It’s been a while since I’ve done a Pet Doctor Barbie post. It’s past due for a new episode, yes? I think it’s time for Pet Doctor Barbie to meet one of her self-appointed arch nemeses, Pet Food Dude.
Hi Mrs. Sandford, good to see you and Muffin. It’s been a while!
I’m really glad you’re doing housecalls now. I want to get Muffin’s bump looked at again.
OK, I’ll just look at my notes here- 1 cm, top of head…mm hmmm… So where we left it one year ago was that you were going to go talk to your husband and then we were going to aspirate it.
Oh….yes. It’s grown quite a bit since then. We really need –
Yes, I wanted to talk to you about that. I’m a bit upset that you didn’t mention last time how his kibble might have caused this.
We don’t really understand why cancer occurs, Mrs. Sandford. The important thing now is to take care of this mass. I’d hate for you to blame yourself because of your food selection.
I don’t blame myself. I blame you. How much do you make from Big Pet Food anyway?
Actually nothing. But aren’t you feeding a boutique brand anyway? You told me last time you were feeding…let me check…organic grain free non-GMO preservative free all natural Wolf Chunks.
Yes, and you told me to stop and to go back to that one full of corn and despair!
Actually, no, I said Wolf Chunks were fine if that’s what you wanted. But about that mass…
I’ve been using turmeric on the advice of Pet Food Dude. Do you know Pet Food Dude? Can I borrow your computer? This guy knows all your tricks.
Sure, have at it. May I ask what tricks you are referring to?
Vaccines. Pet food. You know. Poison. They are full of free radicals that are overpowering the antioxidants and preventing cellular apoptosis no matter how many carrots I add.
Here’s his site. He knows your medicine is a lie and you’re really just after our money.
I’m going to log on and see what the forums say about your “cancer just happens” line. Oh wait….shoot. My membership is expired. Can you hand me my wallet?
Oh, I think I’ve seen his site. Is he the one who sells supplements and seminars on dog juicing?
Yes! He’s a pioneer. OK, credit card updated, I’m in.
OK, here we go: Have I at any point in the past fed kibble from Big Pet Food or gotten Muffin vaccinated? Yes, 10 years ago. So they say here that this is why he has cancer and it isn’t responding to the turmeric. They also said you would say exactly what you said about it not being their fault, and not to fall for it. What do you have to say to THAT?
Mrs. Sandford, I need to level with you here.
It really doesn’t matter to me what you’re feeding Muffin. I am glad you care about him and want to do what’s best for him. I do too! I promise! I’m having a really hard time talking to you when you’re typing at someone who is convinced I’m out to hurt you both. Right now I am just really worried about the size of this mass on his head. I think we need to get him in for a full evaluation ASAP.
*tap tap* I’ll think about it. I haven’t tried coconut oil yet.
May I ask why you even had me come out?
I just wanted this all on DropCam- see it over there? It’ll be on Pet Food Dude’s YouTube tonight. He’s doing a “Vets Revealed” bit. Well, since you didn’t do anything I’m sure you aren’t expecting payment. You can see yourself out.
As a veterinarian, I’ve seen lots of cancers: lymphoma. Melanoma. Osteosarcoma. Hemangiosarcoma. Mast cell tumors. Wait, those are just my own dogs I’m talking about. When I factor in my clients, I think I’ve seen it all.
Dogs get cancer, at very high rates: about 50% of senior dogs die of it, if the statistics are to be believed. Why? Well, if you read overly simplified, graphics-intensive websites by people who really don’t know what they’re talking about, they will tell you that they know why cancer happens: GMOs. Preservatives. Kibble. Microwaves.
I wish it were that simple. It’s not. And the reason that line of thought drives me nuts is that it has sent so many lovely people into spirals of depression when their dog dies and someone on the internet convinced them it was their fault because they, the owner, did something terrible like feed their dog kibble or use a plastic bowl. People end up in therapy because of things like this.
Cancer is not a singular diagnosis; the type and breath of neoplastic disease means there’s often little resemblance from case to case; a transmissible venereal tumor bears very little resemblance to a splenic hemangiosarcoma. If we could pinpoint cancer to one cause, we’d all be rich. And yet, with all this secret knowledge, overall cancer rates aren’t budging.
Because I love a breed known for having one of the highest rates of cancer (is it the fact that Golden Retriever owners feed worse food overall? Or is it genetics?) I watch Brody pretty closely. Knowing that 60% of Goldens get cancer in their lifetime, I spend a lot of time inspecting him for lumps. As we speak, the largest observational study of its kind is currently underway to help us better understand what’s going on. In the meantime, you do the best you can but truthfully, there’s not a whole lot of ability to predict and prevent cancer. Even for the people who home cook organic food (sorry. Do it because you want to, not because it will make your dog live forever.)
You can save money (and life expectancy) by doing some simple things:
Knowing he is an at-risk breed, I do what I can to try and keep Brody healthy. When he gained too much weight on his food, I got the weight off. Obesity is thought to be a risk factor for cancer. Just as importantly, I get his bumps evaluated and when I find one, I don’t mess around.
The dog eats like a king; I give him the good stuff because I care about quality ingredients, though not enough to condemn people who can’t afford it. But even with his high end diets, at age 6, he’s on his second cancer. The first one, a melanoma, was excised two years ago and has yet to recur- because we caught it early. And now we have this: a little teeny ear lump.
I thought it was no big deal, but I got it evaluated anyway. See? We vets do it too. A lump is a lump is a lump. Until you get it microscopically evaluated, you just don’t know. I just got the call last week: it’s a mast cell tumor.
I’m thrilled we got this diagnosis
Am I thrilled Brody has a mast cell tumor? Of course not. They stink. Despite the fact that the visible mass is only half a centimeter, this type of tumor has tons of microscopic disease and is notorious for requiring huge surgical margins for a complete excision. For that little tiny tic-tac mass on his ear, he is very likely going to need to lose his entire pinna. (I’m getting a surgical consult this week.)
However, losing an ear is minor compared to where these things end up when people wait. You can lose an ear, but you can’t lose an entire head, for example. This is small beans compared to what lots of pets need to go through later in the game when masses grow. If we get a complete excision, this should be a closed case. And guess what? It’s so much cheaper than tons of radiation and chemo and massive surgeries. Win-win for the dog and your wallet. I’m not happy he has it, but I’m happy I know now, early.
Why wait? Aspirate that shizz!!
What one thing can you do to guarantee your pet won’t get cancer? There isn’t one.
What you can do is maximize their chances of survival and recovery: Don’t mess around. Dr. Sue Ettinger, veterinary oncologist and all-around brilliant person, has an initiative called Why Wait Aspirate that is as simple as can be: when a vet tells you that a lump is ok to “just watch”, what does that mean? When do you do more than watch it? Here’s Dr. Sue’s guidelines*:
ASPIRATE OR BIOPSY IT!
Easy peasy, no pun intended. Of all the things you can do to help your pet live long and live healthy, none matters more than early detection.
*Photo Credits: Calendar by Michael Hyde, Flickr Creative Commons license; Peas by Isabel Eyre, Flickr Creative Commons License
I am becoming increasingly convinced the communication gap between veterinarians and clients is the number one problem we’ve failed to solve. We’re just not on the same page a lot of the time, it seems, and it makes me sad. I can’t read a single article online without coming across “veterinarians are money grubbing pigs that suck” (true blog title) and someone else saying “if you can’t afford x/y/z/q you shouldn’t have gotten a pet, jerk.” I feel as though this is perhaps a bit extreme, but it’s what happens when we don’t work together to identify our goals.
Common Fallacies of Bad Client Interactions
(In just as many cases, the vet on the left is an associate up to his or her ears in student debt and just trying to make it through the day without getting yelled at one more time, and the client on the right is a stressed out single parent who just spent a grand fixing her car.)
Much of this angst comes from the pervasive assumption that in all cases we will do everything we can medically, no matter what, which was fine a while back when “everything” meant “antibiotics” but as veterinary medicine has advanced, has come to mean “MRI, spinal tap, radiation.”
This assumption, of course, carries over from human medicine: if you’ve got the insurance, you’re getting the treatment. Everyone’s happy, right? Right?
Not so much. Satisfaction with a medical course of action relies on multiple factors.
Sometimes getting to “Everyone Happy” (Square B) is impossible. D’s not so bad either, but A and C are no-fly zones.
Human Medicine Satisfaction
I would argue that satisfaction with outcomes is directly correlated to the balance between the amount of treatment pursued, and its benefit.
So really, the goal here isn’t to push everyone towards the far extremes of treatment; it’s about getting to that center line of balance. In human medicine this change is slowly creaking along with things like hospice care, which moves people from C to D in low treatment benefit situations, and increased access to insurance coverage, which moves you from A to B in high benefit situations. With Mom, we were squarely in the D category, and while we’re not HAPPY, it’s a hell of a lot better than if we had treated her to death.
So how does this apply to veterinary medicine? It’s similar, except we tend to find ourselves walking a line most strongly related to finances.
Now, since we have no ability to magically divine which people are up for specialty treatment and which people are not, we always offer all the options to clients- as we should. There are people who spend thousands, lose their pet, and are still ok with the outcome- but they were also very clear on the risks and made an informed decision. Many clients, it seems, feel as if they are not.
So what do we do to improve outcomes? In my experience, the best way to move the dial from A to B is pet insurance, at least for emergency situations. There are few situations more likely to prompt a Facebook mob than a pet who died a preventable death because the owner couldn’t afford treatment and the ER vet wouldn’t do the treatment for free- nor should they. Owners need to shoulder some of the responsibility here of financial preparation, and if they refuse to take even basic steps to be prepared, maybe they really are a crappy client.
And conversely, moving the dial from C to D involves good veterinary communication, and a willingness to understand that lots of factors go into the decision about whether or not to seek treatment. If a veterinarian talks a senior on a fixed income into a kidney transplant for a 15 year old cat in renal failure, after she expressed concern about paying her rent for the month and her own upcoming surgery- maybe they really are a money grubbing vet.
But I like to give everyone the benefit of the doubt. Clients and vets both have work to do here. And I believe with all of my heart that the better we get about empowering clients to make informed decisions, the more that will carry over into human medicine- which is a wonderful thing.
I realize this is a vastly oversimplified explanation of some really complicated issues, but hey, we have to start somewhere. Whatever it is we’re doing now sure doesn’t seem to be working too well.
Perhaps you are the magnanimous sort. “Dr. V,” you say, “I ordered the book but I don’t need the free Halo or Sleepypodstuff or PetHub tag or Dog + Bone collars or Groom Genie or any of those items you are giving away, not even the awesome little activity book with coloring pages and a word search featuring ANALGLANDS and DEMODEX.” You are an ascetic. You don’t have a pet. You’re decluttering. OK, I get that.
But surely you aren’t opposed to a donation in your name, right? I have a treat for you.
Newflands is a New Zealand company, started by a veterinary nurse (don’t give me a hard time, that is what they are called in New Zealand) who was looking for an ethically sourced, sustainable brand of fish oil for her dogs. With none to be found, Fiona started her own brand, and Newflands Hoki Oil was born.
We all know that fish oil is a well-utilized and effective essential fatty acid supplement, with a high ratio of omega 3 to omega 6 fatty acids. Hoki is a fish native to the waters off the coast of New Zealand, but starting this summer it will be available in the United States through Newflands.
Newflands founder Fiona Robertson wanted to support my book campaign with a donation that would also give back to the community, so she suggested a donation of Hoki oil products to a US Charity. We selected Vets’ Pets, a program run by Angels for Animal Rights NYC helping veterans with low cost pet food, supplies, medicine, and deployment support. For every preorder Charity Treat, Newflands will donate a bottle of Hoki Oil to Vets’ Pets to support this wonderful program.
See? Win-win. A book for you, a donation for them. What could be easier?
A few weeks ago, while my publicist was asking online dog lovers if they might be interested in reviewing my book, he came back with a question:
“Do you recommend Science Diet or raw?” he asked.
“It’s really not an either/or thing,” I said. “The book doesn’t talk about nutrition at all.”
“Well, one of the people we approached said they only write about things from a raw food perspective,” he said.
“Oh, then they don’t want my book,” I said. “It’s just from a dog lover’s perspective.” And that was that. Because here’s the truth, which is going to probably cause a few people’s heads to explode: when it comes to my belief about the omnipotent power of food, I’m an agnawstic.
This belief started, as many things do, with my own experiences with food evangelism: Atkins, paleo, etc, wash, repeat. For one brief, terrifying month my husband dropped down the rabbit hole known as “extreme diets.” Now, I can’t blame him for trying- I’ve tried them too over the years, but he’s never been on board. After years of ignoring my attempts at zoodles, banana “ice cream” and other current food trends on the paleo circuit, he announced one day he was “going keto.”
“What does that mean?” I asked.
“Less that 20 net grams of carbs a day,” he said. “I heard it’s great for detoxing.”
“Did you find this on reddit?” I asked. He didn’t answer.
For the next 30 days, I learned what it is like for someone to be discovering enlightenment. He would follow the kids around the house asking them if they had any idea how much sugar was in their ketchup, pouring verboten salad dressings down the drain, and meaningfully wait until we were all in the room at the same time before turning on “Food Inc” on Netflix.
He preached fire and sugarstone, swallowing almonds with one hand while tossing pretzels in the trash with the other. He was flush with the light, or maybe just a little zany from ketotic acidosis, who knows. He says he felt great. He was online talking to people who gave up dairy, sugar, alcohol, gluten, fruit, potatoes, and on life in general and were now convinced their nuts were causing inflammation when he finally broke and had a fudgesicle. Now we are living a life of moderation together, and it is wonderful.
Now, don’t get me wrong. I think the idea of knowing what you are eating, and preparing it yourself, is a mighty fine thing. I try to avoid bread and pasta and sugar in favor of veggies, water instead of soda, but the last two months it was ALL CHOCOLATE AND CHEESE AND WINE and I didn’t feel bad about it at all. I have permission to meander in my choices. Good nutrition matters, but it isn’t the only thing that matters.
Life is balance, right? I eat well mostly and exercise a lot and don’t smoke and try to get enough sleep. Know who else did that? My mom. All my grandparents lived to 90 and she got brain cancer when she was 67 and she did everything right. It doesn’t mean I’m going to start lighting up. The CFO of Rady Children’s Hospital was killed a mile from my house during my mother’s memorial service while he was out riding his bicycle, being healthy. Sometimes shizz happens, and while diet matters, it’s no more a guard against bad luck than any of those other multitude of things in your life like genetics and a careless woman in a Range Rover.
Which brings me to what I refer to as “blog chum,” the words I always hesitate to type lest it attract a group of angry club wielding acolytes the way blood draws a Great White: Dog Food. I don’t care what you do with it. There. I said it.
You can feed a crappy kibble and your dog might live to 20 or he might look like he got run through a wood chopper.
You can feed a high quality kibble and your dog might live to 20 or he might get cancer when he’s 2.
You can feed raw poorly done and your dog might live to 20 or he might look like Casper when he’s 4 months old because he got nutritional hyperparathyroidism.
You can feed raw that someone balanced for you and your dog might live to 20 or he might get kidney failure when he’s 7.
That’s the way it works. Food is one piece of a really complicated puzzle, and anyone who tells you otherwise is selling something. (Probably dog food, magazines, or coconut oil.)
Now clearly, my education (paid for without the aid of Big Pet Food, by the by) and my experience lead me to recommend that with which I am familiar- that would be commercial dog food- but if you want to feed your dog raw and you swear it’s the most amazeballs choice ever and your dog is the healthiest dog who ever walked the face of the earth, go forth and be happy, because I really don’t have the energy to fight over any of the following:
who taught me
who bought me
who sends me places
how much I make off selling food
If you want my opinion, I’ll give it, and I think it’s an educated one. I’ll listen to what you have to say, though I may not agree. If you have decided that my views on that one topic mean my years of experience and knowledge about all things animal health related are bunk, well, we might as well enjoy a lively discussion about the upcoming primaries while we’re at it because might as well go out with a bang.
And then I will go make a healthy chicken salad and wash it down with a glass of wine, because that’s what agnawstics do.
A year ago, my husband gave me a telephone number and said his insurance company now had phone consults available. 24/7, from the privacy of my own home, I could call in and get “seen” for ear infections, get a prescription for Ambien for travel, even get marriage counseling, should I desire it. I only used it once, but I was amazed that at 10 pm I could just call and talk to some random person and 15 minutes later pick up a prescription at the 24/7 Rite-Aid. I’m not going to lie, I think it was pretty cool.
For the past five years, I have said the same thing over and over to people in the veterinary profession: telemedicine is coming. How are we going to handle it? And over and over the response has been the same: no it’s not. This is only half true: it’s not coming from inside the vet profession.
But it is coming, as this piece from dvm360 goes into. And not just Vet on Demand. I’ve been approached about 10 times in the past year to sign up to be a telemedicine/internet consultation vet, and I always say the same thing: I am bound by my state practice act’s definition of valid client-patient relationship, which says that I must examine an animal in person to establish that. Anything outside of that and I’m breaking the practice act, which is why my FAQs are so clear on the topic.
Veterinarians make excellent points as to why telemedicine for us differs so much from telemedicine for people:
Doctors get a lot more out of history than we do. People can describe symptoms they are experiencing; pets cannot say, “I have chest pain radiating down my arm”. Veterinarians rely much more heavily on physical examinations.
Human medicine is incentivized to keep people out of the clinic to keep costs down, since general practitioners are already in short demand. Vets aren’t that slammed. Come on in.
And while we are perfectly content to say “This is a terrible idea,” others are not, and are trying to reap the benefits of it. People with background in restaurateurism see a chance to make a few bucks and throw an app together, paying a vet some pittance like $5 to put their license on the line. Why not? They don’t have anything to lose. They get around it by saying things like, “oh, we’re offering general advice, not specific diagnoses,” or take the old Miss Cleo approach:
For entertainment purposes only. Riiiiight.
This is from the VetonDemand website. I dunno guys, sure sounds like diagnosing to me. (By the way, my favorite saying is a lump is a lump is a lump. No biopsy, no diagnosis, unless the lump was a tick or a piece of sticky kibble.) That’s wasted $$ right there.
To sum up: individual veterinarians are bound by their state practice acts in terms of whether or not diagnosing over the net is legal, and it’s all over the place in terms of who can do what. This is reason enough for people to fold their hands together and say, “See, it’s not going to work.” I disagree.
My husband called the human telemedicine line to ask about a cough, and they refused him antibiotics and told him to get a chest x-ray. They were clear in their limitations. I think there are opportunities for veterinarians to use telemedicine to our advantage in responsible ways:
consults for pre-existing clients
Online ER consultations in coordination with local clinics for things like post-op questions: “My pet’s incision looks puffy, can it wait or should I come in?”
With clearly defined limitations and expectations, it has its place. Truth is, most of the time the answer is, “It could be x, y, z…you should be seen,” but that’s still better than what I see happening now.
I don’t have all the answers, certainly, but I think it’s a huge mistake and a missed opportunity for the veterinary profession to not take this on proactively. It’s not a matter of if, it’s when, and if we pass up our ability to drive the bus then two restaurant entrepreneurs from Nashville are going to take the wheel instead, and we probably won’t like where they take us.
I love technology. I think we can use it, we just need to be a little creative and stop digging in our heels like those old guys who still- STILL- insist on fax over email for sending records over. Give up, man, the world is moving on.
What do you think? Would you use a service like this if you could?
Disclosure: This post is sponsored by Mars Veterinary Wisdom 3.0 Panel. Opinions are those of the author.
So, if I showed you a picture of a dog, you may be able to tell me a little about him or her.
You would often be able to make some generalizations about temperament-
Or adult size-
Or medical concerns, such as whether or not a dog can tolerate ivermectin.
But what about when it’s not entirely obvious, as is the case with my friend Karen’s adorable dog Ramone?
He’s been labelled everything from shar-pei to Bernese Mountain Dog to pit bull. Karen doesn’t care, because she evaluated him on an individual basis before deciding he was just perfect, which is what groups with extensive adoption experience like the ASPCA recommend anyway.
On the other hand, there are some good reasons to know the genetic history of a dog beyond the simple novelty of it all. Shelters who have used DNA testing such as the Wisdom panel have found potential adopters really like having a bit of extra information in front of them. For example, my friend adopted a pup about a year ago with a projected weight of 30 pounds who looked pretty similar to these guys:
As of his first birthday, he just topped 50 strapping pounds and still growing.
Or what if you have a dog who might be part Australian shepherd but you’re not sure and he has Demodex? It would be nice to know if he has the MDR1 mutation before taking your chances on a course of ivermectin treatment.
When Mars Veterinary Wisdom panels first came out a while back, people (myself included) had mixed reactions. What started out as a novelty has grown to have some real use. As our knowledge of the canine genome has evolved, so too has the role of DNA testing in dogs, everything from keeping dogs in homes when a misinformed landlord says, “but he LOOKS like a pit bull!” to increasing shelter adoption rates to helping HOAs bust the person who isn’t picking up after their dog’s business in the common area.
The latest version, Wisdom Panel 3.0, has the added benefit of screening for the MDR1 mutation, a test licensed for home use for the first time to Mars Veterinary by Washington State University. The MDR1 mutation is known to affect particular breeds and results in some very specific drug sensitivities.
Over the next six months, the Wisdom Panel Swab-a-thon Tour will be partnering with communities and shelters to swab the DNA of a number of their dogs, with the reports showcased to help match the pets to compatible homes. (I am really excited about the way this is helping shelter pets!) They will also be offering the product to consumers at the events.
The regular test runs $84.99, but the Swab-a-thons will offer discounts to pet owners during the events. On April 10, 11, & 12th Wisdom Panel will be hosting the first Swab-a-thon at the America’s Family Pet Expo in Costa Mesa, California. Visitors to the Wisdom Panel booth can take home a discounted kit for $49.99. 3 weeks later, you get a report and the results of the MDR1 test for you to discuss with your vet.
This month’s JAVMA features confirmation of what those of us in the profession for more than a year or two already suspected: veterinarians are a sad bunch, compared to the general population. Consider these stats from the CDC’s first-ever survey of the veterinary population:
1 in 6 have considered suicide;
25% of men and 37% of women in the profession report depressive episodes;
1.1% of men and 1.4% of women have attempted suicide;
That last stat is the only one where vets figure in below the national mean, but before you cheer consider this: it’s because more veterinarians successfully complete suicide.
This preliminary data doesn’t delve into the causes or the proposed solutions, though those are currently hotly debated. Nonetheless, it’s good to see on paper what so many who are struggling have needed to hear: You’re not alone.
After watching my Ignite talk on being a Death Fairy, a veterinarian asked me how I avoided compassion fatigue in my work. I told her I would answer that, but first I have to admit this:
For a long time, I didn’t avoid it at all. I didn’t just float out of vet school and find an amazing job and love every second and plan to be a hospice vet because I knew that was the right thing for me to be. I wish I could tell you I was that organized and thoughtful, but the truth be told I did what most people I know in this field do when they’re stressed: power through bad situations until they became untenable, taking on more responsibility every other second.
So no, I didn’t avoid compassion fatigue. In fact, I burned out and quit. But then I reincarnated, I guess you could say, with a lot more perspective and a healthy understanding of what I’m really supposed to be doing here. But not until after I got really sick, like going to specialists and talking about scary tests sick, did I decide to get my priorities in order. Once that got sorted out, life got really good!
How to be a zen vet in a Prozac profession
1. Don’t underestimate the importance of your co-workers
I think there is no greater indicator of how happy you will be at work than how well your team works together. They will prop you up when you’re down, have your back when things get nuts, and inspire you to do better every day. Unfortunately, the converse is also true. The saying “turd in the punchbowl” exists for a reason.
2. Don’t settle for a toxic environment.
Temporary Like Sadness by Dominic Alves on Flickr
Sometimes you think you’re starting in at the best place on the earth, but something happens. The office manager is stealing. Your mentor turns out to be Voldemort. You get pregnant and can’t work overnights anymore. So many people stick it out in a bad situation because 1) we’re taught not to whine and 2) we’re scared there’s nothing better out there.
There’s always something better out there, but you won’t find it if you don’t look. If you are in an office that is causing you physical symptoms of anxiety, it’s time to start looking for a new job. Living in modern day American comes with certain advantages, like the whole “no indentured servitude” thing.
3. Don’t be afraid to explore.
I had no intention of being a veterinary writer. Blogs didn’t exist when I started vet school, nor did hospice veterinarians. Sometimes you just have to strike out in a direction that looks good and see what’s out there. Because guess what? I don’t care what anyone else has told you, you’re allowed to come back and be a vet if you leave. Taking time off to explore another career, take care of family, get another degree, none of it is a one way valve- unless you want it to be.
4. Set boundaries. Mean it.
Out of every rule I laid out, this is seriously the number one important one. With the exception of the rare shining star who really does want this to be their life, most of us want a life of which veterinary medicine is only a part. This is a profession where it is very easy for it to take over your life, because there will always be more asked of you than you are able to give. Always. It is not a failing to recognize that.
Set boundaries with your clients, your co-workers, and yourself. Take vacations. Exercise. Enjoy your family. Do not let work intrude on this or else you will begin to resent it, and that is the seed of burnout. You can (and should) work your butt off, then go home and play your butt off.
Set those boundaries, and enforce them like your life depends on it.
It was an ironic realization to figure out that point of diminishing returns in terms of giving of yourself. You cannot truly understand compassion unless you’re willing to extend it to everyone, including yourself.
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.
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.
All 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?
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.
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.
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.
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!
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-
And the pitchforks came out, because how can you prove you aren’t?
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.
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.
As you may or may not have heard, the internet was abuzz last week with a series of alarming headlines, such as:
PURINA IS KILLING DOGS
CLASS ACTION LAWSUIT AGAINST DOG-KILLING BENEFUL POISON
And as these things tend to do in today’s internet age, the story has taken on a life and momentum of its own, just like last year’s “Eukanuba is killing dogs” story that ended up fizzling out and the “New parvo strain is killing dogs” story that also ended up fizzling out. Remember those? No? They were huge at the time, until they realized there was no actual evidence to support the claim and WHOOSH gone, not that it seems to matter these days.
I take lawsuits with a big huge salt-lick sized grain of salt, because once you’ve seen what people do in court rooms you gain a grim view of human nature. One veterinarian I know of lost a court case alleging intentional infliction of emotional distress for a phone call that never happened, because the plaintiff was able to bring in several family members to perjure themselves and say they heard the harassing call that never took place.
The veterinarian was able to prove the call never occurred using phone records, and the case was overturned on appeal, but not before the plaintiff called in the local consumer advocate, got the clinic on TV, and had to endure months of people coming into the clinic and yelling at the staff. The damage was done.
CC by MikeMccaffrey on Flickr
Filing a lawsuit is easy. Anyone can do it. I can sue the guy across the street tomorrow if I want to. I’ve never met him or interacted with him, but I could, just because. Winning one, proving damage- that’s another story.
Here’s a hard truth: a lot of dogs die every day, and much of the time we don’t know why because people don’t have the money to spend getting a definitive diagnosis on a 15 year old dog who has been vomiting. So they look to the obvious thing: the food! and never actually learn that the dog’s had a percolating abscess in the liver, or a hemangiosarcoma that metastasized, or any one of a number of things that happen. If 1.5 billion bowls of Beneful got eaten last year, it’s a given some of those dogs will die because that happens in life not because their food killed them; but they’re the easy target.
Here are my own FAQs based on the questions I’ve been getting this past week:
1. Is it possible that Beneful has a problem?
Sure. It is possible the case has merit, but until we see the actual proof I can’t say much about it. Given the fact that the suit mentions “propylene glycol” as an antifreeze analogue (it’s not), it seems to be one more tired rehashing of the whole ‘I can’t pronounce it so it’s bad’ argument people like the Food Babe have made so popular recently. Possible? Yes. Likely? I can’t say I have seen any evidence of it. Dr. Weeth has an excellent analysis here.
Were you to believe every “this kills dogs” claim on the net in the last 10 years, you’d have to have given up the following entirely:
Febreze, Swiffer, Iams, Eukanuba, Purina, any commercial dog food, Trifexis, ice water, vaccines, corn, anything with toxins, preservatives, moldy food resulting from lack of preservatives, veterinary care, Advantage, life as we know it.
2. Don’t you believe this poor man?
I believe that the man who filed this lawsuit believes in his heart that this is what killed his dogs. My heart goes out to him for his losses, it truly does. People want accountability for sad events and that is understandable. That still doesn’t prove that the food had anything to do with it.
3. What about melamine? Is your memory so short that you think pet food companies are flawless?
Here’s the thing about the melamine incident I want everyone to remember: Do you know how that story was discovered?
-It was not one person with a Google account and a phone book opened to “law offices.”
-It was not the FDA or companies testing dog food (melamine isn’t something normally tested for.)
-It was individual veterinarians who noticed a pattern, did some digging, talked to each other, and pursued an answer. I watched it happen, and it was incredible. There are some smart vets out there.
I can list about 3 major food problems off the top of my head that veterinarians figured out, and based on their experiences I would agree that not all pet food companies are forthcoming or proactive when it comes to potential issues (none of those companies I am thinking of, by the way, is Purina or any of the other big name companies. They were boutique ‘premium’ brands.) Yes, it happens, but the answers come with careful analysis by trained scientists, not lawyers.
4. If I feed Beneful, should I change my food?
Food is kind of like religion: people get really worked up about it. Each food has its place in the market, and if you’re the type to obsess over food labels and ingredients (nothing wrong with that! I do!) you’re probably purchasing a different category of dog food anyway, right? But this food has its place too, even if it’s not in your house. For plenty of people it’s been working fine.
I say the same thing about this that I do any food: if your personal individual pet is doing fine on their food, I wouldn’t change a thing. If he isn’t? Well, let’s talk. So yes, you should always report weird symptoms to your vet and tell them what the dog is eating (it is one of many, many data points.) Most of the time it is not the food. On occasion, it is.
Any questions? Then carry on. I have to catch up on Walking Dead.
Disclaimer: This post was NOT sponsored by Purina, Nestle, Big Pharma, or Corporate Shills. In fact I’m losing money writing this because I could be working on another project I actually get paid for. Information in this blog post is for informational purposes only and should not substitute for mass hysteria generated by your regular inflammatory website.
I’m sure you get fan letters all the time, from people who love your art: Clerks, Dogma, Chasing Amy. I think Chasing Amy was one of the first movies I watched with my boyfriend, who is now my husband. He thinks you’re the cheese.
I think you are a great writer, and like all great writers you have an amazing willingness to share things that other people hold close. Painful things, like a humiliating experience with an airline or, in this case, the terribly personal loss of a beloved dog. I am so very sorry Mulder died. I hope it is OK I am sharing the photo you posted because the love and the bond you share in this shot is there in a way I think others would be very comforted by.
To everyone: I encourage you to read Kevin’s words about Mulder here: They are beautiful.
I’m writing you today to thank you because I don’t know if you know just how special this is- not only your bond with Mulder but the fact that you are open to sharing this with the world. As a hospice veterinarian, I see people every day who are torn to shreds to have to say goodbye to their beloved companion. All kinds of people: women, kids, men, even big burly Marines and wrinkly faced Charlton Heston types. I worry about those men the most, because they have so often been taught not to express grief and sadness that they are as worried about my own reaction as they are just letting themselves experience the moment and admit, yes, I love this creature. Of course I am grieved.
I can speak all I want and tell people that they have permission to feel this way and let themselves cry and share and ask for camaraderie in a time that often feels incredibly isolating and lonely, but until more people like you- people with influence, whose words matter to so many- do what you’ve just done, it will continue to be a struggle for many more.
The conversation you opened up on your Facebook page- that matters. That’s huge. There are so many people starved for the opportunity to reach out and know it’s OK to drop your basket over this kind of loss, it’s like a dam breaking every time. What a testament to Mulder to have so many share in kind. It doesn’t lessen the pain, but I think the sharing the burden does help cushion the blow.
He was a beautiful dog and I know your heart must be broken into bits right now. For every idiot out there who called you an ‘attention whore’ for this, there are hundreds more moved to empathetic tears by your loss. You have fans who have your back. The average person out there who doesn’t have that support needs to see that.
And in the spirit of sharing, I’ll post a picture I never planned to share for all the reasons I just mentioned: I look horrible and tear streaked. It was a private moment. It is my dog Kekoa kissing me on the day she died. I was really annoyed with my husband for pulling out the camera that day, but in retrospect, I’m glad he did. You’d be surprised- at least I was- at how many people do the same when I am there to help them say goodbye. Maybe this will help others feel more permission to do the same.
I guess now I’m attention whore too. It’s all good.
Dr. V, your newest fangirl
P.S. Will have a pint to toast Mulder’s long and storied life tonight.