Do not mistake my calmness for indifference
The other day, I experienced a challenging interaction with a client. Her dog had been vomiting all night and now could hardly stand without support. He was one sick little boy. After evaluating him I went into the room to talk to the owner. I explained my examination, discussed the facts, recommendations for treatment and informed her that hospitalization at this point would be imminent. “How can you be this calm?” she asked. “I simply do not understand how you can do this job.” I have been asked these questions and others like them many times and I’d like to share the answer with you.
As an emergency veterinarian it is my privilege and duty to care for animals that are brought in for care. Those animals are often very sick, sometimes dying, and in fact, sometimes they are brought to me already dead. Many times I am required to make split-second decisions that will ultimately impact how my patient fairs and can very often mean the difference between life and death. In these moments I must quickly determine and consider many things—the history I have been given, this animal’s age/ sex/ reproductive status, any pre-existing medications or surgeries, any treatments that may have been initiated, and much more. In addition I must make a rapid assessment of the patient’s vitals and look for other signs that may indicate the root of the current problem such as gum color/body temperature/strength of the pulses/ responsiveness/ breathing character/ evidence of heart disease/ distention of abdomen, etc. All of these and others are coursing through my mind as I evaluate a patient and all are critical at helping me make an accurate assessment of the situation and determine how best to help the patient. Oftentimes this is the first time I have met these animals and all this information is completely new to me.
Please understand that it is not possible for veterinarians to fully focus on the issues at hand if they allow emotions to consume them. I absolutely cannot do what I do and do it well if I am overcome with emotion and am breaking down. Understand that you may break down and that unfortunately, the information that I present you with may contribute to this, but that I must remain strong in order to give your pet the best chances of a positive outcome.
Yes, I have come into the room, introduced myself and very quickly shattered your expectation that your pet just needs a shot and he or she will be good as new. For this I am sorry and I will do everything in my power to try to help your pet. Yes, I have provided you with facts, that when emotions are high can be very difficult to hear and process, but I will explain it to you again and again as you need, and answer all your questions. Yes, you love your pets and this is why you have brought them to the ER at an inconvenient time, but I am here as well and I am doing all that I can to help you. And yes, this whole thing is scary. I would feel the same way if I were in your shoes. With all of these emotions, I understand that what you may need is someone to hold your hand, give you a hug, cry with you, and tell you everything will be OK. However, while I will be here to support you and help you in your decision-making-process and give you all the empathy that I can muster, I won’t break down with you, I cannot, I will not!
We, as veterinarians, are exposed to so many challenges each day. We must face difficult situations that we may be unable to resolve, we must experience animal suffering, which we have spent our entire careers trying to prevent. We are also exposed to raw emotions from people—which sometimes come out as sadness, denial, anger, frustration, or other times complete indifference. Emotionally, this career choice is grueling, at the best of times. So it follows that each of us adapts his/her own coping mechanism, so that we may continue to be at our best for each animal that comes in and needs our help. Your regular veterinarian may know you well, may give you hugs when you need them, and may cry with you when your pet is sick. I understand that this may be what you need at that moment, in the ER, when everything comes crashing down, but I cannot go down that path with you. I must remain strong through it all, because the stakes are too high and I care too much to fall apart.
