine. We were going to behave as professionals. Our ethics would drive our behavior, not greed or pride. Look around the room....brilliant educated dedicated professionals....colleagues, not competitors. We would hold ourselves to the highest obtainable standards. And the animals and their people would benefits from this. So we all would win.

We would not disparage our colleagues to enrich ourselves.

We would be honest to a fault.

We would not advertise, self aggrandize, lie cheat or steal.

We were professionals. And if we worked hard enough, and sacrificed enough, and achieved enough, we would earn the respect that went with this claim.

And we would refer to ourselves as Veterinarians. We were not to be “Doc”. We would not be the “Vet”. Were were Veterinarians. And yes, we learned how to spell the word. Weren't gonna be no vetinaries in this group.

And through this we found ourselves joining a profession. We were proud. We even earned a degree of respect in the real world. Not like “real doctors” of course, but we did OK. People could trust us. Many did trust us. And we helped them and their animals.

Over time we became really good at this helping animals thing. In the decades of my career we changed Veterinary Medicine into something I would not have recognized at the beginning. Our training became so very much better. Our medicine got ever so much better. A set of blood tests that once yielded information a week later after we mailed them to a lab 300 miles away soon became an over night set of numbers, and then an hour's wait while the machine right there in our office spewed out the results. The x-rays got better, and then we gained access to endoscopy, ultrasound, cat scan and even MRI. Oh, we could do so much more to help.

We've conquered diseases that were the scourge of the animal world. We fix things now that were certain death 40 years ago. We have become so good at preventing some diseases that our critics claim we invented those diseases just to scare folks into spending the money they'd rather spend in casinos and bars.

A days drive to a specialist became twenty minutes across town. Anybody could get world class medicine to save their precious pet in a time of need.

If they wanted to.

My career has spanned the time that can only be described as the golden age of veterinary medicine. This profession has grown, matured, improved so very much as I have watched and participated. We've become damn good at what we do. We are so much more wonderful than when I began. We can offer so much to the animals and their people.

Problem is, we've left some folks behind. And a lot of those folks are our clients. These left behind folks don't want all that we can do to help them. They want the less exciting, less effective, less intimidating, less expensive version we used to offer. As one once told me in total honesty. He didn't want it done right. He just wanted something less done.

Veterinary Medicine has always adapted to the needs of our clients and their animals. Here's the best way to fix that broken leg. Well yeah doc, that's nice, but doncha have a cheaper way? Well, it's not as good, but back in the day we used to do this, and it might work. Do that doc. Sometimes this worked, despite the odds, and we were the heroes.

And when it didn't work....well that was the doctor's fault.

Veterinarians want to do the best job possible to help the animals and their people. Some people want this. Some can afford this. Others cannot, or more often simply choose not. And so we do the best we can with what people let us do.

We hold ourselves to a much higher standard than even our most strident, malicious critics. We want to offer the best. We want to be the best. We lay awake nights wondering if we have done our best. And our clients beg, bargain, connive, demand that we do something less than the best, and when we don't they hate us, and when it goes wrong they hate us. I've had clients scream at me because I will not commit overt malpractice for their convenience, or their wallet.

This is hard.

None of this is new. Read between the lines in “All Creatures Great and Small”. That was pre-war England, but it happened back then, too. Through all those decades of my experience, the Golden Years of Veterinary Medicine, it happened every day. It still does.

But this is going to change.

Law schools now offer classes in how to sue veterinarians. Veterinarians have always carried insurance against malpractice suits. That is our reality. But now the lawyers are seriously sniffing around us.

Sometimes we make mistakes. Sometimes we do the wrong thing, hoping it will somehow turn out to be the right thing. Sometimes we shrug our shoulders and do the shitty job the client demands of us. And the outcome is bad. Sometimes....we simply are not perfect.

Well hell....sue the bastard.

Everybody sues everybody in America. Win a big lawsuit and retire. Play the lawsuit lottery. Listen to the ads on afternoon TV. Sue for this injury, about that drug, because of that product. Good thing the lawyers are looking out for those folks who sit around most every afternoon watching TV. Sue the bastards.

Veterinarians exist to care for animals. But this only happens because people care enough about the animals that they will ask us to help. If people didn't care, we'd be doing something else. But now, because people care, the lawyers can smell a profit. Because if they can prove that we injured a person because the outcome for an animal was not perfect, the lawyers want to turn this into really large pieces of money, as compensation. Sure, they will take a bit of this money for their efforts, but they can dangle the lawsuit lottery in front of people who already hate veterinarians.... and this is coming soon.

Suppose the rewards from suing veterinarians reach the levels the lawyers want. What happens next?

Well, what happened when they did this to the physicians?

Remember “defensive medicine”? That's what the physicians were forced to do...are forced to do, as they try to help in a hostile environment that will bankrupt the doctor if a less than perfect outcome results. Wonder what wrecked human medicine leading to the abortion known as Obamacare? Ask a lawyer.

Ever beg your veterinarian to pass on the blood tests before she cleaned your dog's teeth because you didn't want to spend those few extra bucks?

Well, forget that ever happening again. All those things veterinarians have done to try to help the less committed animal owner, the corners we've cut, for the less wealthy animal owner, the most ignorant animal owner, the liar and cheat....well forget that. Don't even ask. All those things veterinarians have done to compromise doing their best possible job to help the animals and their people will never ever happen again, because the doctors will now have to protect themselves from the consequences of not being perfect.

Every person who has hated his veterinarian for insisting on doing things correctly, every person who had lamented the cost of doing things correctly, every jerk who has accused veterinarians of just doing things for the money..... well get used to it.

You can beg, cajole, insult, nag...to get us to cut those corners. But you will not get your wish.

We will be forced to do things correctly. We will have no choice.

We will be doing what those old guys who lectured us in our basic training class urged us to do, because it was the right thing to do, and some of you will hate it. But you know what? Get used to it, for we will no longer have the choice of choosing malpractice to keep you happy. We can't afford that luxury anymore.

Welcome to our world. Too bad it took greedy lawyers to make you all realize this. Hope you all enjoy it as much as we will.

Thank a lawyer, for if experience bears out, you sure as hell won't thank your veterinarian.

Thursday, March 20, 2014

A Simple Lack of Respect


A different perspective sent in by an intern - what?  We aren't all perfect?  You don't say....   great job, KittySurg.
 



Hi Readers, KittySurg here. I am writing in hope of raising awareness of another issue I see as a great contributor to the high suicide rate in our field. Indeed, performing 4 euthanasias in one day, dealing with Velcro Martha who needs a video of her cat devouring kibble at 2 am to prove the techs aren’t lying, and finding lung mets in your favorite patient can be extremely stressful, but what sends me over the edge at the end of the day is having to deal with some of my asshole superiors and frankly peers, who are so overconfident as to believe that they are always right.

We are a field packed to the brim with type A self-absorbed individuals striving for perfection. The prevailing proclivities are to criticize oneself or criticize others. There is precious little teamwork going on, and support of each other is something we simply don’t have time for.

In the November 15, JAVMA article, “Finding Calm Amid the Chaos,” the consensus from various studies seems to be that those veterinarians transitioning from training to practice seem to be at the greatest risk of depression and suicidal ideation. Entering a new career is always difficult, but working 80-100 hours a week, never seeing family, and living on the poverty line while interest on student debt accrues, can be hellish. If this is coupled with criticism rather than support, one can reach a tippling point, and believe me, many of us have been dangling over the edge.

The fragility of those navigating their first years in practice is a well know fact in Australia and the Netherlands, both of whom have mentor programs that pair newly graduated veterinarians with more experienced colleagues, who help them negotiate their first years in practice and offer general support and advice. I believe that the AVMA should be arranging the same type of mentorship, given the current struggles amid my generation of veterinarians.

Sure, interns and new doctors make mistakes. Constructive criticism is welcome and helpful. I recall giving long-acting insulin IM rather than SQ. The particular criticalist in charge was firm, but nice about my error, much to my great appreciation. She apparently understood that I wasn’t going to learn any more if I’d been able to see the steam blowing out of her ears.

Obviously, constructive criticism for medical mistakes is not the problem I am trying to address. Let’s get back to the topic of unsupportive asshole superiors…

During the first month of my internship, I made what apparently was an insufferable constellation of blunders: I RSVP’d late to the intern dinner, failed to greet a technician in the hall on my first day, wrote in a record that my patient’s anxiety made it difficult to tell if he was painful, and asked Visiting Southern Surgeon if there was a reason not to use a larger holding pin as I watched his 1.6 mm K wire bend under the stress of an overzealous rotation that probably should have been augmented by a cranial closing wedge osteotomy. These mistakes were deemed so serious that they landed me in the office our Very Blonde and Very Crass Hospital Administrator, who has already told our intern class 10 times that she was Business Woman of The Year in our state (after nominating herself 5 years in a row, a detail which she has selectively omitted every time.) VBVC, with her coral lipstick running several millimeters beyond her lip line, asked me why I couldn’t tell the difference between anxiety and pain. “What the hell did you learn in vet school?” she asked, quizzically. “With all due respect, Ma’am,” I learned that animals do not talk.

When I asked Visiting Southern Surgeon about using a larger holding pin, he put down his instruments, looked me in the eye, and told me to “shuuut up.” Later that night when we were finishing up records, he turned to me and told me interns were to be seen and not heard, and that, in one millions years, no question or comment I had during surgery would prove to be useful or correct. “Ahh’m just tryin’ to help you, girl,” he said, with his condescendingly chummy Alabama drawl.

This surgeon’s assumption that the intern is always wrong, and in fact, to blame, has played out perpetually during my year.

Last week, I saw a patient with vestibular disease and a long-term history of otitis externa. I believed that the otitis was a red herring and that the patient had central signs. The attending, Dr. Perfectly Practical disagreed and spent 5 minutes telling me what an idiot I was for missing the obvious—the patient already had otitis, a source of vestibular insult; why would I look elsewhere for an etiology? I was vindicated and (amazingly enough) apologized to when the MRI revealed a giant cerebellar tumor, but I'd spent the morning feeling useless and ignorant.

Then there was the time when I felt my tiny chihuahua patient with a long-term chronic bleed and resultant regenerative anemia (PCV 18) should remain in hospital. Because the source of his chronic bleed had been “fixed,” the attending, Dr. Holier Than Thou Ain’t Never Been Wrong felt he should go home. Yes, the area had been debrided, I thought, but it hadn’t been closed. Little Rembrandt wasn't clinical for his anemia, but I believed he should be in a place that could provide blood transfusion, should he become clinical. Dr. HTT, in so many words, conveyed to me that I had no clinical judgment whatsoever. Yep, time to go work at Starbucks, or better yet, jump off a cliff, I thought. Starbucks won’t even put a dent in my debt. Sure enough, overnight, the little Chihuahua developed tachycardia and bounding pulses. PCV had dropped even further. HTT never apologized—no surprise there.

The next incident involved "Spikey", a cat with paraparesis and pelvic limb ataxia. Spikey needed an MRI, but our MRI couldn't provide appropriate resolution for a creature as small as a cat, so we gave his owners the option of going a few hours away for a stronger MRI or staying here at the hospital for CT/myelogram. Our neurologist had left the practice, and trying not to lose our neuro clientele, we had been given scripts by our Very Blonde and Very Crass Hospital Administrator in response to client questions. One such script stated that all of our surgeons are proficient in CT, myelogram, MRI, and all neurological conditions. Sure Thing, Blondy.

Of course, in spite of these scripts, our Interviewed in Flip Flops Saturday Surgeon from the Virgin Islands had not yet learned to use CT. He'd been here several months, but couldn’t manage to drag his ass to the hospital on a day off (he has 3 every week) to learn how to operate it. The radiologist (who I actually like and respect) was able to operate it, and was slated to be present on the morning my patient needed the CT. All was a go. No one said anything to the contrary in rounds that morning, and Flip Flops had never said that his morning appointments would preclude fitting this in. He said he might have to call in the head surgeon if he got stuck, but this was a "might," and I'd gotten permission from the owners to do the imaging the following day if things got too booked.

This said, I was quite surprised late that morning to learn that Dr. Flip Flops had decided that CT/myelo was out of the question for several different conflicting reasons provided to me by Dr. HTT and later, Dr. Flip Flops himself. I was now supposed to lie to the client and say we felt the cat needed an MRI. I'd had a decent relationship with the client, but he was incensed when I told him that, out of the blue, we'd decided CT/myelogram was going to be useless. Wooden Q Tip (not to be confused with the plastic, pliable variety), the head surgeon, read my client communication (and from home, nonetheless). He grew frustrated with Dr. Flip Flops, and offered to come in and do the CT/myelo himself. Great! Time for the intern to change the story on the client again. Frankly, I felt the clients should just hit up the MRI at the other hospital and give them the business, because we couldn't get our act together and worse, we had lied about it.

The confusion and frustration led to displacement of blame. Where? To the Scapegoat Intern. Where else? Dr. Flip Flops told Dr. Wooden Q Tip that he'd asked me to arrange for him to be there to help run the CT, etc. etc, and I got an earful from everyone involved. Q Tip screamed at me over the phone, “You and everyone else there are useless; completely useless, “ he said. Flip Flops told me I was a waste of his time, and Very Blonde and Very Crass marched downstairs from her corner office and took the case away from me. “Flip Flops and HTT will be handling the case from here on out, she said.” She was nice about it, so I have reason to believe she saw that I was right, but in a pinch, had to apologize to the clients and blame Scapegoat Intern, who didn't know the ropes; Spikey’s owners later came to visit him in the hospital and looked right through me, as if never having met me. After his CT, Spikey became intractably fractious and impossible to handle. I wished so hard he’d bite the shit out of Drs. Q Tip and Flip Flops, but sadly, the docs never saw the need to actually handle him and give him the chance.

I just finished another 100 hour week, much of which was spent dealing with Velcro Martha, who didn’t believe her cat was eating in our hospital. Three nights ago, I was in the exam room with her, trying to explain every alteration in her cat’s fluid rate and why, if he was fluid-overloaded, we weren’t even bothering to exercise him. Worse, I had to talk over her 100 year-old mother, who was alternately slurping her Ensure, farting, and chanting “necky necky, rubby rubby,” while petting the poor cat, who like me, seemed stifled by Grandma’s fart cloud.

The next morning, on my day off, I got a call from a client and friend who asked me to euthanize her diabetic dog, whose blood glucose had grown increasingly difficult to control. In between sobs, she told me the dog was completely distraught, pawing at the water bowl and vomiting. It was 6:45 am when she called. She said she lived 30 minutes away and that it would take her another 30 mins to get ready and get the dog into the car.

I got to the clinic at 7:45, euthanized the dog, and was feeling sad about the whole thing, but at the same time, I had a moment of feeling useful—a  very short moment. As I was leaving, Patronizing Good Ole Boy ER doc/New Dad approached: “If you meet a client here, you have to be here on time,” he said, sneering. The client had arrived at 7:20 and told Dr. PGOB Daddio that they were supposed to meet me at 6:30. I explained to him that the client was distraught, and had surely had been confused. He rolled his eyes as if to say “whatever, dumb ass”. “Furthermore,” he said, blood pressure should have been taken earlier on your renal failure cat.

I have a surgical internship next year, but unfortunately the ending date of my rotating internship and the starting date of my surgical internship are June 29 and July 1, respectively, and also unfortunately, they are on opposite coasts. Neither program will budge. I can feel it: next year is going to be even better.

Thursday, March 13, 2014

Bums and Bullies

VBB small animal hospital occupies the street end of the property, with the hedges, bushes, and trees arrayed to one side across the parking area and scattered about the back half of our land. We have plenty of room to air our dogs in the back half (away from the street), and the time spent patiently waiting whilst the dogs finish their sniffing and their other tasks can be spent listening to the birds. One bunch of bushes sports red flowers, and the hummingbirds nest in there. We've had killdeer nesting in the weeds, and there generally are some mockingbirds and jays lending their noise. I invite the dogs to go “out” often, for back there is a haven of sorts away from the crazy and the stress that packs the inside of the hospital.

It's not a national park back there. But then I don't need to pack the travel trailer and tug it for hours to get there. I'm generally better adjusted when I return to the grind. I love the place for doing that for me.

So perhaps you can understand our outrage when each spring some folks find our back property the perfect place to dump pickup loads of garbage, mattresses, old furniture, and tree prunings. We so look forward to spring cleaning time.

Oh, and the relative solitude and peace is a draw for the homeless people who make their nests back in our bushes. Most times they move in after dark, and move out in the mornings, unseen except for their trash left behind and the sure knowledge the local McDonalds has put locks on the bathroom doors, so they only buzz in their customers. The homeless are now left with only our bushes and the back walls of the hospital when they need to go “out”.

For years we were nice guys, and we didn't hassle them unless their behavior demanded it. Too many needles back there, too many broken bottles in the parking area, too many visits from the local police because of too many outstanding warrants, and we'd tell them to leave. We wouldn't kick them out if it was raining. We'd give them some time to find a new nest. But we'd eventually ask them to leave. They earned that.

I won't suggest that we felt sorry for them, for they clearly had earned their lot in life. But we tried not to punish them for their lives. We simply didn't wish to sacrifice too much of our lives to their bad judgment and behaviors.

These are not traditional people. Most have addictions. Many are mentally ill, with most all the varieties that make up that lot. And some are vindictive, dangerous folks. So sometimes we've paid for our audacity in asking them to leave.

Our cars have been broken into in broad daylight a dozen times over the years. Broken as in broken windows, that of course we paid to fix so that we could still afford auto insurance. Shortly after we told one guy to leave, he confronted me in the parking area. It was a week after Easter.

“Damn rich doctors, living in your house on top of the hill. You don't give a damn about the little people.”

Sounded like some of my clients, but that's another story.

“I'll bet you'd kick Jesus Christ off of your property.

I looked him right in the eye.

“You aren't Jesus Christ.”

The woman had lived in her tent in the back of the property all winter. We knew she was there, but she made no mess, didn't walk through the parking lot when clients were around, and you couldn't see her tent. She even had someplace else to ah.....go “out”... for she left none of that mess either. Then a guy moved in with her, bringing his drinking buddies.

When they began breaking bottles in the parking area at one in the afternoon, we tossed them out. The woman apologized. And I told her she was not the reason she had to leave.

A week later, the glass exit door at the front of the hospital was smeared with human feces, locks, handles, glass. It was a thorough, dedicated effort. We figure we know who did it, and he wasn't Jesus Christ.

A couple of months ago, we found a new nest way in the back. They'd rigged a camo tarp over the gap in the trees, so we'd not seen them for some time. They'd built a two room house from tarp and cardboard. One of my canine officers stopped by with a problem with his dog, and he was kind enough to invite them to leave. They left behind several truck loads of trash for us to clean.

A week later, my wife left the passenger window of her car open two inches. The car was parked behind the hospital. Someone urinated into the car. Pretty sure that wasn't Jesus Christ either.

So yeah, we know these folks are not right. And they can respond to normal situations with a variety of abnormal, often harmful and even dangerous behaviors. Like monkeys in the zoo that throw their shit at the people outside their bars, they make do with the most powerful weapons upon which they can lay their hands. And even, or especially when we try to help them, they eventually turn on us. And they hurt us as best they can.

No, they don't know any better. They likely think they are in the right. They likely think they are entitled. They are making do with the most powerful weapons upon which they can lay their hands to harm those they feel harm them. Us.

Kinda like those folks that show up on the net with their virulent, irrational hatred of veterinarians. They are condemned to their own reality. And when we try to help them, and their reality collides with the actual reality, they simply cannot recognize their roll, their blame, for the harm that they feel was deliberately laid upon them. Instead, they turn loose their hate. And we are handy target for their irrational response.

I suppose we should feel sorry for them, but we won't. Still, we won't punish them for how they fruitlessly try to cope with their own lives. But we will look both ways if we think they are around. For folks like that make the world a more unpleasant and dangerous place for the rest of us.









Tuesday, March 11, 2014

Guest Post - Some Great "Isms"


A LOVELY guest post sent in by a truly happy veterinarian.  Some of us *do* love what we do!  :)



I love getting up and coming to work every day. 



See, since 1985, I’ve been collecting client and staff anecdotes.  The short ones are usually immediately jotted on a whiteboard in the hallway behind the exam rooms, for the amusement of the staff and, well, me.  It helps me remember them long enough so that when I get a moment, I go to my desk and type them into a document called Charlene-isms. 



Charlene has been working here either full-time or part-time since she was a teen.  She is petite, has a pretty face and great hair with which she can be a little adventurous.  A married mother of two, Charlene is a high school graduate and a born-and-bred local.



Local here is south of the Mason-Dixon line and east of the Mississippi, and small town/rural.  She was raised by her papa, a farmer who left her the farm and a nice house.  Charlene is pretty sharp with her assets but that is where her sophistication ends.  Her use of the English language is more crumbled than colorful, and you must use your mind to insert a pleasing Southern drawl for Charlene.



The sad part is that compared to my clients, Charlene is a model citizen with good diction.  For my clients, you should auto-insert the type of accent you hear when the local news covers a trailer park tornado.



My anecdotes cover a range of sins by clients and staff from errors in grammar and syntax to mispronunciations, faux pas and outright idiocy.  I’ll start with an actual Charlene-ism:



            A client called regarding her bitch, which was in heat and 
           was in the throes of  a coital tie with a male dog. 



Of course the panicked client urgently said, “My two dogs are stuck together!             What do I do?”  



I am practically omniscient within my office and from a nearby room, I perceived the urgency of the call, could picture the shocked look on Charlene’s face as she fielded the it, “Well, what do you think happened? Do you think somebody put superglue on them?”



Picture me in slow-motion, arms extended, mouth open in a silent scream, trying to run to the reception desk, dive and intercept the call before it terminated.  Picture Charlene, idly twisting a lock of hair around her index finger as she suggested, “Well, could you try to gently peel them apart?”



And see my anguish as I got there too late to salvage the phone call.



*  *  *  *  *



Charlene, planning a mountain vacation near several whitewater-rafting establishments:



“Well, they are advertising this new thing called shuttle tubing we want to try.”



After laughing hysterically, I drew a picture on the whiteboard of an old school bus, loaded down with river rafters, the top piled high with river tubes and rubber rafts.  Then I printed “Shuttle” on the side of the bus.



“Charlene,” I said, “They have a bus that shuttles you to the river and back.”



*  *  *  *  *



During a discussion about adventurous sex practices such as nudist colonies and swingers, Charlene came up with this jewel, “I don’t understand why some people want to have what they call a twosome.”  



Me, in reply:  “Charlene, unless you’re flying solo, sex is meant to be a twosome.”



*  *  *  *  *



Out at the local Wal-Mart on her lunch break, Charlene ran into a woman with long fingernails.  In fact they were about six to eight inches long and curling around in circles. 



Charlene blurted out “Are those real?”  And then, “Well, how do you…function?”



 Apparently the woman replied something to the effect of, “Very carefully” to which Charlene commented, “Well you should be in National Geographic.



*  *  *  *  *



A typical Charlene faux pas, said to a client who was pregnant and her usually lush breasts were even more voluptuous than usual, “Hi, Mrs. Smith, what can we do for Nipples today?”  The cat’s name was Ripples.



*  *  *  *  *



Charlene regarding a client with an accent:  “She has a Europe accent.”  We are still wondering which Europe accent she was talking about.  For the record, the client was Italian.



*  *  *  *  *



Charlene, to client, “Okay, Mrs. Jones, let’s get Kol-lol-NELL up on the scale and get his weight.”  The dog’s name was actually Colonel.





*  *  *  *  *



Assorted other Charlene-isms:



            “I tripped on a dingleberry and fell down.”  Regarding stumbling on a sweetgum ball.



            “That gave me the weeping willows.”  Regarding anything scary or creeping that gave her the willies.



            “ That scared me so bad I turned white as a sheep.”   Sheet, Charlene.  White as a sheet.



            “I didn’t do my toenails cuz I don’t wear toes any more.”  Charlene, remarking when complimented on her fingernails.



            “There seems to be some confusement about this,”  Charlene was emceeing a horse show and said this over the loudspeaker.



            “I was franticking.  Charlene regarding how panicky she was after running over a Great Dane.



            “Really?  So it’s just been out there wandering all over the world since then?”   Charlene, on being told there was a new Tropical Storm Emily in 2006.  She thought 1993’s Hurricane Emily had just been out there wandering around the world’s oceans and was making a return trip.

           

            “We’re having shrimp KUH-nups at my wedding.”  Canapes, Charlene, canapés.



            “I’m attached on them already.”   Charlene, telling a man that she has become very fond of kittens that she is bottle-feeding.  Calls to mind Charlene being physically attached to three neonatal kittens, which is frankly against the laws of physics.



            “That just bozzled my mind.”  Yep, and it boggled it, too.





And one of the most telling Charlene-isms:    “Papa said I was the smartest one in the family and I should have gone on to college.”



If you’ve ever wondered why your veterinarian is certifiably crazy, look no further than his/her collection of stories.  Dealing with staff and clients day in and day out will make you bonkers.

Tuesday, March 4, 2014

Fully funded!

We have received a message regarding the Suicide Awareness webinar funding. Great news!!
 
Thanks to everyone who sent money to cover the RACE accreditation fee for the Veterinary Suicide Awareness and Prevention webinar. The webinar is scheduled for May; I will send a note with the final date to the blog administrators, so they can pass it along as they did the appeal.  
The appeal worked.  We received over twice the needed amount!

The additional funds will be used for additional prevention efforts.  What do you all think of this idea: commissioning a pendant that could be worn as an awareness tool.  It could be an interesting piece that could be used to open conversations about this difficult topic when people ask about it.  

It could also be worn by those at risk, a physical reminder always within reach that there is a whole community of people who care about them.
 
People who care  so much they will send money sight unseen to a total stranger :)  

Thanks again to the many generous people who responded to the appeal.
Sincerely, 
Eden Myers DVM
You guys ROCK! It's so great that you all opened your hearts and your wallets to help fund this program. Seriously, we are overwhelmed by your generosity.