Thursday, November 7, 2013


Came into work today, at the VBB West Coast office.  Just a typical day, but nearing the end of the week and I'm feeling a bit...   tired.

Sometimes the fatigue comes in the form of true sleepiness, like the kind most of us are experiencing right now because of the time change.   Other times it's a different kind of fatigue - the compassion fatigue sort of sleepiness.

So I wasn't really looking forward to the stack of messages on my desk, a few of which were from some very emotional clients who were having great difficulty making important decisions for their pets.  Clients who had to decide "if it was time" or not.

Some of us really understand what it means to sit in a room with a crying client and think to yourself, "I really wish I didn't have to sit here and play psychiatrist and listen to this person cry about how hard it is to make this decision.  Grow up.  Be an adult."  All of us have had those thoughts at one time or another.  We are human, after all.

As much as I wish it wasn't so, this kind of stuff simply wears you down over time.  You HAVE to grow hardened by it or else you'll end up blubbering along with every single client who tries to pull at your heart strings.

Anyway, a particular client didn't leave much of a message other than to say he'd be down later this morning to talk to me about the terrible prognosis given to his beloved pet this week by the internist.  I admit it, I was sort of dreading it.

Client arrives, and my staff puts him into an exam room, and then they warned me, "He's very emotional." 

Sigh.  More emotional parasitism.  Into the room I go.

As soon as he saw me, he burst into tears.  He was really struggling with letting go and knowing when it was truly time to put his dog to sleep.  The dog is dying, no doubt - eaten up with cancer so badly that no amount of surgery or radiation therapy will save him.   The veterinary oncologist simply...  sent them home.

Something happens to me in these exams.  I'm burdened with compassion fatigue on an epic level.  But, occasionally, one still gets to me on the inside.

See, as he was crying and tears were streaming down his face and snot pouring out of his nose, the real truth about why the decision was so hard for him became evident to me.   It wasn't because he loves this dog that much, although he admittedly loves it a lot.  It was because his wife, who had passed away a few years ago, had picked out this dog and gave him his unique name.

It was his last tie to his wife.  I get that.  I get that desperate feeling of not being able to let go of something you love.  I'm certain that the void brought about by those decisions is never filled.  Ever.

Its such a dilemma on my end.  To let myself think about these things can sometimes be gut wrenching but on the other hand, I have to stay tough and hardened or else I would go crazy.

This client asked me how often I do this.  I heard myself tell him "every day".  It made him cry harder and he said he was crying for me because he couldn't do it.  He couldn't face those kinds of emotions every day. 

At the end, he decided he was not strong enough to stay with his beloved dog.  In my detached psyche sort of way, I told him I'd be there, make it peaceful and kind and loving, and I told him I knew his wife would probably be standing right there besides us in spirit, waiting to take their dog with her and then start their wait until he would join them both in spirit as well.

It doesn't matter that I'm an atheist;  it matters that I help end suffering.  That is my job.

And sometimes, I really do wish I wasn't so good at it.   But sometimes I do get the glimmer of humility that comes with truly helping pets and people, a feeling so few really understand at all.


  1. I had an overnight ER shift during which my technician and I euthanized a dozen patients during our first hour. Some shifts, you get to be a healer. Others, you alleviate suffering. That latter part is why I'm no longer in clinical practice.

    1. And yet the sole reason I haven't walked away from this dysfunctional profession myself is because I've been thinking of starting a home euthanasia and end of life care practice. Just goes to illustrate the breadth of personal opine when it comes to views on euthanasia. :)

    2. I left private practice to do just that. I started an in-home euthanasia and hospice service. It is often very difficult, and it is certainly not for everyone, but in order to get through it I constantly remind myself that I have been given the honor and privilege to do this for my patients. And the clients are more appreciative than you would ever guess. I never leave an appointment with a smile on my face, but i do leave with peace in my soul.

  2. And, somehow, it's always after dealing with one of these clients that the next client tells you that you must "have such a fun job"...

  3. Lately I've been feeling this a lot and I've been fighting to stay positive, find the balance between shutting off emotionally and losing it. It's the burden of being a doctor. I imagine it's worse for human doctors but that doesn't mean it's easy for us. I try to remind myself that this is the other side of the coin for having a job that allows me to help so many people and animals…it helps sometimes.

    1. Hang in there. What I tell clients, and what I tell myself... is that euthanasia is a gift, especially in a suffering animal. It's the last gift of love that the owners, and we, can give to that animal.

  4. A euthanasia such as described above is almost my 'favorite'. It does rip your heart, to see a fellow human so distraught. But at least it's a gentle end to a life. It's the ones where you know you are alleviating suffering in the animal that I am best able to handle.

    Convenience euthanasia and economic euthanasia are the ones that I can't handle well at all. When you have an animal that if it was just in another situation would go on to live, happy and healthy, yet it's being put to sleep. Those ones I can't let go of very well.

    Putting a suffering animal to sleep are the times when I know that I can then tell myself that I did the right thing, without a doubt, and after the immediate sorrow... I can let it go.

    I've had several clients through the years that have had deep attachments to their pets. Some to the extreme oddness, (such as the owner who slept with her ferret's ashes and believed that his ghost visited her), and others that were just a commitment and nothing would stop them from taking care of their animal, (such as the woman who spent a lot of money and kept her cat that was in renal failure going for over two years with medications, subcutaneous fluid therapy, and periodic hospitalization, all because it was her dead husbands cat, and that's just what she had to do). Even though these are also the ones that hurt the most in the short run, I also think that at least part of our ability to go on in our profession are ALSO these clients. The ones where you know that, whether it's a good or bad diagnosis, you are making a significant difference not only in the life of the animal, but in the client and their bond to their treasured companion.

  5. By helping both the animal and owner, you help the heart to heal by your compassion. It's tough but in the end, you have made a huge difference. You may not see it but you help the healing process by making the final stage of life a dignified and caring one. Don't ever lose your compassion and love.

  6. In my opinion we as pet owners have a moral obligation to be there for our best friends at the end of their lives. I have had several dogs over the years that had to be euthanized as a last resort and as hard as it was I held every one of them during the procedure. I know that if the situation were reversed they would never leave me at the time when I needed them the most. Just my opinion.