Daily Life

What Your Natural Health Magazine Doesn’t Want You To Know

After the fifth time someone forwarded me “The Shocking Truth Your Vet Is Hiding” type articles in the past week, I had to take a stop from my scheduled 12 Days of Clinics to address it. I debated on a few clickbait titles for this post:

alt: “Why Magazines are Getting Away With Murder”

alt: “The Shocking Truth These Publishers Are Hiding”

It doesn’t really matter what the title is or if it related to the content anyway, but I imagine you already know that. But let’s step back a moment, and go back for a breath to 2011.

The most singularly amazing experience of my life took place in a forest in Tanzania. I had waited my whole life to visit the chimpanzees of Mahale, an experience I had anticipated with baited breath. Good, gentle, kind chimps.

And this is what I actually learned: chimps can be asses. Petty, sneaky, grumpy asses. Most everyone kind of knew that, though, right? They’re allowed bad days just like everyone else.

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But I learned something else, which was also an eye opener not only for me but for the rest of the people there, for researchers who have spent their whole careers in the M community (by convention these communities are all lettered). Chimps, under pressure, can be vindictive.

The events I witnessed in my time, a Machiavellian soap opera of alliance forming, led to the never before witnessed assassination of the alpha chimp by his own community, an event so unexpected and rare it was written up in multiple journals. Pimu was a jerk, no doubt about it. He ruled with an iron fist. But no one expected the other males in his own community to kill him.

I was there. I saw it. I saw the way the pot-stirring chimp, third in line from the top, systematically groomed all the other males in the group, waiting for just the right moment to take advantage of their fears and frustrations with Pimu. Then- triggered by some small infraction that in other circumstances would have passed without comment, he lit off the powderkeg that resulted in an alpha getting his head smashed in by a rock.

The instigator didn’t even have to get his hands dirty. He was the Petyr Baelish of Mahale, climbing the ladder of the chaos he sowed.

chaos

The argument can be made that we are hard-wired for a black and white view of the world, to see people as friend or foe, with us or against us. Once someone’s a foe, there is nothing valuable, worthy, or meaningful in anything they say or do, ever, marinating in their evil fortress of pain or whatever it is enemies do.

It takes work to suppress that natural inclination and try to genuinely understand the actual truth of things- that most people, even those on the other side of the fence, usually have good intentions and may actually have a point about some things. But you can’t start a conversation when the guns are firing.

There’s always one person who benefits when two factions are fighting, and it’s rarely the ones out there actually getting bloodied.

Skull Smashing in Modern Veterinary Medicine

I am part of the V community of pet lovers: the veterinarians. This informs how I view the world and my place in it: as a pet lover, trusted advisor, someone who cares enough about the health of our companions that I chose this as my life’s work. I believe in the value of our work and our research and use that to make recommendations for my clients.

I am also part of the larger O community of pet lovers: the owners. I understand knowledge evolves. I attend hundreds of hours of continuing education, became certified in acupuncture, and I’m not afraid to change my advice based on evolving knowledge. I came out the gates of vet school ready to challenge old assumptions about vaccines, pain management, and nutrition, and over the last decade we have changed the way we practice medicine as a community.

I kind of assumed it was ok to be on both teams. So do you understand why it drives so many of us crazy to see this sort of thing?


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These are Dogs Naturally Magazine’s most popular articles. Half the time the articles don’t even really correlate with the tone of the headline, but the damage is done. Clickbait is the equivalent of the pot stirring chimp sticking a rock in your hand and then shrugging and saying, “What? I didn’t tell you to hit anyone with it.”

evil vet

I promise I never once looked a dog straight in the face with maniacal glee as I prime a syringe in front of their face, imagining the piles of money I get to roll in after work after wiping the blood of a thousand sickened pets of the floor with the research showing all these medications I recommend are actually totally unnecessary.

I’m not holding the V community blameless here. I understand there are vets who dig in their heels and refuse to admit that you have a valid interest in researching things and asking questions. There are those who look at everyone with a concern about DOI studies like this:

tinffoilcat

And they really wish you would just stop looking things up and just do what they tell you, no questions asked.

But that’s not most of us. If Dogs Naturally (who I’m picking on here but that’s only because they’ve published about 10 pieces like this in the last month) really cared about the overall wellbeing of pets, they would be advocating for better ways to communicate with your veterinarian instead of just telling you we all want to kill your dog with Drano injections, euthanized horsemeat kibble and drugs we are prescribing solely because we were given a free pen, so you should just stay home and feed them coconut oil and canned pumpkin and whatever else their advertisers are selling you.

help

(I aced “Making Little Kids Cry in Terror”, which I took the same semester as “Why Sick Pets are Better for Business than Healthy Ones so Make Sure To Keep them Sick Through Recommended Shots and Foods.”)

So yes I’m irritated, not because the content in articles like “Why Vets Are Getting Away With Murder” has no merit despite the misleading headline, but because those clickbait pieces really just serve themselves. Information is good. Using it to sow discontent instead of discourse? Not so much.

Communication, not Coconut Oil: The True Key to Health

Concerns about vaccinations, sarcomas, immune system function, and nutrition are all perfectly valid. This should be able to be part of a discussion with a good veterinarian without bloodshed or Yelp. You are all smart people. A nice, polite, rational approach to collaboration may not sell magazines, but it does create better outcomes. I will talk to you about anything, even coconut oil, delayed neutering, titers, and raw food.

I understand the difference between your pet and the community as a whole, and if you ask why we have the recommendations we do, I’d be happy to go into all the boring public health theory and discussion of cell mediated immunity and why titers don’t prove definitive immunity and all those other things a drug rep with a burrito did not teach me in a one week course. This is communication, and it’s what two people who don’t want to kill each other do.

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The Truth I Don’t Want You To Know

Is there one? I don’t know, maybe this:

  • the times I went home crying because I couldn’t save a pet.
  • The times I vomited in the parking lot because of the stress of the day or the person who threatened my receptionist with a gun.
  • The fact that on some days, I said to myself had I known the physical and emotional cost of this job, I might have chosen a different path. Especially on the days people tell me I’m only doing it for the money, or the glory, or the free pens.
  • I understand there are crummy vets out there. There are crummy whatever it is you do for a living, too. Just try not to be one of them.

You know what I’d really be doing if I was in this for the money? Looking for a pet with a genetic problem to exploit for fame and fortune. Alas.

I find it ironic that people are willing to believe, without question, the word of a person selling magazines, conference tickets and, I assume, advertising, and that this is done solely out of their benevolent desire to tell you the truth about the crapfest that is my profession and nothing else. There’s no room for nuanced discussion and benefit of the doubt when you’re trying to grow a brand in a world that thrives on conflict. I’d have a much larger site if I were willing to throw a few thousand colleagues under the bus for fun and clicks, but sadly, I’m plum out of rocks today.

You and I want the same thing, long and happy life for your pet. Bananas for everyone.

Filed: Blog, Cats, Dogs, Featured Posts, Health, Musings Tagged: , , ,

On the sixth day of clinics…

My clients brought to me:

 

6pic

 

5 Moldy Rings!

4 Gastric Grommets

3 Dead Pens

2 Blown Up Gloves

And a linear Foreign Body!

Filed: 12 Days of Petmas, Blog, Daily Life, Featured Posts, Features Tagged: , ,

On the fifth day of Clinics

On the fifth day of clinics, my ref lab sent to me:

moldy rings

 

4 Gastric grommets

3 Dead Pens

2 Blown up Gloves

And a linear Foreign Body!

Filed: 12 Days of Petmas, Blog, Daily Life, Featured Posts, Features, Goofball Antics Tagged: , ,

On the fourth day of clinics

My clients gave to me:

grommet

 

3 Dead Pens

2 Blown Up Gloves

And a linear foreign body!

 

Thank you to Jessi J for the radiograph! She writes: “Boo ate a leather drawstring bag, and my only clue were a few remaining pieces of string. The radiograph was our confirmation…” 

Filed: 12 Days of Petmas, Blog, Daily Life, Features Tagged: , ,

A Veterinarian’s Holiday Wish

It’s the holidays, and that means lots of things: peace on Earth, goodwill to men!

Was Brody this teeny on his first Christmas? Time sure flies.

Was Brody this teeny on his first Christmas? Time sure flies.

Just kidding, it means cranky people fighting in the parking lot, someone getting shanked over the last PlayStation, and passive aggressive fruitcake gifts.

I wasn’t always this cynical. I, too, was once a merry-eyed elf with stars in my eyes and garland round my neck, until I worked long enough in veterinary medicine. Then I began to dread the month of December. It is a month of ill portents:

  • Too many people who blew their budget on Black Friday, cannot afford to work up their cat’s pancreatitis, and then blame it all on you in a waiting room explosion worthy of the Fourth of July;
  • The strange but consistent uptick in euthanasias the week before Christmas. Always.
  • Wondering where your card is from your favorite client then remembering with a pang of pain that they lost their dog to cancer in October. Yes, we feel sorrow for your pets. We love them too.
  • Hearing the two most dreaded utterances in veterinary medicine:

1. Fifteen minutes of telling us how every vet before us has wronged them, but we are awesome.

We’re not flattered. We’re terrified. We know it’s only a matter of time before we’re next on the naughty list.

2. The four words you must never say: “Money is no object.”

Translation: That’s because we have no intention of paying the bill. Been there, done that, many times.

 

So please forgive your vet if they seem a little more harried than usual, if their eyes are open a little wider than normal or their smile seems a little strained. It isn’t you. It’s December and they are bracing themselves is all. Should you wish to improve their month, aside from being the lovely clients I know you are (and appreciate more than you know!) I propose the following ways to make some vet’s day a little merrier:

  1. Food, of course, always lovedMake sure to include the staff in the note. Usually they work as hard or harder than the vet and get none of the glory.
  2. Did I mention food?
  3. Cards. We read every one, especially on the bad days. I still have some from 2003!
  4. Pictures of your pets. They make me smile and I love them.

And should you be stuck for ideas, I’ve made you some ecards:

Feel free to send one to your favorite vet. Trust me, it’s as good as cookies.

 

Filed: Blog, Daily Life, Picks of the Litter Tagged: , , ,

The greatest Thanksgiving ever

I grew up in New England, a place where tradition runs supreme. Holidays were a big deal, and we spent most of the major ones shuttling from this aunt to that grandmother and back again, enjoying the camaraderie only a large and extended family can afford. Those were the halcyon years, when my mother could still get away with dressing me as a doily.

doily

When I was eight years old, we moved across the country to Southern California, and those days came to an abrupt end. We still celebrated every major holiday with all the pomp and circumstance my mother could bring to the table, but in the end it was always just us, and while it was still lovely, it was more….quiet, somehow. We called the family religiously, listening to the hubbub in the background and the people shouting in tipsy voices, “Tell em we said hi! What’s it, 70 degrees out thah? We’re jealous!” And so was I.

We always toyed with the idea of going back to spend the holidays with the family, just once, but the lure of nostalgia was overcome by my father’s distaste for holiday travel, so we remained home, year after year, in the quiet serenity of a sunny and warm Thanksgiving and Christmas.

In 2003, I was just celebrating my first anniversary, settling into a new job, when my mother told me her father, my beloved Pepe, was in trouble. He had been in trouble his whole life, truth be told, but it was a different kind of trouble this time.

In all the old pictures from my childhood, you could see Pepe smiling with the ineffable twinkle of a person who liked to tell stories, usually embellished. Always embellished.

Box_13  Pepe

 

The other thing you could always find, when you looked hard enough, was the small rectangular outline of a box of cigarettes.

We tried for years to get him to quit, bought cartons and emptied them out only to replace the contents with candy, but to no avail. He did quit eventually, when he was finally diagnosed with lung cancer about 20 years after it should have happened, but of course by then it was too late.

We visited him at the start of his radiation therapy, and my mother, who had long missed the embrace of her family more than the rest of us put together, spent a lot of time with him helping him get set up.

She’s a nurse. Of course she would be his caretaker. And when he rallied, he sent her back home to California.

 

pepe

 

Several months later, she was once again beckoned to New England. Pepe was doing poorly, and now he was in the care of hospice. Did she want to come, they asked. And she did.

She warned us that this time it was different, that the end was actually coming. If we wanted to say goodbye, she told us, we should be ready.

The week before Thanksgiving, Mom called both my sister and I and told us that Pepe had only days left, and should we wish to say our goodbyes, we should get on a plane. So we did.

The story of his passing is for a different time, but suffice it to say he did it his way, like he always did, and as strange as it is to say, we spent a good deal of those last hours laughing even through our tears.

He died on November 23, 2003. He was to be buried the following week, and Thanksgiving was only 4 days away. We piled into my aunt’s home, collapsed in the basements and crammed into the living room, while my aunt tried to manage both the grief of her father’s death and the sudden influx of new guests. The preparation was a welcome distraction. She shopped for turkey while my mother took my grandmother coffin shopping. “Mom picked our her own while we were there,” she said with some chagrin. “She always was a bit of a control freak.”

I don’t remember what we ate, balanced on paper plates on our laps. I don’t remember the pie or the turkey though I know we had them all. I remember laughing my butt off at regular intervals, my father looking in horror at the assembled group and asking, “Why are you all smiling and laughing? Your grandfather just died.”

And my mother smiled back and said, “Because he would have been so happy to see us all together again. This is what he would have wanted.”

Even if it took him dying to do it. Stubborn man.

Life gives us beauty when we least expect it, and what I am most thankful for is the ability to recognize those moments when they arrive. A blessed Thanksgiving to you all, my friends, and may you find your beauty in strange places as well.

Filed: Blog, Daily Life Tagged: ,

The Long Dark Twee-Time of the Soul

As you probably know, I have a bit of a complicated relationship with the PTA moms. Not moms in general, mind you, just the small subset of Pinterest loving, glue-gun wielding domestic lifestyle experts whose expectations I can never, despite my best efforts, seem to live up to. It doesn’t matter what school we’re at, it happens every time. First it was the art project/pooper scooper incident in kindergarten. Then it was the Have a Very Agro Valentine’s Day episode. And now it’s crudite, crudite that torments the soul.

It started simply enough: an email asking for volunteers to bring in food items for the teachers this conference week. I looked on the sign up sheet and put my name next to crudite: veggies and dip. Easy, I thought, a quick run to the grocery store for some carrot sticks and dip and done.

I forgot where I was.

(Not two weeks ago, I found myself in the midst of a malestrom for the fifth grade Halloween party when all the room moms got together and asked the parents to bring in food. I asked my class parents to bring in pretzels and fruit. The other moms showed up with cookies shaped like rotting fingers with almond nails and jelly blood, and eyeball eggs with veins hand-painted on with food dye. My pretzels were shoved under the table.)

So now, a few minutes after signing up for the veggie tray, I received an email instructing me to be creative!  which is always concerning. To illustrate her point, the organizer included this helpful photo:

crudite

As to what our vegetables should aspire to be.

Now at this point a normal person would laugh and say, “OK, lady,” and bring in a tray from Costco, but unfortunately I still have the sin of pride to contend with on a regular basis, so I instead spent the afternoon standing in line at the grocery store watching YouTube videos of Martha Stewart blanching asparagus. Three hours of cursing later, with piles of peeled burnt chestnuts and carrot shavings dripping out of my hair like Jackson Pollock on a bender, I came up with this:

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This is the dogged tenacity that makes people like me get through vet school even when all indicators point to the “why?” factor. We can’t explain it. We just have to.

I shared this with my friends, and they all got a good laugh out of how silly it was, and then later in the day my friend in Ohio sent me a link and said, “See? You’re not alone.” It was a photo of some artfully arranged food items a group of mothers had arranged for their teachers.

It was, upon further inspection, a photo from my very school from earlier in the day. It had already made the Pinterest rounds and ended up in Ohio, where my friend saw it and sent it to me as an example of Moms Gone Styled. I scrolled through it, looking for my contribution.

Notably lacking? The crudite. They were apparently so lackluster as to have not even rated a Facebook photo, and when I returned to pick up the dish I found they had been shoved in the corner in order to make way for some gluten free turkey wraps with hand-whisked dressings in, of course, Mason jars.

At this point, even a not quite normal person would just give up, which is theoretically what I should do, but it’s become clear to me I live in a parallel universe where I am destined to almost-quite get it, over and over and over, but not get it entirely. This is why I am a veterinarian, the almost-quites of the medical field.

So you know what? I’m embracing it. This afternoon I decided to go on a Pinterest binge and make a little Pinterest and dog-friendly crudite platter my way. Hope you enjoy it.

twee

A bright autumn day, full of promise and gently whispered secrets amongst best of friends, calls for sustenance.

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Lovingly hand-extruded kibble, with ingredients sourced from local artisans in an organic human-grade facility in Portland by men with bushy beards. In a Mason jar.

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We end our afternoon in the garden of delights (it’s water friendly succulents! We’re eco friendly here in drought-parched SoCal) with hand-cut carrot bones from the local CSA, mint from the garden, words of wisdom from the dog sketched in canine-friendly peanut butter hand ground at Whole Foods. And of course, no pet garden of delights would be complete without the coup de grace:

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nitrate free ham roses.

IMG_7369

 

You saw it first here, folks. I’m waiting on sponsors for a YouTube tutorial but I think a ham bouquet is a lovely thing.

Filed: Blog, Cooking, Goofball Antics, Mother of the Year, Musings, Photography Tagged: , , , , ,

Rumble in the Doghouse: Evil Breeders vs Crazy Animal Rights People

There was a time, back in a pre-internet era known as the Good Old Days, when two people who had different opinions on a topic could talk about it and, even if they did not come to an understanding, could at least part ways with a better grasp of the other person’s point of view. People with different opinions were still, at the end of the day, people.

I’m not entirely sure that is the case anymore.

Lest anyone doubt me, proof enough should be the fact that we’ve just come off an election cycle. I live in an area with one of the most hotly contested Congressional races in the country, better known to us locals subjected to the campaign ads as “Mouthbreathing Carbuncle-Having Satan Worshipping Slimeball” versus “Luciferous Mucusbucket Festering Wound.” (Definitions supplied by opposing parties.)

Politicians Before and After Elections(1)

It was a close race. I think most of us voted for one or the other not based on deep unabiding adoration so much as we held our noses and selected the one we found less odiferous. Nonetheless, after the Slimeball defeated the Festering Wound by the narrowest of margins, the loser went on the air and graciously wished his opponent “all the best”, which is a strange thing to wish someone you truly thought was the Antichrist. If you truly thought he was the path to death and destruction, you think one would continue to rage against the injustice of it all and exhort people to do something to undo this miscarriage of justice.

But politicians know the truth that a lot us seem to have forgotten. All that bluster is just that, bluster. And at the end of the day they actually have a lot more in common than not:

  • both middle aged men of the same demographic savvy enough to be successful in local politics
  • Neither advocates overthrowing Congress and disbanding the Constitution
  • both against selling tanks to minors
  • Both for free sunlight
  • Both generally want to work for the constituents in order for people to live well in our beautiful city, though their ideas of how to get there might vary.

And now they will retreat to their corners to do whatever it is they do until they are again required by the tenor of American culture to again start yelling about how much the other person stinks.

Rumble In the Doghouse

We all know this about politics, we all roll our eyes with the silliness of it all, but don’t be mistaken- this “live and die by the sword”, “you’re with us or you’re worthy of a messy death” attitude has permeated many corners of our lives, and it’s not pretty.

The first time I met someone at a breeder’s event, I started talking to a person very involved with the dog fancy world. When she learned what I did, she looked at me a little sideways and said, “So you’re an animal rights person.”

Peta, protesting that abhorrent group of animal haters known as the American Veterinary Medical Association (true story)

PETA, protesting that abhorrent group of animal haters known as the American Veterinary Medical Association (true story).

“Not animal rights. Animal welfare,” I corrected her, as the person who introduced us (you know who you are, you rotten troublemaker) rubbed his palms together and waited in glee for us to start ripping each others’ hair out.

“What’s the difference?” she asked. So I called her a puppy mill, because all breeders are the same, right?

Best-In-Show-Best-In-Show-001

We looked at each other, hesitated a moment, then burst into laughter as she said, “Point taken.” We’ve been friends ever since.

I suppose in another world, maybe hidden behind an anonymous screen and keyboard, we could have become mortal enemies, but we’d spent too much time face to face to be able to call the other person demon spawn. We both knew we had too much in common, including:

  • a love of good wine
  • writing long and probably way too involved stories
  • thinking dogs are the absolute bee’s knees. We both totally adore and spend most of our free time thinking about, canines.

This friend recently began a Kickstarter campaign to create a website commemorating National Purebred Dog Day. Now, I’m not trying to convince anyone to go and support the campaign if it’s not your thing, no more than I would try and convince someone to donate to a political candidate they did not agree with. But the simple fact that she waited a long time to even begin the campaign because she was nervous about people targeting her for being an Evil Dog Person is honestly, pretty sad. I feel the same way about that as I do people who target pittie advocates trying to end BSL: why would you do that? We are not each other’s enemies here.

Who’s right?

A few weeks ago I wrote a piece for Vetstreet about purebreds versus mutts. I wonder if perhaps the editor was wanting me to go for the easy kill, the one that would bring 5000 shares and bloodshed in the comments section: quote people talking about how wrong the other side was, how misguided. But I didn’t want to do that.

Instead, I talked to someone from the American Kennel Club and the ASPCA, and guess what? They said the exact same thing:

We want people to find the right dog for their family so they keep them forever.

They had different ideas about the best way to do that, but they’re both perfectly valid approaches, really, and people have been using both successfully for some time. Let me repeat: at the end of the day we all want the same thing. The rest is just window dressing.

Can you tell which dog is more worthy, loved, or better for my family? I can't.

Can you tell which dog is more worthy, loved, or better for my family? I can’t.

Who’s the real enemy here? Apathy. Ignorance. Greed. Say what you want about either the dog fancy or the rescue community (and indeed, the large numbers who belong to both): they are not apathetic people. They care, and they want what’s best. Instead of shaking your fingers at the other side’s perceived shortcomings, listen. There is much to be learned, on both sides. I know this from experience.

judging

It’s very easy to continue to point and shoot at the easy target. Keep on doing it if it makes you happy. It certainly makes life easier for the people at CheapPuppyMillDog.com; whenever someone gets turned off by the antics they encounter at either end of the spectrum, guess who’s waiting with open arms?

We are not each other’s enemy. If you want someone to hate on who really deserves it, I suggest these idiots. Seriously, no redeeming qualities whatsoever.

Filed: Blog, Daily Life, Dogs, Health, Musings Tagged: , ,

Halloween has hit rock bottom

Things were simpler back in the 80s. We only has three things to do the week before Halloween:

1. Watch the Great Pumpkin.

great-pumpkin

2. Carve a pumpkin. No one helped. If you cut your finger off, oh well.

halloween_jack_o_lantern_2-t2

3. Run to Woolworth’s and pick out your plastic costume that tied in the back like a surgeon’s gown and suffocating mask you could only see out of one eyeball at a time. Trying not to kill yourself tripping over the pavement was half the fun.

smurfette

And that was it. Our biggest worry at the time was the ever ubiquitous ‘old man hiding razor blades in apples’ trick, which we were all scared of but no one actually ever saw.

I long for those simpler times. My week has been, shall we say, a bit more complicated.

1. Who has time to watch the Great Pumpkin? I have a Halloween party to plan at school. Except we can’t call it Halloween, so it’s a “Harvest Party” (with costumes) in grade 3 and a “Mystical Science Party” (with costumes) in grade 5. Two weeks ago I was summoned to a summit of all the room moms so we could coordinate our party activities, which were delegated as follows:

  • candy potions lab
  • luminescent fingerprint experiment
  • homemade spooky finger cookies
  • dry ice punch
  • Pretend blood coagulation experiment

I missed the meeting. When I was asked after the fact what I’d like to do I offered to contribute some sort of preserved creature in formaldehyde, which was the best I could do. I was assigned plates and cups.

2. Pumpkin carving has now become an Olympic sport.

No!

No!

 

 

 

 

 

 

 

 

 

No!

No!

 

Nooooo!!!

Nooooo!!!

 

 

 

 

 

 

 

 

 

 

My garage is filled with half-used Pumpkin Masters and the sad remnants of plans gone awry. This year, we’re painting them and calling it a day.

3. Costume shopping began two months ago when the Chasing Fireflies catalog arrived. They cost a small fortune, but they are the only catalog where ten year old girls are still allowed to be ten year old girls.

tween-halloween-costumes-1

Over my dead body.

 

“Why aren’t you wearing a costume, Mommy?” asked my daughter.

“Because I can’t find anything I like, honey,” I responded.

“How about a dog?” she asked. “You like dogs.”

That was out.

That was out.

“Maybe I’ll just be a veterinarian,” I said. “That’s hard to mess up.”

DANGIT!!

DANGIT!!

Desperate, I tried to think of the least sexy things on the planet. A lamp. A body bag. A hazmat suit.

 

badcostumes

We’re all doomed.

 

“I don’t think that’s going to happen,” I said to her. “Maybe we can just get Brody a costume instead.”

tramp

Or maybe not.

monroe

Go home, Halloween. You’re drunk.

Filed: Blog, Daily Life Tagged: ,

The midwife at the end of life

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.

brittany

 

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:

  1. This must be so hard.
  2. 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 am the midwife at the end of life.

And I am OK with that.

Filed: Blog, Daily Life, Euthanasia/Hospice, Health, Picks of the Litter Tagged: , ,

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: , ,

Then there was that time at the bordello with Dr. Lorie

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.

lorie

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.

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.

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.

She will be missed.

Filed: Blog, Musings Tagged: ,
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