Like many of you, I’ve been mesmerized by the bravery of Brittany Maynard, a 29 year old woman who is dying of Stage IV brain cancer. After hearing the course of the disease progression from her doctors and considering what the end of her days were likely to be like, she made the incredibly difficult decision to move to Oregon, one of a handful of states in which assisted suicide is legal, and choose the day and manner in which she will die.
While her story is compelling and awful, it is not so surprising a concept. For veterinarians, taking part in these sorts of heavy decisions is an everyday occurrence, and to the Maynard family I say: I am so glad you have the ability to make that choice.
As I travel to Indianapolis for the annual meeting of the International Association of Animal Hospice and Palliative Care (the mouthful acronym of IAAHPC), I find myself struck by the two most common things clients say to me when I come to their home to euthanize a sick pet:
This must be so hard.
I wish we had this for people.
Though we all wish for ourselves, and our pets, to die peacefully and unaware in our sleep, the truth is, that doesn’t always happen. Sometimes death is peaceful, but sometimes it is horrible and painful and agonizing and drawn-out. To say that is a fate worse than death is not a metaphor in this case. Death can be a relief. We don’t always get to choose the way in which we die, but when we know it is coming and it is going to be unpleasant, I am very grateful this is an option we have for our pets, and for some people.
I suppose in many ways veterinarians are leading the charge in normalizing people’s attitudes about this possibility, right in there with hospice workers and other professionals who deal with these realities. None of us probably gave that much thought when we signed the dotted line on vet school admission forms, but it’s there nonetheless.
There is a small but important distinction I wish more people made when talking about Brittany’s situation: they say, “She is choosing to die.”
This is not true. She wants very much to live. She has no choice in the matter. She is dying.
The accurate statement is, “She is choosing how to die,” and that is a vital distinction. I’ve seen differing views on this, people who genuinely believe that there is beauty in every moment of life, even in suffering an agonizing death with a ravaged body, and to that I simply say: I respect your view on it and your right to choose that end. I also respect those who choose as Brittany is doing, and I find beauty in that as well.
There are limits, of course. I do not show up at people’s homes and simply provide euthanasia on demand for pets who do not have a terminal disease. For my own emotional well-being I have very specific requirements and lines I do not cross. There are situations (such as a dangerously aggressive pet) where the lines about what is ethically acceptable are fuzzy, but my personal limits are not. I feel very proud and honored to be able to do what I do.
This is how I continue to do this every day: by reminding myself and the grieving owners that we are not killing a pet; the disease is killing him or her. We are simply aiding the process and making it more comfortable. I wish for the Maynards the same I do for my patients: comfort, peace, as much as can be gathered in a stressful situation.
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.
I think a lot of depressed people look like this:
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:
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, aphysiological 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.
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.
This has been an almost unbearably terrible week for those in the veterinary profession, and those who love animals. First the awful news that Dr. Sophia Yin had passed away, and then not one day later, we learned of the passing of another tremendous voice and educator, Dr. Lorie Huston.
Like many of you I considered Dr. Huston a friend. She was extremely well regarded for her work online as the Voice of Pet Care with the Pet Healthcare Gazette, her many contributions to various publications, and most recently her position as president of the Cat Writer’s Association. But I think even more than her fantastic work, she was admired for her kindness.
Her gentle manner and empathy were unrivaled, and a shining example of the compassion that veterinarians so often extend to animals but sometimes struggle to extend to each other. She never had an unkind word for anyone. I don’t know how she did it. She made me want to be more like her.
As a denizen of the online community, I have nothing tangible to offer in condolences, no casseroles to deliver, no walls to place a white flower upon. All I have are words, those intangible, ethereal ideas that seem so unremarkable in the face of such sadness, and my attempt to express them in the hopes that in some small way they help someone else understand what Dr. Lorie was all about. And because I cannot bear to cry any more today, I want to instead share a story that will maybe make those of you who knew her smile a little through your tears.
The Marble Room Incident
A couple of years ago, the AVMA national convention was in San Diego. I touched base with Dr. Huston and learned she would be attending, and made plans to meet up with her at the Winn Feline Foundation booth, where Dr. Huston was sharing the work the foundation is doing to advance the health and well-being of cats. Dr. Huston had six cats, six well-loved, adored felines.
“Shall we go get dinner?” I asked, and she said she thought that would be a good idea. We walked a little bit through the Gaslamp district, and as I was starting to get tired I saw the name of a restaurant I had been to before and said, “How about the Marble Room? They’re great.” Lorie agreed.
I had been to the Marble Room with my husband shortly after it opened, a throwback steak house type place with amazing truffle fries. That was how I remembered it. No one told me they had changed ownership.
We sat outside since it was a pleasant evening, which in retrospect was an error since had I gone in I would have seen the new theme: old timey bordello masquerading as a saloon. Within a minute, what I thought was a streetwalker but was instead an embarrassed-looking server in a too-tight corset and can-can skirt asked us what we would like to drink.
“Iced tea,” Lorie said with a pleasant smile, as I sat horrified. “Me too,” I squeaked out. “Are these uniforms new?”
The server nodded with a frown, trying not to catch the edge of the menus on her fishnets.
A quick Google search would have helped immensely in this situation.
So Lorie and I shared a pleasant meal of not-quite-as good as I remember truffle fries while we talked about the role social media played in the evolution of veterinary medicine.
As always happened when we spoke, I was blown away by how sharp she was- never mind her calm and quiet demeanor, her brain was always churning away a million miles an hour about what the next big step was in improving the human-animal bond. Her greatest gift, as many of you know, was in explaining these complicated health concepts in concise and clear language. She made medicine accessible, and to those like me who knew medicine, she made social media accessible too.
Midway though dinner, she excused herself to find the ladies room. When she returned, she assured me that she located it just fine. When I followed suit a moment later, wedging between red leather banquettes towards the back, I saw that the hall leading to the ladies room was hard to miss as it was covered in, uh, tasteful I guess, nudes. I paused a moment to dab my forehead with cold water, mortified that I took poor, sweet Dr. Lorie to the world’s tackiest themed restaurant for subpar potatoes.
Seriously, naked people everywhere.
When I returned, Lorie was talking to the server and quite kindly ignoring her attempts to hold her top up as she cleared the plates. “I am so sorry,” I said. “This is not the place I remember.”
“Oh no, it was delicious,” she said kindly, ignoring the rest of the situation. “The truffle fries were excellent. Thank you.”
And that was Dr. Lorie, always. Gracious to a fault. She was generous with her friendship, advice, and compliments, even when they were not deserved, even when her friend subjected her to an awkward, PG-13 rated evening out after a long day at the conference booth.
When I was in school, I accumulated a lot of textbooks. Books from the titans, the Nelsons and the Feldmans and the Fossums. I stood in line at the bookstore with these heavy tomes weighing me down, and noticed every other person in line with a tiny mahogany text balanced on top of their piles.
“What’s that?” I asked.
“The Nerdbook,” they said. “I heard you can’t make it through vet school without it.”
I had an earlier edition, because I’m old.
They were right. I spent many hours in rounds with my Nerdbook balanced on my lap, trying to look up answers to questions before the clinican called on me. It was unlike any other book I ever owned: concise, easy to navigate, organized by clinical signs to be completely usable. I heard it was written by a veterinary student, which made sense because it was so perfect for the way we used it, but also made no sense because who had time to write a book in vet school?
“Some gunner student a few years back,” I was told. “She was brilliant.” The author? Sophia Yin.
It was the only book I brought to the teaching hospital each and every day, taking it with me the following year into clinical practice: highlighted, scribbed on, well-loved. One time, I made a diagnosis that my clinician, a man who had been in practice for 167 years, said was impossible. “How did you know to put that on your differential diagnosis list?” he asked, before telling me I would be an amazing internal medicine resident. “Oh you know,” I said, but the answer was it was in the Nerdbook. Dr. Yin told me. The Nerdbook was everything. My techs used to hide it from me sometimes just to watch me panic for a few minutes.
Dr. Yin’s name popped up again soon after I began work, this time as a behavior expert. When she got into practice, she again sensed a void: a need for reasoned, science-based behavior approaches that would keep pets in homes and out of shelters. It’s hard to imagine now, but in the early 2000’s behavior was held in lower regard than specialties like neurology or internal medicine, a fluffball elective. “Nothing in life is free”, the foundation of positive reward based training, was in its infancy. Alpha rolling was still the norm in many circles, and training programs based on shock collars were being franchised left and right.
She helped lay the groundwork for what we now view as the best science-based approach to training, one of the most fundamental paradigm changes in our field in the last decade. Dr. Yin became a world-renowned behavior expert and fierce advocate for positive training, an amazing communicator whose lectures were always overflowing into the halls by an audience who finally recognized that her advice, when passed onto clients, was saving lives.
Though she was often known as a dog behaviorist, I remember her most for a series of cat lectures I attended at Western around the time Apollo was marking in the house. My husband was about to lock him permanently in the garage. In one hour, she gave me enough actionable tips to fix the problem, for me, and later on for clients and blog readers. Those tips keep animals out of shelters and in homes.
Dr. Sophia Yin- you are missed.
Dr. Yin’s latest work is, again, revolutionary. As a board member for Dr. Marty Becker’s Fear Free Practice movement, she is one of the key figures teaching us low-stress restraint techniques that change the way we practice medicine. It makes sense, right? Why do we just accept the fact that pets hate the vet? Why do we not try to make it better? Just this week I used a technique of hers I watched on video to help bring a frightened cat out from under the bed; he was already ill and the last thing he needed was more terror. Dr. Yin’s reach and her influence is everywhere, her touch felt every day in the way we practice modern medicine with compassion.
Dr. Yin was the best of what veterinary medicine is all about, a passionate veterinarian, a dedicated revolutionary, a person whose accomplishments knew no bounds, an inspirer of colleagues. Her unexpected passing has left so many saddened; I hope her family and friends know just how much she was beloved by so many people. Thank you Dr. Yin for everything. You will be sorely missed.
by Dr. V | Thursday | September 25, 2014 | Comments are off for this post
If you were awake at 7:50 this morning and happen to have been watching San Diego 6, you’d have seen me trying with varied success to get a very sweet and nervous Saint Bernard to eat some treats. You know what they say about pets and kids. But that’s OK, because Gabana was still a precious prop to our perhaps less entertaining but still very important topic, saving money on pet care. Here’s the tips I shared:
1. Don’t skimp on preventive care.
Pop quiz: what is more expensive-
Regular dental cleanings on healthy teeth once a year
One set of extractions on a majorly diseased mouth, complete with antibiotics and an echo to check out that heart murmur the bacteremia ended up causing over time.
I brought in some Minties as an example of a home care item you can use in between cleanings. Love them within caloric reason, but again- cleanings at the vet are just an important as cleanings at your dentist.
Early detection of problems like diabetes, kidney failure, and cancer results in lower vet bills, and more importantly, a healthier pet.
2. Ask for a written prescription
Yes, veterinarians often charge more for some meds than what you can get it for at Target or Wal-Mart. They pay more for them in the first place than the big pharmacies. The tradeoff is convenience, which is fine when you are getting one prescription but can add up if your pet needs regular medication. We all get that.
Ask for a written prescription. The veterinarian should provide one on request. Sometimes they will price match, too. The primary concern of our office is to make sure your pet gets the care they need, and the price of meds is often the difference between getting treated and going without.
3. Make your own treats
I’ve covered this extensively, from cupcakes to donuts and jerky, but making your own treats can save money and be a ton of fun as well as give you lots of control over ingredients. Making dog treats is how I got my kids interested in cooking.
Words cannot express my deep love for Fido’s Frosting from K9 Cakery, which is how I made the donuts above. If you recall, Kekoa like to eat this straight from the bag.
There’s only so much you can fit in a quick segment so I didn’t get to cover other topics like pet insurance, but we just spoke about that here a couple of weeks ago anyway. If you have any other tips that’s helped you save without losing out on quality care for your pet, I’m always up for ideas!
My first year of practice, I was talking to an owner in an exam room when I saw her eyes go wide and she yelled, “SPIDER!”
I looked down and saw a large arachnid crawling across the table towards her poodle. Without missing a beat, I grabbed a large drug compendium and put an end to the assault. The lady looked up, cocked her head, and said, “I guess you don’t love all the animals, then.”
I felt terrible, actually. My grandmother would not have approved. She would capture daddy longlegs in little glasses and transport them outside, or just as frequently, leave them alone. “They eat bugs,” she said. “It’s bad luck to kill them,” she said.
But I didn’t live with my grandmother, my dad’s mother. I lived with my mom, who learned from her mom that the best way to deal with a spider was a Dr. Scholl’s sandal, the one with the big wooden sole.
I think about that day, and how I would have to make up for it lest I be followed through my life by angry hordes of spiders. As you are about to see, I think I’m still paying.
Yesterday, the kids called me in to assess a spider situation in the guest bedroom. It was, they claimed, a huge spider, which could mean anything from “dime sized” on up. I went in, and yes, it was actually a huge spider. Probably an inch or two across, I didn’t get too close.
The good news was, it wasn’t a black widow or a recluse, and in the interest of being good to my grandmother’s memory I told the kids, “let’s just shoo it under the armoire. See? It’s as scared of you as you are of it.” I did not notice the tiny peals of laughter from the spider as it ran away. I did not realize she was simply approaching us with a familial sense of pride to show off her brood.
A couple of minutes later, my son came out again. “There’s a bunch more,” he said.
“What?” I asked. “Spiders?”
“Yes,” he said. “Like, 8.”
I went back into the office, a sense of disquiet taking over me. “Where?”
“On the bed,” he said.
And there, crawling all over the guest bed, was an army of teensy tiny baby spiders, which had apparently just hatched from whatever hellspawn was hiding under my armoire.
No. I do not love all the animals. This I can say now with great certainty.
Since I can’t find my flamethrower, I was stuck with simply tossing the entire set of bedding out into the courtyard with a scream and spending the next two hours vacuuming every nook and cranny in the room, stopping only long enough to call my husband on his work trip and freak out into the receiver. The mother spider, of course, was now nowhere to be found. Her work was done. For now, at least.
I was up until three in the morning startling at every shift of the bedsheet. If anyone can recommend a good pest control service in San Diego, I need one out stat. *shudder*
I remember this about September 11, 2001: I felt very lonely.
It was my senior year of veterinary school. My husband, who had only been my husband for about 2 months, was far away in San Diego. My mother was the one who called me, waking me up to tell me to turn on the news. She was alone too, as my father was on a rare business trip in Texas, one he ended up having to drive home from. We held the phones to our ears together until there was nothing more to do, so I said, well, I guess I ought to go to school.
I was doing a rotation in a lab that week, spending my day alone in a dark basement underneath the medical school looking at slides. Every few minutes I’d wander upstairs where I could get radio reception, and the other lab denizens would join me for a few minutes before we retreated back down to our holes.
Later that afternoon, after I returned home, there was a knock on the door. It was two nicely dressed missionaries. “How are you?” they asked.
“Not so great,” I said.
“Why?” they asked, genuinely concerned. “Do you want to talk about it?”
“Do you have any idea what’s going on?” I asked. They shook their heads in confusion. I shut the door.
Behind me, Nuke gently pressed his head into my hip. I had adopted him the year before, thanks to my friend Dan. “I want a dog,” I had said. “A Golden, maybe, or a pug.”
“I have just the dog!” he said, before referring me to the radiology department and the 10 year old coonhound who had been getting irradiated on a weekly basis as the vet students learned how to take films.
“He’s not housebroken and doesn’t know what outside is, so he’s a little addled. If it doesn’t work out, it’s ok,” said the tech. “They were going to euthanize him so I figured, I’d give it a shot.” No pressure.
He was a little addled. He was the dumbest dog I’ve ever had. He was neurotic and howled if he was outside for more than 2 minutes because he was scared of open spaces. He refused to learn ‘sit’. I loved him.
In those long and sad days after September 11, he was my greatest comfort. He died of cancer shortly after I graduated the following year. I miss him.
This Sunday marks National Pet Memorial Day. I hope you’ll join me in thinking of those we lost, or sharing a memory below. They leave this earth but they never leave our hearts.
There is nothing that will make you gain an appreciation for a creative process more than attempting to do it yourself. You know, like those people who scoff at the museum and say, “A kid could do that!” and then go home and paint something absolutely horrid.
Or those people who look on Pinterest or food blogs for new recipes.
This is how I feel about writing a book. “I write a blog,” I said. “I have a command of basic English,” I said. This will be a piece of cake. James Patterson cranks out like 4 of these a year, surely I can do at least one in five years’ time.
Then I tried to do it. I sent to my agent a proposal that I thought might work, much the same way this sculptor thought his modern take on “a snake” might work.
These things are, clearly, subject to interpretation.
Much like the kindergartner who says, “I can do it MYSELF!!” before nearly running into the path of an oncoming school bus, my journey has required a good deal of handholding, gentle redirection, and tactful suggestions from people who have been doing this much longer than I have.
Today I sent off the second draft of All Dogs Go To Kevin to my editor. I don’t know how many drafts one normally goes through; enough to get it right, I suppose. It took forever. I did what all writers do and sat, paralyzed with indecision, for months before hitting the keys in a panic. I procrastinated. I took a short break to read Stephen King’s The Stand (not the best decision from a time management perspective, that one.) But we got there.
I’ve read that George R.R. Martin writes his manuscripts on a typewriter. I can’t even fathom how that works. Without word processors, I’d have been dealing with trying to make sense of something like this:
But it’s working! We have made progress! I have slogged through my favorite dogs’ deaths enough times now to count as official desensitization therapy. It’s actually, after lots and lots and lots and lots of work, starting to resemble an actual manuscript. It’s nuts.
We are on target for a summer 2015 release, which seemed like a long time away until that whole Hachette/Amazon debacle where Amazon is penalizing first time Hachette authors by burying their works and potentially ruining their fledgling careers before they even had a chance to get started.
Now, summer 2015 seems like “Plenty of time to get it figured out, right guys? RIGGGHT?” because if not, I’m going to be begging you all on hands and knees to put aside your Prime for just long enough to get my book at Barnes and Noble because yes, I am one of those Hachette authors affected by this, and it’s making my hair fall out.
In the meantime, my editor has been keeping me entertained by sending me photos of some of the dogs that may be featured on the book cover. Her job is to take the pictures I sent her of Taffy, Emmett, and Kekoa and come up with three reasonable stand-ins. It’s a tall order, at least so far as Taffy is concerned, seeing what they have to work with: “A slightly neurotic, half-shaved Lhasa with chronic skin issues who always looks like she wants to be anywhere other than with the two 80s relics who always insist on holding her, Joan Jett and Jeanette from the Chipettes.”
It’s National Dog Day, a day to celebrate the love and bond we share with our canine companions.
It’s hard to top. What could possibly be better than National Dog Day?
Having your birthday fall on National Dog Day. Especially if you’ve always proclaimed that dogs are pretty much the best thing ever. It is also, in a strange twist of fate that I cannot tell if it is coincidental or not, is also National hot dog day, which is a fact I’m not as excited about so I will choose to ignore.
But it’s my birthday! And the fact that it’s National Dog Day is a welcome distraction from the fact that I am now old enough that birthdays are officially depressing, so Brody and I are going to have a great walk and have some treats and I may, in a fit of generosity, even give him a bit of hot dog, even though I won’t partake myself because I watched that episode of “How It’s Made” and eew.
In another wonderful coincidence, just yesterday GoPro released their new Fetch dog harness. I’ve been waiting for this for years. Some of you may remember my failed attempts at Brody cam, when I actually commissioned a person on Etsy back when you still could do that to make me a helmet harness for the dog. He looked like a Spaceball. It didn’t work. So we waited, and finally, our patience has been rewarded.
Heck yes I have one. To make things even scarier my husband bought himself a drone for his birthday so we have all the tech. Brody cam is COMING. Be warned.
ETA: Have also just been informed that today is also Women’s Equality Day, a celebration of the 19th Amendment ratification on 8/26/1920. The day just keeps getting better and better!
I admit I am biased about pet insurance. I like it, mostly. Clients who had it were, in my experience, much more likely to approve necessary treatments. That dog with a case of happy tail who wagged it so hard and so fast he got a nasty deep infection that ended up necessitating a partial tail amputation? Insured. Hit by car? Insured. From my perspective, it allowed owners to focus on the pet’s immediate needs and get them taken care of.
I also liked it because I didn’t have to do anything to get it taken care of, other than fill out a brief form. The owners paid me upfront, and were reimbursed by their company after the fact. If the owner and the insurer had a disagreement about what should or should not be covered, it wasn’t something I had to get involved in. It was nothing like human medicine. The summer before I started veterinary school, I actually worked the front desk in an internal medicine MD practice and good lord, those staffers spent probably 33% of the day dealing with insurance issues.
Just a few years ago, I could list three pet insurance companies, tops. Now there’s almost too many to count, with good policies and bad policies and fine print a mile long and exclusions even longer, especially if you have a bulldog in which case you might as well just get a second job.
Some pay a flat percentage of your bill. Others use benefit schedules, and specify exactly what amount they will pay per procedure. Most reimburse you, but I know of at least one that is rolling out a program that will pay veterinarians directly. Some cover preventive care. Some cover accidents. Some cover breed related illnesses, and others don’t. Tooth extractions? May or may not be a pre-existing condition. WHO KNOWS.
It’s gotten so confusing, even for me, that when people ask me what I think all I can say is, “Yes, go for it, but with caution.” Caveat emptor. But even then, even knowing all there is to know and asking all there is to ask, I’m hearing more and more people tell me they just spent five hours on the phone with an insurance rep trying to figure out how a newly diagnosed endocrine condition counts as “pre-existing.”
If this sounds familiar, that’s because that’s what all of us have done with our health insurers at least once, right? It’s confusing, and getting even more so the more players that enter the field. All companies are not created equal. I think most people completely understand the need for exclusions and limits, but for goodness sake let people know when they sign up what, exactly, they are signing up for.
While lawmakers in California had hoped that pet insurance would fall under the auspice of state insurance regulators, it hasn’t happened, and people with complaints have found they were pretty much out of luck. Fortunately, a new bill that already passed the legislature and is headed for the governor’s desk should give consumers a good deal more protection.
AB 2056 will make California the first state in the nation to specifically pass regulations about the pet insurance industry, separate from its current designation as miscellaneous property and casualty. It specifies the need for clear language about co-pays, exclusions, waiting periods, and caps- all the stuff people run into issues with now.
This is good news for everyone: the excellent insurance companies out there whose reputation is being sullied by the shyster groups, veterinarians who are able to better care for pets, and most of all the clients and pets who stand to benefit from better access to care.
So let’s hear it: what’s been your experience lately? Have you been blindsided or pleased with your insurance coverage?
A week ago, I called my husband on a business trip in China for the urgent assistance in locating my DVD of Aladdin.
“Why do you need it this very second?” he asked. “You haven’t watched that in like 15 years.”
“I know,” I said, “But our daughter is singing a song from Aladdin in summer camp this week and she really, really needs to see this movie.” She’d seen it once before, years prior; my son hadn’t seen it ever. It was an unforgivable omission, one I felt an almost irresistible need to fix.
So we sat down and watched it, this movie that came out when I was still in high school, and I marvelled. The computer animation looked so dated now, the pop culture references flying over the kids’ head like a magic carpet. But it worked. It still worked, and it was all because of Robin Williams’ genius.
He wasn’t a person who had been in my thoughts much in recent times, though he was a fixture of my childhood from Mork and Mindy through Good Will Hunting, Patch Adams, Good Morning Vietnam. Watching Aladdin rekindled my interest in his unique body of work and I’ve been on a Robin Williams binge this last week- Aladdin followed by The Birdcage, Good Morning Vietnam, and Mrs. Doubtfire scheduled for later this week. Robin had, in addition to his brilliant improvisation and manic energy, an exquisite ability to layer melancholy and sweet, delving into the deepest pains of humanity in a way that made you hopeful despite its ugliness, a compassion that balanced the sometimes cruel realities of being alive. He inhabited those characters in a way few others could. Williams and Alan Alda, the actors that defined the genre for me.
That level of perception and intuition about the human condition, often begets a certain creative brilliance. Comedy relies on it. It also, as we all too well know, often drags along behind it a heavy dragline of depression. It is the contrast upon which such artistry must be laid in order to make it pop. It takes an awful lot of mental energy to wield the two simultaneously, I suspect. No one described it better than, well, himself:
Phenomenal cosmic power!
iity bitty living space.
Depression is not a fight that can be won, a demon vanquished. It’s simply there, a weight people carry around and manage the best they can. Robin wrought his depression like a kettlebell, swinging up and down and up and down and in the process put out the energy that was-is- his legacy. I can only imagine how exhausting it must have been, but he did it, over and over, though his life. He made it work for him.
He was a dog lover, you know. Of course he was, right? When you live with that kind of pressure and expectation from those around you to be on all the time- why aren’t you saying something funny?- the presence of an unconditionally accepting creature is a comfort and a joy.
Having so recently been drawn back into his life and his work and his bright eyes that never entirely belied the stormy grey beneath, I was so enjoying re-experiencing the creative rush of his work, immersed in how much he gave of himself to make others smile. Today was a shock, in many ways.
And I guess that is why so many of us are so insanely devastated, at least I know I am. He always made his depression work for him, turning the swirling rivulets of thought and extremes in his brain and transforming them into art. I see in the world the same sort of wide eyed despair that followed Kurt Cobain’s death, that sense of hope snuffed out. I think a lot of people looked up to them both. They were proof positive of the transformative power of creative will, but while Kurt succumbed at a young age, Robin managed to persevere, and that made him even more infallible in our eyes.
I thought he had it figured out. With all his success and fortune and mastery of substance abuse, he was a tick mark on the list of success stories with this particular type of chronic disease. I thought he had won the battle. I was wrong.
We are reminded today, yet again, that depression is a fire that never gets put out completely, a smolder you can never turn your back on. Never, ever.
We’ll never know why this time was different, why today was insurmountable when every other day was a day to soldier on, but the world is all the dimmer with the Genie flown back home to the Cave of Wonders, beyond the horizon and beyond our grasp. All we can do now is celebrate the shimmer he left in his wake.
Look out for one another, friends, help one another. It’s a rough world out there, and we need all the joy we can get. We need each other. Tolkien said it best: “Despair is only for those who see the end beyond all doubt. We do not.” We do not.
Can we talk about the fainting schnauzer video? We need to talk about it, because if there’s one thing I don’t get in this world, it’s the current trend for pets with a myriad of medical malfunctions or genetic issues becoming internet sensations.
You’ve seen the video, I imagine. A dog is surprised by the owner she hasn’t seen in a year or two, and after freaking out for a few seconds she loses consciousness briefly.
Attempting to head off criticism, Carson Daly helpfully interjects “CLEAN BILL OF HEALTH GUYS” into the video. No problem, dog is great, everyone can go home, right?
Syncope, Part 1
Now without knowing the dog or what went down at the veterinary clinic, I can’t really tell you what happened, but I can tell you in general that fainting episodes (what we term syncope) are not normal, no matter how excited a dog is. There is a pathology there, whether it’s cardiac or seizure activity or something, but “she just got the vapors” is not a diagnosis.
Let me share with you the general arc of a visit when a patient brings a dog like this- and I’m including both seizure activity and syncopal episodes here- to me. Because the episode itself is short lived, by the time the dog shows up to the clinic he or she often looks fine. After taking a history and keeping in mind things like the age and breed of the pet, we begin the examination.
“Well, the physical examination findings are normal,” I say.
We could end things right here, and you could read that as saying “The pet has a clean bill of health!” But that’s missing the fact that while physical examinations are wonderful tools, they are limited in what they can tell us. The causes of syncope are rarely evident based on physical examination alone.
Syncope, Part 2, 3, and 4
“If we want to figure out the underlying cause of the issue,” I will say, “We should begin with some bloodwork and a urinalysis.” The client may or may not agree, mentally calculating the cost.
“If that’s normal, and it often is, we could proceed next to a cardiac workup: an EKG/cardiac echo/24 hours on the Holter monitor and have a cardiologist review the results.” Now we’ve definitely ventured into “need to think about it” territory.
“If the heart is fine, and we’re more concerned about seizure activity being what’s going on here, a neurologist is your best bet. Unfortunately, diagnosis usually involves costly procedures like CSF taps or CT scans. Epilepsy? Well, we don’t have a definitive test for that at all, so we just have to make the diagnosis based on ruling everything else out first.”
Many owners, especially after a first time episode, go as far as the bloodwork and decide to wait and see if it gets worse before moving to the next step. I don’t blame them- it’s expensive, and you have no idea if the dog will have an event a day later or a year later- but I just want to emphasize that unless they actually performed all of those diagnostics I just listed, it’s hard to definitively say the pet truly has a clean bill of health.
There’s a reason “The dog’s fine!!” is in the Today show headline and Carson makes sure to tell you “the dog’s fine! Someone said so!” and that reason is, we all intuitively know things aren’t fine. Just because you haven’t found the problem doesn’t mean it’s not there. It just means you haven’t located it yet. And I imagine somewhere in that visit, between answering calls from the Today show and counting YouTube hits, the vet did say just that.