Life as a Veterinarian

Gratitude

Gratitude. Appreciation. Thanks. Recognition.

As a veterinarian, there are times when you seemingly pour your entire heart and focus into a patient. The reality is often clients have no idea how much time and expertise went into their pet’s care or just how close their pet was to a disastrous outcome. Those cases we bookmark for our inner feel-goods, aware that we did our best work and nature cooperated for a favorable outcome

Then there are those cases were we gave our best effort and it just wasn’t enough….nature didn’t follow the book… the disease was too progressed… the resources or funds were limited…the list goes on. I have two file folders in my mind… I can remember those heart-warming feel goods but also those heart-breaks.

I remember a case from years ago; Chiquita, a little Chihuahua that presented in a Chiquita banana box. Her eyes somber and her distress and discomfort apparent as I looked into the worn brown cardboard box with a cheery bunch of bananas across its side.  The irony of Chiquita the Chihuahua in a Chiquita banana box had not been lost.

She had been in labor for days and had a puppy stuck in her birth canal, necessitating an emergency C-section. She was quiet and sweet but her owners had little to no money. We worked with what little funds we had but really she needed a C-section 3 days earlier and had this point needed intensive emergency stabilization. We did what we could and worked with what was available. A catheter had been placed in her vein and the milky anesthetic solution, Propofol, was slowly injected. Her eyes relaxed and she took a breath and just like that her struggle was over. She was the one I had lost at induction. Though the odds were against her and I was angered we couldn’t have saved her I knew she had peace and her pain was gone. But I remember that little Chihuahua, Chiquita, in a Chiquita banana box.

That case was added to the heartbreak mental folder. 

The owners may have since moved on and probably don’t think about the vet that tried to help them. Or they do but feel anger and disappointment. Though all our heart and being can be put into a case, the sad outcome may have brought those feelings of denial and anger that comes with grief. The anger often needs to be directed somewhere and the veterinarian or veterinary hospital may be the target of choice. Those situations hurt…they just plain hurt.

I don’t expect thanks for every ear infection I treat or spay I perform. To work for acknowledgement of others robs us of our own joy and peace in our life’s work. But sometimes when the days get long and the battle hard-fought the appearance of a thank you card in the mail or plate of cookies from clients in the break room brighten my mood and makes the struggle just a little easier.

thank you card.jpg

I received the most “thank yous” during my days as an emergency veterinarian. The lobby of the emergency entrance was dated with orange linoleum and brown paneling yet clean and warm. The walls had large bulletin boards plastered with photos, cards, and letters, mostly honestly not from owners of pets saved but from owners of those pets we had helped them say goodbye to.

I always supposed it was because we were a stranger giving a service of kindness and gentleness, present during one of their most vulnerable times of need. Many of the letters served to introduce us to their lost pets, to tell us of their antics and better days. We had only known these pets at the end and at their worst so these photos and letters brought a sense of what this pet meant to their family, of the love and bond shared.

So today when a card came in the mail with kind words and photos, my heart was touched. The struggles of patients not improving, hard good-byes, and the general struggle of working with humankind and their nuances and challenges was made a little lighter because of someone’s kind words and appreciation.

So today think of someone that could use some appreciations, some words to show that their presence and work in this life matters. Send a thank-you, a text message, a phone call to a family member or friend. Say thank you to that server or cashier. I know I need more awareness of gratitude and appreciation.

“Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest act of caring, all of which have the potential to turn a life around.”

 

 

 

 

 

Community, Life as a Veterinarian, Life Lessons, Ranch Life

Windshield Wiper Installation for Dummies

I had politely suggested to my hubby that my rear windshield wiper needed to be replaced. After a number of “suggestions” I decided surely I could handle purchasing and installing a wiper. So I stopped at the local parts store and walked to the counter declaring my needs…. then they asked if I would like help with installation.

Dummies

I wanted to DIY this and show my self-reliance but thoughts of  the possible complications that could arise…looking like a defeated fool if I should fail at this, breaking the wiper right off the vehicle, or worse yet flipping the wiper switch while driving down the road only to watch it fly off, hit a passing car, and result in an epic interstate collision. So I said, “Sure” like of course I know how to put a simple little wiper on but why not utilize such a convenience service, hiding my fear and insecurity.

Here’s the thing… I am not a DIYer unless I have been properly educated and received the necessary instructions, certifications, etc. to declare myself “trained”!

Blame it on my decades of life in the educational system. I can remove the ovaries and uterus of a two pound living, breathing creature with ease but replacing my wiper without proper training…well that just seemed dangerous and complicated!

My hubby on the other hand is a very confident DIYer and to suggest we hire someone to roof our house or change our oil is an insult at the core of his manhood. About the only thing he admittedly refused to DIY was the birth of our kids, though he had plenty of experience as a ruminant midwife.

I remember as excited new homeowners we had decided to put up crown molding in the dining room our 1890 “corn crib” of an Iowa home. I was frantically reading the how-to books in the aisle of the Lowes determining what supplies we needed and how this project should be done “properly” while my hubby was randomly throwing supplies onto the flatbed cart.

He is definitely a “Learn by Doing” and I am a “Learn then Do”. 

He even laughs at our veterinary “cook books” he calls them, with detailed pictures and guidance for surgeries and procedures. Turns out the living body is pretty complicated and while you could probably just dive right into a adrenalectomy there could be some serious complications without the correct game plan and knowledge base prior. Many hours are spent “learning and training” with mentorship prior to being set free as a full fledged veterinarian. Of course there is plenty of learn by doing but it rides on the back of a pretty solid education in physiology, anatomy, and pharmacology.

IMG_4441 surgerybook
My favorite “cookbook” as my hubby calls them!

So I carefully watched the parts store woman put my wiper blade on and thought about asking for detailed how-to instructions but settled for the mental how-to. I even thought about lying to my husband, declaring “I did this all by myself!” but he knows me too well and would see right thru the lie. Now if the purchase of “How to Install a Rear Windshield Wiper in a 2010 Ford Expedition…for Dummies” book showed up on our debit card statement he might….

 

DIY

 

Life as a Veterinarian, Pet Care, Veterinary Health Topics

How Much is that Doggy in the Window…

….going to shed, bark, run, eat, need to see the vet… and the list continues! 

 

I have had the great pleasure of meeting many different breeds in my career (I am referencing dogs mostly as I see fewer purebred cats and most get lumped as a domestic short, medium, or long-haired cat). I have also had the pleasure of sharing my life and home with a number of different breeds. I have also seen the disastrous ending to a relationship when the breed of dog was not considered or researched.

Thinking of adding a puppy or dog….Research the Breed

There are so many breeds available to choose from. We humans have manipulated our canine companions into extremes of small or large, furry or hairless, flat faced or long-nosed, friendly or fierce. I certainly have breeds I would love to invite into my life and plenty that I will pass on. Yet all these breeds were created for someone’s purpose or desires!

AKC Breed Poster Guide to Purebred dogs.jpg
So MANY options!

I have Brody, my lovable aging Lab, whose sole motivation in life is eating! Left to his own devices he would have every one of cupboards empty and be on the canine version of my “800 Pound Life”. Labs as a breed LOVE food! Then there is Ripp, our newest very active addition. Guess what he wants to herd….the goat…the chickens…sheep…cows and he has the energy to do it 24 hours a day! Some things are just in that dog’s DNA!

Yet so many times I have seen a family fall in love with an adorable puppy or a sweet faced rescue with no idea of its genetic history.  Just like us people there is a bell-shaped curve and there will be extremes on either end (ie the lazy Collie). Yet, I have seen the case where the family adds a Border Collie to the family, yet works from the home 12 hours a day and can’t understand why the dog has developed anxiety and hyperactivity. That adorable little terrier was bred to work. Many are tenacious active little creatures that need time, attention, and exercise.

We are all drawn to certain breeds for our own reasons… a childhood memory, positive experiences in the past, a certain purpose in our life. But there are definitely some less desirable reasons to want a certain breed. I have made the mistake of buying a pair of shoes based on their adorable appearance and coordination to my outfit, only to find them to be the most uncomfortable shoes in the world, deeming me completely unsound and pained. Those shoes, as adorable as they may have been, quickly got tossed to the back of the closet, forgotten and discarded. And so when we make a decision about adding a puppy based on appearance, only to find they “don’t fit”, what happens to that living creature when it gets tossed aside?

What one loves the next may hate! I love Newfoundlands, their goofy immaturity, super furry faces that I can bury my hands into, and slobber…glorious slimy, stick-to-the-ceiling slobber. But they are not for everyone I know.  So don’t get a Newfoundland if you only want to spend $50 a year at the vet and are a neat freak that hates pet hair and slime.

So as a vet here are my recommendations when researching a breed:

  1. What is your lifestyle today and in the future? Your pet may live 10-15 years so if you plan to move to a townhouse in 5 years when you retire that may effect your choices.
  2. Do you want a family dog? If you don’t have kids now consider if you might. Many breeds are great with kids, but some may need extra socialization and experience to be OK with kiddos.
  3. Hair…so many dogs are picked based on hair. I have even had people tell me there distinctly X breed couldn’t possible be because they were promised a low maintenance, non-shedding breed. Every dog sheds unless they are hairless (that is an option). You may or may not want to base your preference on how much you like hair (but don’t be fooled thinking you won’t have any hair in your life) and how much you want to deal with hair…grooming it, cleaning it…brushing it!
  4. Looks matter but remember it is just like dating…looks aren’t everything! Ya, some dogs look awesome…Belgian Mallinois… Cane Corso…Great Dane…but they certainly aren’t a breed for every lifestyle.
  5. Little is cute but little can bring problems…teacup and designer are often beyond adorable but being so small can bring its own health challenges.
  6. Designer breeds….this could be a blog post on its own. I meet so many great mixed breed dogs but realize they aren’t a breed so there can be inconsistencies between even litter mates let alone all the various -poos and -oodles. My own mixed breed sometimes seems confused if she should be this breed or that breed. Mixed breeds are great but they may still have tendencies based on their parental breeds.
Spreadshirt Mutt t-shirt
Spreadshirt.com T-shirt- Throwing some love to the Mutts!

I love dogs because we have so much variety and choice…how human of us to design creatures to fit our own needs and whims. But with that ability brings a responsibility to breed healthy, emotional and physiologically fit individuals. As owners of these dogs it is our responsibility to be responsible in meeting their unique needs and concerns.  As a veterinarian, I ask that if you choose a certain breed please educate yourself regarding the possible health concerns that may arise in your pet’s life.

So what are your favorite breeds? I have so many I adore that I  may not have enough years in my life to have them all but I get to enjoy them in my work so that is second best.

Here is a fun quiz to look into what breed may suite you? Dog Breed Selector Quiz

 

 

 

Life as a Veterinarian, Pet Care, Veterinary Health Topics

The Worst

Even though you prepare for the worst outcome, can you really ever be prepared. I feel like I jinxed it or cursed her recovery by sharing enthusiasm in her progress. Abby was doing so well and just like that nature reminds us we have no control, no cure. She started seizuring last night and the difficult decision to let her go was made this morning.

 

IMG_1137 Abby

“Miss me but let me go, for this is the journey we all must take and each must go alone. It’s all part of the Master’s Plan, a step on the road to home.”

 

 

Goodbye sweet little dog….

 

“Grief is the last act of love we have to give to those we loved. Where there is deep grief, there was great love.”

 

IMG_1134 Abby

 

How blessed we are to share our lives with these creatures that don’t speak our words yet can so powerfully bond with us, forever capturing a piece of our hearts.

 

IMG_1133 Abby

Life as a Veterinarian, Pet Care, Veterinary Health Topics

Preparing for the Worst, Hoping for the Best…Making Tough Decisions in Patient Care

I heard the cries and screaming vocalization in the background with my own mother’s voice on the phone saying

“Abby’s in real pain. I can’t even touch her without her biting. What should I do?”

There is always a desperation in the call for help but when it is your own mother you can hear the unspoken words, the anguish in seeing her beloved little dog so painful she would bite in opposition to handling.

Abby is a senior Dachshund and had fallen from the couch earlier that week and had been a bit sore. I recommended some pain meds and rest. With a Dachshund it is always their back until proven otherwise. I had years before stood on the other side of the exam table with their other Dachshund, Harley, when he had back pain secondary to intervertebral disc disease, and progressive paralysis.  There comes a point in this disease when it progresses fast enough or far enough that surgery or a humane goodbye become the two options.

I saw the bottle of euthanasia out of the corner of my eye while we discussed the options. My father hadn’t handled it well and was reliving goodbyes from years ago and was essentially distant from any reasonable discussion and my mother held the weight of the decision on her shoulders. While Harley’s body was failing him his brain was very much intact and aware of his distraught owners. They had elected to drive all night for imaging and surgery. Harley walked again but now how has neurologic deficits and was never 100% normal again. Now it was Abby, their other Dachshund. They had been down this heartbreaking and difficult road before.

“I knew the discussion would come…wait and see, referral for imaging and surgery…or euthanasia.”

It was decided that we could try what we could here but the option of referral and surgery just wouldn’t be available. Abby had been on a variety of pain medications including a Fentanyl patch but nothing was touching her pain. She was even sedated for radiographs and bit me as I was trying to touch her. The happy little dog at your feet just waiting for a crumb to drop had transformed into a screaming painful feral creature.

“Her radiographs showed intervertebral disc disease.”

We breed these lovable little dogs for their long backs but with that comes the risk of instability of the discs between the vertebrae. They can bulge and burst, pushing on the spine or nerves, causing unbearable pain or even complete paralysis.

IMG_0427 Abby
Abby’s acupuncture treatment

I started a morphine/lidocaine/ketamine continuous rate infusion and intermittently just sedated her to facilitate her pain. I brought her home and kept her by my bed in a tote. The Kiddo peeked into the tote and with concerned eyes asked if she would need to go to puppy heaven. My heart ached.

It had been two days and I couldn’t touch her without the screaming and biting and she had progressed with motor loss on her left hind. The bulging vertebral disc was pushing on spinal nerves and her spinal cord, causing pain and loss of function. First it is conscious proprioception…knowing where your feet are…then paralysis…then superficial pain…and then at the end there is no pain sensation left at all.

We made the decision to pick up the  “supplies” that would be needed to end it all…the strong sedation and thick blue syrup that would stop all her earthly pain, but open up a pain for those that knew and loved her.

“With our animal companions, I have seen the struggle to know “when”. Do we allow a day’s worth of suffering so they may enjoy a lifetime without? Do we allow no suffering at all?”

It is emotionally tasking to watch pain in an animal knowing they can’t communicate if it is all too much or they are willing to keep going. I had stopped her MLK drip, continuing her other pain meds,  with the decision that if she couldn’t maintain comfort without it, it was unfair to continue.

I continued her therapy exercises, hoping and praying those little neural pathways would be stimulated, that the unstable disc would stop its pathway to paralysis. I stimulated her toes, did bicycle motions, stretches, massages, even took a electric toothbrush to her toes to stimulate her nervous system.

 

With clients there are lots of words and discussion, the knowing when, the hows, the questions. With my own family I found it harder to find the words. When someone has know you your entire life, they can read your face, your ticks, your eyes, and hear the words unsaid. So much of the discussion wasn’t a discussion at all but a knowing. I wanted to make the right decision for Abby.

The bag of “supplies” lie on my vehicle’s floor board and as we drove home my mind spun, dreading the moment, trying to push the details out of my mind. I felt frustrated that it had come to this. Should I have ended the pain sooner? Should I hold on for a miracle?

I peeked into the tote and Abby was bright, alert, more upbeat than I had seen her. The test would be could I pick her up without the screaming. I could and she even wanted to eat something. Could 5 hours have brought a miracle, a turning point? I knew the drugs would affect her and cause her to be dysphoric but I hadn’t expected her pain to be controlled without them.

I texted an update and said let’s give her more time. Thru the weekend she was able to start moving, placing her left hind leg that previously was worthless. I did her sessions at least 3 times a day…stretching, massaging, stimulating, hoping. A new day came and her appetite improved, her attitude improved, her function improved. Had the suffering she endured been worth it to get to this point?

IMG_1048 Abby
Doggles eye protection for laser therapy
IMG_1052 Abby
Laser therapy

We added acupuncture and continued laser treatments and she went home with my parents yesterday. Is she out of the clear…I don’t know. Will she ever be 100% normal…I don’t know. She has chronic changes that will probably always be a risk…and lead to a relapse. But at least we have hope, though prepared for what may be.

“How do we define the end? We all share so much earthly emotional and physical suffering that we want none of it for our animal companions.”

Was her suffering selfish? Maybe. Was her suffering worth it if she can recover to enjoy another day? I look back and say yes now.

This isn’t the first time I was disheartened, preparing for the worst, wondering if we humans were selfishly keeping a patient alive for our own purposes, only to be amazed at the recovery that can be made. I have literally had the euthanasia solution in hand walking to the exam room when the owner cried out the door “He tried to walk!!!” The paralyzed HBC (hit by car) dog had pulled himself to his unsteady feet after no improvement while hospitalized and there were simply no more financial resources to continue the effort. He made that first step and didn’t look back making a near full recovery. As a new vet it was a powerful lesson about making that decision for our pets which we do from a place of love and concern for their suffering, but sometimes they decide it just isn’t time and want to keep fighting. I am forever amazed at the healing and recovery possible.

“As a veterinarian, the struggle comes with trying to predict that recovery, only having the info available at that moment, with no magic ball to guide decisions.”

*Update on Abby. She had some regressions with her rehab and became a somewhat difficult patient. She has since been staying with me to continue her exercises and monitor her recovery. She is still periodically weak in the back end and mis-steps occasional. While she may never be 100%, we are hopefully she will recover to enjoy more quality time, with her pain controlled. Her spirit is definitely back.

 

Life as a Veterinarian, Pet Care

Assigning a Voice.

DSC_2837pIt came up in a conversation at work this week. When you work with a crowd of similar animal lovers and you meet hundreds of animals a week it seems natural to want to assign them a voice. The question was “Do you talk for your pets?” “Do you share their inner dialogue?” “How accurate are we really in knowing that voice?” Besides our own pets we know and love well, we may even assign the voice and thoughts to our patients during their exam or hospital stay with us.

We often give clients an assumed dialogue from their dog’s perspective after their adventure with us. This can be after a brief stay for testing or when we return them to the owner after a quick trip to the treatment area for a blood draw. In a given day, I’d say I meet quite a few animals that would be up for making casual small talk if it were possible but I’d say there are a fair amount that we would talk thru a panic attack or grimace at the shouted explicits. I often wonder if our dialogue and “voice” given matches that which the owner may have.

In some ways, we create this inner dialogue for them to ease our own concerns for them. When your child is hurt you say comforting words and you hope they understand those words and respond with trust and feel safe and comforted. Our patients may understand the soothing tone but they don’t know the words “We are here to help.” or “It is really important we get this sample and it will only hurt a second.” We make verbal promises of care and relief from pain and fear they really can’t understand.

I think it is natural to want to know them better or question the inner workings of their minds since they are such a large part of our families and world. Voice and language are such a huge part of how we communicate. I sit in anticipation and sometimes frustration as I communicate with a toddler on the verge of language explosion. Sure they are words but we still communicate with grunts, gestures, pointing, and body language. In a year, I will probably be requesting a break from the chatter of the inner workings of a busy toddler brain but today I just want the words to come so as to open that connection.

Many of my pets have a “voice”, but especially my dogs. The dialect, pitch, cadence all contribute to the personality I have created and that which has come forth. Roscoe, our former Newfoundland, was assigned a simpleton, sort of dumb voice really. His name also alluded to that personality. He was goofy, comical, immature, and sometimes a royal pain in the you know what.

Roscoe Newfounland with ball
Roscoe’s first picture- forever thereon known as “Big Dumb”

This is the first picture I ever took of Roscoe so it is no wonder I didn’t assign him a voice of a British intellect. It was 2009 and he quickly got the knick name “Big Dumb”. But maybe I was wrong? Maybe he was an intellect with a large and impressive vocabulary. I just heard the demanding bark of a hungry dog that had us well trained to deliver dinner.

Cassy, our Lab Collie mix, is a bit of a frantic, anxious, overzealous pleaser. So we don’t have deep “conversations”. Most include a discussion of retrieving and balls, and throwing the ball again and again. I hear her voice as “Oh, a ball. I love balls. I really love balls. Please throw the ball. Please. Please. Please. Oh, you threw the ball. I love running to get the ball. Oh again, again!”. She isn’t a calm minded creature so when I hear her voice it is a high pitched, fast paced question, always a question….”What do you want me to do now? I can sit? Or bring you a ball? Did you want me to sit? Just tell me what you want and I will do it!”

DSC_1730

I meet a lot of dogs in a day and some very clearly have a voice and often it is associated with a breed. Call it stereotyping if you will. Well groomed Poodle. You probably get a classy snooty diva voice. Big Mastiff or overweight Lab. Sorry you probably get a slower paced simpleton voice with a focus on food. So do we create our pets voice or do they have a voice of their own we bring to life? Shelby, our miniature poodle’s voice has likely changed from her previous life with a Senior Citizen woman to her current life as the
“Rhinestone Cowdog”.

Ripp, the Australian Shepherd puppy… well he is finding his voice. He is this obnoxious testing teenager now so in a way his voice is being found and than changing just as I can see the voice of my own Kiddo changing. How it was always “Mommy” and now I hear “Mom” sneaking in that vocabulary more and more.

Does your pet have a voice? Are we accurate in our idea of that voice? What do you think…do you wish pets could talk? As a vet, there are plenty of times I wish they could just tell me already but I also know I would get cussed out and that may change my level of career satisfaction.  I think I like the world as it where we create the voice and build a relationship with our pets beyond words.

“Dogs do speak, but only to those that listen.”

-Orhan Pamuk

Community, Life as a Veterinarian, Veterinary Health Topics

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.