04/05/2023
Any vet could write this, and about any, each and every week of their career I'll bet.; but most often it does not get mentioned, and can't be shared or understood. And if I might shed a tear whilst I type this, remember these words aren't just mine, they belong to everyone in this profession of ours who will all feel the same as they read. And every vet, vet nurse, receptionist, student - any colleague amongst our whole team who share a practice staff room will recognise their place in this tale, many, many times over - be it a different place, different pet, different name, this story remains ever the same. Here goes:
You were sat very quietly in the corner of the waiting room, head tilted down to the greyhound entwined round your legs and chair. A picture of close companionship; both of an older generation, quietly dignified and by nature uncomplaining. I called both your names - pet's name, your surname- you both rose to your feet as one. And as I introduced myself, we shook hands in greeting; your eyes met mine and silently screamed a plea of hope.
In the few stoic steps towards the consult room door, the issue was plain to see; a right hind leg that could bear little load, with thigh muscle already thinning.
Just a few short weeks from first flawed step to this but already you'd noted some weight loss - you shared that part with a catch in your voice, you knew it was no small thing. Then, as I listened, and you released the flow of your concerns, like an unbearable burden sliding from your shoulders, you shared some more.
She was your wife's dog really; and it had been a year and a half since you lost her. It was a short statement that seemed to escape from you; coming at a little rush.
"It's just the two of us now, old girl"
The best I could manage was 'I'm very sorry to hear that, sir'. It really didn't feel like enough. The truth is my mind was already a few steps ahead - moving along a pathway that I wished would have other turnings or exits besides the one I felt loomed ahead.
I bent down and talked to her, explaining for you both what my fingers were finding. In the past you'd had another dog, different breed, similar signs, and a diagnosis treatable with surgery. It felt cruel to say the knee was stable, and to pull that rug of hope away from under your feet.
The silent wince as I felt round her hip echoed around the small room. There was little else wrong, no flaws in her lean and muscled form, a testament to your care.
I stood, and we spoke, and I saw you were ahead of me as I introduced an ugly word as gently as I could. Our possible diagnoses still include some alternatives, a likelihood is not for sure. Radiographs will guide us more but in outline we have some options; it's a personal decision which of these you choose and if any of those choices were wrong we wouldn't offer them; but what's right for one owner may be uncomfortable for another, and that is OK too. It's my job to let you know all your options, and I'm happy to help guide you too. That part of the discussion I've said many, many times before but its never an automatic flow; I know my words, however gently voiced, will feel like a pounding sledgehammer and so there's spaces and pauses, awaiting and detecting your permission to move on to the next.
Some formalities of paper and pen, a carefully written phone number; a guide of when we'll know more and a promise it will be me calling you soon. You knelt to give her a stroke and a pat; unfussy, undemonstrative but a truly sincere farewell.
Nurses and I worked together, a catheter gently placed, cradled once sleepy to take the pictures we needed.
We don't need to dwell on those radiographs, nor to name the condition involved. Its enough to say as the digital image scanned onto the screen, our shoulders all dropped as one.
The phone was just a few feet away but I waded slowly towards it; and flumped on the stool, paper sheet in hand. I checked the names, and actually your patient's gender too, before making the call. It may be irrelevant to this diagnosis but a slip at such a key time would convey a hurtful flippancy, and leave an unpleasant memory to linger. Its a small thing but actually a big thing, to ensure all language is respectfully correct.
There is a flow to any conversation; you'd clearly allowed yourself the return of a little hope at the outset, and it was my horrid task to quash it, as gently but clearly as I could. It's not time for cutesy euphemisms that may be misleading, but nor is it time for alienating 'medicalese'. Once the situation was clearly understood between us, and we moved on to your choices, you shared some more of your wife's passing, sadly a very difficult time.. You wanted no part of that for your pet, your resolve to honour her with a gentle and comfortable passing was resolute, admirable and courageous. Yes, courageous - as you were prepared to lose her precious company from your life sooner, in order that she might not suffer any further discomfort at all. You checked she was still asleep - indeed - and just said whilst it would be nice to have a last farewell, its her who comes first, so please, now. I thanked you for your decision; and yes, I would hope I'd have the same courage to do the same for my own.
We said farewell, and I shared the news with the team as I drew up the injection. That part ever so practiced, and we held her for you as the anaesthetic deepened to a final conclusion.
Later, you came to collect her and I met you at your car round the back. Incongruous 'thank yous' and handshake exchanged again; once more I articulated my respect for your courage, hoping that by that repetition and by quiet affirmation and eye contact that would become part of your lasting memories to carry with you once this day was past and gone. We carried her with stretcher and blankets to lay her in your car, just as you wished.
And as you turned away finally to get in the drivers seat I saw your chin slightly wobble then catch back, and honestly sir, I'm just amazed at your strength throughout.
I know these days and weeks ahead will be difficult; I just hope we've done everything we possibly can to make today and those days that await ahead even just a little easier to bear and endure.
Now, that's just one vet's story of one patient, in one day, at one practice. Very little of it involved clinical training or medical expertise. Most vets will have done the same, or very similar, most weeks if not most days.
In fact, each day will bring a collection of cases where humanity, empathy and care will be vital to an outcome that we can all take pride in; and as I said at the beginning, these words might be mine today but this story, albeit with slight differences, twists and turns, belongs to all of us in this profession.
It's not just your pet's care that your vet, and their practice colleagues, takes into their hands.
