I had a client complain about me this week.
To back up a bit, he had come in a month ago with his dog, whose left side of her head was swollen to about twice its normal size. “It’s an abscess,” he told me, and wanted me to ‘stick something in it and drain it.’
I do what I always do, and come up with my list of differentials- all the things it might be. You just can’t assume it’s the most likely thing, even though it probably is, because sometimes it’s not, and if you aren’t keeping all the possibilities in your head you make mistakes. I was thinking of abscesses, cancers, foreign bodies, rattlesnake bites, all sorts of things.
I took a little peek in the dog’s mouth, but with her head as swollen as it was, I couldn’t mess with it too much. So my plan was to do the following: sedate the dog, which would make her more comfortable and allow me to do a full exam; and go from there. The next steps might be, depending on what I saw: remove a rotten tooth, drain an abscess, do some x-rays if it looked like a mass.
The owner was very upset I didn’t know the problem right off the bat. He asked me several times, incredulously, why I couldn’t tell if there was cancer by looking at the outside of the dog. There’s a planet Krypton joke in there somewhere, I just know it.
So he stormed out, then called Doc Good Ole Boy down the road, who, according to the owner, diagnosed a tooth root abscess over the phone based on his description. He passed on some rather uncharitable things the other vet supposedly said about my experience level (and this is a person I have never met). He went on and on to my office manager about my incompetence.
“Well, what exactly did Doc Good Ole Boy do?” my office manager asked.
“He gave her a pain med, then he pulled the rotten tooth.”
“OK,” said my office manager, “So he did exactly what our doctor suggested we might need to do, then?”
“Well, yes,” he conceded. “But he knew right away without all that other hooey. He stuck his fingers right in there and knew.”
“OK,” said my office manager. “So you’re mad my doctor didn’t put her fingers in a painful dog’s mouth and force her jaw open? Because I wouldn’t do that either. Aside from the risk, that’s a very painful thing to do to pet.”
“Well,” the man scoffed, “You shouldn’t be working with dogs if you’re scared of them.” As if overconfidence is the key to not getting bit. Actually, I would say the key to not getting bit is sedation and pain control, but that’s just me, Doc-who-likes-her-face-and-hands-intact.
I wonder how many fingers Doc Good Ole Boy still has. I found out his name and was debating whether or not to call him and see if he really said the things this person claims he did, but my tech very correctly pointed out that it wouldn’t really accomplish anything. I try very hard not to throw other vets under the bus, because most of the time the client’s side of the story is about 30% correct compared to what really happened, so it bothers me when others do it to me. This is the part where I take solace in my superior pain management, alone in my self righteous indignation.