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Friday, November 27, 2015

Useful Skills For A Veterinarian

Here is an interesting question that I recently received.

what personal qualities or abilities are important to being successful in this job?

Believe it or not, medical and surgical abilities are only part of success, and not always the most important skills.  I've seen great vets fail to do well in their practice because they lacked "people skills", and I've seen vets performing malpractice but had a thriving practice because clients liked them.  I'm certainly not saying that it's acceptable to have poor medical skills, and every doctor should strive to be the absolute best that they can.  But it's important for new vets and those who want to enter the profession to realize that your skill in diagnosing and treating diseases will only get you so far, and may not be the real key to having a successful practice.

So what abilities are important to success?

Communication skills! This is likely the top skill that will help every veterinarian. I've seen some vets with incredible medical and surgical skill who have rather sorry people skills and have a hard time developing clientele. Being comfortable talking to people and having a good ability to connect with them is going to be the single most useful non-medical skill. A great communicator can handle a cranky client when a case goes bad. A poor communicator will have a hard time keeping a client happy when everything goes well.  The better you are at relating to your clients, explaining situations to them, and handling their questions, the more your practice will grow.

Emotional resiliency is another useful skill. As a vet you go through some incredible highs and lows throughout a day. You lose patients you've grown attached to. You have clients get mad at you when you've done everything correctly. You get overwhelmed with the number of cases you have to see in the course of a day. You get staff that can be difficult. All of that can combine to make it really tough to maintain a positive outlook and handle the stresses of the job. Someone with a steady emotional outlook or who has good coping mechanisms is going to be more successful at getting through those challenges.  If you can't handle these stresses you'll burn out quickly and potentially have a serious breakdown.

A good head for business is also extremely helpful. Even if you don't own the clinic, having a good understanding of charges and how to keep the doors open will keep you from giving everything away and potentially sending the practice into bankruptcy. Knowing how the charges are figured and what goes into them will also help you feel less guilty when charging a client, as you know that the prices really are reasonable for the service.  You never want to overcharge or gouge a client, but at the same time you have to charge appropriately in order to keep the doors open and invest in new equipment and staff.  

Being successful as a veterinarian is far more than being a good doctor.  Thankfully it seems that veterinary schools are better preparing their students for this reality.

Thursday, November 26, 2015

Happy Thanksgiving

Here in the US today is Thanksgiving.  This is an annual holiday inspired by some of the first English settlers on this continent, and is a pretty big deal.  We overeat, many people watch football games (the American football), and we get together with family.  It's supposed to be a time where we focus on the things for which we are thankful.  So I thought I'd share my list to the world.

I'm thankful for a wonderful wife that loves me unconditionally, supports me in all that I do, puts up with my interests that she may not share, and is my best friend.  She is beautiful, sexy, silly, and an amazing woman.

I'm thankful for my kids, who are quirky, odd, and wonderful.  Even when I get aggravated at them I am still blessed because they are better than I could have hoped for.

I'm thankful for a wonderful childhood and great parents, who raised me in wonderful ways.  We had great adventures and lots of fun, and my parents taught me how to be polite and the difference between right and wrong.  They taught me to be independent and an intelligent thinker, and I'm glad to have had them.

I'm thankful for a job that allows me to touch and help people, and gives me a good salary that allows me to support my family on a single income.  We don't have a fancy house or luxury cars, and don't even have flatscreen TVs or blu-ray players, but we get to take fun family vacations and have all of our needs met.  My job is often stressful, but it's a good one and I'm blessed to be successful in it.

I'm thankful for my God and for Jesus.  I would not be the man I am today without my faith, and I survive and thrive each day because of Christ being a living part of my life.

I'm thankful for the freedoms I enjoy in my country.  Though there are a lot of flaws with the US, I wouldn't want to live anywhere else.

I'm thankful for the men and women in the military, public safety, and emergency services.  I can have freedom and safety because of their service.

I'm thankful for geekdom!  Comics, sci-fi, and fantasy are such a large part of my life and my imagination, and I couldn't imagine not having them.  I'm thankful that I'm a comic book fan with all of the new movies and TV shows we've had lately!  And I'm thankful for the new Star Wars movie coming out in just a few weeks!

Even if you're not in the US, take some time to stop and think about what you are thankful for!

Thursday, November 12, 2015

Keeping Faith In God During Severe Illness

Anyone who doesn't like theological discussions should stop reading now.  For the rest of you, press on.  And keep in mind that I'm coming from a very Biblical, conservative, Christian viewpoint, so my comments will be with that in my mind.

Several weeks ago I received this email from James.  

As you know it is a complicated and very emotional thing to deal with and I am feeling a disconnect between emotions of guilt and disappointment, along with the other side which is logic.  I am trying to be grateful for the 14 years my lab-German Shepherd dog Lexi has had.  We've enjoyed so many great times together.  I recently lost her sister back in March to cancer, and I didn't want her to slip away without a fight.

(In May  she has had a emergency splenectomy, a  partial liver lobectomy and after that successful surgery, they discovered a mass embedded in her hard palate in her mouth and de-bulked it.  Being a very difficult place to operate on, we decided on chemotherapy and she received 5 doses of Adriamycin and one dose of another drug in the same class, however that medicine provoked a strong and negative response from her and she had a downturn about a month ago, so we opted to move to oral chemo with palladia. the mass in her mouth appears to be dying from the chemo, although it is effecting her desire to eat, so we may have to back off for a few days to get her appetite back, this is where we stand today)

I noticed that you are a born again Christian, and wanted to ask if you have any advice about how I might be able to balance my faith as a Christian (raised Catholic) and not be angry or bitter about losing my dog.  It seems very unfair that a magnificent sweet animal succumbs to one of life's great enemies: cancer. 

Would you have any recommendations on resources to help easy my anxiety?  Faith has been waning over this very difficult time and though her battle is not over; I feel the need to reach out and ask someone who understands the incredible love for pets with a dose of faith too.

This is always a very difficult topic, regardless of whether or not the afflicted patient is human or an animal.  I watched my own mother go through and eventually succumb to cancer, so I know it from a very personal situation.  Additionally I've lost several pets to cancer and have seen it in countless patients, giving me an understanding from multiple perspectives.

First of all, we live in an imperfect, "fallen" world.  The Original Sin committed by Adam and Eve corrupted our world, bringing illness and suffering to God's perfect creation.  From everything we understand, sickness and pain did not exist until after humanity was expelled from Eden.  And we will not have respite from these things until after Christ returns again.  All of these kinds of horrible diseases and events happen because sin exists.  That sin permeates not only humanity, but all of creation.

 For the creation waits in eager expectation for the children of God to be revealed. For the creation was subjected to frustration, not by its own choice, but by the will of the one who subjected it, in hope that the creation itself will be liberated from its bondage to decay and brought into the freedom and glory of the children of God.  We know that the whole creation has been groaning as in the pains of childbirth right up to the present time.  (Romans 8:19-22)

Second, there is nowhere in the Bible that says that Christians will have a trouble-free life.  In fact, Jesus specifically says that we WILL have trials and troubles!

Remember what I told you: ‘A servant is not greater than his master.’ If they persecuted me, they will persecute you also. If they obeyed my teaching, they will obey yours also.  They will treat you this way because of my name, for they do not know the one who sent me. (John 15:20-21, emphasis mine)

“I have told you these things, so that in me you may have peace. In this world you will have trouble. But take heart! I have overcome the world.” (John 16:33, emphasis mine)

These are just a couple of examples of Christ's words, but you can look at other examples throughout the Old and New Testaments.  Men and women of God were never free from difficulties.  The prophet Elijah was force to live in a cave in the wilderness (1 Kings).  The Apostle Paul was repeatedly imprisoned, shipwrecked, beaten, and almost killed.  Most of Jesus' disciples ended up persecuted and harmed.  So we must be comfortable with the fact that in this world we will see death, suffering, and horrible things.  That's all simply how things are because of the way sin corrupted and still corrupts all of creation.

Now, none of that may be comforting.  Knowing that suffering will happen doesn't mean that we have to like it or that it will be easy to understand.  The question of why a loving God would allow suffering is something that has been debated for all of human existence, and I'm not going to pretend that I will be able to answer it here.  I'm a vet with an interest in theology, but I'm not a true scholar and even the scholars are only human.  Given all of that I do have some insight from my own beliefs.

Everything dies.  No matter how innocent, sweet, "good", cruel, evil, neutral, sadistic, or saintly a person or animal is, they will die.  Death is a part of life and there is no way around it.  The difference is in how and when someone dies.  Some deaths are peaceful and quick while others are lingering and horrible.  We can't blame God for the simple fact that Death exists.  Heck, that wasn't what he wanted for us in the first place!  And it's not what we're going to have when we get to Heaven (those of us who will do so).  But in our lives on this world we have to face the inevitable reality that everything dies.  No matter the person or animal's nature and behavior, they simply will die at some point.  Are we going to get upset every time someone or something we know and love dies?  I hope not, as that means we'll wasted a lot of time in our lives bemoaning something we can't control.

Sometimes the suffering that cancer patients go through is due to part of the treatment.  While surgery, chemotherapy, and radiation therapy are incredibly beneficial and have prolonged countless lives, they certainly have side effects and can cause some pretty intense problems of their own.  Some of what cancer patients go through isn't due to the cancer, but due to the treatment.  We can't blame God for what we do to these patients.  But that suffering is intended to be temporary on the way to recovery.  It's an entirely human creation, and one that keeps getting better.  With current research into new treatments, we will see better outcomes and fewer problems with cancer treatment.  I believe that God helps direct those doctors and scientists in their efforts, helping us learn new ways to treat the sick.

But one of the things that we need to remember is that God doesn't exist to remove our suffering.  He is there for us during the suffering and helps get us through it.  The "Footprints" poem is old and even somewhat overused at this point, but it really does contain a great truth.

One night I dreamed a dream.
As I was walking along the beach with my Lord.
Across the dark sky flashed scenes from my life.
For each scene, I noticed two sets of footprints in the sand,
One belonging to me and one to my Lord.

After the last scene of my life flashed before me,
I looked back at the footprints in the sand.
I noticed that at many times along the path of my life,
especially at the very lowest and saddest times,
there was only one set of footprints.

This really troubled me, so I asked the Lord about it.
"Lord, you said once I decided to follow you,
You'd walk with me all the way.
But I noticed that during the saddest and most troublesome times of my life,
there was only one set of footprints.
I don't understand why, when I needed You the most, You would leave me."

He whispered, "My precious child, I love you and will never leave you
Never, ever, during your trials and testings.
When you saw only one set of footprints,
It was then that I carried you."

When we are hurting from our own illness or seeing those we love suffering from theirs, we really have two choices.  We can go through it alone, relying on our own abilities to comfort, be comforted, and otherwise survive.  How well does that normally go?  James, I'm sure you've been trying this particular avenue and it usually doesn't work out well.  When it's all about us handling things alone, we tend to get into blame and accusations.  We concentrate on our own sadness.  And really what we want is to have someone to help us and ease our spirits.

That's where God comes in.  The second choice is to turn to God during these times of difficulty.  Numerous times in the Bible he says that He will be there to help us through our troubles.  But you may ask "why should I turn to the one who is responsible for it in the first place?"  This is the wrong argument.  God doesn't cause cancer or make people sick.  He allows it, and that's a subtle but important difference.  He doesn't snap his divine fingers and *poof* someone has a terminal disease.  They develop that sickness because of the horrible state of our world.  Can He remove that illness?  Absolutely!  And sometimes he does.  But it can become frustrating to people who don't see him do that in their own lives, and they wonder "why not me and mine?"

Sometimes we only develop and grow stronger because of suffering.  A sword can only be forged in fire, as it is heated and beaten over and over again.  That's really damaging to the metal, and I'm sure if the metal was sentient it would be quite outraged over its treatment!  But with each repeated heating, folding, and pounding it becomes stronger and more resilient, eventually becoming an incredibly fine weapon.  Think about it.  What is the difference between a bar of iron and a sword?

Here are some other thoughts on why we need to go through suffering.

"Character cannot be developed in ease and quiet. Only through experience of trial and suffering can the soul be strengthened, ambition inspired, and success achieved." Hellen Keller

"Out of suffering have emerged the strongest souls; the most massive characters are seared with scars." Khalil Gibran

"Without pain, there would be no suffering, without suffering we would never learn from our mistakes. To make it right, pain and suffering is the key to all windows, without it, there is no way of life."  Angelina Jolie

But he said to me, “My grace is sufficient for you, for my power is made perfect in weakness.” Therefore I will boast all the more gladly about my weaknesses, so that Christ’s power may rest on me. That is why, for Christ’s sake, I delight in weaknesses, in insults, in hardships, in persecutions, in difficulties. For when I am weak, then I am strong. (2 Corinthians 12:9-10)

Sometimes God allows us to go through problems so that we will not only rely on Him more, but so that we can be a comfort to others.  Because I've dealt with clinical depression I can relate to other people going through this same problem, and help them in a way that others may not.  My good friend Ron has dealt with gender identity and was once a Satanist, and as a Christian he can talk to people and help them in a way that I never could.  

Let me try and summarize a few things related to James and likely many other people.

Why is this dog going through this?  Because sin exist and everything living must die.

Why does God allow this?   To help us learn to rely on Him rather than ourselves, and to turn to Him during these times.  To teach us that life is transient and that we shouldn't hold on to it.  To give us experiences that will allow us to help someone going through the same things.

What can I do about my faith?  Pray!  Read Romans and 2 Corinthians.  Study all of the prophets and Apostles and see how they handle similar things.  Remember that God still loves you, and if you turn to Him you'll find the answers (even if they're not the easy ones).  Find someone in your life that can pray with you and give you guidance (someone in person).  Look for what God is trying to tell you during this time, and remember that He has a purpose in everything.

I would also recommend looking at the pamphlet "10 Reasons To Believe In A God Who Allows Suffering".  Another good resource is GotQuestions.Org, specifically "Why does God allow the innocent to suffer?"  and "Why do so many people have to experience terrible suffering before death?"

James, I don't know if this has helped you or others.  I'll be praying for you.

Friday, November 6, 2015

Yes, Clients Can Be This Insane

One of my favorite websites is, and I visit it every day.  It often makes me feel better about my own day and the sometimes crazy people that I deal with virtually daily.  Most of the stories are retail-oriented, but sometimes they have veterinary stories.  I often shake my head when I read them because as crazy as they may seem I recognize similar situations from my own experience.  Just in the last week there have been several choice interactions that I'm repeating here for people who don't go to that website daily.

(The owner brings in a little, quite adorable, mixed breed dog. After talking about everything under the sun about her pet’s healthcare we get to the topic of having her pet spayed, which the owner agrees to.)
Me: “We have to wait a couple more months but this is an estimate for how much the spay is going to cost, so you can go ahead and plan for it.”
Owner: *looks at estimate and her face gets really red and she yells* “It says here you have to put my pet under anesthesia!”
Me: “Well, yes, she is getting spayed. It is a it is a surgical procedure where we have to go into the abdomen and remove the—”
Owner: “You are trying to rip me off! There is no reason my pet should have to be asleep for that!”
Me: “Ma’am, like I said, it is a abdominal surgical procedure—”
Me: “Well, that is a very different procedure than the one we are discussing. Doing surgery on an animal is different than a human.”
(The owner goes into a rant about how she read on the Internet that vets like to rip people off and that her pet will die if she is put under anesthesia.)
Me: “Ma’am, would you want someone to hold you down, cut into your abdomen, and remove your reproductive organs while you are awake!?”
Me: “NO! We are a medical practice, not Macy’s. Your pet is our patient.”
Owner: “You clearly don’t know what you’re doing! I’m going to take my pet to a more competent vet!”

(I then gave her her pet’s records and off she went ranting and raving without even paying her office visit fee.)

(I’m a vet tech. The first appointment of the day is two ladies in their 30s bring in a young Shih Tzu puppy for its first visit. The owners tell me that this is their first puppy.)
Me: “Wow, what a cute little guy. How long have you had him?”
Owner: “Him? The breeder told us it was a girl.”
(I lift puppy up and all the male parts are there, I then turn him around and show owners. Both owners look shocked!)
Me: “Ma’am, he has a penis and testicles.”
Owner: “NO! NO, IT’S A GIRL!”
Me: “Ma’am, if you look here there is—”
Owner: “The breeder said it’s just a ambilican hernia and I believe the breeder! Why would he lie?”
Me: “Umm, I don’t know, ma’am. It’s pronounced umbilical hernia, and no, he doesn’t have one. That is his prepuce which sheathes his penis.”
Owner: “What do you know? You’re not a vet! I want to talk to a vet!”
Me: “Sure, no problem.”
(I walked out and informed my vet of the clients’ concerns. I went into the room with the vet and he told them the same thing. The owners actually continued to try to argue with my vet as to whether it was a boy!)

The last one below has happened to me many times over the years. People seem to think that we will do whatever they want, regardless of medical necessity, and aren't willing to listen to our explanations.  And they want things NOW, no matter what our schedules may be.  

Caller: “Hi, I am looking for pricing quotes for my dog.”
Me: “All right, no problem. What is going on with your dog?”
Caller: “My dog can’t walk and I want [dangerous medication], and my current vet will not sell it to me without checking her blood work first, because it is potentially hazardous to her health. So I am switching vets!”
Me: “Well, our exam cost is [amount] but that only includes the exam, no diagnostics or medications. Once the doctor does her initial exam, we can get you a more accurate estimate based on what the DOCTOR recommends for your pet in order to get her the help she needs safely.”
Caller: “No, I am the paying customer. I tell the doctor what I want and they do it. That is how this works.”
Me: *speechless*
Caller: “I want an appointment. When can I be seen?”
Me: “Our earliest appointment would be tomorrow morning. Would you like me to schedule you in for that?”
Caller: “No, I want to be seen right now. Thank you for wasting my time!” *click*