Idiopathic Issues

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Don't Go It Alone

Posted by Jessica Gramlich on September 2, 2015 at 7:55 AM
Jessica Gramlich
Dr. Gramlich is a 2008 graduate of North Carolina State University College of Veterinary Medicine. After completing a one-year emergency internship in Rhode Island, she spent five years working as a small animal general practitioner in New Hampshire.
My dog has cancer.IMG_0025

My dog has CANCER. The thoracic radiographs are so extremely obvious I can’t even give myself a second of denial. I try not to cry but the tears come anyway ,steadily streaming down my cheeks. My sweet dog, my poor sweet dog. I knew there was something very wrong. A lab that refuses breakfast? You might as well just start filling out the cremation paperwork now. But this is my dog, my 9 year yellow lab and I love her and I don’t want her to die. My mind is racing while my heart is breaking. My friends hug me and say that they are sorry. It’s clear that relaying this news is just as hard to give as it is to receive. I’ve always hated having friends for clients because it is SO much harder to give them bad news, but now that I’m on the other end, it is comforting to hear the devastating diagnosis from those that I trust, who I know care as much about me as they do about my dog. We all cry together.

I went home after that appointment and started texting my veterinary friends and coworkers. I sent a picture of the radiographs and a “what would you do if this was your dog?” I really thought that I would be more professional when my dog became ill. Unfortunately, I was just like any other owner, I lost it. I cried for an entire day. I cried so hard that my face hurt and my eyes were so puffy that I could barely see. I tried calling my best friend but all she could hear was my sobbing. It wasn’t just that I was sad that my dog was sick, the weight of having to decide how she was going to die overwhelmed me. Being a veterinarian and having the knowledge of what was ahead mixed with the emotional baggage of being the owner was a new kind of stress that I wasn’t ready for.

Soon, texts starting coming back. Wait, is that YOUR dog? Looks like a cranial mediastinal mass, that might be treatable. Do an aspirate/don’t do an aspirate. Do a CT/CT probably won’t give an accurate surgical prognosis. Go for surgery/I would never do something so invasive to my pet. Think about radiation or chemo/don’t make your dog suffer. The advice was incredibly conflicting, but it was so comforting. Hearing from friends and experts in all kinds of different specialties from technician to veterinarian, general practice to surgery, oncology to emergency. There were so many pearls of wisdom to sift through and instead of just reading about thoracic surgery in a book or comparing statistics in an article, I got to hear from people who had been there, who had seen these patients do well or not, and who could help guide me in my decision making.

It seems comical that I would even need help making a decision. How many times has a client asked, “What would you do if this was your pet?” And how many times have I answered diplomatically yet honestly? Hundreds of times. I should have been prepared for this. I am really good at talking owners through end of life discussions, but here I was completely unable to help myself. My biggest fear? Making my dog suffer because I can’t let her go. My husband’s biggest fear? Giving up too soon. Not exactly the same wavelength. But through it all, we are surrounded by caring veterinary professionals who will counsel us during this very difficult time.

Why do I share this incredibly painful experience with you? For a couple of reasons actually.

1) You don’t have to go it alone. So many people feel that asking questions or asking for help is a sign of weakness. This is ridiculously false. When you see a tough case, consult with a buddy. When you are feeling overwhelmed, ask for help. When things are beyond your scope of expertise, refer that patient. It’s ok to seek guidance. None of us can know everything about all diseases in all species. That’s why we have each other.

2) Don’t burn your bridges. Right now, it might be really important to you to get a better grade than your class rival or to look good in front of your boss compared to your know-it-all co-worker, but resist the urge to be a jerk to your classmates and colleagues. It is wise to hold on to these future resources. Once you graduate you will spread out all throughout the country and even to other continents. You will pursue different areas of interest and gain experiences in various species and specialities. You will work with amazing doctors in school, at your internship/residency, at your first job, and your subsequent jobs. You never know when you will need to reach back into your past and call in a favor.

3) Appreciate these teachable moments. While I hate that my dog is sick, I know that this experience will make me a better practitioner. Does it feel like that right now? No, not at all. Right now, I’m beyond upset that she doesn’t want her dinner, but learning how to get my dog to eat will only give me helpful hints for my future patients. I hate that I’m struggling with the pros and cons of aggressive lifesaving treatments, but just think of how much more compelling my “I’ve been there” speech will be when I really have been there too. I hate that I have to consider cost when deciding how much longer my dog will live, but now I will have even more empathy for my next client with financial concerns. Perhaps I’m just reaching for a bright side, but this tragedy will make me a better doctor.

I just want to say that I’m so appreciative of the support of my veterinary community. I’m so proud to be a member of this incredible profession and I’m amazed by the skill and compassion of my colleagues. We still have a long journey to figure out a best course of action for my dog, but I’m comforted to know that we don’t have to go it alone, we have a team of experts on our side.

Topics: Learning The Hard Way

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