I was reeling all day from two back-to-back cases that had me questioning myself and my profession.  The first case was a dog I had been seeing for about 1-month with a left hind lameness that seemed to be a cruciate injury. However, a swelling developed near its hock, so it was brought in for a recheck.  As I palpated the swelling my heart sank.

What if this was the real reason for the lameness and I had missed it? I started to hear white noise, I couldn’t form words and my heart was pounding in my ears as I heard the damning words in my head that I am stupid! I need to quit! I’m going to be sued for malpractice!  Stupid stupid stupid!

The radiographs confirmed my worst fears – cancer with spread to the chest. If I had found the swelling earlier the dog might have a better prognosis. Shame on me!!

The second case was a cat that had been seen about 6-weeks ago for inappropriate urination. An initial work up indicated a medical condition, but the problem was not resolved and after several phone calls and other treatments the owners brought the cat in to be euthanized. I was furious as I walked into the appointment. How could anyone do that to their cat over this?  Without even trying everything we recommended.

My anger was radiating out of me as I chastised the clients for even asking me to do this. My hands were clenched in fists and I was leaning over the exam table talking to them with short, clipped sentences so that I would not explode on them. How dare they put me in this position? How can I euthanize this cat?  The tape in my head was screaming at me that life is so unfair, these people are cruel and ignorant, and I’ll never sleep tonight cause this cat will be haunting me!  Unfair, Unfair Unfair!

There was no use even trying to sleep last night. I was depleted and exhausted, but my mind was racing with all the mistakes I had made in the first case and all the self righteousness of the second case.  A couple of gin and tonics later and after watching mindless TV, I did fall asleep to horrible dreams and woke up with the covers pulled firmly over my head.  It is not going to be a good day today either.

OR…….

I had a trying day yesterday.   

Two cases allowed me to reaffirm my belief that I do the best I can but I do make mistakes.  They also allowed me to reaffirm my belief in creating safe boundaries for myself and my staff.

The first case was a dog I had been seeing for about 1-month with a left hind lameness that seemed to be a cruciate injury.  However, a swelling developed near its hock, so it was brought in for a recheck.  As I palpated the swelling my heart sank. What if this was the real reason for the lameness and I missed it? My voice was a little shaky as I admitted that I had not seen this swelling before, and that while I didn’t think it was there, I could have possibly missed it.  I was feeling jittery in my body and I had a huge lump in the back of my throat as I discussed the next steps. Did I miss this? Maybe. Maybe I didn’t do a thorough exam each time I saw her. I made a mental note to be sure I wasn’t getting rushed or lazy during exams.  Then I moved on to create a plan for the next steps.

The second case was a cat that had been seen about 6-weeks ago for inappropriate urination. An initial work up indicated a medical condition, but the problem was not resolved and after several phone calls and other treatments the owners brought the cat in to be euthanized.  I could hear and feel the owners’ distress. They felt backed into a corner and euthanasia was the only option they could see. I held my body tall and straight as I talked with them. My voice was a little shaky and my palms were sweating. I knew that I would NOT be performing the euthanasia today, but wondered if I had the ability to communicate well with the owners.  I had a blunt discussion with the owners about my decision and expressed my understanding, but not agreement, with their decision. The owners temper flared a little at first, but I offered options that included euthanasia at another hospital, just not here, with me.

They decided to take the cat to a relative’s house where it could live outside, yet be very loved. But later that day, they came back and agreed to the full work up I had recommended.  They thanked me for my honesty and I thanked them for their commitment to their cat and their trust in us. I felt so strong after the first interaction with them. I listened to my inner voice and set a clear boundary. I allowed my young technician to see that I value her mental health as well. In the end, as I wait on test results, I do not know what will happen in the future to this cat. But for now, I feel strong and so proud that I set the boundary in a way that allowed both parties to be heard and understood.

Last night I went to bed exhausted but intact.  I did have some very vivid dreams that I will be thinking about today, but I feel rested and ready to see how today goes.  I have the day off and so am up and moving early to enjoy my day.

It is your choice, you choose the stories that define your life.