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InFocus

Ethical dilemma conjures visions of Dante’s Veterinary Practice…

GARETH CROSS had a very bad day recently and finds it very hard to write about it – or does he?

THE usual author of this column is
away. In his first “Cross-words”
column he promised a peek into the
mind of a stressed vet. This has
now been penned for your reading
pleasure by Mr Cross’s close
relative, Mr Stressed, who is more
stressed than usual
right now as he
recently had a very
Bad Day…

I recently was
responsible for a major
humanitarian crisis: I
caused an estate agent
to miss his lunch.

I can feel your
shock, but before you
phone the European
Commission on
Human Rights, first
read the reason, and
the reason I have had
to sub this column to a
relative.
Correspondence can, however, still be
sent to garethcross@hotmail.com.

It was about 2pm on a busy
weekday in a busy week in a busy
month. By some degree of luck and
planning, my wife, a selection of
children and I were not at
work/school/swimming, etc., for half
an hour and we had arranged to view a
house we were really excited about in
this narrow time slot.

It was like one of those rare
conjunctions of stars and planets to
have all these bodies normally in
continual motion available and in the
same place at the same time.

Countdown begins

This was it: the one half hour in office
hours in the whole week when we can
view a house together, the house.
Countdown had begun, small feet were
being inserted into shoes, coats put on,
smaller children being dragged from
their beds.

Parent: “Hurry up, we’re going to
see a house.”

Urchin no. 2: “A house! Why are we
looking at a house?”

Good question, we had a house,
and there are plenty nearby to look at
from the window; to her it was about as
logical as going out to look at a specific
lamp-post on the other side of town.
Stress levels rising, time ticking on, no
time to explain, just get your shoes on.
Then the phone goes.

“Can you come back to work?
We’ve got a poisoning coming in and
it’s an emergency.”

For those of you who have or
know small children, you will have seen that when they really hurt themselves
they don’t cry straight away, they go
silent, inhale deeply and then after a
brief pause let all hell break loose. I did
one of those inhalations but, as I have
learnt to inhibit my reactions, I calmly
said, “OK, I’ll be right down.”

I then very
thoughtfully called the
estate agent’s office to
inform them I
couldn’t make the
appointment we had
booked with them as I
had to return to work
unexpectedly. I heard
the person on the
phone doing a similar
little inhalation-pause
as I had just done.
“But he’s left the
office to meet you,
you can’t just cancel,
he’s been really busy … rant, rant, rant …”
This went on for a while before delivering the killer fact: “He’s going to
miss his lunch to see you.”

Coincidentally, I was missing lunch
too but I let it pass. I had taken enough
abuse for one phone call and informed
her of the nature of my recall to work.

A week of planning

I hardly ever say “I’m a vet” to excuse
or explain anything, but it did slightly
help my case to explain that although
we all wanted to see the house and it
had taken us a week of planning to
engineer a time when we could do so, I
now had to decide if I should cancel
the viewing and save the cat, or see the
house and let a cat die a horrible death
in the waiting room.

Hmmm, an ethical dilemma for you
there (could be an A module question).
Small shoes were removed from small
feet and urchin no. 2 was now
completely confused as we were clearly
not going to see a house. And so I
arrived at work all psyched up to deal
with the emergency: bring it on.

I was hoping to channel the energy
blasted at me down the phone back out into some major ER
situation. Now most of
you can safely predict
what will happen next in
this tale of everyday
veterinary folk. Yes, the
“emergency” actually
possibly ate poison the
day before, but the
owner just decided it
needed seeing right now!

It was a bit shaky
though and did need treating (but maybe yesterday would
have been better, or even in half an
hour from now?) Yes, you guessed right
again: the clients had no money and
couldn’t pay for all of the treatment.

By this stage my
patience/stress/exasperation with the
human race and my working life had
reached critical point. Then the
computers crashed and displayed the
following message: “invalid procedure
or argument”. One of the few things
more annoying than annoying people is
computers crashing and then, with their
dying message, blaming you for it. It
tipped me over the edge and I silently
and inwardly had a little meltdown.

Imaginings

I started to imagine what a hell for vets
would be like. Imagine Dante’s
Veterinary Practice: on the first level
demons in receptionists’ uniforms
descend on you as soon as you walk in,
like the birds in the Hitchcock film.
There will be many of them, all
brandishing messages on bits of paper,
all at the same time.

Another level opens into a place
where it is always 5.50pm on a Friday
and is full of cats all of whom “…just
hasn’t been herself for two weeks…”.
The next room is just a giant dog
abdomen where you swim through
blood. Another is in perpetual on-call
time with demanding owners with no
money with cats that ate poison two
days ago.

Another level takes the form of an
upside down pyramid of events with
one ovarian ligature at the bottom, on
top of that is you, then a lawyer, the
dog’s owner and the RCVS, and the
huge top-heavy base balancing
precariously in the air carries your
house and all your dependants.

Practice owners have a special level
full of numbers on accountants’ sheets
of paper and all the numbers in
brackets are bigger than the ones not in
brackets.

Stress does strange things to your
brain. There must be a limit to how much stuff you can have in your head
at any one time. I
think I regularly go
beyond this limit and
can feel bits of
information relating to
the day’s goings on
dropping out of my
head to make way for
something else
someone has just told
me.

I imagine if you
followed me around it would look like confetti cascading out
of my ears and trailing round the
building. On each bit of confetti
would be written a message to phone a
client, or put up some drugs; some
would be tiny little insurance claim
forms.

The night of the estate agent
episode was fairly sleepless as I was
convinced I hadn’t tied off a cat’s
uterine arteries during a spay. I could
remember and replay in my head doing
the ovaries and finishing up, but could
not recall doing the cervix at all. My
brain must have just not bothered to
store the information as it was so
routine.

I rarely worry about cases or work
at night but I can imagine that for
those of you who do, and there are
many, it must be a pretty awful thing. I
also imagine that for some of you my
rare day of internal meltdown is not
such a rare thing and some feel you
live and work in Dante’s Veterinary
Practice.

The big question

How do we deal with it? That’s the
big question we all live with. Some
vets don’t deal with it and raid the
DD cupboard for valium and other
drugs, and some sadly for euthatal.

Most of us vets have some degree
of reliance on legal drugs such as
alcohol and tobacco. Exercise and
outdoor sports are also popular ways
of escapism for many.

Possibly reading about me
cracking up for a day may have
helped someone who thought he or
she was the only one. Writing about it
may have helped me. And I managed
to get through my rant (but sadly not
my day) without using a single swear
word, which, I think you’ll all agree,
is a complete bloody miracle.

  • Footnote. The author wishes to make
    it clear that the reference to
    receptionists with messages in
    veterinary hell is no reflection on
    receptionists themselves, but to
    illustrate the feeling vets sometimes
    get of being inundated and
    overwhelmed with messages and
    phone calls from clients.

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