“Malpractice lawsuits against veterinarians have seen nearly a seventeen percent increase in the last decade.”
It became apparent that the legal standing of our pets is a complicated and emotional issue. Many laws are outdated, and they vary considerably from state to state. Assigning the family dog the same status as inanimate property like a lawn mower or a hair dryer just doesn’t cut it in this new millennium. Pets are animate, they have feelings, they have the capacity to demonstrate pain and suffering. Pet death has the potential for significant emotional repercussions for those left behind, regardless of how it came about. The problem lies in defining this loss of companionship and proving the degree of emotional distress that ensues.
Semantics have only complicated the picture. There are arguments for a label of pet guardian versus pet owner, for defining pets as sentient property (any warm-blooded, domesticated nonhuman animal dependent on one or more humans for food, shelter, veterinary care, or compassion, and typically kept in or near the household of its owner, guardian, or keeper), for pecuniary (replacement value) versus punitive (assigning emotional value and punishing the wrong doer) damages. I came away with the feeling that pets continue to be a legal work in progress, though progress seems to be inadequate, fickle, and highly dependent on jurisdiction.
Our twenty-first-century love affair with the animals in our lives appears to have placed veterinary medicine and the legal system at a crossroads. Today, almost half the law schools in the country offer courses on animal law, moving beyond the prosecution of animal cruelty cases to the kind of work that usually applies to human offspring, such as setting up trusts to bequeath money to a pet after an owner’s death and dealing with pets in divorce custody disputes. The arguments against punitive damages have so far held up and still pack a powerful punch. Will punitive damages encourage a flood of lawsuits, significantly increasing veterinary malpractice premiums? Will veterinarians seek the security of practicing defensive medicine, thereby reducing the overall quality of health care for our pets? Will vets be forced to raise their prices and make responsible pet ownership a luxury? These questions will need to be resolved because now that our dogs have discovered the family bed, they won’t be returning to the kennel anytime soon!
I logged off, haunted by one tidbit of information that stuck.
“The plaintiff has to prove emotional distress, to support the allegation.”
All I could see was the image of Sonja Rasmussen, collapsing to the floor when I told her about Cleo’s death, and I thought, “If that wasn’t emotional distress, I don’t know what is.”
THAT night, hypnotized by the glow of red numbers from a bedside digital alarm clock, my mind refused to shut down for sleep, preferring to continue obsessing about thorny veterinary situations.
I thought about a colleague named Neil, as flamboyant and passionate a vet as you will ever meet. Thirty years of general practice had done nothing to quash his excitement for the job, his desire to connect with animal and owner alike. You would think he had discovered how to split the atom when he dragged an owner from his examination room and forced her to look down his microscope and gape at the magnified ear mites swimming on his oily slides, her cat’s head-shaking disorder unearthed. Determined to befriend a nervous rottweiler, convinced he had learned all the necessary pointers from an episode of Dog Whisperer, he would risk a reassuring pat even if it meant his hand was gnarled to the consistency of a spent rawhide chew. And faced with a surly dog in need of a nail trim, Neil would choose charisma over chemical intervention every time, growling as he took the patient’s scruff between his teeth, inciting memories of the dog’s mother and life as a submissive puppy before setting to work with his nail clippers.
His style was sufficiently unique that he either attracted clients to his fan base or repelled them to his partner in their practice. However, one client, the inimitable Ms. Adelaide, owner of a Persian cat, Arthur, began to seriously question her allegiance to Neil and his unconventional approach to his patients.
Ms. Adelaide was a former Broadway actress whose commanding stature, raptorial features, fulsome gray locks, and dramatic affectations dwindled to insignificance the moment she set foot inside Neil’s clinic. It hit her in the manner of a third martini, creeping up on her, catching her off guard with its dangerous blend of antiseptic haze, confined spaces, blood, and needles. She lost all pretension, as though her part were being played by a timid understudy.
It didn’t help that Arthur insisted on making up for his mother’s infirmity in hospitals by morphing from a state of placid domesticity into feral savagery, swiping and hissing as soon as he was extracted from his carrier. Arthur’s indignation would build to a crescendo, his cry winding up from a low growl to a high-pitched scream like a high-revving motorbike.
I’m reluctant to use a weathered cliché, but a perfect storm had been brewing for some time, not least because Arthur’s illness made him a frequent visitor to the hospital. Arthur was infected with feline immunodeficiency virus, FIV, a close cousin of the notorious human retrovirus HIV. FIV only infects cats, but in many ways it behaves in a similar manner, hiding out for months or even years, biding its time, teasing the body with unpleasantries such as gingivitis, sores in the mouth, and fevers. A weakened immune system leaves its victims vulnerable to infections. They lose interest in food, they lose weight, and ultimately, they lose the battle.
Still, with supportive care and prompt attention to secondary infections, FIV-positive cats can do great, and that was why Arthur found himself on an examination table, poised to strike, eyes wild, trash talking, taunting Neil with a feline version of “You talkin’ to me?”
“I need to give him a shot,” said Neil, pulling out needle and syringe as Ms. Adelaide backed up, body pressed flat against the wall as though by centrifugal force.
“You need to get an assistant. Someone who can keep a hold of him,” she said, her words squeaky and terrified.
Neil considered the woman, who appeared to be bracing for a firing squad.
“For Arthur?” he said. “Don’t be so silly. This will be quick. I just need you to put a hand on his back end to stop him from rearing like a bronco.”
She asked again, more plea than demand, and once more Neil swatted her uncertainty aside.
Reluctantly Ms. Adelaide stepped forward, Neil flirting with Arthur’s swiping paw, taunting him with a dainty finger wave as his other hand swooped in with a secure grasp of his scruff. The maneuver, swift and forceful, did little to assuage Ms. Adelaide’s fears.
“Don’t worry, Arthur’s simply remembering the good old days when his mother used to pick him up in her mouth. Now, put your hand here. That’s right.”
The rest happened so fast: the needle piercing tough feline skin, the plunger depressed, the injection delivered, Ms. Adelaide letting go, Arthur’s legs snapping out from under him like a Cossack dancer, Neil’s hand jerking upward, and the shiny steel of the needle flying straight into a new and unexpected target—the back of Ms. Adelaide’s hand.
If we freeze the action right here, before Ms. Adelaide has had a chance to scream or declare she is about to faint, with Neil mystified and still armed with his dangerous implement, we can ponder the many thoughts that should have been running through his mind:
Make sure the client is okay by seeking or at the very least offering to get her medical assistance. Call a doctor or drive Ms. Adelaide to the nearest hospital.
Apologize profusely and pray she forgives you.
Document the entire event in the medical record, including all communications during the aftermath.
Contact your malpractice insurance company, describe the event, and seek their advice.
Tell Ms. Adelaide not to worry, you will send her the bill later.
Don’t be so ridiculous as to charge Ms. Adelaide for stabbing her in the hand.
Don’t be so ridiculous as to not charge her, since this is tantamount to an admission of wrongdoing.
&nbs
p; Later, one or more of these thoughts might have stood a chance, but in the heat of the moment Neil instinctively did the one thing he believed would best demonstrate how perfectly harmless this accident had been.
“No harm done,” he said, plunging the same needle into his forearm, trying to keep the demonic out of his smile.
“Oh my God,” screamed Ms Adelaide, “you’ve given me cat AIDS!”
And it wasn’t this impossibility that suddenly lunged at Neil, it was the realization that he had foolishly but voluntarily shared needles with a virtual stranger.
Personally I have never thought to use self-mutilation as a “get out of jail free card,” but here’s the thing: as unorthodox and unprofessional as Neil’s spontaneous approach to this accident may have been, as easy and justifiable as it would have been to seek alternative veterinary care, Ms. Adelaide remained loyal to Neil. Despite the drama, the eccentricities, and the sharing of bodily fluids, Ms. Adelaide could overlook her personal incompatibility with Neil because his determination to help Arthur, at considerable risk to himself, remained transparent and unwavering. When a pet owner has the vision to see genuine intention, even huge blunders can be overlooked.
And besides, no one else in the practice wanted to handle her cat.
THE second horror story that kept me awake that night concerned a surgical colleague whom I’ll call Mike and a nine-month-old male basset hound called Pickle. Basset hounds are intended to have short bowed legs, but Pickle’s right front leg was not growing properly. It was so twisted that his paw turned out at ninety degrees to his body, the poor dog’s walking gait looking more like a flapper dancing the Charleston.
Pickle was owned by an assertive woman in her early twenties, vocal about the cost of her pedigree “lemon.”
“For as much as the dog cost, I reckoned on breeding him,” she said. “But what with his gimpy leg an’ all I might as well get his balls taken off. I mean, who’s gonna want to pay for some of them genes?”
Mike was confident that the deformity was traumatic in origin and not hereditary, and he went on to discuss corrective surgical options. The owner thanked him but did not want to schedule the procedure. Mike forgot about the case until Pickle showed up unexpectedly some six weeks later ready for his surgery.
For a couple of hours, saws hummed and drills buzzed until symmetry was restored, Mike shrewdly shaving and prepping both front legs to include them in his sterile surgical field so he would have a normal basset leg for comparison. Pleased with the result, he was ripping off his gloves and mask when an astute technician noticed an additional request on both the anesthetic and the surgical paperwork.
“It says here that Pickle is getting neutered as well.”
Mike had only a vague recollection of the original consultation, but the financial paperwork confirmed that the fee for Pickle’s sterilization had been signed for by his owner. Pickle was repositioned and a routine castration performed.
Everything looked great on the postoperative X-rays. Mike tried to call Pickle’s owner with the good news but was forced to leave a message on her answering machine. The next day, as expected, Pickle was reluctant to use his bandaged leg, but he was hungry, happy, and eager to go home. Mike called again, once more routed to the machine, where he left precise details regarding Pickle’s home instructions and invited his owner to get back to him.
She did the following morning. When Mike arrived at work he was bombarded by all manner of messages to contact Pickle’s irate owner as a matter of extreme urgency. Second-guessing and a hefty dose of pessimism had Mike imagining Pickle thrilled to be home, leaping from the car, his surgically corrected leg falling apart at the moment of impact. Worse still, absurd paranoia had Mike achieving symmetry on Pickle’s front legs by doing the unthinkable and operating on the wrong leg!
He prayed for something simple—the communication breakdown in his failure to speak to her directly, Pickle licking out a skin staple, or getting his bandage wet. But when they finally spoke and this young woman unleashed her disgust and fury, Mike discovered the problem had nothing to do with the leg at all. It was only when Pickle’s owner had paid her bill and turned to leave the hospital, thrilled to see her dog trotting out in front of her, happy to be going home, that she noticed something more than just his front leg had changed. Between his back legs lay a flaccid empty sac, no longer containing the balls it was entrusted to protect.
At first she wasn’t sure, but when she inspected the place where that essential component of his reproductive manhood used to reside, it was obvious no one was home.
She claimed that she had not requested the castration, adamant that Pickle was a breeding dog, from a long line of champion stud dogs, purchased specifically to breed, with a potential to make her tens of thousands of dollars. Breeders across the country were lining up demanding his services, all ready to pay, and now that they couldn’t, somebody else was going to.
It turned out that Pickle’s future sexual prowess was curtailed by a clerical error, a mistake in the preparation of Pickle’s paperwork on admission. However, a signature and consent for castration had been given, witnessed and countersigned, the claim of “too nervous to read the details” considerably weakening his mother’s assertion.
Lying in bed, thinking about Cleo and thinking about this case, I realized how fortunate Mike had been. Okay, so Pickle never had a chance to prove himself as a canine Don Juan, but he healed, his leg’s function restored to normal. There was some unpleasantness, the necessary letters and phone calls and lawyers, but in the end what mattered most was surgical success and a healthy dog with an excellent future. Ah, what I wouldn’t have given for making a surgical mistake like Mike’s, something disastrous but not fatal—catastrophic hemorrhage and multiple blood transfusions or even an infection necessitating an amputation. I would welcome these calamities if they meant I had a dog that was still alive.
And then my mind traveled to its most depressing, most telling destination and I thought about what would have happened to Cleo if I had done absolutely nothing at all, if Cleo had been managed conservatively, with nothing but medications to alleviate pain and six weeks of strict cage rest. No anesthesia. No attempt at a surgical repair. Nothing. The painful truth caused my breathing to shift, deep and swift, with the certainty that Cleo would be deformed, she would always walk with a limp, but this special little dog would still be very much alive.
As I lay there, hoping sleep would soon rescue me, a possibility began to take shape. Somehow I needed to make this right, to get a second chance. I desperately wanted a shot at restitution for Cleo’s passing. I simply had no idea how I might get it.
I CALLED Ms. Rasmussen at her hotel shortly after eight o’ clock the following morning, and as soon as she recognized my voice, I could almost feel her falter as she was transported straight back to ground zero, and our last encounter.
I gently forced my way past pleasantries that sounded so trite and redundant after what we had shared.
“Did you have a chance to speak to your mother?”
“Yes, yes I did. In fact she’s already on her way to Boston. She’s flying in from Calgary today. She would like to meet you in person if that’s okay.”
“Of course,” I said, trying to hide my surprise and reflex trepidation. I suppose I had imagined a long-distance phone call, uncomfortable, no doubt painful, but ultimately remote. If Sonja’s mother was prepared to drop everything and, at considerable expense, take the very next available flight across a continent so she could look me in the eyes when I told her what went wrong with Cleo, this could only mean trouble.
“When will she be here?”
“Later this afternoon,” said Sonja. “Will that work for you?”
“Sure,” I said, hearing the nervous levity in my voice. “Should I bring my lawyer, a Kevlar vest, an armed bodyguard?” I wanted to ask, but went with “If you don’t mind me asking, how did your mother handle the news?”
Sonja Rasmussen paused, a
s if she wanted to find the right words.
“She was brave, for me,” she said. “She was everything I expected.”
A rather oblique response, I thought, now even more curious about the relationship between Sonja Rasmussen and her mother and the integral role of a little dog named Cleo.
“Please, there’s no hurry, but I wondered if you came to a decision about Cleo’s body.”
“Yes, of course,” she said, as though grateful to be reminded. “My mother wanted me to tell you to go ahead with the … the examination of Cleo’s body.”
And there it was, the request for a formal investigation into the cause of death. Ideally, a postmortem allows the doctor to achieve full disclosure while providing the owner with an opportunity to lay unanswered questions to rest. A postmortem was the right thing to do and I had been the one to encourage it, but now, given this impromptu but official appointment with Sonja’s mother, I began to feel as though it was a quest for proof of liability rather than a search for answers from which we all might learn.
“Will it still be possible to have Cleo privately cremated and her ashes returned to us?”
“Yes,” I said, seeing a problem and a solution at one and the same time. “I visit a practice in Bermuda several times a year to help them out with surgery. I’ll be there in the next week or two. It’s the least I can do to personally deliver her remains by hand.”
As she thanked me, I realized that I had no idea how one goes about air travel with the remains of a deceased animal, but I could not allow Cleo to be delivered to her final destination in this world chauffeured by a stranger in UPS brown.
“I’m really sorry about the way this all turned out,” I said.
Another pause and I wondered if Sonja caught a tear, or maybe she had nothing left to cry.
“I hate to rush you,” she said, “but I have a flight to catch back to Bermuda.”
Love Is the Best Medicine Page 13
