Little tests

I am holding the phone as a woman cries about the level of pain that her precious pet is experiencing. We have turned over every stone to diagnose and treat the little bird that is the best part of her heart.  She would spend any amount of money to save him — go almost anywhere to get a diagnosis and treatment.  None of the specialist that we have consulted seem to be able to help, so here we are facing this helpless uncertainty together. I can only listen to her grief, brainstorm possible solutions, and suggest things that just may be a last resort to help her.  Multiple veterinarians have weighed in and we still do not have an answer.  This is one of the most frustrating things that we deal with in veterinary medicine — second only to the frustration of losing a patient due to the owner’s financial constraints. These little tests that we face each day…

I see my job as part detective, part caregiver, and part grief counselor.  So many things that we deal with as a veterinarian fall into one of these categories.  We want to think of our role as a technician, logically working through problems to get to a diagnosis and treatment.  It would be so easy if that were our only job.  Tell me the symptoms, do the tests, and prescribe the treatment — take all of the emotion out of it.  However, this job is filled with emotion. There is emotion entwined into everything that we do. 

There is a feeling of helplessness.  Another little test of my ability to overcome helplessness to offer hope to a suffering client. 

Helplessness is an adjective used to describe the inability to help oneself.  It feels weak, dependent, invalid, powerless, and incapacitated. How do we overcome this feeling when we have reached the end of our diagnostic power? 

I will focus on what I can control.  I know how to express empathy and I am usually very good at it.  I know how to listen, coach, and allow negative emotion.  I can express understanding without having a solution.  If I practice offering empathy, I am no longer helpless.  I give space and understanding, which in turn helps my client navigate the situations and the decisions that need to be made.  Focusing on my abilities as an empathetic listener allows me to feel helpful not helpless.

I will not self blame.  There are times when we blame ourselves for not having all the answers.  Acceptance of medical limitations puts the “blame” on medicine, not my inability to make a diagnosis.  It is not unusual for medicine to stump us; it is our job to not take the limitations that medicine offers personally. Some things are beyond our control.   

I will continue to embrace optimism.  Optimism allows me to see possibilities and continue to search for an answer even in the face of overwhelming odds.  When a case goes wrong, I choose to see it as a learning experience to help me navigate the next puzzling case.  When my brain tells me to throw in the towel, optimism allows me to give it one more try.

We will fight another day for this little painful avian.  We will not give up until he does.  Accepting things that we cannot change is part of life and veterinary medicine.  I will practice optimism over helplessness when I am faced with these little tests. 

Dr. Julie Cappel