Thursday, January 4, 2018

exit strategy and my professional headstone.

Exits are the inevitable precursor to change. Change happens, death is inevitable, and if you can foresee both early enough you might be able to succumb to them on your own terms. Isn’t that what we all hope for? To be able to exit stage right when YOU are ready, and not when the shepherds hook is secured around your waist and demanding you do so.

It has been a time of exits for me. Too many friends and colleagues are having to make quick decisions to protect the business they spent a lifetime building and invested everything into. We do it. We get caught up in feeling needed, wanted, and irreplaceable. It is the reward to the sacrifice we don’t want to face. The loss of a life in the creation of an empire. You have to build a life outside of your business or your exit will become an abrupt transition to a life you suddenly have to manifest from the few foreign tangible raw materials left over from your last chapter. Abrupt changes don’t work well. Our bodies, our minds, or being, is about gradation and slow evolution. Waking up in a hospital to be notified that the curtain call is approaching faster than you had anticipated is a stark harsh reality. For some of us it arrives in life changing accidents. For others it is a house of cards under someone else’s hand that collapsed. And for a few others it is the realization that escape is the only way out. To us, the “flee and be free” crowd the collateral damage is not simply protecting a lifetime of efforts, it is about getting out and hoping to still be alive on the other side. (Maybe it is that way for all of us at the threshold of the “emergency exit”?)

I am really (really) hoping that this isn’t all I am meant to be and do. That there is a life on the other side. More concerning, that this life, in whatever form it has, has meaning and purpose? That there isn’t just a shell of stuff with my scent on it. Some piece of detritus I left behind to mark my presence like some ancient hieroglyph to a life left and lost.

 At some point we all have to face the fact that life has choices and you’re going to have to accept the consequence of the choices you made and the life you built, (or forgot to make time to build). No one likes change. Especially a forced change. The answer to accepting them is to try to manage them on your own terms with your own fate in your own hands. If you do so quietly I think you torment yourself into fear based options. Fear and doubts are the devils recipe book.

Here are a few quotes I am stuck in between these days;

“Don’t wait to get sick or have some dramatic life-changing event. Build a life, not just a business.” Angela Benton

“When fear isn’t dominating you, there’s very little you can’t accomplish in business or in your personal life.” Tony Robbins.

I am working towards this one;

“I convinced myself that whatever was the worst thing that was going to happen, it wasn’t really that bad.” Sarah Kauss

And here I am, a new year, the same old insecurities, and the same old challenges (only apparently on a larger scale, or I just haven’t slayed the old ones and therefore the festering masses of dismay grew,, like some cancer I didn’t get clear margins on), and I have to get through, get out, or wait for the hook to pull me away on its terms.

Shit, if there’s a legacy here I hope it fits on a headstone and isn’t some snarky remark about the veneer of a girl who just couldn’t make it easier for herself.

P.S. This is a blog about a girl who dreams big, falls hard, and tries to coach herself back to the path of being kind and compassionate to the patients of vet med life.

If you are someone who struggles you already know you aren't alone. It is the single best directive for finding humanity and the quest for inner peace. 


More information on me, this blog, and who we are at Jarrettsville Vet can be found here:

Pawbly.com is about saving lives, and providing options with data. Let the data set the standard of care and integrity via transparency be the guide.

If you care about pets, believe in making happy endings happen, and want to help others please join me on our Jarrettsville Vet Facebook page, our Pawbly Facebook page,and also on Twitter and YouTube.

Saturday, December 30, 2017

The Reason Veterinarians NEVER USE RUBBER BANDS!

There are a few Never, Evers! in veterinary medicine. They are the secrets that every veterinarian knows because one of our clients has learned the lesson the hard way. 

Like grandma used to say, "Never, Ever.. do this!" 

Here is my list of things that no sensible veterinarian would ever do. I hope they help you and your pet avoid a potential trip to the vet. 

This is Samantha. She is like many pets in that she licks her feet. 


She licks her feet for two reasons;
1. She has allergies.
2. The allergies have led to secondary skin infection on her feet. The licking causes infection, and dogs make their sore feet feel better by licking them. This is a cyclical snowballing syndrome. 

Her parents tried to discourage the foot licking by putting socks on her. But socks don't stay in place without help. So, they put a rubber band around the socks on her feet to keep them in place.


My Never Ever part of this story is, NEVER, EVER use a rubber band on a pet. In fact, I would even go so far as to say, if you have a pet in your house "don't have rubber bands in your home."


 This is even more important if you have small children and cats.


One of my worst rubber band story came from a cat who has an obsession with playing AND swallowing them. Two abdominal exploratory surgeries later, (to the tune of about $2500), and in all we have removed over 50 elastic bands from this "My Strange Addiction" feline edition episode.


My other "worst rubber band" story came when a cat was brought in for limping. Turns out the cat was frequently the Barbie doll replacement for the young daughter in the family. She routinely dressed up the cat, brushed her, and played house with the family cat. At some point she also tried to 'do her hair'. This included placing a rubber band on her leg. By the time I saw the leg it was swollen and the cat was unable to walk on it. It wasn't until we did surgery to amputate the leg that the rubber band was found acting as a tourniquet and cutting off the blood and nerve supply to the leg. Rubber bands have been found on tails, feet, legs, necks, and all with the same dire results.


In Samantha's case the sores from the rubber bands go all the way around her ankles and wrists. She may never grow hair back here. But, she walks normally, and it seems that no permanent damage to her feet or legs has occurred.


Samantha is a very loved dog. Her family didn't ever intend to hurt her. Accidents happen. It is our hope that her story will help others avoid the same situation.


If your dog is licking their feet excessively the answer lies in identifying and treating the underlying cause of the itch. This is almost always require a trip to the vet. There are some very good, very effective, and even much safer medications available these days. In cases where licking is severe and red, inflamed, smelly feet have resulted it is also important to get an antibiotic/antimycotic for the infection. If cost is a concern ask about over the counter options; Like foot soaks, topicals, or even over the counter antihistamines. As always, cheaper options are often available online, or at the local pharmacy.

It is also important to discuss prevention products like e-collars, booties, and pet shirts so pets cannot access the area that is bothering them. If you are considering stopping the licking by denying access to the area (with the use of an Elizabethan collar, booties, socks, muzzle, whatever) please remember that you are not helping your pet in an effective meaningful way. I see these as torture devices if used inappropriately, or incorrectly. How would you feel if you had poison ivy, allergies, an itch that was so compelling you couldn't stop itching it, and then someone put handcuffs on you? Don't put anything on your pet without asking your vet if it is ok to do so.

Stay tuned for more tips and Never, Evers!

If you have a story to share, or a pet mishap that you think others might benefit from please add it in the comment section below.

If you have a pet related question you can ask it for free at Pawbly.com. For more pet related information find me at my YouTube channel, my veterinary clinic's Jarrettsville Vet Facebook Page, or Twitter @FreePetAdvice.


Gratitude. The Grace That Hardship Gifts

Farewell 2017. It has been a year of ups and downs. A year I am struggling to find a reason to ever want to traverse through again. There were hard lessons and the end brings forth preparation for resolutions more reliant on self-preservation to protect from losing the part of myself I hold most dear. The end brings graceful acceptance and gratitude that I am still standing.


There are lessons in struggles. It is my belief that if you don't stop, dissect them, understand the cause to the pain, suffering, and disease, you are likely to be back here again. Medicine is the same. Every disease/illness/affliction has a cause; a sequence of events that allowed it to happen, a host response that saw some benefit to permit it to perpetuate and flourish, and there has to be a conscious effort to provide a cure or your host self will succumb, or, lie in wait to become the victim once again. Who wants to relive, revisit, and get stuck in the same merry-go-round of pain and struggle? You can throw in the towel to be replaced by a headstone and a memory, OR, you can learn to live and walk on stronger. Parvo puppies who survive never get parvo again.

I am here. Stuck between a belief that is the very core of the person, (the vet as they are one in the same) I am, standing beside what I believe in, and facing the reality that at some point I may have to chose to just get out alive if I cannot convince myself that I am strong enough to keep going. At some point you have to put up armor, stop beating yourself up, and care a whole lot less about what other humans think about you, while trying to not become as uncaring as these same people have become to you.

At some point you walk away older, wiser, and stronger. Or, you give up. You learn hard lessons and become grateful for them. They build you into a stronger, more resilient, gritty soul.


At some point you seek more credible sources for judging your own self worth and trust the puppies, kittens, your own kids, and your own patients, who love you unconditionally. If you can trust them perhaps you can even grow so much as to try to reciprocate it to all others across all species lines? I have to learn this. It isn't easy. I'm not having an easy time with much of it.

How many of my colleagues hope I give up? How many will celebrate in their successful destruction of another? Is their gain, my loss? Or, is it the concession to the chips I am willing to throw on the table? This profession of mine. Where death is so rampant, is trying to become the death of one of me. It is the sole source of the pain I am burying with 2017's departure.

The problem of killing each other, our companions, and our own soul is as pervasive as the hateful judgmental vitriol that spreads like cancer we cannot put into remission long enough to reflect on the gifts of gratitude and beauty we all know lies in the ripples of each struggle. Economic euthanasia, the indifference we hold with it, and the abandonment of serving all of those less fortunate then ourselves are my enemies. I bring these old enemies with me into 2018. But I do so with a resolve to search for healthier ways to do it, and more resolve to cure them. I HAVE to bring them with a clearer firmer steadfast course forward. 2018 holds new challenges, old struggles and back up plans I never thought I would have to consider. But as with each new beginning there will be an end. I just have to get out alive, and still care about the person I carry through every journey. My patients need the exact same commitment from me.

To every vet reading an obit to some soul who fell along this journey I hope that you remember compassion matters most while we are still trudging away from fates indifference.



I am grateful to be challenged. I am grateful to know who I am. To be able to walk away because there is a problem I can tackle better from the outside without fear of alienation, castigation, and recourse. You can be stripped and beaten but you decide if you walk away to hide, or to be who you were born to be. I'm here exchanging exoskeletons on the dawn of a new year ripe with possibilities, burgeoning on the eruption of the rebirth of humanity or demise of trust in loves endless hopeful potential.


At the end I am going to try to be grateful that life wasn't easy. I am most grateful that I am not hoping or expecting that it will get easier. To fear that wishing for easier is going to cost me more than I can die with. I can at least leave without feeling pushed out of the nest. I can leave for another quest, a higher purpose, a better resolve to a problem that fear prohibits my peers in facing. I am not going to read one more obit for one more vet that says "I never knew she struggled so much". This profession of excuses to protect us from feeling responsible eats us away.


I hear you. Each person out there struggling silently.

I would much rather stand with the masses I serve, the patients I hope to help than the hateful crowd whose infighting, neglect and sheer indifference marks time by obits to each other. Never in my life have I been treated so hatefully by strangers. I am not denying my contribution in the passion that emotional ties to our pets elicits, but, the problem of our societies hate and misery lies within our ranks as much as it lies outside of them.

Gratitude for the really difficult times of 2017 lies within my family too. This family extends from those who have known me through every year and decade to those who share their family with our Jarrettsville Vet family every day. If I have to carry a torch to find more compassion whilst feeling alone and damned I can only do so because I have them to remind me that I am not alone. Alone is a terribly heartbreaking place to be. Courage, determination, and conviction cannot offset crushing despair from loneliness.


Farewell 2017. I have few parting words to leave you with, therefore, I will greet 2018 with optimism, eagerness, and gratitude. I don't have to sum you up to want to leave you behind. I can just march forward less inclined to slow down to answer the demands of the angered mob, and more determined to build something worth preserving.



Here's my To-Do list for 2018;
1. "Get Out Alive" series. A blog, a plan, a schematic for the most common conditions that cause economic euthanasia to be chosen.
2. Storylines. We share, you learn, pets win.
3. Veterinary Patients Bill Of Rights.
4. Build a grassroots network unlike any before, more powerful than corporate controlled greed allowing the chasm between available and affordable pet care to grow wider and deeper. (This might be more than I can accomplish in one year).

Be who you are. Be not ashamed to be different, and always be kind.


For more information on me, and my vet clinic, Jarrettsville Veterinary Center, please see;

Here is our complete Jarrettsville Veterinary Center Price Guide for 2017

If you would like to follow our Facebook page you can learn more about us. If you have a pet question you can ask it for free at Pawbly.com. You can also find interesting pet facts, cases and stories at my YouTube channel and @FreePetAdvice.

Thursday, December 28, 2017

New Trainers

Shuffling toward the finish line. That's me; Stumbling. Swaying. Faltering.

I remember vividly watching the marathon runner on tv who collapsed mere feet before the finish line. Then by some miraculous intervention random runners, all strangers, scoop her up and carry her over the line. I am that runner. I'm exhausted.


I get home, I collapse, and I ask myself "if I ever want to put those trainers on again?" And yet, I am a creature of habit. A kinetic soul meant to wander. I cannot sit along the sidelines. I do not know where else to go and there is this nagging yearning to not walk away from the problem. I am here to  solve it.

It's Thursday morning. I need to go to work. I need to fix a broken leg on a kitten no one wants. No one would otherwise be responsible for. And, I need to convince myself to be happy about it.

I'm not really happy about it. It weighs on me. It eats me. It is what everyone else calls collateral damage to investing more than the bank account has available for withdrawal, and compassion fatigue. I know it well. Its the shadow that lurks behind me.. toe to toe, and it keeps me moving forward.



There is an endless need, and a short supply to meet it. It is an opportunity for ingenuity and innovation. If I can just find someone to carry me to the finish line. Maybe the new me on the other side of December will have new legs and trainers?

More information on me, this blog, and who we are at Jarrettsville Vet can be found here:

Pawbly.com is about saving lives, and providing options with data. Let the data set the standard of care and integrity via transparency be the guide.

If you care about pets, believe in making happy endings happen, and want to help others please join me on our Jarrettsville Vet Facebook page, our Pawbly Facebook page,and also on Twitter and YouTube.

Sunday, November 19, 2017

Fate vs Indifference.

Perhaps I have had it all wrong this whole time?

Perhaps it is not that I am supposed to be forced into indifference, but rather the acceptance of fate? Fate beyond my stubborn dogged determination to thwart, remold, and re-imagine. Fate as the force that is dictated by something far beyond my perception.

I had to euthanize another kitten I had grown too fond of today.. One I had invested my heart and soul into, and another I refused to be "sensible, rational, or honest" about.

Last week it was Moana, the kitten with four broken legs who was too cute to refuse, and too pitiful to turn away. It was a massive exhaustive team effort to try to save her, her four broken legs and their open flesh of jagged bone. In the end the cost of trying amounted to many thousands of dollars and immeasurable stress as we all worry who might become a casualty in the disease no one unarmed wins; rabies.

Today it was Wallace. The kitten with the prolapsed rectum I spent countless hours trying to coerce into functional compliance. In the end his colon did stay inside his abdomen, but the rest of him decayed secondary to FIV (which we had tested in his intake). I lost two souls I battled over, cried over, sweated over, and refused to concede to. Even after all of this I lost. Worst of all, they had to die at my hand. I hate, absolutely hate, having to be this person. The hand of death, the last warrior in the duel I know I yield more weapons in.

I hate the grief process and the juxtaposition of knowing I did try everything, and am left to play the part of both the slayer and the fool, again.
How can I try so hard, (to bend and alter fate just a little?) and be disappointed,, again?
How many times do I keep trying even if heartbreak and losing is the cost?
Has every other veterinarian learned this lesson already?
I thought I had to avoid the "professional indifference" to preserve my "compassionate heart"?
But was this really just "unavoidable fate" the whole time?
Does acceptance lead to indifference?

I will never learn. I know no other way, and I accept the fate terms on the conditions I applied for.

So today I cried Wallace away with all the love he always had from all of us. I buried him in our pet cemetery to keep the others company. And, I moved onto another. Meet Scotty. Last week he was trapped, neutered, ear tipped and almost (should have) died on the operating table as he tried to bleed out for three hours in front of us. He didn't. He's turned into a love bug. And I'm thinking that this one might really be the one?

Scotty
 Wallace and Moana...
Celebrating on the day Wallace was adopted.
Moana
Post Script;
I secretly fear the repercussions of this post. The reminder I will get from some awful cold hearted venomous vet who has told me that I am #atrainwreck and an #idiot for every reason imaginable. Because I remain an eternal blind Polly-Anna. I try too hard. I think I can and it will be. Whatever reason they choose to hurl at me in hurtful fists and contempt. That they can take comfort in my failing is the side I grapple with confessing. It is the voice of the afraid, who still sits here heart-on-my-sleeve trying. Maybe losing here and there, maybe feeling like I haven't quite learned whatever lesson is supposed to bring me clarity. But still here. As if the self worth, doubt, and hardship isn't enough.

If you have any questions or comments please find me on Twitter at @FreePetAdvice, or ask me any pet question for free at Pawbly.com I am also at the clinic Jarrettsville Veterinary Center in Jarrettsville Maryland. 

Saturday, November 18, 2017

get out alive..

at some point you get to the place where a choice is needed...

at some point you get to a place where your life is being surrendered, taken or foregone as not being your own any longer...

At some point you are just trying to get out alive.

There is hardship in life, no one gets out of it. It is as universal as it is inescapable.

I'm trying to remember why,,,,

why i am still here,

why i am still trying,,,

and why the world, the world that too often makes no sense, has no fairness, and holds the cards too close to the chest, still let me in.

There are little pieces of me everywhere. In each case I invested a little piece of myself. In some cases I invested more than the return might yield, and in the cases you cannot foresee you can go bust. It is the nature of the game. You can occasionally, outwit, and outsmart, but life cannot be outlived.

I hit the wall, I fell to the floor, I hid it, (I tried to at least), and I found myself at the place I know others have been... I found myself asking whether it was time?

you walk away knowing you have to,

or,

you walk away a different person,

simply to get out alive.

There is still a voice here. There is also still a soul, broken, beaten, afraid, and yet still determined.

Maybe only determined to get out alive, and maybe that's enough to resurrect the rest of me.

If this little place is mine, and there is a place for me to be simply me here, then I need to stay small, think large, and hope that courage is enough to sustain me,,

and I have to have hope,,, hope I can get out alive with some small voice I am not too afraid to abandon.

Friday, November 10, 2017

Is Suffering Really So Bad?

Preface: This is a blog about my experiences as a veterinarian and the professional dilemmas present, hence, it is titled as a "diary". This is not a one-off account and it is not intended to be proclamation of the state of the profession. If you are a pet parent and you pined over the passing of your pet to alleviate their suffering and you did so with love in your heart be at peace with that. For those within the profession who believe this doesn't apply to our day to day lives I hope it opens a productive conversation about who we are, what services we provide, and why there is such a divide between those with resources and hope and those without either. 

It wasn't too long ago that I was one of those many voices in the veterinary chorus.

"We treat our pets better than our own fellow man. We at least can deny them the long struggle and suffering to their death." It our professional credo that our pink syringe of stillness delivers mercy we deny our fellow man. The power, the glory and the compassion that a quick easy death brings was once my 'salvation lies in my arms' song.

It is a well known joke that the most sincere accolades given to our profession often reside with the provision of euthanasia.

Veterinarians, take pride in our merciful ability to provide an end to suffering. It is the one place where we are not bullied nor liable. The clients regale in our easy efficient willingness to provide it and it is the one safe place for a practitioner to practice.

Pride. Mercy. Suffering. They shouldn't be strung together in a cohesive sentence when compassion and healing are the thread that binds us to our professional oath.

I used to be that bold. That cocky. That drunk in my own delusional deliverance. I used to drink the proverbial, (not lost on my sarcasm), pink Kool-Aid with beaming pride.

Murray lived 1 year after his family brought him in to euthanize him
as he required a "diaper" for his bladder tumor incontinence.
I am a veterinarian, (with a few more decades under my belt), who has begun to question that the pervasive denial of struggling (or 'suffering' as we too willy-nilly coin it) has instead brought us to the place where life is cheap and death is easy. The pride in yielding either instantly is costing us our desire to face the struggles of life along with the acceptance that the marrow of living a full life with all of its deep, difficult, confounding troubles builds us to be who we weren't before.

Kittens dumped on the road,,
there are after all too many of them, and they can "fend for themselves."
The drive to and from work every day is exactly 22 minutes. I know this because my smart phone stalked me in my previous travels and knows what I am about do before I pull out of my 'park' position. It prompts me with push notifications to simplify my unconscious dependence upon it. Along the way I pass the local police station. Everyday the numeric tally of "overdoses" and "deaths"  creeps incrementally higher. It is the communities annual count up reminder in ticker tape tally form of local lives lost to the losing war on drugs. Overdoses have become our generations escape gone wrong to avoid the perils of daily life and the struggles it takes to get through. The lives behind those statistics often seek relief from suffering, escape from pain, boredom or anxiety. Drugs today are expansive and omnipresent in the big pharma saturated advertising society.* We can't settle to living in the middle of mediocre, and yet we deal the deadly wish for death when a struggle might be looming.

A treasured Murray moment.
In vet med we euthanize too much and too often. So much so that we can justify just about every conceivable scenario as a way to accept it. So much so that we HAVE TO OFFER IT AS A TREATMENT OPTION, a mandated, OPTION, to clients. If you are a practicing veterinarian you HAVE to tell people they can euthanize to TREAT their pets dilemma. It is so pervasive that I often find people who won't go to the vet for help because they FEAR WE WILL FORCE THEM TO EUTHANIZE. How did we get to the place where anyone feels they will be forced to kill their pet? Isn't that admission of fear enough to cause us to take pause as to the power we yield and the divide that exists?

I fear that we give up too often and now we have colleagues who build their whole career on providing that home catered "peaceful passage". The pervasive push for making everything easier has cost us our ability to feel the ends of the spectrum. Our kids are spared the edges where questions lie, the earth shifts beneath you, and the answers may not have a consolation prize, or a merit badge "just for trying." We give up so often that our profession has an alarming, suicide rate to prove it.

Now I am very well aware how much pride veterinarians take in being so compassionate to end the suffering of our beloved pets. (After all it is the place where you all love us the most). We are without question a big part of the "avoid the responsibility" problem. We, far too often, place the option to end 'suffering', (even when it is not 'suffering' by any stretch of any medically based imagination), to every single ailment imaginable. Parasites, infection, half-baked guesses of cancer, the homeless, the elderly, the sick and too young, the overwhelmed and too many to account for... the list includes every conceivable reason making a problem go away. Death, euthanasia, makes it all go away quick, cheap, and easy. We can call it suffering, but it has been too often my experience that we don't try. We don't want to be inconvenienced, and we don't want to invest in a potentially losing proposition. It is after all, cheaper, easier, quicker, and legal to do so. If our clients can't/won't/don't want to we can offer a "peaceful passage" and in some odd twist of humanity, be hero's for it. (No wonder we are confused about who we are and where we stand anymore?).

Life, death, and every trudging crippling, staggering step along the way can be brutal. Heartbreaking, mind numbing, fall to your knees in hopes the rain will cease to drive you into a shallow grave, hard. It can be unfair, unkind, and unyielding. Isn't that what we are supposed to teach our kids? Remind them to not feign from? And yet, why, WHY?, do we so malevolently permit it so eagerly when we acquiesce to providing death to so many?

Bottle baby from a feral colony.
We cannot have it both ways. The victim to a heartless hard society where drugs luring escape is so intoxicating we need a public billboard to be updated daily as the head count rises AND the compassionate society that bears peace via pink syringe to remove your responsibility to the life you don't want to face any longer. We give up too often because it is easier, cheaper, and we want people to like us. Worse yet, we do it to make our (the vets who need payment upon services rendered) don't/can't/won't try to make a life matter more. We all matter more. The beauty lies just as richly and deeply in the struggling/suffering and the despair as it does in the joy of sunny days and puppy breathe. If we deny the end of the difficult spectrum we cheat ourselves and others from understanding that they can get through it. To deny anyone any chance at hope that there is more to life than the quick and easy and chose to surrender to deny the edges is the true worst side of this society.


References;
1. Nine Reasons People Use Drugs. The Jennifer Act.