Oh my goodness. One week from tomorrow and it’s going to be one of the most important days of my life: right up there with graduating, getting married, having my kids.
I will be an official published author. Aieeee!
I dreamed of this long before I thought about going to veterinary school, back when I was seven and I pulled every book off my shelf and artfully arranged them around the house playing bookstore ( Or was it library?)
When I sat under the kitchen counter reading National Geographic.
When I perched at the bus stop reading Piers Anthony, hoping today was the day the other kids at the bus stop would forget to throw spitwads at me.
To me, writing is transcendent: a waystation to another place or time where your life ceases to be front and center, if only for a moment. If you are fortunate and have chosen your book well, you return slightly better than when you left. If you are seeking respite when your choices are limited, books are a way to travel, to find camaraderie, to escape. Reading and writing are two sides of the same coin.
When I started writing, it was almost a compulsion, banging away at my dad’s IBM 5150 about unicorns or Weird Al or whatever it is that interests 10 year olds. It might have even been a story about Weird Al riding a unicorn, I don’t know. I printed the stories out on the dot matrix printer and presented them proudly to no one but my mother, who always said they were excellent even when they weren’t.
I thought we were tres sophisticated, since we didn’t use typewriters. After that, we progressed to Macs, which were even more amazing save one little blip:
These were the computers I used in high school when I was editor of the school paper, a job which taught me two things:
- Writing can be tremendously powerful
- I enjoy poking the badger (still do)
As the years have passed, the computers have gotten better but two things never changed: my desire to write and my mom’s support.
Authors are my heroes, and to be allowed into even the peripheral orbit is an honor I can’t describe. Well, I could, I guess, but you know what I mean. When I got the very first draft of my book, bound in blue construction paper and full of typos, my mother was frothing to read it and I said no, you have to wait until July 14th like everyone else.
Fortunately, I changed my mind.
She read it in a day and called to tell me all the things she thought about it, which were beautiful and joyful and redeeming. I am so glad my first review was from her. She told me once a few years back that she always wanted to write a book.
“About what?” I asked.
“Hobos,” she replied.
“Hobos?” I asked, completely confused.
“Yes, hobos, you know, the guys who rode the rails?” she asked.
“Any particular reason why?” I asked, since as far as I knew she had little experience with rail riding vagabonds from the Great Depression Era, though my Uncle Steve does come close.
“Nope,” she said.
And here I always thought I got my weirdness from Dad.
Nonetheless, it is her love of the word, the countless hours on her lap being read to and carted back and forth from the library, that comes to fruition next week. Obviously, I want the book to be successful because that’s the only way you get to write other books, and I already know what the titles will be because I am always dreaming and wishing and writing things in my head as I walk around.
I want it to do well, because I’m proud of it and I want others to enjoy it too. But even if that never happens, if this is as good as it gets on that front, I will never be prouder than I was the moment Mom teared up and told me how much she loved my book. And that, all by itself, is enough.
FOR TODAY Outside my window… The weather is beautiful. It’s more than beautiful. The sky is clear with maybe sparse clouds here and there, but the blue is deep like a lake and watching the birds fly about, brings a sense of wonder of what God has created. I am thinking… I need an easy…
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If you have ever had the good fortune to go on safari, you know that everyone talks about the “Big 5″: rhino, lions, elephants, cape buffalo, and leopards. The term was coined by game hunters and refers to the difficulty in getting all 5 because of their ferocity when cornered, but now is mostly used by safari operators as a virtual checklist of animals one must see in order to consider it a successful outing.
When I was working on the book, I tried to pick out a combination of stories that laid the foundation for life in general practice. Along the way, I discovered some of the stories that I thought were so hysterical and weird has happened to EVERY SINGLE VET I know. Now that I’ve been out for a long enough period, my classmates and I can all nod our heads like the sage old people we’ve become and say yes, we’ve earned our stripes, done that.
So in honor of this, I present to you the Big 5: You know you’re a vet when edition. Once you’ve experienced the Big 5, you know you’ve made it.
1. The undercover detective dog
Dogs eating underwear is like the giraffe of the veterinary world: yeah, you see that everywhere. No big deal. The rare and treasured lion of the underwear eating world, on the other hand, is the dog who manages to not only eat something unpleasant, but bust a cheating boyfriend/girlfriend/spouse in the process. Dogs who poop out a red thong that doesn’t belong to the wife. Dogs who vomit up a condom wrapper. Interestingly enough, the dog is almost always the closer companion of the wronged party. They know. They always know.
Animal rating: lion. It’s messy, it gets your adrenaline going, and you are so glad you are in the car and not out there with the lion when they go in for the kill.
2. Involuntary nude client exam
No veterinarian wants to see a naked client. This is why we are veterinarians and not physicians. Nonetheless, with the MD shortage out there and the easy access to veterinarians, it is only a matter of time before a client tries to slip in a totally inappropriate question while you’re examining a pet, complete with stripping. In my case, it was a woman who pulled her shirt down and asked me to examine her breast. I consider myself lucky: a colleague once had a client ask her about hemorrhoids and was halfway to dropped trousers before she got him to stop.
Animal rating: Leopard. It sneaks up on you. You can usually chase it away by yelling.
3. The accidental grope
Physical examinations are, by their nature, very hands on. Most clients get this, but on occasion there will come one who refuses to let their pet out of their protective embrace. Usually the pet in question is a small, heavily haired squirrelly dog. There is only so much you can do when a chihuahua is placed squarely in a woman’s bosom before getting an unintended handful of human. This can vary in embarrassment level from mildly mortifying to near criminal, depending on the client, the location of the pet, and their outfit. Lesson learned: any male clients in running shorts must place the pet on the table, no exceptions.
Animal rating: elephant. Fine from a distance, dangerous up close.
4. The client who makes ass-umptions
I don’t think we spend a disproportionate amount of time dealing with pet’s rear ends: anal glands, rectal exams, fecal exams are but a small part of the work we do- but for some reason some clients get it in their heads that 99% of our interactions with a pet is via their rectum. “Oh no!” they say, when we get the thermometer ready. “Gird yourself, Tommy!” etc etc. These same clients have a hard time believing that medications are administered in any manner other than per rectum. Here’s the kicker: You don’t get to check this item off your list until you’ve been asked about whether each of the following is administered in this manner: Advantage, dewormer, antibiotics, pills of any kind, chlorhexidine scrub.
Animal rating: cape buffalo. Comes in herds. You never know what they’re thinking.
5. Face full of anal glands
You are a seasoned practitioner. You know all the tricks about how to angle your thumbs and cover your target area with a paper towel. You know to evaluate glands by feel, how to note the tell-tale pressure of an impacted gland that is prone to blow. It will never happen to you, you say. You are careful.
It will happen to you.
It will happen to you in a moment you let your guard down, when you’re looking over your shoulder to answer a question and the glands sense an opening. You won’t see it coming. One minute you’re chatting about someone’s tapazole refill, the next moment you’re standing over the eye flush station screaming for Altoids and crying. Two hours later, you will relay the story to your family at dinner with great relish, laughing while the waiter makes a moue of horror and rushes away as quickly as possible. Because that is how vets roll.
Animal rating: rhino. A rare and memorable interaction you are unlikely to repeat but will talk about forever and ever.
How long does it take the average vet to complete the Big 5 Vet Safari? Did I miss any? I’m sure I did.
I am becoming increasingly convinced the communication gap between veterinarians and clients is the number one problem we’ve failed to solve. We’re just not on the same page a lot of the time, it seems, and it makes me sad. I can’t read a single article online without coming across “veterinarians are money grubbing pigs that suck” (true blog title) and someone else saying “if you can’t afford x/y/z/q you shouldn’t have gotten a pet, jerk.” I feel as though this is perhaps a bit extreme, but it’s what happens when we don’t work together to identify our goals.
Common Fallacies of Bad Client Interactions
(In just as many cases, the vet on the left is an associate up to his or her ears in student debt and just trying to make it through the day without getting yelled at one more time, and the client on the right is a stressed out single parent who just spent a grand fixing her car.)
Much of this angst comes from the pervasive assumption that in all cases we will do everything we can medically, no matter what, which was fine a while back when “everything” meant “antibiotics” but as veterinary medicine has advanced, has come to mean “MRI, spinal tap, radiation.”
This assumption, of course, carries over from human medicine: if you’ve got the insurance, you’re getting the treatment. Everyone’s happy, right? Right?
Not so much. Satisfaction with a medical course of action relies on multiple factors.
Sometimes getting to “Everyone Happy” (Square B) is impossible. D’s not so bad either, but A and C are no-fly zones.
Human Medicine Satisfaction
I would argue that satisfaction with outcomes is directly correlated to the balance between the amount of treatment pursued, and its benefit.
So really, the goal here isn’t to push everyone towards the far extremes of treatment; it’s about getting to that center line of balance. In human medicine this change is slowly creaking along with things like hospice care, which moves people from C to D in low treatment benefit situations, and increased access to insurance coverage, which moves you from A to B in high benefit situations. With Mom, we were squarely in the D category, and while we’re not HAPPY, it’s a hell of a lot better than if we had treated her to death.
So how does this apply to veterinary medicine? It’s similar, except we tend to find ourselves walking a line most strongly related to finances.
The Veterinary Experience
There’s a whole lot of people in square C these days, who spent more than they really had on treatments they weren’t sure they wanted, because they felt like they had to, and when things go downhill as they often do with very ill pets, people can end up really, really disillusioned with the profession.
Now, since we have no ability to magically divine which people are up for specialty treatment and which people are not, we always offer all the options to clients- as we should. There are people who spend thousands, lose their pet, and are still ok with the outcome- but they were also very clear on the risks and made an informed decision. Many clients, it seems, feel as if they are not.
So what do we do to improve outcomes? In my experience, the best way to move the dial from A to B is pet insurance, at least for emergency situations. There are few situations more likely to prompt a Facebook mob than a pet who died a preventable death because the owner couldn’t afford treatment and the ER vet wouldn’t do the treatment for free- nor should they. Owners need to shoulder some of the responsibility here of financial preparation, and if they refuse to take even basic steps to be prepared, maybe they really are a crappy client.
And conversely, moving the dial from C to D involves good veterinary communication, and a willingness to understand that lots of factors go into the decision about whether or not to seek treatment. If a veterinarian talks a senior on a fixed income into a kidney transplant for a 15 year old cat in renal failure, after she expressed concern about paying her rent for the month and her own upcoming surgery- maybe they really are a money grubbing vet.
But I like to give everyone the benefit of the doubt. Clients and vets both have work to do here. And I believe with all of my heart that the better we get about empowering clients to make informed decisions, the more that will carry over into human medicine- which is a wonderful thing.
I realize this is a vastly oversimplified explanation of some really complicated issues, but hey, we have to start somewhere. Whatever it is we’re doing now sure doesn’t seem to be working too well.
It’s pub day! The book is out at long last! I really hope you all enjoy it- All Dogs Go to Kevin has truly been a labor of love. (That link goes to my new website. Did I mention I have a new website? It’s been so busy around here I think I forgot.)
Last weekend I went to Warwicks to sign the preordered books. Brian and the kids were at ComicCon, so I went to Warwicks by myself. It was a short task, no more than 20 minutes, so I couldn’t figure out why I was so bummed about going alone, and then I realized ohhhh. It’s another one of those moments.
The thing I will miss most about my mom is not the big celebrations, the ones everyone goes to: holidays, book signings, that sort of thing. It’s the little celebrations, the moments no one else would think mattered, but she always did. If she were around, she would never have let me go alone. She’d go with me, we’d get lunch, then she’d talk me into shopping for a little while in downtown La Jolla. But she’s not here, so my twenty minute task was just that- 20 minutes in a little bookstore office with a Sharpie feeling terribly sad.
I’m trying not to let my sadness get in the way of being happy, but it’s so hard not to have her here. We have a series of white rosebushes in our backyard that bloom almost year-round, and I really like them because they remind me of my parents’ yard. Plus, it made it really easy to send random nosegays to teachers and the like since they were always blossoming, scattering white petals all over the grass like confetti. Mom loved them too, of course.
Brian- not so much. He’s been threatening to pull them since we moved in. He’s been talking about it again the last few weeks, and I made him promise to leave me at least one or two, for Mom, and he said, “OK.”
This afternoon he had someone come over to give us a quote for doing some of the backyard work. I peered through the window to make sure Brian saw me giving him the evil eye- not ALL the rosebushes, ok??- and I noticed something I had never seen before in all the time we’ve been here:
Someone’s been painting the roses red.
The roses stay, obvs.
It’s funny how the moments that impact are not the large and grandiose gestures, but the fleeting surprises that hit you like a much needed breeze. How I can be sad about a less than perfect rose in my garden when so many people in this world know nothing but weeds? Mom’s here in every sunset and every butterfly and her love feels no less potent for the lack of her physical presence.
It’s a beautiful day here in San Diego. The book is out and it’s my fourteenth wedding anniversary- a date traditionally marked by ivory but now the theme is “animals.” Mom sent flowers. How can I complain?
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