Lessons learned

The sky is an icky shade of green and we're sort of in the basement because the tornado sirens have been going off. It reminds me of a friend/client of mine, who not only had her house demollished by a tornado a few years ago (while she was in it!), but was also diagnosed with stage 4 colon cancer two years ago at the age of 34. Crazy. Why does she get all of the bad luck? Why did my cancer turn out to not even be cancer, while she will be on chemo for the rest of her life? Why was my house spared and hers wasn't? These, of course, are questions we can never answer. Several of my friends have told me that my new diagnosis was possibly due to prayers and positive thoughts. Or that God had a plan for me and he needs me around for awhile. I don't buy it. I mean, I get that a person who knows that others are praying for them will do better clinically than one who doesn't know people are praying. The scientist (and non-believer) in me knows that it's because humans are social creatures and we thrive on energy from others.  Also, I refuse to believe that I am any more special than anyone else out there. It's luck. We can make lifestyle choices to minimize our risk, but at the end of the day, it's a crapshoot. What you do with your good or bad luck is a different story. What you do with your life in general is even another story. Are you living in a manner that makes you proud? At your funeral, will people talk about your "life lived well" and how full your life was? No? Well, there is still time to change it. Don't wait until tomorrow, because tomorrow may be the day you get hit by a bus. Hey, it happens.

Every time I have an interaction with the human medical community I look at it through the eyes of a veterinarian. Even though we are essentially working on similar creatures, with the same diseases and body parts, I believe our training and thinking are remarkably different. I don't know where it diverged, but somewhere in the evolution of medicine it did. I will always remember the time my son Jalen (at the age of about 15 months) was sick. He had been vomiting several times a day for about a week, and he would hardly eat anything. We called our pediatrician several times during his illness and they didn't seem to think he needed to be brought in. It was probably a virus and we just needed to make sure he stayed hydrated. Finally, we coudn't stand it anymore so we brought him in anyway. The exam was unremarkable (except he had lost some weight), and when I asked what tests she thought she should run, the doctor said, Well... maybe electrolytes. That's it! If he were a puppy who had been vomiting for a week, we would for sure recommend abdominal x-rays. And maybe even comprehensive labwork. Don't toddlers eat things they shouldn't? Maybe foreign object ingestion is a really uncommon cause of vomiting in one-year-olds. What do I know?

What I'm getting at here (albeit it not very eloquently), is that I am struck many times about how different things are between human and vet medicine. But I still try to learn things when I have the opportunity to cross over and experience the human side, even if it is as a patient. Here are some things that stand out. Actually, I knew these lesson already, but they were driven home again when I was able to see thing through the eyes of a patient:

Try to call a pet owner as soon as you get any lab results. Even if you, the vet, are not concerned, the owner may be. Sometimes when I run a routine test, the results may sit on my desk for a day. I may not think twice about it, but the pet owner may actually be stressing out. You don't know. Give them the courtesy of a prompt phone call. I actually disobeyed this very rule just last week when I was waiting for my own biopsy results. I had taken hip radiographs on a lame dog, and thought that one of the joints looked abnormal. Not just from arthritis, but possibly from a condition that would require surgery. I told him I would discuss the films with my colleague the next day and call him. I did discuss them, and she thought it was probably just arthritis. Well, I got busy and didn't call him the next day as I had promised. Honestly, I didn't think it was a big deal - there was nothing about this owner's demeanor that told me he was especially anxious about the x-rays. But two days later, he actually showed up at the office and wanted to know what I had found out. I told him they were probably fine and the dog wouldn't need surgery. He was so relieved! Thanks, Doc, he said. That is great news. But I wish you would have called me yesterday. I haven't been able to sleep for two nights. I, the patient, really appreciated how all of my biopsy results were relayed to me when promised and I regret that I didn't give this client the same courtesy.

Be honest. If you make a mistake, own up to it. If you don't know something, admit it. It's funny how a new vet will do everything they can to hide the fact that they don't know the answer. I was sure like that. As I've progressed through my career (15 years now), I've become much more willing to tell someone I don't know, or if I screwed up. Ironically, I think that comes with confidence and also makes the client more confident in you as a doctor. I got to experience this firsthand yesterday as a patient. The fact that the pathologists are willing to talk to me about what could be an error (I don't have the final verdict yet), makes me respect them so much more than if they tried to hide, or downplay the situation.

Don't make a client wait for their appointment. If the appointment is at one, they should be seen at one. Your time is not more valuable than the client's. You shouldn't be more than 10 minutes late seeing a routinely scheduled appointment unless there is an emergency situation. Being very thorough with all of your patients and thereby going over your allotted time is not a good excuse. If this is happening regularly, you need to re-vamp your schedule or learn to delegate. And if you do make a client wait, apologize! This lesson was driven home to me when I had to wait for an hour for my pre-op physical. Although my physician's assistant (whom I love) took her time and was very thorough with me, I started off the appointment bitter about the long wait, and that is what stands out about the experience.

Accept that the client may know more than you think, and that many clients feel better when armed with as much information as possible. In this day and age, our clients know a whole lot more than they did even ten years ago. This is the information age and we need to get used to it. I have a patient to whom I have been giving chemotherapy for much of the past year. Every time she comes in for labwork, the owner wants a copy. Why? Well does it matter? She wants as much info as she can, that's why. And she asks questions of me that I oftentimes don't know the answer to. She challenges me, and it forces me to learn new things. I appreciate the huge packet of  infomration the nurse gave me right after my diagnosis. And she also told me about other internet resources, The Breast Book, and gave me copies of my path report. Being the crazy analytical person that I am, I have spent hours researching breast cancer related topics on the internet. I am definitely an informed patient and I know that my healthcare team knows and accepts that.

Oh, I am sure there were more lessons I learned as a patient. Maybe tomorrow, I can impart some lessons I have learned as a vet that the human healthcare team could probably put to use! The first one (that is aimed at my primary care office) would be to get electronic medical records. Hey! It's the year 2011!