Expounding on the Cryptic
Hum, so I posted a rather cryptic comment last week and haven't taken the time to expand upon it till now.
Last week was my week for patients with serious, likely terminal conditions. It started on Tuesday when Dr. Ruaux came into the medicine rounds room and said "who wants to go on a cancer hunt?" It wasn't so much that I wanted the dreary hunt, but I had placed my stakes on the previous big case that week and someone else had taken it. I now think that was a "God thing." I jumped at the new case.
It was the second animal of that unusual name we have seen so far on this rotation. A history of polyuria/polydipsia and a single electrolyte abnormality. The kidneys were normal. Our top differential was cancer, but I was still hoping for the random granulomatous disease. I cared even more after I entered the exam room, stethoscope slung around my neck. The unusual name became for me a real and a unique dog, and the owner an intriguing fellow, an outdoorsy scientist, who understood some medical terminology and was great to work with. I wanted it to go well with them... but I had a feeling, especially after Dr. Ruaux found the enlarged lymph nodes, that all was not well. Aside from the abnormalities I mentioned, the dog was the picture of health and had great athletic stamina. It was the young guy with his middle-aged dog -- and I didn't want this to be happening to them.
We admitted the dog to the hospital for diagnostic tests -- needed to analyze the situation further -- and the initial results were not promising. I didn't know the truth until the next morning, but when I spoke with the owner that evening I had to tell him lymphoma was our top differential. Hard for the owner to hear, hard for me to say. I have thought for a while that the best grief counseling training is facing it in real life, and after last week I really think that is true. To think ahead toward a situation, a conversation with a client, is good -- but when the rubber meets the road, you just have to follow your heart. Be in tune with the other party, put yourself in their shoes, and take time to choose your words wisely. If your heart is good, it will turn out.
The owner came the next morning, early, to pick up his dog. I checked for the final lab result, and it was as we had feared. My heart sank farther. As I brought the owner into a room, we talked about a book he was reading the previous day and had just finished. It was a book about an Irish wolfhound with osteosarcoma and how he helped his owner learn love instead of fear. My owner handed me the book information and advised me to read it.
Once in the room, I did a slow, thoughtful twirl and faced him. I reviewed the findings of the previous day... paused... and told him the cytology results had come back and what they meant. I had told him of the chemotherapy options the previous day. It was very important to me for him to know that whatever he decided to do was okay. The last thing I want is for owners to feel guilty about not treating -- treating is not for everybody. It is NOT inhumane to allow your pet to die 7 months earlier than it would have with chemo. I reminded him of the chemo option, and brought his dog to him.
I encouraged him to take long hikes with the dog as long as the dog was able, to not allow knowledge of the dog's cancer to affect what they would normally do.
They always told us, back in our grief counseling training, to be careful with offering physical things like hugs to our clients. Somehow we were supposed to be in tune with the client and figure it out. I guess I always felt like such a situation would be awkward, feeling like you should lay your hand on the person's shoulder but not knowing if it would be deemed offensive or otherwise undesirable. So, bearing the warning in mind and initially ignoring the indications of the other party, I was intent on shaking the owner's hand when he gave me a hug. I guess I hadn't thought clients would initiate such a thing themselves, I thought somehow they would be in too much agony -- but in both grief-related cases last week the hugs were always initiated by the clients and they all were pleased with how I handled the situation. Learning is doing.
The other case was an old dog with a tumor blocking the urethra -- it was hard in a different way than the first case because we had to euthanize it. It came in Friday afternoon, we did some diagnostics, and a decision was made to euthanize the dog the following day. Because of my religious background, the owner wanted me to say some words when the dog died. I can't say I'd ever done anything like it before, but I was willing to try. So we all drove in, the owner, the dog, the doctor, and I, Saturday in the evening. We had a short "memorial service," and I said a prayer for the owner and her friends -- the first time I have prayed semi-publicly in the state university.What do you say in such a prayer? I don't know -- I prayed for comfort, for the sensing of God's nearness, and included the verse about the sparrow falling because it suddenly came to mind. I guess it was o.k.
I had never euthanized an animal with the owner present -- the whole thing put my mind in a state of semi-fog.
In both experiences it was good to hear that the owners were comfortable with my manner -- it's always good to hear such affirmations.
These were hard experiences, but they remind me of one of my big reasons for becoming a vet -- to be there for the people. They remind me that grades and fame are not what matters.
I have often prayed that I would be a channel of God's love to others.... I have likewise wondered if my effect on the world is ever more beneficial than that of non-Christians.Yes, for good reason your "?", Mark. :) Let me provide leaves to the bare, cryptic branches.
And I think God is smiling as he answers those questions this week. He makes me smile, too, though sometimes in a bittersweet way.
Last week was my week for patients with serious, likely terminal conditions. It started on Tuesday when Dr. Ruaux came into the medicine rounds room and said "who wants to go on a cancer hunt?" It wasn't so much that I wanted the dreary hunt, but I had placed my stakes on the previous big case that week and someone else had taken it. I now think that was a "God thing." I jumped at the new case.
It was the second animal of that unusual name we have seen so far on this rotation. A history of polyuria/polydipsia and a single electrolyte abnormality. The kidneys were normal. Our top differential was cancer, but I was still hoping for the random granulomatous disease. I cared even more after I entered the exam room, stethoscope slung around my neck. The unusual name became for me a real and a unique dog, and the owner an intriguing fellow, an outdoorsy scientist, who understood some medical terminology and was great to work with. I wanted it to go well with them... but I had a feeling, especially after Dr. Ruaux found the enlarged lymph nodes, that all was not well. Aside from the abnormalities I mentioned, the dog was the picture of health and had great athletic stamina. It was the young guy with his middle-aged dog -- and I didn't want this to be happening to them.
We admitted the dog to the hospital for diagnostic tests -- needed to analyze the situation further -- and the initial results were not promising. I didn't know the truth until the next morning, but when I spoke with the owner that evening I had to tell him lymphoma was our top differential. Hard for the owner to hear, hard for me to say. I have thought for a while that the best grief counseling training is facing it in real life, and after last week I really think that is true. To think ahead toward a situation, a conversation with a client, is good -- but when the rubber meets the road, you just have to follow your heart. Be in tune with the other party, put yourself in their shoes, and take time to choose your words wisely. If your heart is good, it will turn out.
The owner came the next morning, early, to pick up his dog. I checked for the final lab result, and it was as we had feared. My heart sank farther. As I brought the owner into a room, we talked about a book he was reading the previous day and had just finished. It was a book about an Irish wolfhound with osteosarcoma and how he helped his owner learn love instead of fear. My owner handed me the book information and advised me to read it.
Once in the room, I did a slow, thoughtful twirl and faced him. I reviewed the findings of the previous day... paused... and told him the cytology results had come back and what they meant. I had told him of the chemotherapy options the previous day. It was very important to me for him to know that whatever he decided to do was okay. The last thing I want is for owners to feel guilty about not treating -- treating is not for everybody. It is NOT inhumane to allow your pet to die 7 months earlier than it would have with chemo. I reminded him of the chemo option, and brought his dog to him.
I encouraged him to take long hikes with the dog as long as the dog was able, to not allow knowledge of the dog's cancer to affect what they would normally do.
They always told us, back in our grief counseling training, to be careful with offering physical things like hugs to our clients. Somehow we were supposed to be in tune with the client and figure it out. I guess I always felt like such a situation would be awkward, feeling like you should lay your hand on the person's shoulder but not knowing if it would be deemed offensive or otherwise undesirable. So, bearing the warning in mind and initially ignoring the indications of the other party, I was intent on shaking the owner's hand when he gave me a hug. I guess I hadn't thought clients would initiate such a thing themselves, I thought somehow they would be in too much agony -- but in both grief-related cases last week the hugs were always initiated by the clients and they all were pleased with how I handled the situation. Learning is doing.
The other case was an old dog with a tumor blocking the urethra -- it was hard in a different way than the first case because we had to euthanize it. It came in Friday afternoon, we did some diagnostics, and a decision was made to euthanize the dog the following day. Because of my religious background, the owner wanted me to say some words when the dog died. I can't say I'd ever done anything like it before, but I was willing to try. So we all drove in, the owner, the dog, the doctor, and I, Saturday in the evening. We had a short "memorial service," and I said a prayer for the owner and her friends -- the first time I have prayed semi-publicly in the state university.What do you say in such a prayer? I don't know -- I prayed for comfort, for the sensing of God's nearness, and included the verse about the sparrow falling because it suddenly came to mind. I guess it was o.k.
I had never euthanized an animal with the owner present -- the whole thing put my mind in a state of semi-fog.
In both experiences it was good to hear that the owners were comfortable with my manner -- it's always good to hear such affirmations.
These were hard experiences, but they remind me of one of my big reasons for becoming a vet -- to be there for the people. They remind me that grades and fame are not what matters.
posted by Claire at 19:54
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