Every morning when I get into work, one of the first things I do is check the fax machine. (OK, I’ll be honest, the receptionist checks it and I just ask her if anything came in. But you get the idea.) There is the usual stuff- requests from online pharmacies, continuing education announcements, Viagra ads- but there are only two things I really care about: labwork, and notes from the emergency hospital.
We have a great 24 hour emergency hospital that we refer to after-hours, or even during normal hours if there is something critical we are not equipped to deal with. In my current place, we have the basics, but we aren’t meant to deal with critical cases that need around the clock monitoring. This hospital usually keeps us updated by fax, with the occasional phone call if something really wonky is going on.
The most common fax from them, unfortunately, is notice of euthanasia. In part that is just the nature of emergency medicine, but I do think that is somewhat heightened in these days of economic devastation. So I look through the notices and see who got hit by a car, or diagnosed with heart failure, hoping each time it isn’t one of the previous day’s surgeries gone terribly awry. I am always saddened to hear of a patient’s passing, but like all things in life you learn to separate yourself a bit from the things you can’t control and be grateful that for people who can’t afford extensive treatments, there is at least a humane option to dying at home.
I was reminded of that this week. About 15 minutes before closing, a person came in with a cat who had been vomiting for 2 days. My receptionist had told me it had diarrhea, which was the only reason I agreed to see it that late to begin with- 15 minutes is just not enough time to address a serious problem. Looking at the cat, it was immediately apparent he was in pretty crummy shape. My initial guess was renal failure, though there are a lot of other things on the differential list at that point. They agreed to labwork, knowing I wouldn’t get it until the next morning.
That morning, I beelined for the fax and grabbed his bloodwork. It was not good- he was a diabetic who had progressed to being ketoacidotic; in short, he was in a medical emergency. I called the owners at the only number we had for them, repeatedly. When I finally got through, they said they were at work and couldn’t get in until 6 that night. I went over the bloodwork and the seriousness of his condition and told them to please come in ASAP.
When they arrived, I went over the situation and told them they basically had two options: take him to the emergency hospital and begin treatment, or euthanize him. They said they couldn’t afford the treatment (it is lengthy and difficult; even if/when you get them under control you still have a diabetic pet requiring lifelong treatment) but they weren’t ready to euthanize him yet, and could they come back tomorrow.
I feel a lot of sympathy for people when they get a bomb dropped on them; at the same time I feel a responsibility to advocate for their pet, too. In this case one member of the couple agreed with me and wanted to euthanize him right away, and the other one was pushing to take him home. I explained why I felt the way they did, how sick he was, and they told me they would be back in the morning. Just in case, I gave them the emergency hospital number in case they changed their mind overnight.
Today, I was off, so I had to call in to work to ask if we had gotten any faxes regarding Neptune. “Yes,” the receptionist said sadly. “They euthanized him at the emergency hospital last night.” I sighed in relief.
She seemed very confused that I would have that reaction. It’s hard to explain, but in the face of certain types of suffering sometimes yes, the notice of euthanasia is indeed a relief.