Please pass the alprazolam.

Lately things have been kind of getting on my nerves.

First of all, I do not believe it is ok for anything that has lungs to ride in the trunk of a car. Call me crazy, but this is my strong opinion. So, you know, I found it pretty shocking when my client came to pick up her in-heat bitch, and asked a staff member to carry the dog out to the car and *put her in the trunk*. I'm pleased that my staff member responded appropriately and refused to do this. So the client came inside and asked to speak to me, and told me she didn't understand what the problem was. Her mom's car, you see, has white upholstery, and she was afraid of getting blood on it. I honestly don't really remember the rest of the conversation we had, but in the end one of our towels went home with this lady and her dog, and the dog sat on the towel, and all was good (at least until they were out of the parking lot. For all I know she moved the dog into the trunk around the corner, but I hope not).

Second of all, there is the issue of names. Now, I'm not an idiot (shut UP!). I understand the concept of nicknames. Hell, I even have a few myself. But, in general, for official documents such as medical records, consistency in naming is important. If you, Dear Client, have a pet named Butterscotch, and call him Buddy for short - I totally understand, and that's just fine. However - if you have a pet named Butterscotch, and you register him with my clinic as "Butterscotch Smith," but then you take him to a cardiologist and register him as "Buddy Jones," because you got married or divorced and changed your dog's last name accordingly but never mentioned it to us, then I am going to get a referral letter from Dr. Cardio in regard to our mutual patient, Buddy Jones. And then I am going to search my database for a Buddy Jones, and I may or may not find one - and if I do find one it may or my not be the same age/breed/sex. And I will pull out my hair if I do find a matching signalment because hey - there's nothing in the notes about heart disease! And I will pull out my hair if I do not find one because hey, what WAS the name of the last dog I referred to Dr. Cardio? It's just all very frustrating. PLEASE, Dear Client - be consistent.

Third of all, we have the issue of emergencies. We all know that sometimes emergencies happen. When you roll into my parking lot while I'm walking out the door to head home to my family, and your dog is gasping for breath, guess what? I am going to run over and start helping you. If you walk in during my lunch break and your cat has blood pouring out of its rectum, I'm going to put down my quinoa salad and start working the case. HOWEVER -- if you walk in during my busiest appointment time and DEMAND that we see your dog RIGHT NOW because he has been licking a red spot on his foot for three weeks and it is now an EMERGENCY because you have to leave to get to the airport in 20 minutes or you will miss your cruise, well, GUESS WHAT? That is not, in fact, an emergency according to the Laws of the House of VBB! That is what we call a "client emergency," and if you are very very lucky, and I'm in a good mood and the stars are aligned, I'll accomodate you. But if I am busy with people who thought ahead and made appointments for their pets, I'm not going to make them wait past their scheduled time because you were thoughtless. Sorry. Just the way it is!

Tell me - what's been getting on YOUR nerves lately? And please pass the alprazolam - this chamomile tea isn't helping at all.

Getting Crispy Around the Edges

Burnout can be insidious. I noticed the signs in myself today as I prepared myself to call a client regarding the findings on his dog's physical exam. The dog had been dropped off for grooming & my exam had revealed some significant progression of the dog's heart disease. I could hear the conversation playing out in my head before I picked up the phone. I was sure it would go like this:

[ring ring]
Mr. Apathy: Hello?
Me: Hi, Mr. Apathy. This is Dr. VBB from VBB Animal hospital. I'm calling about Foxglove.
Mr. Apathy: Well, I'm at work. What do you want?
Me: As you requested at drop off, I did perform a physical exam on Foxy today and-
Mr. Apathy: Can we discuss this when I pick her up?
Me: No, Foxy needs additional diagnostics and treatments because her heart is-
Mr. Apathy: She saw a cardiologist six months ago. We already did the heart stuff.
Me: well, today she is having trouble breathing and -
Mr. Apathy: I'm not talking about this again right now. I'll discuss it at pick up.
[click]

I was so sure I would be having that conversation that I postponed making the call for probably an extra ten minutes. I got myself all worked into a frenzy internally. I'm sure I ground off some tooth enamel. However, after a few deep cleansing breaths I psyched myself up for it. I made the call.

[ring ring]
Mr. RealGuy: Hello?
Me: Hi, Mr. RealGuy. This is Dr. VBB from -
Mr. RealGuy: Doc! How's Foxglove?
Me: I have some concerns, and -
Mr. RealGuy: is it her heart? I know, I was supposed to bring her back to the cardiologist for a recheck in December, but I got so busy and she seemed fine. Is she in trouble now? I feel terrible.
Me: well, I think her medication needs some tweaking. I'd like to go ahead and give her some extra diuretics today, but I do want her to see the cardiologist as soon as possible too.
Mr. RealGuy: I was actually planning to take her next week, but they almost always can get me in same day. I'll call them right now and see if we can go there this afternoon or tomorrow.
Me: Great. I'll have her records ready to go for you.
Mr. RealGuy: thanks doc! See you soon!
[click]

I was of course really pleased that my patient will get the specialty care she deserves. I was also really pleased that I had a nice client interaction. I was DISPLEASED by the realization that I am starting to always expect the worst. This bothers me a lot. I don't want to be one of those old and crispy burned out people!! I want to be able to think positive! Or even be like the Whether Man from The Phantom Tollbooth, who said "Expect everything, I always say, and the unexpected never happens!" But to always expect the worst - well, it's draining. Any creative tips on dealing with burnout??