powerful words

You never truly know what someone is going through.  How their day, their week, their year, is going.  You never know the power your words can have, so use them well.

It was a terrible, horrible, no good, very bad day.

It started the moment I walked in the door to the clinic.  The inpatient I had hospitalized was not in his cage.  He had been admitted for pancreatitis two days earlier, and when he wasn’t improving after 24 hours, I had the specialist come in to ultrasound his abdomen.  The pancreas had looked normal so I felt reassured that it wasn’t necrotizing.  I hoped he just needed a little more time and supportive care to heal.  The ultrasound had also shown fluid in his prostate so we got a sample for cytology and culture and started antibiotics so that we could treat that once he got though the pancreatitis.

Though he was a difficult dog to handle, I was quite fond of him and his family.  They were already going through a difficult time as they had just suffered the loss of a human family member.

I kept my hopes up.

The technician probably took him to get started on his morning treatments, I thought to myself.  I headed up to the treatment room but he was nowhere in sight.  Once the worst had been confirmed, I called his owners to tell them the devastating news—he had passed away overnight.  They were on their way to a funeral.

I had a few minutes before my first appointment and I used that time to head to the break room and cry.

Once I got myself together, I went back down to start my day

Appointment number one—euthanasia.  I got through that and one relatively routine wellness appointment before being notified that there was a walk-in emergency that appeared to be in critical condition.

An 8 year-old springer spaniel was carried in.  She was laterally recumbent, obtunded, and breathing shallowly.  She was also covered in thousands of maggots.  The elderly couple that owned her had taken her to another clinic the week prior, but didn’t seem to know what had happened there.  “The doctor ordered her some medication from Arizona, but it hasn’t arrived yet, so she’s not on anything.  Since she hasn’t been feeling well, she’s been going off to hide in the shed.”

Mom loved this dog with her whole heart, despite the fact that her presenting condition might have indicated otherwise.  It turned out she was a diabetic.  I advised the client of the very poor prognosis given her current condition, and euthanized her.

Not over yet 

Not long after I finished my second euthanasia of the morning, I had a recheck appointment on a patient I had seen the day prior for vomiting.  He had looked pretty good at the time so we took some bloodwork and treated him out-patient.  The blood results came back and I called Mom and told her the news—he was a diabetic too.

I had asked Mom to bring urine with her so I could check it for ketones.  You guessed it–4+ of them.  This dog was literally Mom’s only friend on the East Coast.  Her entire support system was 3000 miles away in California.  He had to be okay.

I gave Mom a hopeful prognosis but warned that until we got the ketones out of his system there was a chance he might not make it.  We admitted him to start treatment with plans to transfer him to the emergency hospital before we closed for the holiday weekend.  He died at the ER 30 minutes after arriving.

And to top it all off, a frequent boarder, an elderly tea-cup yorkie beloved by everyone at the hospital, arrived DOA.

The Bright Spot

I shed tears several more times after my morning cry session.  And in the middle of all of this mess, when I was beginning to wonder how I was going to make it through, something happened.

I was bringing up a chart to the front desk when a client who was picking up medications for her dog stopped me.

A few months ago her dog had been pretty sick.  We ran a lot of tests and couldn’t come up with an answer.  After a while the family decided they didn’t want to pursue it anymore.  The dog was continuing to decline and they felt putting her though more invasive testing wasn’t fair to her.  I understood and suggested taking her off the anti-inflammatory she had been on and putting her on prednisone for palliation.  Two days later I got a note that they had made an appointment with a house call vet for euthanasia in a couple days.  I called back and let them know I understood and respected their decision, but to please start the prednisone in the mean time and see if it helped.  The next day I got another call.  One dose of prednisone and 12 hours had changed everything.  She was running around the yard like a puppy.

A few, small, powerful words.

Mom and Dad have thanked me many times since.  At the front desk on this terrible, horrible, no good, very bad day, Mom thanked me again.  “I love you Dr. Smith,” she declared.  “You gave us our dog back.  We are so grateful to you.”

“Thank you.”  I replied, tears welling in my eyes for the umpteenth time that day. “You have no idea how much I needed to hear that right now.”

Even now, writing this two days later I am weeping. A few kind words from an appreciative client saved my sanity and got me through one of the top 10 worst days of my career.  As grateful as she is to me, I am now just as grateful to her.

You never truly know what someone is going through. How their day, their week, their year, is going.  You never know the power your words may have, so use them well.  It wasn’t my medical skills that saved that dog and brought her owners untold relief and joy—it was a phone call.  And Mom’s words to me were just as powerful.  When you appreciate someone, tell them.  It could be that what seems like a small gesture to you, has an immense impact on someone else.

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