7/7/2007 Trust
July 7, 2007
It is Saturday morning at 3:00 am. I am working the overnight shift at the emergency clinic. It has been a slower than normal night thus far. As I sit here, thinking about my career choice, I have started to question a few points. The one that returns often to my mind is “Why do people trust me?” Most people present their animal to me because of some slight change in behavior. “He has been hiding more”; “He has a decreased appetite”. From this piece of information, it is my job to figure out the problem and choose the therapy. Let’s talk about a common emergency situation.
Gastric dilation with Volvulus (GDV) is a process that occurs mostly in large breed/ deep chested dogs. During this event, the stomach fills with gas and becomes greatly distended. It then flips, rotating the bottom of the stomach to the top and the top to the bottom. This twist is what makes this an extreme emergency. The twist damages the tissue of the stomach as well as cuts off blood supply to the rest of the abdominal organs. If this process is not quickly corrected, death is imminent. In order to correct this process, we must place a tube into the anesthetized dog’s mouth and into the stomach in order to relieve the pressure. We then take the dog to emergency surgery to evaluate the damage already done as well as to sew the stomach to the body wall, so this process cannot happen again. During this surgery it is sometimes necessary to remove dead parts of the stomach or remove a devitalized spleen. In the worse cases, the stomach has turned black and died. The only humane option at that point is to not wake the dog up from the anesthesia and euthanize the dog on the surgery table. This procedure, if the GDV is recognized in a timely fashion, has a 80-90% success rate, and my record is reaching 95% success. My improved rate is probably due to recognizing the GDV’s with the worse prognosis and euthanizing those animals even before the surgery (there are several ways prognosis can be better determined, one is a simple blood level that can be done before surgery.) I am also faster at the procedure than a lot of veterinarians because we see so many in this line of work.
On presentation, my technicians are very good at diagnosing the problem, so they tell the owner we need x-rays immediately. By the time I talk to the owner, I have the x-ray in hand, there is usually an IV catheter in the dog and shock dose IV fluids are being given. I walk into the room, put the x-ray on the view box, explain to the owner what is going on and tell them of the life threatening situation and therapies needed. I hand them a paper describing GDV and step out to get them and estimate. These estimates can reach an average of $2,000.00. In about 10 minutes, the owners have entered my building, been told there dog will die without medical intervention and surgery and tell them a price that will put a financial burden on most families.
Why do these people believe me? How do they know I am telling the truth? They have never met me before; they have never been to my clinic. I usually see these people under the most stressful times. Why do they put their dog’s life in my hands and usually a large sum of their hard earned money?
I think the answer comes down to the veterinary profession’s reputation. For many years, we have been voted one of the most trust worthy professions, usually right behind nurses. It is generally known that veterinarians take care of animals because of our love for our four-legged companions. We come out of school with debts reaching greater than $100,000.00. Knowing we will never get paid like our human doctor counterparts.
I feel very privileged and honored that people put their trust in me. I will always do what I can to cure their fury family member. And if there is one thing I need to improve on it is not considering the cost of the drugs/therapies, but considering the best drugs/therapies to quickly heal our animal friends.
