My Despair Will Not Help My Patient

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[I originally posted this image (a dog’s ear covered in ticks) on Facebook captioned “I guess he was a little…ticked off!” The dog was treated for tick infestation and at time of discharge was parasite-free!]

Black humor and other coping mechanisms are a fact of life in veterinary medicine. Sometimes I forget that not everyone sees things the same way we do. The above picture, much to my surprise, received quite a bit of flack for the pun in the caption. People were upset not because the pun was terrible (I will freely admit that!) but because they saw it as making light of an animal’s suffering. The sad fact is that veterinary medicine is full of suffering; whether you’re in general practice or specialty, wildlife or shelter medicine, spay/neuter or disaster relief, and we all find our own ways of dealing with it. I think I had forgotten that. For me, this was an interesting picture showcasing a heavy parasite infestation in a village dog. The dog was with us to be sterilized and treated. I knew that we would be alleviating his discomfort as well as we could. I also knew that in the weeks before and after I had seen and would see so much worse, from gangrenous legs to massive blunt trauma, emaciation and deliberately inflicted injury. And I knew that my sorrow, my discomfort, my anger, my personal emotions — none of that would help my patients.

 

My despair will not help my patient.

This is a familiar mantra. It’s not the only one; I have several little quotes and ritual words I use to focus throughout the day: this too shall pass, one way or another everything works out, shake it off shake it up, go big or go home. One of my favourite things about my job is that it’s never boring and there are never two days exactly alike, but this brings with it an element of chaos that personifies the English curse of may you live in interesting times. Workdays can have the feeling of attempting an ocean swim; you may get lucky and be able to have a light paddle through smooth waters or a storm may blow up and leave you thrashing, every brief moment of floating accompanied by another crushing wave. When a veterinary facility fills the role of both hospital and GP office it means that your day can oscillate wildly between emergency cases — applying pressure to a spurting wound, pushing lifesaving drugs into a vein, decompressing a collapsed lung, last-minute surgery as an animal’s life hangs in the balance — and the every-day minutiae of the office visits, cute puppies for their first shots and glossy-coated cats in for annual exams and dewormer, sometimes within minutes of each other.

As you can imagine, veterinary medicine is an emotional roller-coaster. We see the beginnings of life in puppies and kittens, C-sections and prenatal exams, and we see the end of life in euthanasias and animals who just can’t hold on any longer in the face of their illness or injury. We see suffering and pain, joy and kindness side by side. We listen to your stories, to your fears and your hopes, your plans and your memories. We share your highs and your lows. And yet we must remain professional, impartial, able to think on our feet and make decisions with what facts are presented to us. Each patient we see and interact with is relying on us to have their best interests in mind and our mind on them, not on the multitude of other patients we’ve seen that day or currently have in care. That’s a lot for anyone to deal with.

But we don’t have a choice. So we compartmentalize and we repress and we develop a sense of humor blacker than Batman’s wardrobe. We learn how to swallow emotion and tuck it away somewhere it won’t bother us. We become experts in leaving one room after a painful euthanasia and entering the next ready to laugh and squeal and exclaim over the new puppy inside. We joke about the feces and the urine, the blood and the vomit, the bites and the scratches. We place mock bets on the outcome of cases and we laugh loudly, and often. We swear and we joke about things that no normal person would imagine joking about because sometimes the alternative is despair and, I remind myself swiping away a stray tear, hiding in the radiology room for an extra moment or two because I need the dark and the quiet before I return to light and laughter, hiding from the things we can’t fix, my despair will not help my patient. Kicking and screaming about the wild injustice that is cancer will not relieve my patient’s pain. Sobbing my heart out for those animals who lost the genetic lottery and grew to adulthood loved and cherished and with a ticking time bomb inside their chest where their heart should be will not help my patient breathe. Freezing in shock and terror at the sight of the carnage caused by a car that hit the brakes a moment too late will not stop my patient’s bleeding. Losing myself in the dragging depression of a day where every other case ends in euthanasia will not bring comfort to those who need it most.

My despair will not change what has happened to my patients. It will not change the fact that they need me. It will not educate their owners on options and medication, it will not change soiled bedding and patiently hand-feed. It will not take blood from the most delicate veins. It will not hold tired, painful bodies through invasive tests.

My patients do not need my despair. My patients need my strength. They need a soft touch and a calm voice reassuring them that everything will be okay even when they are far from all they’ve ever known. They need my mind sharp to recognize the smallest change in their condition. They need my hands steady to keep them safe through surgeries. They need me to control my emotions the way they cannot.

In the car at night, at home, during a rare break — these are the times for sorrow. To remember the lives lost too soon or the suffering that could have been avoided, changed. But each morning I shake it off, shake it up and each day I go to work with a smile, to make the world a little better and alleviate a little suffering the best way I know how. 

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