Thursday, January 19, 2012

My boss is a bleeding heart

Either that, or I’m a cold-hearted, hard-assed bitch.

My boss is the sweetest person you’ll ever meet but she has a hard time saying no. She lets clients walk all over her, and takes on hard-luck cases.

It’s a nearly daily occurrence that someone will bring in a patient who has a serious illness or injury and the person can’t (or won’t) pay to treat the pet. Our hospital policy is that in certain cases if a staff member is willing to sponsor a pet, the owner can sign over ownership to the hospital. The pet will then be treated and adopted out to a worthy home. The important part is that the employee must take complete financial responsibility. Before we instituted the “put your money where your mouth is” policy we had numerous sign-overs whose treatment drained the hospital’s budget.

In fifteen years, I’ve had exactly one patient signed over to me. It was a Boston terrier with dystocia and dead puppies. I only took the dog because we had a vet student who needed experience performing a cesarean and I already had in mind a sucker loving person to adopt her.

But my boss, the compassionate soul, has a habit of taking in pets whose owners can’t afford treatment. A few months ago she took over a pit bull with parvo. Granted, it was a sweet puppy, but our hospital is in the ghetto and our neighbors are meth dealers, so pit bulls aren’t exactly an endangered species. Now she’s taken over ownership of another parvo puppy, a runty Aussie mix. I admire her for caring for animals when their owners don’t, but I can’t do it myself.

Having a pet is a privilege, not a right. If I weren’t a vet I would still have a dog. A dog, as in one—not the four dogs, one cat, five birds, two rabbits, and one guinea pig I’ve had since vet school. If you can’t afford a pet, don’t get one. And by “afford,” I’m not talking just food and vaccinations. I’m also talking about a slush fund for the inevitable illness or injury. A few days ago I saw a six-month old Pomeranian puppy with a fractured leg (tibia and fibula, transverse, overriding). We talked about options: orthopedic surgery (best), amputation (okay assuming the other leg stays healthy), splinting (likely to fail), or euthanasia (obviously not ideal but would end the puppy’s suffering). In the end we splinted the puppy but I wouldn’t have had a problem with euthanasia. The puppy is suffering and I don’t want a Pomeranian. I can’t care about my patients more than their owners do or it will break my heart.


  1. The last sentence is possibly the truest statement ever written on this blog.

  2. Umm do you work at my clinic!?! I am in almost the exact same situation. I go along with a lot of them though because I am a newer grad & its gives me the experience with out the pressure :) In fact doing an FHO on a cat today.

  3. What really stresses me out is - I'm supposed to offer all the available options, right? So, sure, in this case: turf to ortho, amputate, splint, or kill. That's pretty much all the options. So, the owner hears me say this, and asks what I would do. "Well, that's not really a fair question - my costs are not the same as yours in this type of situation." Owner still wants to know. Ok fine! I'd do the repair or I'd do the amputation depending on a variety of circumstances. Well, gosh - the owner thinks amputation is cruel and can't afford ortho so they want to splint. I do not want to splint. If I splint it, there is SO MUCH ROOM for complications. If they aren't 100% compliant, things can end up even worse, and then I'm the asshole. I just feel like it's lose-lose - that is to say, lose sleep for me worrying about the poor puppy, and lose sleep for the puppy who ends up suffering when it's allowed to run around on the broken leg, gets the splint filthy, there's a ton of swelling and maceration and blah blah blah and when it FINALLY comes back in 3 weeks later instead of first thing Monday as planned, well - it's septic and dying. Theoretically I could also lose money if the owner sues me when the splint goes wrong and I'm judged for having failed to provide the standard of care - because let's face it - the owner's not going to go to the board, or the judge, and say "oh, sure, the vet warned me this could happen but I chose to do it anyway in the hope we'd have a good outcome," the owner's going to say "I had NO IDEA this could happen, if I'd known, I'd have never done this!"

    Gosh, sounds like I'm a little crispy 'round the edges, doesn't it? Well, you know. Fact is every now and then one surprises me and listens to everything I say and is the perfectly compliant client and things still don't work out. And sometimes they do work out. And the ones that do - those are the ones that keep me showing up for work. I love those.

    1. Actually, my response is that I cannot answer the question "what would you do if it was your pet" because I WOULD NOT LET MY PET GET INTO THAT SITUATION.

      Ie, my cats don't go outside, so really I can't tell you what I would do if my cat got hit by a car because unless a car comes plowing through my apartment, it ain't gonna happen. I'll give you the recommendations based on what the pet looks like at the time and all the possibilities that could potentially happen (that I could think of), but don't throw that piece of crap statement at me or I will chew you another orifice.


    2. How can you be so sure your pet wouldn't get into any situation that was brought in? Your cat might fall, break a leg, tangle in a curtain, chew a cable... I don't know, but s**t happens, even in padded cleanrooms.

    3. I gotta agree with Time-Out. Some things are just unavoidable.

  4. mmm, that has become my mantra of late. I can't care more than they do. I'm OK with the splint. I write down everything they decline first. And I'm OK with tearing them a new one if they are poorly compliant with followup. Sometimes, after pointing out what they will spend on rechecks and splint changes they see the light and allow me to repair it surgically.

  5. I started having clients sign a splint treatment form giving them the dates that they should return. I started that after about 4 years ago I had a client bring back a young growing medium sized dog for a splint change 3 weeks after the placement...taped oh so tightly with duct tape and with oh so many ulcerations. When I informed her that she missed her first recheck appointment to change the bandaging material, she told me that if I cared so much, I should have come to her house to get the dog (meth-head driving a hummer). At that point she started to scream, curse, and had to be removed and fired from my practice....

  6. I have been bitten in the ass by people that signed animals over then got really nasty after the animal was better. They preyed on the sympathy of the staff then they acted like jerks, making a huge stink, and management gave them their animals back. What did they learn? They learned that playing peoples' heart strings then acting like asses will get them what they want. So, now I have very little trust in people. Fool me once and shame on you, fool me twice and shame on me. And though I have sympathy for people that are in need, I cannot live my life feeling guilty that every 4th person that walks in the door cannot afford care. I will not be held hostage by my feelings. I have my own weight to carry. I can't carry the weight of my clients too.

  7. I hate that "What would you do if it were your pet?" question. I've had tons of pets over 40 years and none of them has ever gotten parvo or HBC or rat bait--cuz I take care of them!

    And windvm, I really like the idea of a splint release form. I'll have to work on writing one up.

  8. Just remember that everyone is different and be thankful that your boss has provided an option to offer when you have an appropriate case. Some of us are worse suckers than others; doesn't make either of you wrong - just different. Life would be really boring if we were all the same! As long as your boss takes care of her sucker cases, they're none of your concern. If she starts pawning them off on you, that's a different story:) Just keep practicing according to your integrity but don't give her a hard time about hers...

  9. Had a lady in the situation at our clinic, didn't want surgery so we splinted. Well she was my *favorite* profession among clients, she was a nurse, so she (and I quote) "knows" "well I'm a nurse... and I know" .. about yakatta yakkata yakkata..
    The boxer puppy's splint was always sopping wet & filthy & late on changes. She was forever taking off the splint & re-doing it at home. (With every orthopedic case we send home detailed sheets about how NOT to do all the stuff she did, they get an updated sheet at every check out).
    The best part was the time the puppy came in with a SHAMPOO BOTTLE cut & fashioned into a shitty "splint" & placed over the leg.
    Get real lady. Where do you work as a RN? Ok great I will never go there.