Gazette Vet: To the Least of These

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The fourth year of veterinary school involves a year of three-week “clinical rotations” where students spend time in different parts of the veterinary teaching hospital such as surgery, internal medicine, and cardiology. In addition to the “core” rotations at Virginia Tech, we had the opportunity to spend a few blocks at private practices to gain some different experience and perspective than we would find at the university.

One of my blocks was at a large emergency hospital in northern Virginia, where I am originally from. I would be able to live at home and catch up with my family, while at the same time get some real-world experience in a busy emergency setting.

Emergency work is tough! No one wants to go to the emergency room – human or veterinary medicine. Every single client who comes in is dealing with some sort of unexpected problem with their pet. Sometimes these are fairly benign emergencies such as a torn toenail or a minor cut, however there are unfortunately many severe emergencies where pets are dying and people are beside themselves with grief.  The true art of emergency medicine is being able to handle the medical stuff while at the same time handling the emotional stuff.

On this note, there was a lot of humor behind the scenes. The staff would poke fun at each other, at themselves, and find humor in just about any situation that would happen through the night. If a stranger happened to walk in the back and just listen, they might think they walked into a room of truly heartless people who can somehow laugh and make jokes while sad things are happening around them. After enough time, though, you can see that it’s simply a coping and survival mechanism. If all you do is accept the emotion that every sad story brings, you won’t be able to perform at your best. Like it or not, you’ve got to figure out ways to put up some emotional walls to protect yourself, and humor seems to be one of the best defenses.  

At the same time, with so much self-preservation to be considered, can you still be truly compassionate? If we are putting up boundaries so that our hearts don’t become overwhelmed with the grief, sadness, and frustration of others, is it possible to allow anything good in? One of the veteran emergency vets I shadowed showed me a lesson in compassion that has always stuck with me.

This doctor, let’s call her Dr. Smith, was one of the more reserved veterinarians in the practice, never getting caught up in too much laughter or conversation and always getting her work done.  Yet she was very experienced and smart and always seemed to have an efficient fix for whatever problem walked through the door.

Her veterinary technician (aka nurse) came to her and presented the summary of the next case that had checked in. “Dr. Smith, the cat in room 2 is having some difficulty urinating and seems pretty thin, but there’s something wrong with the owner. I think there’s some sort of mental handicap or something because she just kind of stared blankly at me and I’m not sure she really understood what I was asking her. Good luck.”  Dr. Smith calmly took the chart and said, “Let’s go see,” and we walked into the room together.

While I can’t say I remember the woman’s face, I can remember her demeanor. Nervous, anxious, worried, but also definitely some sort of mental disability. Eye contact was difficult and communication was often unanswered. However, by the way she held that cat in her arms, you could tell it was very important to her.

After flying through emergency after emergency and dealing with difficult situations and difficult people all day, it would be easy to believe that Dr. Smythe would just work her way through this case like a problem she didn’t want. Does this woman even know what’s wrong with her cat? Can she afford any treatment? Where does she even live? Ugh, I’m not in social services, I’m a doctor, right?

What I witnessed, however, was one of the finest examples of a human taking care of another human.  Dr. Smith immediately shed herself of any of the stress, sarcasm, and callousness of the day and was what supremely compassionate. She introduced herself and asked the woman her name, and then spoke clearly and reassuringly to her as she tried to get more information. At first, the woman was difficult to get any clear information out of, but with a patient and kind approach, Dr. Smith slowly teased out the needed information.  

“I think your cat has an infection in her bladder, but she’s also older and I worry she may have a kidney problem.” Dr. Smith carefully explained her treatment plan and the next steps, truly concerned that not only the woman understood what she was saying, but also making sure that she knew Dr. Smith truly cared about her and her cat.  She even went so far as to ask if she had driven here or if she needed a ride, and gave her a business card with a number to call if the cat wasn’t doing better in a day or two. As we were approaching the end of the appointment, you could finally see the woman letting down her guard a bit, visibly relaxing as she seemed to trust that Dr. Smith was going to help her and her cat.  

I can only imagine the number of times this woman did not get kind or patient treatment from other people in the world, and also how her cat was probably one of the only things that didn’t judge her and that offered her unconditional friendship and love.  

What I witnessed that day was Dr. Smith caring. She could tell this woman, wherever she came from, had a tough life and needed not only some help, but some kindness. I’m not sure I saw Dr. Smith ever be so caring or compassionate to any of the other clients we worked with during the three weeks I was there than this one who probably had the least, but needed the most.  

That was one of the transformative moments in my veterinary education. Caring for other people is one of the reasons we are all here and we can do it one case at a time. And while there are people who are handicapped and disabled, there are also people who are lonely, mad, sad, and frustrated in their life and I look at my interaction with them as an opportunity to maybe shine just a bit of light into their day and let them know that no matter who they are, there are people who care and who are willing to help. 

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