The Gift of Pets: Stories Only a Vet Could Tell
Page 9
And with that, Mr. Johnston took Thurgood home. I sent along a course of antibiotics for him to give Thurgood and a short course of anti-inflammatory drugs to relieve the discomfort. Four days later, I got the results of the culture and sensitivities back. A very aggressive bacterium was identified, one that was resistant to many types of antibiotics. Fortunately, the particular one that I had sent home with Mr. Johnston was effective.
At the recheck appointment two weeks later, I learned that Thurgood had recovered completely. No longer was he experiencing pain, and the swelling of the salivary gland and duct were resolved. His appetite had returned and his temperature was normal. He was, in all respects, a completely normal cat again. Yet there was a palpable undercurrent of unhappiness as I discussed the case with Mr. Johnston. It was as if this near-miraculous response was a keen disappointment to him; as if he would have preferred his cat to still be suffering rather than have my diagnosis and treatment be right.
To this day, I have never had another case quite like Thurgood’s. I cannot recall a patient with the same constellation of symptoms and physical findings. I have not since diagnosed bacterial sialadenitis, nor seen it in the journals. I still cannot explain exactly how or why Thurgood developed such an unusual problem. But I can look back on a successful outcome to a puzzling case. And there is much satisfaction in that.
For months, though, I seethed inside whenever I recalled the insolence and anger that Mr. Johnston had shown me during the management of Thurgood’s illness. I could have understood the attitude had the patient not recovered completely, or had the medication caused some deleterious side effects. It might be forgiven if the bill had been excessively high or if I had been as hostile and argumentative to him as he had been to me. But none of that had been true.
It is a bit embarrassing how much the frustration nagged at my mind. I vowed that if ever I was presented with one of Mr. Johnston’s animals again, I would be assertive in addressing his demeaning and disrespectful attitudes, and this resolve brought a sense of closure to my troubled mind. Mr. Johnston’s attitude faded from my attention.
My First Veterinary Technician
As the caseload in my nascent practice increased, I needed more help. True, I had a number of staff members by that time, receptionists and kennel attendants. I was no longer walking the dogs during the weekends or mopping the floors each morning. But I did find myself spending more and more time doing things that I could just as easily have delegated to others.
I was the only one, for instance, who could legally give injections, take X-rays, place intravenous catheters, induce anesthesia, or draw blood for laboratory testing. In Virginia, these tasks, many of which are similar to the tasks a nurse does in a human hospital, require education, training, and licensure. Since these were routine procedures in my office, it was necessary for me to devote a significant amount of my time to accomplishing them—time that I needed to commit instead to other patients. I needed a veterinary technician.
At this point in time, I cannot conceive of practicing without the assistance of veterinary technicians. Currently in our hospital, we employ five technicians. They are the ones who really allow my training and skills to blossom. I can see a patient, evaluate its condition, formulate a diagnostic plan of blood tests and X-rays, and prescribe a course of intravenous fluids and a smorgasbord of medications to treat the diagnosed condition. I then turn the patient over to my crack team of technicians and assistants and move on to my next patient. Their work makes my efforts a thousand times more efficient and increases exponentially the care provided to each patient.
When I was first starting out, though, I could not afford to hire a technician. Those tasks fell to me. This worked out okay for a while, when the caseload allowed me enough time to be a technician, as well. But my ability to treat my burgeoning number of patients efficiently was hampered by that lack as the practice grew.
This realization actually hit me full force one incredibly busy day as I was developing an X-ray in the darkroom. In those days, the job required a person to go into a closet-size room in absolute darkness and remove the X-ray film from the cassette, attach it to a metal frame, and dip it sequentially into the three tanks, which contained, respectively, the fixing, rinsing, and developing chemicals. It is much like a photographic darkroom process and requires that these things be done entirely by braille in almost palpable blackness. Because I could not open the door during the two or three minutes the X-ray was in the fixative and developer, the darkroom was often a haven for me during an incredibly busy and stressful day. Regardless of what was going on outside the darkroom door, I knew I had at least three minutes of uninterrupted calm. In the relaxation of complete darkness, I could, for a moment, completely empty my mind. I loved to develop X-rays.
It was at the beginning of this three-minute interlude that day when the receptionist banged on the door and informed me that a very serious emergency had just arrived unexpectedly and my presence was required in an exam room. No minutes ever went slower than those three minutes in the darkroom that day. Before I emerged to treat my patient, I had come to the unmistakable conclusion that I needed to hire a technician.
Unfortunately, knowing that you need to hire one and actually doing so are two completely different animals. At that time in the state of Virginia, we were experiencing a significant shortage of veterinary technicians. The two schools in the state with vet-tech programs were graduating only about sixty or so graduates each year to fill the hundreds of slots in veterinary practices across the state. Most of the graduates were snatched up immediately by practices in larger cities and major metropolitan areas, where salaries were high. My chances of competing with those practices and attracting a technician to tiny little Woodstock were remote. Hourly wages for technicians in northern Virginia and the D.C. area were even higher than what I was able to pay myself at the time.
I placed a call to Dr. Potter, a friend and colleague of mine who headed a veterinary-technician program, one of two such programs in the state. He was not very encouraging, either. His graduates, he said, were in high demand and accepted positions often about a year in advance of their graduation dates. He had no current students who were not already committed to employment after graduation. He suggested that the best course of action would be for me to identify a worthy candidate among my staff to send to school, in the hopes that this person would choose to return to my practice after graduating.
“But that would mean more than a two-year delay in hiring a technician,” I protested.
“You’re right, Bruce, but I think that’s your best hope,” he replied. “And you’d better hurry. Applications for the next class are due next week. If you’ve got someone to send, you’d better get right on it.”
Lisa came to mind even before I had put the receiver down. She had proved to be committed and responsible in her duties, duties that had grown as she had demonstrated her willingness to learn. But she also had some incredibly difficult challenges to consider. She had two children, one in elementary school and one in high school, who demanded a lot of time and attention. She also had very real financial constraints, which might make full-time schooling impossible. Finally, her background as a teenage mother who had not completed high school had left her with real self-esteem issues, which had hampered her ability to reach her potential. Still, I had confidence that all of these barriers could be surmounted if only she’d be willing to try. I called her into my office.
She came in with a look of concern on her face. Why was the boss bringing her into the office and closing the door? I motioned for her to take a seat, then fixed her with as enthusiastic a look as I could muster.
“Lisa, I think you have done a tremendous job since you joined our staff.” She said nothing, her face a pillar of questions. “Are you enjoying your job?”
“Yes.” Her response was tentative and guarded.
“Good. I’ve noticed that you are always willing to learn a new task and that you especially
enjoy working directly with the medical aspects of the work.”
“Uh-huh.” She shifted uncomfortably in her seat.
“Do you see yourself continuing to be happy in your job?” I asked.
“I like my job a lot, if that’s what you mean. I wouldn’t want to lose it.” Her face registered near panic.
“No, no, no,” I said. “I don’t want that, either. But I do see a larger role in the practice for you. Would you like that?”
“You mean a promotion?” She leaned forward in her chair.
“Well, yes. Absolutely a promotion,” I replied. “Here’s the thing. What would really help me a great deal would be to have a licensed veterinary technician whom I could lean on to do a lot of the technical things for the patients. A licensed technician could take X-rays, place catheters, give IV injections, induce and monitor anesthesia, do blood work, and manage patient care. Having someone who could do that would free up a lot of my time.”
“Yeah, but I’m not licensed.”
“Not now, but you could be.”
“But doesn’t that take a couple of years in college?”
“It is a two-year degree at a community college.”
“But, Doc, I didn’t even graduate from high school. I’m not a good student.”
“You didn’t graduate from high school because Melanie came along, not because you weren’t a good student. And no, you didn’t graduate, but you did get your GED, right?”
“Yeah, I did. But that was only because my mom pressed me on it.” Anxiety edged Lisa’s face, but it was an anxiety highlighted by a dawning of hope and eagerness. I pressed on.
“Lisa, it doesn’t matter why you did it. The fact is, you did it. That means that you are qualified to apply to the veterinary-technician program. I’ve seen you work with the animals, and I’ve seen them respond to you. I think you could do it.”
“They would never give my application a second look. I’d never get in.”
“There certainly is that chance. But you never know till you try,” I replied. “Besides, I happen to know the doctor in charge of the program quite well. I’ll put in a good word for you. My guess is, they’ll jump at you. You have experience at two veterinary hospitals. You have a level of maturity that most of their students don’t have. And you have the full support of a veterinary hospital staff for your clinical work and the promise of a job coming out of school.”
Lisa was quiet for a while. I watched her eyes wander around the room as she vacantly processed the million reasons why such a dream could never happen to her. On her face was such a mixture of excitement and fear that I wasn’t sure whether she would jump up and hug me or run crying from the room. I let her mind grapple with the idea for a minute or two before proceeding.
“Lisa, you have so much more potential than being a kennel attendant forever. You’re doing a great job at it and we’re glad to have you here. But I see so much more you could do. I know it would be tough. You’d have to travel the forty-five minutes to and from school each day. You would have to juggle your time to be a mom and a student. You’d have to figure out the finances of your schooling. You’d have to study your brains out. But I don’t think any of those obstacles are insurmountable. I think you could do it. We can help you do it. And I could really use your skills in that role. I’d like you to pursue it. I want you to give it serious consideration.”
“I don’t know, Doc,” she answered without conviction. “It sounds cool, but I’m just not sure. I will think about it, though. I’ll get back to you in two or three weeks.”
“You don’t have two or three weeks. I’ve spoken with Dr. Potter at the school. The applications for this fall’s class are due in one week. Think about it overnight and we’ll talk tomorrow.” I handed her a sheaf of papers with information about the career and the program. She left my office, shaking her head in bewilderment, unable to process the possibility that she might be in college that fall.
But the next morning, she was the picture of resolve. She had considered my suggestion seriously and had discussed it with Steve, her kids, and her mother. All of them had been enthusiastic about the possibility, offering to help out with the housework, the yard work, and the studying. Her mother had graciously offered to help with the tuition as much as possible. One by one, the barriers she thought were so towering had evaporated. She came in to my office first thing and settled confidently into the chair, her chin up and determination inhabiting her features.
“I’ve decided to give it a shot,” she said. “But I’m going to need your help on a few things.”
“Anything I can do.”
“I might need your help getting my application together.”
“I already had Dr. Potter fax me the forms. You can fill them out today and we’ll go over them together.”
“I need a letter of recommendation from you.”
“I’ll write you a doozy of a recommendation. They won’t dare pass you up after they read my letter.” Lisa laughed.
“Okay. Also, I think I’m going to need to continue to work part-time during school.”
“I was hoping you would.”
“And I might need some coaching and tutoring. I haven’t been in school in a long time.”
“I’ll be glad to help with any of that you might need. But I bet you won’t need as much as you think.”
“Well, I’m going to go for it, but I’m just going on the record now to say that I think my chances are slim.”
“On the contrary, my friend. I think your chances are great! Only your confidence is slim.”
It took Lisa most of the week to complete the application process. With little help from me, she wrote a compelling essay on why she would be a good technician, pulling from her experience working with sick pets. She outlined the type and extent of her exposure to the profession during the time she had spent as an employee, detailing the cases she had seen, the surgeries she had observed, and the work she had done. Her time with us far exceeded the fifteen or twenty hours of observation required of applicants, placing her in the upper echelon of candidates. I contributed a stellar endorsement of her professionalism and skills in my letter of recommendation. I was confident that she would be given strong consideration.
The two months between when the applications were due and when the candidates were accepted was inordinately long for Lisa. I maintained that her acceptance was a foregone conclusion. But Lisa spent the time in anxious, lip-biting anguish. I did note that just the process of outlining her accomplishments for the admissions committee endowed Lisa with a new flush of confidence and optimism. There was a fresh level of interest in each case, a renewed commitment to the needs and comfort of each patient, and an invigorated approach to interacting with the clients and her coworkers. Goals do that for a person.
I must admit here to a bit of foreknowledge. Dr. Potter contacted me about some other business, and during our conversation he let slip the fact that the admissions committee had selected Lisa to be in the upcoming class of veterinary technicians. I knew the outcome two weeks before Lisa did. But I kept quiet. I did not want to spoil for her the joy of opening that letter of acceptance. Nor did I want her to think that I had interceded on her behalf and convinced the committee, against their better judgment, to give her a chance. I had not. She had been accepted on her own merits, without any input from me. It was her triumph and I did not want to diminish it in any way. But that was a difficult secret to keep as I watched Lisa’s nails get bitten shorter and shorter.
When the letter did arrive, Lisa’s sense of success and achievement was beyond my expectation. To see the jubilation of accomplishment on her face as she laid the envelope on my desk was a thing of beauty. With glistening eyes, she listed the things she needed to do before the fall semester started. It would be work, but I could tell that a fire of pride and accomplishment had been kindled in her heart. She turned to me before she left the office.
“Doc, I would never have thought this was possible. I
can’t thank you enough for encouraging me to give this a try. I won’t let you down.”
“I have no doubt of that, Lisa. You’re going to do great.”
* * *
And she did. She was not a straight A student, but her grades were respectable, and though she tended not to test well, she clearly knew the material. I saw her training reflected in her job performance. Her part-time work took on a much more serious and clinical approach, a change that benefited the patients and set a good tone for the rest of the staff. As she learned more about specific techniques, she brought that knowledge to bear on each animal she worked with. Her classes provided her the opportunity to understand the significance of the tests and techniques she had helped me with for years.
As her medical-knowledge base increased, so did her confidence and sense of self. She became more and more assertive in dealing with clinical situations and directing the efforts of the staff. Her interactions with the clients reflected this change, too. In no time, she grew well beyond my limited expectations.
Between her first year of school and her second, she was required to complete an internship in the clinical context of a veterinary hospital. She spent the summer with us, of course, honing her skills. I quickly began to rely on her growing arsenal of clinical tasks and knowledge. Tillie’s disease had provided her a special reason to nourish an interest in treating cancer patients, and this skill was put to use that summer in treating a number of patients so afflicted.
Before I knew it, Lisa’s schooling was coming to an end. She took and passed her national and state board exams, the culmination of her training and the gates through which every technician must pass to enter the profession. I received a graduation announcement in the mail one day. Graduation day for her was a cool Saturday afternoon in May. With an almost paternal sense of pride, I watched Lisa march down the aisle in her cap and gown. She had accomplished a nearly miraculous transformation since my first introduction to her—truly a caterpillar to butterfly metamorphosis. From that quiet, self-conscious, and timorous person had emerged this confident, skilled, and intense woman of achievement and resolve. Even her physical movements reflected this change, her strides confident and purposeful as she walked to the front, the tassel swinging from her mortarboard.