Be The Change

The Everything in Nothing

I know I’ve been remiss in posting, and I wish very much I could say it’s because I’ve been so busy creating amazing and exciting book campaigns and creating a plan to hit the NY Times Bestseller List in July. I still want to, don’t get me wrong, and I still plan to at least give it ago. But that’s not why I’ve been quiet.

I guess you could say I’ve been doing nothing. Nothing. Let me explain.

I’ve said to many people when I started working with Paws into Grace two years ago it was like my career and work finally made sense. I liked working in a clinic, I liked the day-to-day stuff, but only two jobs in life ever touched my soul and felt as close as one could come to a calling: writing, and veterinary hospice. Stepping into hospice work was like buying a new pair of leather shoes and finding them already perfectly worn in.

If you recall, I took it a step further when I began speaking on the topic at various Ignite talks, the first one being in January this year at NAVC:

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Then later, in San Diego in February:

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Putting those two talks together forced me to really dig into why I thought this work was so important- first, I realized, we can do a lot to help people understand the process of grieving a pet.

Then, I realized losing a pet is in itself a really important lesson in how to lose a person, or more importantly, how to help them gracefully experience the end-of-life process. I really, really wanted to share that message.

I remember a lot of things about that night at Ignite San Diego, namely about how I said that all people should hire me so their kids wouldn’t stick them in a nursing home later in life because they were too scared to deal with them. I pointed at my parents and said, “See? Aren’t you glad I made this promise to you guys in front of like, 200 people?” And they laughed, because we knew that was all a long time away.

It all happened very suddenly: the fall, the seizure, the diagnosis of an inoperable brain tumor. One day, my life was filled with the usual concerns, getting annoyed with pseudoscience on the net, figuring out Teacher Appreciation Week. The next day, I forgot everything except this: My mom, still young, beautiful, and full of life, looking at the same diagnosis that made Brittany Maynard a household name last November. It is perhaps one of my worst fears, this particular beast, and now it has invaded someone I love more than words can adequately express. The person who, in other circumstances, would be the one I called for support.

Now she was looking to me, and then it all made sense, this need to understand the importance of hospice and advocacy and learning to let go gracefully. I wasn’t meant to help other people understand the difference between living poorly and dying well. I was doing all of this preparation, whether I knew it or not at the time, for my own mother.

In the space of two weeks, I moved my parents into my house, earned frequent parking points at the hospital, and had to dig deep into everything I ever stood up for and ask myself if I really meant it when I said I thought people should change how they dealt with illness and end of life in their families:

  • Would I help someone honor their own wishes to say no when everyone in an authority position was pushing for treatment? It seems like oftentimes it is easier to do all the treatment than to say no and risk upsetting loved ones who want you to try it.
  • Would I be honest with my children in an age-appropriate way or just kind of try to avoid it for a while? Use the old la-la-la-everything’s-fine approach our family has relied on for generations?
  • Could I bring this whole experience into my house, ask my husband and my children to take on this really intense experience, when it would be a lot easier on them- in the short term at least- to keep my parents at arm’s distance, in their own home, in skilled care?

The two weeks during the diagnosis phase was an unending slog up and down the linoelum floors of the hospital, trudging from one cramped waiting area to another: CT. Neurooncology. Neuroradiology. Neurosurgery. Each appointment took an emotional toll that far compounded the physical one, leaving mom too pooped by the end of the day to do more than go to sleep. Waiting rooms filled with other seriously ill people nervously picking at the fraying vinyl upholstery, doctors too aware of the gravity of the diagnosis to be able to offer a smile.

My mother was so upset at the prospect of poorly effective radiotherapy she didn’t want that she could barely speak after the appointment with the radiologist.  He had recommended six weeks of daily radiation and chemo, tied to those halls and the stale air. Glioblastoma, a poorly researched and dreaded cancer- even in the world of oncology, it’s a bad one- has had few treatment advancements in 25 years. Treatment doesn’t cure the disease, just kind of kicks it down the line a little.

“And if we choose not to do the radiation?” I asked.

“You could do nothing,” he said, “But I don’t recommend it.” No one did, but nonetheless that was exactly what Mom wanted.

So we did it anyway, leaving through the doors of the hospital one last time into the cool evening breeze of the evening marine layer rolling over, before calling in the ‘Nothing’ that is hospice. So far, Nothing has included the following:

p1

  • Watching hot air balloons fly by in their sunset flights
  • Getting through all the Harry Potter movies
  • A comprehensive plan for managing every symptom, every discomfort
  • Greeting the children every morning and tucking them in every night
  • Trying every flavor of macaron at the local French bakery (lemon = best)
  • Getting our nails done
  • Going through old photo albums
  • Driving to the beach

Brody, exhibiting that strange instinct most dogs seem to possess, hasn’t left my parents’ side. He’s been so protective, in fact, that he came barreling out of their room last night to bark at me when I got up at 2 am for some water.

p3

My mother has chosen to die well instead of living poorly. But really, I can’t call what she’s doing right now dying. The walls of the hospital, filled with fear and extended wait times and the ever-looming spectre of illness, feels more about dying. She is living. Each moment, each breath of spring air, each hug, is imbued with a gratitude and a joy it wouldn’t have had in a different situation.

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I don’t believe one person’s tragedy is any greater or less than anyone else’s, no story more worthy of being told. But I do hope that in sharing this one I might reach someone who is struggling with a similar situation or just looking to understand why a loved one may have made the same choice.

We’re terrified, but we’re ok. We’re devastated, but happy. I have an incredibly high tolerance for stress right now but Rubio’s running out of pico de gallo leaves me in tears. We are doing what we can and continuing what routines we are able to do. We are together, and that matters most.

We are doing nothing but living, and that is enough. It is, in fact, everything. And this Mother’s Day, we’re having a hell of a celebration.

 

Filed: Be The Change, Blog, Cancer sucks, Daily Life, Mother of the Year, Musings, Picks of the Litter Tagged: ,

Do No Harm

I always assumed my experience as a veterinarian would serve me at some point when I needed to navigate the human healthcare system. The similarities between veterinary training and medical training, after all, lend themselves to a good number of similarities: how to read scientific articles critically. How to read an MRI. When to call the office and say, this prescription doesn’t seem quite right, is this what you wanted?

The similarities are all well and good, but I never understood, in the marrow of my bones, until recently that what would serve me best was our differences.

We MDs and DVMs are both given an ethical mandate to ‘do no harm’, which we as communities hold dear. Our duties to our patients are guided by this overarching principle; we look to it for direction in complicated cases, fall back on it when we feel conflicted about a request, and hold it like a flashlight when we shine a light into the cave of an uncertain future, looking for direction.

But oh, do those lights shine in very different spectrums.

Recently, a man in Russia volunteered to become the subject of the very first head transplant, an idea that leaves most of the world recoiling in horror. “There are some things worse than death,” said many of the neurosurgeons commenting on the piece.

As a veterinarian, I agree. We veterinarians occupy a strange place in the medical field in that most of us view it as not only an option but often a moral imperative to ease the pain of a traumatic death process through pharmacologic means. We are precise in our process, with the goal of minimizing stress and pain. We view it not as causing death, but as easing an uncurable pain. In this, we view our fulfillment to do no harm.

But in the human medical field, the prevailing attitude is by and large that hastening death is, indeed, harm, and anything we do to prolong a life is conversely fulfilling their requirement to do no harm, no matter what it does to a person or family in the process.

Even if it is multiple craniotomies.

Months of chemotherapy.

Daily radiation therapy with a bevy of ill effects. And you have to get screwed down to the table wearing one of these while they shoot brain shrivelling radiation beams at your head:

radiation mask

Not to cure a disease, but to make a patient breathe one more day, for better or for worse. It is the second most common utterance to me in my hospice work: we do better with our pets than we do our people when it comes to end-of-life decisions, and truly, friends, we really do.

I was recently-by invitation- listening to a doctor outline just such a series of events and possibilities to a patient who didn’t want to partake in them, who has been looking- without success- for someone to say, it’s ok to say no to months of hospital visits and yes to fewer days filled with this:

Ha

Plenty of people do want everything we have to throw at disease, and more power to them all. Thank God for modern medicine. But when did it become not only an unthinkable mistake, but an outright affront to the medical community to say, “thanks but no thanks”?

Searching for information on hospice and palliative care has been as challenging as getting bootleg rum during prohibition, furtive conversations in hallways and whispered hints at such necessary things as family support and respite care, secondary concerns far down the to-do list after scheduling yet another CT. I never knew how much of an afterthought the emotional wellbeing of the patient truly is in many medical decision making processes.

“So what if they don’t want to do this?” I asked.

“Well, this is the standard of care,” the resident responded.

“And if they choose not to do this?” I asked again.

“Why wouldn’t you?” he said, dumbfounded. He never did give me an answer.

Do no harm.

 

Filed: Be The Change, Blog, Cancer sucks, Daily Life, Mother of the Year, Musings, Picks of the Litter Tagged: , ,

The Salem Shill Trials

1692

In the early days of the Puritan settlements, colonial Massachusetts was gripped by fear. Between the British and French warring over colonial dominance, smallpox, and potential attacks from Native American tribes, the residents of Salem Village lived in a constant state of anxiety and worry for their safety. In addition to these real concerns, an overlying and persistent worry that some people possessed supernatural powers tickled away in their psyche.

When two young girls began exhibiting strange symptoms of fits and screaming (now believed to be caused by fungal contamination of grain stores), the local doctor diagnosed ‘bewitchment’, because why not. The first to be accused were a family slave, a homeless beggar, and an elderly woman- but they weren’t to be the last.

800px-Witchcraft_at_Salem_Village

 

As the hysteria spread and some of the accused confessed in an attempt to save their own skins, others took note: accusing someone you don’t like of witchcraft is an effective way to get them out of your hair while also setting yourself apart as someone virtuous enough to be worthy of bewitchment. Rivalry, desire for power, fear and suspicion, ego- pretty much everything except reality itself seemed to play a role in the accusations.

 

WondersoftheInvisibleWorld-1693All you had to do was point your finger and yell “witch!” and out came the pitchforks.

It was quite effective- after all, how can you prove you aren’t a witch? After all was said and done, 19 people were hanged that year before everyone came to their senses.

The evidence that sent them to the gallows? Dreams and visions; and of course, some very self-assured charlatans.

Nowadays, we scratch our heads at how this could happen, how people could go so easily down the road of hysteria and gullibility. Or do we?

 

1998

In 1998, a medical researcher named Andrew Wakefield published a now discredited study linking the MMR vaccine and autism. Young parents, petrified at the increasing incidence of autism in children and worrying that their own choices could play a role, began delaying or declining vaccines altogether.

In first world countries where preventable diseases were being, well, prevented, parents felt the risk of a vaccine injury was now greater than the risk of the disease itself. There’s only one problem: it wasn’t true.

As the research proved Wakefield a fraud and everyone came to their senses, the medical community assumed that people would go back to business as usual. But, people are funny creatures, and sometimes we don’t really evolve. It only took the people of Salem a year to come around, but a strange thing happened at the turn of the millennium.

scumbag-jenny-mccarthy

The “all natural lifestyle” turned out to be a very lucrative phenomenon, tapping into all our current fears: corporate conglomerates controlling the food chain. Large pharmaceutical companies more interested in lining their pockets than curing disease. Money over health. Go back to nature, they proclaim, and the world will be a better place.

2015

The era of social media. There was a time where in order to be heard, you had to earn a spot at the podium through having something worthwhile to say. Now, you just have to get there first and have the loudest megaphone. Also: be a babe.

vani

On the sidelines of the ‘nature vs chemicals’ battleground, people with no stake in either the pharmaceutical industry or the coconut oil industry shook their heads. “But look!” they said, holding up science papers. “That’s not how it works! GMOs aren’t causing cancer, vaccines aren’t causing autism, and pet food doesn’t contain dead cats!

bill

“I appreciate your desire for transparency in consumer goods,” they continued, completely misconstruing the authenticity of those with the pitchforks, “but do we have to say things like airplanes should contain 100% oxygen and a bleach enemas cure autism? Surely we can be reasonable here.”

They smiled, holding their papers in front of them with their palms up, waiting for the coconut salesmen to welcome them with open arms.

The coconut salesmen, who had just celebrated their millionth Facebook fan and launched a new website selling crystals, lowered their pitchforks. They looked at the people with the papers, pointed their fingers, and in a clear, loud, voice they yelled-

“SHILL!”

And the pitchforks came out, because how can you prove you aren’t?

shill

A word from the stake

Whenever I speak on the worrisome outcomes of the current trend of science illiteracy, people say to me, “but don’t you agree that pet food should be transparently sourced? And that companies should tell you where their food comes from?” I imagine them saying this as they hold a match to the pile of wood underneath my feet, shaking their heads sadly.

And to those well-meaning but nonetheless about to burn me people I say, “Yes, but I don’t understand how you can make the leap from ‘I’d like more information about my food’ to ‘Subway contains yoga mats’ and ‘vanilla ice cream contains beaver butts.’ ”

Industrialized society is a double-edged sword. There are great benefits and some pitfalls, worthy of trying to improve. But why bother with such nuanced debates? It’s much easier and faster to call someone a shill. Next!

Toxins are today’s sorcery. Shills are the modern day witch. I take pride in being put to the stake, because I know history will vindicate me. And the only reason I’m not laughing at the absurdity is because while we sit here and have these nonsensical fights, children are dying. And there’s nothing funny about that.

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Low Stress Week: Dog Approaches

I have an idea. Let’s make this a week where we all walk away with at least one new idea, one way to make things better for the animals we work with and/or love.

ETA: I’m actually going to pause and take a little more time with this idea, and hopefully get more ideas and more people involved! Stay tuned!!

Today, I want to remind everyone of the best way to approach a nervous dog, featuring a short clip from Dr. Yin:

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I chose this for a few reasons:

1. I don’t know any people who teach their kids to do this;

2. I don’t know any vet offices who teach their staff to do this;

3. I don’t do this (that will change)

It’s no wonder that pets who routinely come to the clinic to get stared at head-on, tackled and/or pinned for a nail trim and then get their temperature taken have no interest in coming back. I am so glad my OB/GYN doesn’t take that approach; there’s really no reason we can’t make some changes for our pets too.

A simple change in body positioning can make all the difference to a nervous dog, which is better for the dog and better for you. If you work with animals, make a promise to try it this week and report back. And if you don’t, make a promise to try it with a pet you meet out and about, or teach your kids to try it out. Please, please teach your kids to try it out, if they are of the “I love and want to meet all dogs” variety.

For all you Instagrammers, I propose a #lowstress tag this week where you post a picture of a good low stress handling technique. There may be prizes. Let’s make this a good week, what do you say?

Who’s in?

 

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Knuckle cracking real-time talk here.

This is not about Sophia Yin.

I feel the need to say that before launching into a discussion about suicide and depression in the animal community, because the horrible news that she took her own life and the ripples it is causing in the veterinary world is the reason I’m talking about it today. But it’s not about her or her situation, which none of us will ever really know; Dr. Yin’s legacy is the work she did during her life, and it should remain that way. This is not about one person.

Whenever a tragedy like this happens, I see the same posts over and over: “Shocking. Tragic. Hold your loved ones close and tell them you love them. If someone seems to be suffering ask if they are OK.” And so it goes for a day or two, as we hug our kids and our spouse and our dog and then go back to work and assiduously ignore the suffering of those around us. Not that we recognize it most of the time anyway, but I’ll get to that in a moment.

One of the biggest misconceptions people seem to have about stress, burnout, and depression is that it is inevitably obvious to those around the person. I blame Zoloft ads for making us think all depressed people walk around weeping with little clouds hanging over them.

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I think a lot of depressed people look like this:

positive-people

Totally fine, I’m fine, I’m fine.

You know how we always say cats walk around looking like a million bucks with BUN levels through the roof until one day, way past the point it was an issue, it’s finally too much but you never had a clue? A lot of depressed people look like that. So maybe this is a little more accurate:

flesh-wound

They do just fine at work, and out amongst friends, and then come home and realize man I am not fine. But we’ve normalized stress in our lives to the point many of us don’t even necessarily recognize the signs of depression in others, and even in ourselves. I sat on the floor of the bathroom for four hours straight one day, when I was suffering from postpartum depression, and still had no idea that sitting on the floor of the bathroom unable to muster the energy to move two feet might be a sign something was wrong (protip: it is).

I don’t like talking about that time in my life, but I will because every time we censor ourselves from discussing these things we perpetuate the stigma that drives people away from seeking treatment. We are more scared of the consequences of admitting depression than we are the consequences of not being treated, and oh my god, how awful is that? I’m pretty sure the mental health professional community has been watching us in horror for years, waiting for us as a profession to finally say yeah, we could probably use some assists here.

So while asking someone if they are ok and offering virtual hugs is lovely and kind, I really think the time has come to try and do something a little more impactful. Open dialogue is a good place to start. So let me share some things that I have discovered over time, watching us wring our hands in despair over and over while we wonder what we could have done differently:

1. You would not believe how many other people out there are going through the same thing.

People at the top of their field, with lovely families and good jobs and beautiful dogs. People who seem to have it all together. And maybe they do, if they have good treatment.

2. I wish someone had told me about these things in vet school.

I thought I was the only person plagued by worry and self-doubt in school. In retrospect, ha! That was really not the case. Nonetheless, a little peer-to-peer support or support from people already out there would have been very reassuring. I believe we need to start letting people know at the start of their career, not at the middle or end, that stress/anxiety/depression/burnout are common, but solvable problems.

3. There’s support, although it’s hard to find.

Do you know what the hardest part was for me about getting through my depression? Figuring out who to call. My OB didn’t help, the psychiatrists she gave me the numbers for didn’t take on new cases, I wasn’t actively suicidal, and by the fourth call I was too tired to deal with it any more. So I laid on the bathroom floor for a few more days until I had the lightbulb idea to call my primary care physician, who was horrified and got me in that afternoon and life got a lot better after that.

I feel like our profession is still in the same place. Help should be very visible and easy to access, a rope already floating in the water instead of a life preserver someone has to yell for when they are drowning. Want to really do something to make our profession better? Help me figure out how to make that happen.

So you think you’re depressed/ burned out/ feeling off? Take a deep breath, you are in good company. You do not stop being a successful professional and accomplished person. Life can be good and you can still rock out and kick ass and laugh till your cheeks hurt. Here’s some places to start:

1. There is active peer support, through VIN, and on Facebook. A closed group has been started on Facebook for people dealing with these issues as well as their family and friends- to request membership, click here. Peer support is fundamental, though of course it is not a substitute for-

2. Calling your primary care physician, who if they cannot handle it themselves can at least get you where you need to go. I guarantee you every mental health professional out there is going “uh, of course,” at every thing I have said because they are experienced in these things, while we are not.

3. Stop googling. Seriously, all you will do is come out blaming yourself for not juicing enough and while it is a lovely way to get vitamins, it’s probably not going to be enough. Talk to a pro, just like we tell people to stop treating their dog’s ear infections with diluted alcohol that they read about on a yahoo group and go to the vet. Right?

4. VetGirl has offered their excellent webinar about suicide awareness available for free, for everyone. It is well worth the watch not for anyone who works in the field to help increase your understanding of the issue. You can find it here.

5. VIN is offering a webinar this Sunday at 9 pm PST to honor Dr. Yin and discuss “Dealing With You and Your Colleagues’ Stress and Depression.” My understanding is that this webinar will be made available to non-VIN members as well, so stay tuned as I get more information. Both webinars, by the way, are taught by mental health professionals who know their stuff.

I will be honest and admit I hate overly sentimental statements accompanied by soft-focus ocean pictures like “fall into my arms and I will catch you” and “the world is full of hugs if you just ask for them” and all that other stuff, so I will offer you my own personal unfiltered thoughts on this:

Depression sucks, and it’s real, a physiological crap storm of neurotransmitters, and if you are reading this experiencing a dawning sense of dread with unasked-for tears rolling down your face as you desperately say nonononononono I’m fine, you might not be. So call someone who can help so you can stop feeling miserable, ok? Do it today.

hugs

OK maybe one overly sentimental picture. But just one, and only because kittens. And with that, I demand some good news so we can get back to our regularly scheduled program of fur removal device discussions and derpy dog pics.

Filed: Be The Change, Blog, Daily Life, Health, Musings, Picks of the Litter Tagged: , ,

An Open Letter to My Veterinary Colleagues

Please share far and wide because we only have until Monday to get our voices heard.

Dear veterinarians, 

I imagine you have noticed things have changed a bit for us in the last ten years or so. A decade ago, you could look in the “Help Wanted” section on VIN or AVMA classifieds and have your pick of positions. This is good, since most of us carried modest student debt we needed to pay off. Being a new grad was exhilarating, a little nerve-wracking, but thrilling. Now?

molly-you-in-danger-girl-o

Vet school, you in danger, girl.

 

The Changing Landscape

Three things have happened that have dramatically changed the landscape for new grads, leaving them nervously optimistic at best and apprehensively regretful at worst:

1. The economy tanked.

Vet visits are down, and clinics are responding by tightening their belts. Job openings have dwindled.

2. Educational costs have skyrocketed.

I know we have all heard this, but have you really read the numbers? In-state tuition at my alma mater has doubled since I graduated. The average vet student now graduates about $150,000 in debt; some students are racking up debt as high as $500,000. To live comfortably- not extravagantly, I mean comfortably- your debt should not exceed an average starting year’s salary, which hovers around $64,000 in our field. We’re off by over double, and in many cases far more.

Source: http://news.vin.com/VINNews.aspx?articleId=17347

Source: http://news.vin.com/VINNews.aspx?articleId=17347

This is compounded by the fact that a change in student loan policies in 2007 allowed students in professional schools to borrow whatever amount they needed, no cap, assuming doctors and lawyers and dentists would earn enough in the future to make short work of the added debt. But in our field, the numbers just don’t add up.

3. Despite fewer jobs and higher debt, new veterinary schools continue to open. 

Why? After a threatened lawsuit brought by Western University against the AVMA Council on Education in the early 2000s, the accreditation process was relaxed to allow new institutions to become accredited without the added expense of building a teaching hospital. Instead, schools could use local veterinarians to provide clinical experience, which made the cost of opening a new vet school suddenly doable. (Please note, I’m not presenting an opinion on whether or not the quality of education differs- the Western grads I know are fantastic- simply presenting the history.)

Given how much money prospective vet students are willing to pay, this is a very lucrative proposition for private institutions such as Lincoln Memorial, or Midwestern, two new schools opening this year. At some private institutions, expected costs of attendance are reaching over $300,000.

vinmap

Source: http://www.vinfoundation.org/AppUtil/document/default.aspx?pid=0&catid=&objectid=21833&objecttypeid=10&redirectFromMiscDefault=1

More grads, fewer job choices, more debt. Sounds great.

The New Law School

It is no secret to those paying attention that veterinary school is being viewed as the next law school, that horrible disaster we’ve all read about, except- ugh- worse. The market fixes itself, economists argue, when prospective students see new grads flail and sink and stop applying, like that happened with dental school. So, you know, sacrifice a generation or two and it’ll be ok.

Except vet students don’t do that, because there is an emotional pull to this field that dentistry and law simply don’t have. Knowing the debt, and knowing the fact that things will be hard, vet school applications are still up. Will they regret it ten years later when it’s too late to change their mind and they are still living in an apartment because they can only find a 30 hour a week job? I guess we’ll find out.

Can we do anything about it?

Other than the aforementioned ‘let a few drown’ approach, I mean. I have read many practitioners state, “Their fault, too bad, sucks to be them,” and I can’t tell you how sad that makes me. Don’t we want to do better by our future colleagues than shrugging?

VIN has tried, by attempting to educate prospective vet students on the costs of education. Life with that amount of debt is not sunshine and roses. There’s nothing wrong with telling someone the truth about what that can mean for your life; if they choose to take it on anyway, that’s fine, but at least we presented them with realistic scenarios.

And what about the American Veterinary Medical Association, the “collective voice for its membership and for the profession”? Would it be a good idea for this organization to take a good hard look at the impact of these changes and attempt some proactivity in speaking out about the impact of these new schools?

So far, the response has been, “not our job, not our job, not our job.” Then what is? (Aside from making movie theater trailers.)

Accreditation and the AVMA

The AVMA Council on Education is responsible for accrediting new schools. If you’ll remember our history lesson from Part 1, this whole debacle started when the Council hesitated to grant Western a reasonable letter of assurance for accreditation and they threatened to sue. The AVMA cannot act in a protectionist way because as an accrediting body, it’s a conflict of interest to their neutral evaluation of new schools.

But they should, dangit. They should protect this profession. Not from the influx of new grads. FOR the new grads.

And the only way to do that is to completely sever the tie between the COE and the AVMA so they can function independently.

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Take Action!

Every five years, the US Department of Education reviews an accrediting program and decides whether or not to renew its status. If you are an AVMA member, you received an email this morning letting you know this is the year, and asking you to write a letter to the NACIQI stating your support for maintaining the status quo. But I have a different letter to present to you:

Sign the Letter Now

We know where we are headed in terms of the status quo. The scattered corpses of lawyers and dentists line the way. We can do better.

You can submit a different letter, one asking the NACIQI to seriously consider the relationship between the AVMA and the COE, here. For more information about what I’ve written, check out the Resources page.

 

Sincerely,

Just another non-high-level-leadership peon who loves this field and wants the future to love it too

 

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Arya of House Potcake

One thing I’ve learned about going on vacation, is that I don’t like to relax.

How can I, when there’s so much to do and so little time! I want to see ALL THE THINGS!

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And most of the time I vacation with my husband he responds with a blank stare and a “why would you want to do all of that?” So this time around we went to Turks and Caicos, a small island chain in the Bahamas whose island upon which we landed is only 38 square miles, so I think he assumed he would have me boxed in by water and I’d have no choice but to chill out.

He was wrong, of course. Shortly after arriving, I spotted the telltale signs of what I knew to be an island without an animal control program: stray dogs darting across the street, hiding from the midday heat and humidity in whatever shade they could find. In the Bahamas, these distinctive stray dogs are called potcakes, after the congealed rice and pea mixture scraped up from the bottom of the pot that was traditionally fed to the dogs. Scrappers from the start, these sturdy little guys.

With no official animal control and a population subject to the elements, starvation, parvo, and heartworm, one of the ways to deal with them was through poisoning (a very common and unfortunate way to cope when there is no program in place to help the animals.) Potcake Place is a rescue located on the island, 100% volunteer run and donation based, that exists to help bridge that gap and give these dogs a chance. Visitors are welcome to come in and meet the pups, so of course within 24 hours I mapped the place out and planned a trip.

I wasn’t sure what I was going to find, but I sure wasn’t expecting this:

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What they have managed to make out of so little is truly heroic. Enjoy the pictures of these healthy little pups. I guarantee you, before these rescue volunteers took them in they were not this happy and healthy.

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The facility is cheery, tidy, and full of happy. It makes people WANT to go in, as evidenced by the steady flow of tourists into the building to play, learn, and offer to courier the dogs back to the States. As the bulletin board shows, they’ve been successful in that as well.

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(aside- one in Hawaii?? That’s hardcore.)

Best souvenir ever, right? These people all seem to think so.

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Knowing this was ABSOLUTELY NO NO NO out of the question that we would be able to take a dog home, I settled for the next best thing: Potcake Place allows you to be a ‘foster for a day’, taking a dog out and about to give them socialization, exercise, and an opportunity to show off for more tourists on the street.

Who’s available? I asked.

They said, Bran, Rickon, and Arya. Was this meant to be or what? So we borrowed, of course, Arya.

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Come on. This is totally relaxing.

So anyway, we spirited Arya back to our little stretch of beach and told her all about the world. How people are pretty cool, if you trust them. How she should enjoy this water while she could because rumor had it she was on her way to Boston on Saturday. She took it all in stride.


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Did I mention Arya is extremely photogenic? I hope she goes to someone with a blog. Almost as much as I hope she goes to a Game of Thrones fan.

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And she’s great with kids. Seriously, she was awesome.

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So awesome, in fact, that when I saw her in the airport departure lounge on her way to a no kill shelter in Boston I seriously considered changing her out with my neck pillow- they’d never know until it was too late. Cooler heads prevailed, of course, and I decided I would instead focus my efforts on trying to convince them to put in an application for a World Vets team to come and help with a large scale spay/neuter effort.

I know just the right vet to help out.

 

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To learn more about Potcake Place, visit their website or Facebook page. They adopt to people all over the United States, even those who have never been to the island; you put in an application, and once you are approved you wait until someone from your area goes there on vacation and volunteers to courier the pup back to you. Isn’t that a great system?

Filed: Be The Change, Blog, Daily Life, Happy Tails, On Safari, Photography Tagged: , , ,

Bosnia floods- when the world isn’t watching, donate a dollar

Massive floods in Bosnia and Serbia are the worst they have seen in 120 years. The world has been silent on this issue, in large part. In a place that is still struggling to recover from years of war, it’s hard to comprehend the magnitude of this disaster.

Understandably, the people in the affected regions have had little time or money to address the many thousands of animals affected by this disaster. Tens of thousands have died in landslides and floods, and thousands more are still in need of help.

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World Vets is on the ground, led by my friend and all around exemplary human Dr. Teri Weronko.

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In addition to the initial needs of rescue and shelter, stress can often lead to secondary problems such as pneumonia.

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When confronted with such nearly insurmountable odds and tragedy, there are two choices. One, close the computer, turn off the TV, and let it go.

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Two, put aside the sadness, get in, and do what you can. World Vets is a small group, but they have never shied away from going to the places that aren’t media- friendly enough to warrant the attention of larger organizations. It’s personal to me since I know the vet in the trenches, and here’s what she said:

I spoke to one old farmer who told me that from as far back as HIS father’s grandfather, no one could remember a flood of this size and destruction here…So many have lost everything. Your donation will not be lost in some big aid bureaucracy. People like me are here, at the farms, talking to the farmers and the veterinarians serving them. We come in in the evenings and call up World Vets with specific requests for needed medicines and supplies, and those items are purchased and loaded onto a pallet for shipment here. International aid donation doesn’t get more direct than this. Any contribution you can make, no matter how small, will help! -Dr Teri

I ask everyone to consider helping if you can; donate, spread the word about this silent disaster. One dollar means everything. To donate, click the link below: This fund is specifically earmarked for disaster response.

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Much of what Dr. Weronko has seen is too awful to publish, and she is there still scooping up puppies and doing what she can with a local team of veterinarians and animal professionals. Although I can’t be there, I will be making a donation later today so they know concern knows no boundaries. If you contribute, post below and let me know. I’m going to see what I have in my goodie bag and will send something along to a randomly selected person.

ETA: How about this? How about, I will select someone randomly to send something from my pawcurious goody bag to, and if you donate over $50 I will put you in the acknowledgements in my book? You know me, I’ll do whatever it takes here. (Make sure you let me know directly if you do this- I don’t have insider access to World Vets coffers 😉  )

Filed: Be The Change, Blog, Disaster Response Tagged: , , ,

A grateful heart spreads like….well, wildfire

There are many things I could be upset about today. The fact that authorities suspect arson in the vast majority of wildfires that devastated San Diego this week, for example. That’s a good place to start.

Or the trolls whose only response to the news was, “That’s what you get for living in a dry place, morons, burn” as though there were a place on Earth immune to Mother Nature in some form or another.

But I’m too grateful to worry myself with fools and psychotics at the moment. There is too much gratitude to the many to allow myself to be angry with the few right now.

I am grateful to my friend K, who texted me to see if I was OK when she saw on the news that my neighborhood was being evacuated. This was at the start of this whole mess, and when I got her text I had no idea it was even happening. Her warning came ahead of the official notification, and gave me lead time to get back to the house to evacuate Brody and Penelope before the roads were barricaded.

I am grateful I heeded my own warning and had all the pet supplies quickly accessible so I could get in and out in 5 minutes. It is an eerie feeling to be alone in an empty neighborhood with a wall of smoke bearing down. Corollary: also grateful to the cat for not hiding under the bed.

I am grateful to my childrens’ teachers and the district who evacuated them from their school before it became an emergency. When you turn on the news and see your little ones’ faces disappearing into the smoke, your heart skips a few beats for them, even when they are already out and safe by your side. They had no idea why I was crying when I found them at the 2 separate sites they were evacuated to, though they will some day. I credit the teachers with keeping them all calm in a stressful situation.

Source: 10news.com

Source: 10news.com

I am grateful to the first responders from Cal Fire, the police, and sheriffs who were on the scene quickly and efficiently. 1500 acres and not one home lost in the Bernardo Fire, despite a full head-on assault towards hundreds of home.

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These crews left their families behind, from different counties and even different states, to fight for our neighborhoods as if they were their own. That’s a debt one can’t repay.

I am grateful to the many who heeded the evacuation warnings and let these men and women do their jobs, and to those who assisted with animal evacuations- especially with donating their trailers for the large animals who are disproportionately affected in these circumstances.

I am grateful to this community, who I know will help those who lost their homes. I have family here to take us in, but even had I not, so many friends offered their hospitality to us. Today, I turned on the TV and saw my friend’s dad on the news helping a member of his church hose down his property. We will pitch in, because that is what we do here in San Diego.

Filed: Be The Change, Blog, Daily Life, Musings Tagged: , , ,

Paws for the Philippines: The Power of One

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You, right now, are needed.

By now we have all seen and heard about the devastation wrought in the Philippines by Typhoon Haiyan. The stories are almost too much to bear.

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If you’re wondering why the media hasn’t been more active covering the story than they have been, it’s because everyone is still trying to get there. It is BAD. Bad, bad, awful, nightmarish. My heart goes out to those many souls and I will, as always, make a donation to the Red Cross to help the human victims.

The plight of the animals, domestic and wildlife, will almost certainly be overshadowed by the massive human suffering, but make no mistake, they are in dire need as well and even less likely to get it. I view animal welfare in a disaster as one more necessary component of disaster relief, not something to do later or when all the other needs are met, but in conjunction with other efforts. This is why there are veterinarians and animal welfare organizations who are trained for these sorts of situations. As always, World Vets has stepped up to help our friends across the world. After speaking with our contacts in the Philippines, World Vets is sending a team with requested immediate supplies and is on their way now. Once they have arrive, World Vets has committed to continuing support as the needs evolve. This will not be a short-term mission.

I am asking for you, you reading this, to do one thing. One act of love to support the animals whose lives and stories may never make CNN, but whose suffering, we know because our friends there are living it, is intense. Help the people, please, of course, and then do one thing for the animals. Just one. Please consider donating, it’s tax deductible and this fund is earmarked entirely for typhoon relief.

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I am donating one: one day’s worth of salary. That will be my one. You may choose to donate one day’s Starbucks. Or one dog leash. One dollar. One thousand dollars. Or nothing, of course, but I hope you can find one act of love you are willing to put into action. World Vets can take a whole lotta ones and make ONE BIG IMPACT on the lives in the Philippines. I invite you all to be a part, and to make November 15th the day you commit to One Act of Love. What’s your One?

Please help me get the word out and do some good! I can’t do it without you!

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Filed: Be The Change, Blog, Disaster Response Tagged: , , ,

Pet Disaster Relief: How It Works (hint: don’t show up without calling first)

September is National Preparedness Month, according to FEMA. It’s easy to see why. A lot of bad things happen in Mother Nature this time of year; Colorado the latest in a long series of national disasters to catch the eye of the nation. Few images are as evocative as that of a stranded animal, confused, petrified, and facing an uncertain fate while we sit in front of the TV and wonder, is anyone going to help him? How does animal rescue work?

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According to Kim Little, my Technical Animal Rescue trainer who taught me in Nicaragua last year, the craziest rescue he ever participated in was a massive pet pot bellied pig stranded in a flooded home during Hurricane Katrina. If you ever meet him someday, ask him about it. Kim’s a pro, active in professional rescue training for decades. The animal rescue component, however, is relatively new.

RescuedCatKatrinaMost anyone who has been active in animal rescue long enough will tell you Katrina was the game changer in disaster response, for many different reasons. It was a mess in general, as we all know, but the animal component was almost nil. People who refused to evacuate because they couldn’t take their pets later required rescue themselves, preferring to risk death than abandon their beloved companion.

A person I met last weekend at my SEMS/ICS disaster response training spoke of a story from Katrina, a little girl who had evacuated with her cat. The cat was with her, safe, and she was told by the bus driver that would take them to safety that pets were not allowed. They must put the carrier down and leave the cat, no, there was nowhere for it to go, and they needed to leave, now. He said he was haunted by the sound of her screams as her bus pulled away, leaving the cat alone in the parking lot as he scrambled to find help.

That was in 2005, and it was awful. In 2006, President Bush signed the Pets Evacuation and Transportation Standards Act into law. In a really oversimplified statement, it officially makes pets part of the national disaster response framework. In order for this to really function the way it was intended, though, there needs to be a plan at the local, county, and state levels for pets as well.

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Emergency response trickles up. The National Guard is not called in for a small brush fire in San Diego. However, once that fire spreads beyond what the local fireman can handle, they request aid from the county, then on up to the state, then eventually in huge disasters, a federal level. In order to maintain order and safety in chaos, the manner in which these disasters are managed is consistent across the board: the Incident Command System. ICS provides a standardized response framework that functions the exact same way regardless of whether you’re dealing with a car accident on your street, or a 8.5 earthquake.

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It’s absolutely essential; communications breakdown in a rapidly changing situation can mean disaster. Because the system is standardized and the chain of command well defined, you can drop a fireman from Phoenix into Yosemite and he will know exactly what to do.

But is it the same for animal rescuers?

Pet Disaster Aid: The Government Part

As a vet, I can’t just show up to the flood line and ask if there’s a sick pet I can help. I would probably get myself killed standing around where the helicopter is supposed to land or something. This is why ICS is important, and why emergency management teams ask those who have not been trained not to “self deploy” in emergency situations. I’m minimally trained in disasters; my knowledge is pretty specific to pets. I tried to learn water rescue once; in the practice scenario, I killed myself and the victim I was supposed to be helping. My job became “stay on shore and make sure we have enough rope”, which is also essential and as it turns out something I was great at. To truly be helpful in these situations you need two things: a skill that is useful; knowledge of the command structure and who is going to be in charge of you.

Some of us were better at water rescue than others.

Some of us were better at water rescue than others.

During Hurricane Katrina, there was no one in the official government rescue effort tasked with helping animals. ASPCA and HSUS sent in large scale, well trained relief volunteers, and thank goodness they did because no one else was doing it. But without being part of the official effort, there’s no reimbursement from the government, and more importantly no official way to communicate with the other disaster responders on the ground who may have important information: for example, a person shows up at the Red Cross shelter with a dog; would they even know if/where the emergency shelter is? A fireman doing a swift water rescue on a person realizes the victim is with a horse; who do they call?

With PETS signed into law, states are now working to come up with a clear and well defined animal response plan that integrates into the other structures already in place. On a local level, that means working with animal control and local shelters to provide immediate sheltering and aid. As the situation escalates, larger groups come into play.

In my home state of California, the California Veterinary Medical Reserve Corps- of which I am a member- is the veterinary group that is mobilized on a state level- not until the governor declares a state of emergency. Colorado’s Veterinary Medical Reserve Corps functions similarly, and both are units of the National Medical Reserve Corps. Oversight groups such as PetAid Colorado and CARES in California are tasked with the bigger issue of figuring out how this all should also play out at the local level- all the people in charge before the governor gets involved. As well as pets, they are to come up with plans for all animals: livestock, zoos, farms…. you see how crazy this gets. MASSIVE task.

Private Disaster Aid: So Where is My Money Going?

So hang on, if there’s laws saying the government needs to plan to take care of animals, why are these other groups asking for money? Make no mistake, non-profits/NGOs still have a vital role to play here.

1. There are different type of disaster declarations and not every incident is eligible for state or federal aid. In smaller disasters, the first line of defense is the local community: your local SPCA, shelters, vets, and rescues. Their resources, as you know, are often strained. As a disaster gets larger in scope, their responsibilities only grow.

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Groups like American Humane Association provide invaluable support during disasters

2. An “official” government entity in charge may invite a nonprofit in to help. In Boulder, Animal Control was quickly overwhelmed at the flooding before them. They invited Code 3 Associates and American Humane Association’s Red Star rescue team, both exceptionally well trained animal rescue providers, in to help.

How Can I Help?

1. If you want to know who in Colorado needs help, BlogPaws– itself based in Colorado- has a great article listing local groups in action.

2. If you are a veterinary professional or someone with animal experience and you want to be on call for disasters, try searching “(name of your state) veterinary medical reserve corps”. The ASPCA also has an excellent list of disaster response training courses.

3. If you want to be better prepared for a disaster (and who doesn’t), check out this list of Animal Preparedness Tips from FEMA.

 

Filed: Be The Change, Blog, Disaster Response Tagged: , , ,

Fear Me: Fear Free Practice and You

My resting blood pressure, I assure you, is completely normal. I have to state this fact again and again every time I wind up at the doctor’s office, when the nurse places the cuff and then pulls it off with a thoughtful wrinkle in her forehead. “It’s not normally 200/140!” I plead, hoping she doesn’t direct me to the closest ER. “I just get this way when I’m in the doctor’s office.” She nods, and we get on with our day. I have no idea why it happens, but apparently it’s A Thing. I blame it on the scale. I hate going to the doctor and avoid it as often as possible.

Sound familiar?

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It happens at the vet, too. “The cat’s temperature is 103.8,” the tech will say, shrugging. “I think. She was trying to bite me most of the time, so I didn’t get a heart rate.” White coat syndrome in pets can be so significant that some behavior experts counsel the veterinarian to leave the coat in the back room, so as to trick the pet into thinking you aren’t the dreaded vet. We accept this as a reality of practice, our years of blood sweat and tears in service of our love of animals being reduced to this: told, on a daily basis, “Ha ha! My dog hates you.”

“Fear is the most damaging thing a social species can experience.”

I was talking to Dr. Marty Becker the other day (I know, right? I am so excited to actually say that I am a person who talked to Marty Becker the other day) and he was sharing a conversation he had with Dr. Karen Overall about the effect of stress hormones on physical health. It’s not some theoretical thing; fear causes permanent change to the brain. It is damaging in a profound and terrible way.

I think of my mother, who had such horrible experiences at the dentist as a child that she refused to go back for years until the advent of sedation dentistry. I think of my own memories of childbirth and hospitals and how simply seeing the maternity ward from the side of the freeway gets my heart pumping. Fear is an awful feeling. And what we do to pets in the hospital can only be described in many cases as a terror inducing, fear of death experience. Slapping a cat on a cold exam table, sticking needles in their neck like a predator sinking their teeth into prey, staring at them through the bars of the cage. It can take them days or weeks to recover from the stress of a hospitalization, and as soon as they get put in the carrier for a follow up, it starts all over again. No wonder cat visits to the vet are so infrequent. And we are supposed to be their health champions.

As vets, we often blame clients for not caring enough about their pets. “Don’t you know,” we ask sagely, “how important these visits are?” And we shake our heads at the pet owners, blaming them for not having their priorities straight, for not wanting to spend the money on visits. We have done this for years, without ever looking at ourselves and wondering what part of the blame we shoulder ourselves for making the vet hospital pretty much the worst environment possible for pets. “Shelters are so stressful and sad,” we say, ignoring the PTSD we are inducing in the cat with a urinary catheter in the back who has nowhere to escape the prying eyes of the Husky across the room.

When I really started to think about it, I was mortified.

It doesn’t have to be this way.

Some people get it. I worked with a technician who loved cats, like, in a self professed ‘cat lady’ sort of way. She was always sneaking into exam rooms to place a microwaved towel under a cat, or sprinkling catnip in their cage, making little hidey boxes out of recycled cardboard. It was tolerated. It should have been celebrated.

A lot of people in the profession, like that technician, are intuitively doing what they can to make things easier on pets. After hearing Dr. Margie Scherk lecture on this topic years ago,  I started keeping a yoga mat in the back for cats to sit on, on the table. Dr. Becker is taking it one step further: he wants vets to re-envision practice from the ground up, to change them from a vet-friendly hospital to a pet-friendly one. He calls it “Fear Free Practice,” and I love it.

When I was in school, veterinary behavior as a specialty was just getting off the ground. It was scoffed at. It’s not ‘real medicine’ was the prevailing attitude. They were wrong. It is, in my opinion, our biggest oversight as a profession. We blame backyard breeders and lack of affordable spay/neuter for pet overpopulation while neglecting to address behavior issues that eventually result in a pet being relinquished. We make the clinic so unpleasant people would rather let their pet suffer in pain at home than come see us and miss the chance for interventions that can save a life.  The consequences: less visits, more health issues, more behavior issues we never got the chance to address.

The veterinary community needs to do a better job, from start to finish, of addressing and incorporating behavior into practice.

Fear Free Practice: Real Life Implications

Anyone who has spoken to me in the past year or two knows I am passionate about encouraging our profession to take a more active role in maintaining a pet’s healthy role in the family. To me, preserving that relationship is just as important as maintaining a good weight. It is vital. As is, I think, this concept of fear-free practice.

While Dr. Becker and other like minded vets work on our colleagues, I encourage you to advocate for your pet’s mental well being at the clinic. Bring a mat or towel. Spray them with Feliway. Ask the vet to give your dog some of his favorite treats before jumping into the exam, or if they can take the heart rate while the cat stays in your lap. Making a visit less stressful doesn’t have to involve rebuilding the clinic from the ground up; it can start with these little steps. It’s a philosophy more than a set of prescriptives.

Has fear kept you and your pet from the vet? Had a vet that went out of their way to make you comfortable by embracing a fear free approach?

Filed: Be The Change, Blog, Health, Musings, Picks of the Litter Tagged: ,
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