Miracles could happen, but probably won’t.
When pet owners ask me ‘what I would do’ in their situation, I have two basic answers.
Sometimes, it’s a dreaded question. In other situations — it’s a gift.
A gift that provides an opening into talking about something that the owner probably doesn’t want to discuss, but knows they need to. (Spoiler alert and Trigger Warning, a prime example of this is euthanasia.)
‘What would you do, Doc?’ is asked often, many times daily, in probably every small animal veterinary practice in the country.
He got bit by a bee and is swollen in the face. What would you do, Doc?
He got run over two weeks ago and still can’t walk — What would you do, Doc?
He’s got 3 different types of malignant cancer and was given 6 weeks to live about 2 years ago but now he hasn’t eaten in 6 days. — What would you do Doc?
Our beloved hamster has a tumor larger than her entire body, so she’s tethered wherever her tumor is anchored. — What would you do, Doc?
My dog ate my neighbor’s dildo (or insert any other potentially embarrassing household item). What would you do, Doc?
These above, are usually they’re easy questions— and for those, I don’t mind one bit sharing with the client what I would do, and why I would do it.
It’s like shooting fish in a barrel (which I would never do).
Life is full of questions with no clear ‘right’ or best answer, and veterinary medicine follows suit. The fact that I can only non verbally communicate with my patients is a special flavor of weird — which wouldn’t be so challenging if the pet owners were all astute and accurate with their observations of what is important and what is not, however this is not the case.
Back to the ‘What would you do, Doc? -The hard ones though.
Those hard questions are the worst.I see them coming. I dread them. They come anyway.
When I don’t know what I would do or when it’s a heartbreaking decision based on limited information, perception, logistics, finances, quality of life concerns, or based on diagnostic information that we won’t be available until the decision has already been made… Those can be very very challenging for clients to work through, consequently they often need a doctor or skilled technician to walk through the fire of that conversation with them.
To euthanize or not to euthanize?
To do the very expensive possibly (but not definitely) life saving surgery?
Reminders abound. Caveats come up.
There are no guarantees in medicine. Lemme say that again.
There are no guarantees in medicine.
Or palliative care until she passes?
Or euthanize your beloved pet now due to suffering? These are the harder stickier questions.
They’re the flip a coin/can’t know/don’t know/makes me wonder/makes me pray-kinda stuff.
In many situations, there is often a vast amount of medical information we cannot or do not know, making a decision of this magnitude tenuous, at best.
My preference is to approach these situations with a hefty dose of common sense, tempered with a pinch of ‘miracles could happen but are highly unlikely’ and then I close with a ‘reality check’ chaser. It works best when I drop any judgement that I’m able to catch creeping in.
Actively withholding judgement of clients is important, yet challenging since all of the judgment we’re all conditioned to feel is hard to banish at will. Many years ago, I decided that it was not helpful and I should STFU and do my job. It’s hard though, some of that stuff is hardwired, immediate, and involuntary. I still try. I believe it is beneficial.
When I really don’t know what I would do, I say so.
‘I really don’t know what I would do guys, <Name> is a really tough spot for X, Y and Z reasons’,
‘I can’t answer that — I’m not you and she’s not my dog. I’m not the person who knows and loves her best. I know that you will make the kindest decision for her — and whatever you decide, I support you.’
So, What would you do, Doc?