The Headache, Heartache Conundrum


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Ever feel unduly applauded for the work you do?

Here I refer to the clients who voice their admiration in fawning “I-don’t-know-how-you-do-its” and cloying “thanks-for-all-you-dos.” It’s great to hear and I accept it graciously, but sometimes the sentiment misses its mark.

After all, these are the people who pay my mortgage and my kid’s pharmacy bills. What’s more, I count myself lucky to love my work. Sure, the ballerina deserves her applause—but all those roses, too?

Then there’s always the flip side to consider, when we’re attacked for our money-grubbing, service-withholding ways. “You mean you need my credit card before you operate on Fluffy?”

Being alternately admired and reviled, sometimes I wonder if this is what being Paris Hilton feels like. Not only is my own press suspect, I also get to feeling I should just make my money, have my fun and send everybody to hell at will.

But that would defy the purpose of a thoughtful article. So instead, here’s my take on what I see as the truth and consequences of our clients’ conflicting views on our praise/blameworthiness.

 

It’s a conundrum, indeed, this double-edged rapport with the public. Even more so because it translates into how we deal with the direct recipients of our services--our patients. And here’s where an interesting dichotomy exists: between how we treat paying clients’ animals and how we handle the other creatures in our midst.

I feel this difference most acutely when faced with the simplest money cases hot on the heels of a dying backyard lizard crisis.

 

Consider how many of you would fail to yield for a roadside feral cat half-kill or even a writhing, semi-squashed snake. Unless I miss my mark, I suspect most of you engage in some of this save-the-world behavior, too. Personally, I find it impossible to turn away a dying animal I could easily save—or relieve of its suffering.

How could I spend my precious time prying tree frogs from the jaws of my sliding glass doors only to refuse to aid someone's beloved pet in comparable distress?

Yet there are plenty of times in the course of my work when I decline to offer aid to a client in financial distress. When it’s not a life-threatening emergency, when I surmise that I’m being taken advantage of and when I slink out the back door before the client in the waiting room might make me an offer I can’t refuse, I engage in the same sins of omission we all commit at some point in our careers.

Truth is, every vet has to draw a line somewhere if they want to be treated fairly, avert abuse from an irresponsible contingent of pet owners and get home to their families in time for bed.

Yet it’s somehow different should we spy a dog dodging traffic, see a cat laboring to breathe after an unsuccessful game of suburban Frogger, or catch our own dog dragging a baby opossum into the house. Our hearts go out to these animals immediately. We drop everything, eager to help and proud to know we have a special ability to do so.

So why the disconnect between these two categories of needy creatures?

It’s clear to me that there’s something about the fiduciary responsibilities involved that changes the dynamics of care. It affects all of us in this profession, as I expect it does those in human health fields. When there’s an owner, an agent, a “responsible” party to be addressed or held liable, everything changes on a dime.

It’s not all on me anymore…it’s on them.

Too often, we see the Mercedes key in a “needy” client’s grasp and though we know everyone can get into financial trouble (even a luxury car owner), we justifiably feel taken for a ride. It’s not our job to find ways to finance others’ emergencies. Rather, it’s our job to extend our services in return for a reasonable price because we possess valuable expertise.

Why should I have to shoulder her irresponsibility?

I’ve spent countless hours of my time on cases whose owners promised to pay, praised my work, begged my forgiveness for being unable to pay up front … and subsequently absconded on their bills. This situation bests the grateful and compliant recipient 10 to 1. It’s no wonder we try to slip out the back door when we see a money case coming our way. Because, ultimately, it’s not just about the money … it’s also about the lack of respect we have to face down each time someone fails to pay. 

And yet it seems cruel, inhumane, unfair, even, for a vet to decline to yield in favor of a needy animal—even when an irresponsible owner is attached. After all, we would never beg off the very same animal were no client in sight.

And here’s the rub I referred to earlier: the headache/heartache conundrum that reveals itself when our work lives and love lives intersect. Ultimately, the fact that we love our work is no match for the challenge posed by our need to make a living. But it still makes us feel bad—which underscores our aversion to the money case.

This is what I call the syndrome of “the vet’s Sybil within.” Everything in us is hardwired to help them, yet we’re paralyzingly insulted by the suggestion that we might be expected to. This torn personality is what’s mirrored by the love-us-hate-us relationships we’ve all experienced with our clients.

They adore us when we can help. They deride us when we don’t. But it’s the blocked cat that gets sent home with a tomcat catheter, a shot of penicillin and a dose of sub-Q fluids that suffers in the end.

We all entered veterinary medicine through a sense of duty to our fellow creatures. Many of us expected a certain degree of financial compensation and a commensurate level of respect, too.

Without the latter forms of remuneration, it’s true, a great many of us might have chosen other fields. Yet that doesn’t mean we don’t still harbor a squishy spot in our hearts for animals everywhere—whether at the office, in the fields or between our sliding glass doors.

I offer no condemnations or solutions here—just a series of observations. If nothing else, it’s clear that life in veterinary medicine is often as squishy as the hearts that sought to make it their life’s goal.

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Dr. Khuly blogs regularly at www.dolittler.com

11-20-2007

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