The Narrative of Veterinary Medicine

*Disclosure- I wrote this months ago and it sat…I was not quite ready for the world to read my thoughts. But I keep coming back to the purpose of story-telling in veterinary medicine. In our work, we gather and share hundreds of stories of our days working with patients and clients. *

Don’t we all just want to be heard?  I recently stumbled upon the topic of “Narrative Medicine”. It is a topic well recognized in human medicine and makings it entry into veterinary medicine. Narrative Medicine seeks to honor patient stories from a literary persepective. It goes beyond the medical interview and seeks to understand the psychosocial and spiritual perspective. In reviewing the whats and whys of Narrative Medicine I think it boils down to learning to listen…Doctor to Patient and Patient to Doctor.  In veterinary medicine it may be complicated by having a sentinent being with feelings of fear, pain, and happiness but no way to communicate in our language. So we rely on the stories of their caretakers.

Do you still remember the veterinarian you took your childhood pets to? You might still picture the waiting room or the smell of cleaning chemicals or pet odors. If you lived in a small town you likely had a relationship with your veterinary, pediatrician, and veterinarian. They knew our story and we knew theirs, for good or for bad. I still enjoy a small town feel and generally tight-knit community but veterinary medicine is changing as it evolves with increasing services and specialization. That connection and relationship has changed. The friendly, all knowing veterinarian down the street has changed.

Narrative medicine seeks to change that connection to a time of yesteryear where we knew each other beyond the exam room walls. So it goes that in our profession we complain about the numbness of repetition of vaccination after vaccination or the pain of compassion fatigue, the giving of yourself without thought for self-care and restoration. On an average full day I may talk to 20-30+ people in a day and some days I feel completely depleted and mentally gone.  My sanctuary is my home and my family and on those days of sanctuary I  prefer my days filled with casual togetherness and laughter, not words and demands. Those I converse with are carefully selected and the only outsider is the FedEx delivery man, delivering my mail order packages. The energy of the crowded stores, booming music, and bright lights can just be too much after a day of boisterous greetings, goodbyes, and the emotions of helping client’s pet thru disease and death. There is this balance of connection and relationship while maintaining a distance safe enough to prevent injury from the pains of the profession.

In our lives, we all seek meaning and to find our purpose. A wooden plaque with the words “If you love what you do, you’ll never work a day in your life” sits on my shelf as a reminder of finding passion and purpose. But some days are hard…it is hard to give another round of bad news, to share textbook of knowledge regarding a diagnosis starting slow then gaining momentum as the words spill out of my mouth. I see the facial expressions, some empty, sad, upset, angry, or just plain empty as the news hits their minds.

We celebrate the human-animal bond but what a gradient of affections. For some this pet right here, right now is all they have, their companion in life and for others it is as replaceable as the tires on their car and they grumble about the expense of doing so. For me to find purpose and enjoyment in this profession, I find myself needing to look past the signalment. Buddy is more than just a 2 year old neutered male, Golden Retriever. Buddy may well be the best friend to a 4 year old autistic boy and the one to whom it speaks. We celebrate that bond, the specialness of animals in our lives.

With narrative medicine, they look for words or phrases and don’t start with the checklist but ask the question “Why are you here today?”. It is a request to be invited into our patients or clients stories. For some clients I know the story of their pet followed over years, with chapters read here or there. The time they ate the garbage and had explosive diarrhea, the adjustment to the family when the new baby came. Each chapter strengthens the bond of the family and the pet. The most intimate invitation is often at the end of life.

At the end of life there is no longer a race against death, a need to win but an acceptance. For some it is just a dog or just a cat but for others I am one of the few that has read the story of this pet’s life, to understand its meaning and the bond that was shared. In that story, I have seen men fold over weeping for a pet when they didn’t shed a tear for a parent or the woman that holds her beloved pet lost to cancer and in that moment a flood of memories of the loss of her own mother too lost to cancer. I hold that invitation with great reverence.

So when you think of your childhood vet what do you remember? I sometimes ask myself how I want to be remembered. I can give a vaccine, diagnosis diabetes, or spay a cat but there is this deeper psychosocial aspect of veterinary medicine; that call to narrative medicine, where we understand the story behind the medicine.

As a helper and caretaker it can bring great frustration and even anger when I perceive I care more than the actual owner of a pet. In these moments narrative medicine calls for a more mindful detached compassion. One can quickly drown under the tidal waves of poor life choices, painful lives, or just plain indifference that some bring to the exam room.

So I ask “What brings you in today?” and realize mankind is this diverse, never fully understood complexity. We all bring our stories of youth, growth, adversity, sadness or joy when we meet in that exam room.

Narrative, story-telling…we are all connected by our stories. Story-telling and narrative has survived the centuries and though our world has changed, it all comes back to the connection and sharing of our stories.