I take a back step and look at myself in the mirror. A vet really shouldn't be cheering the illness on. Sometimes I end up feeling like an ambulance-chasing blood-sucker - hoping for the worst even as the hope fades from the client's eyes.
Whenever an interesting surgery or procedure pops up, it's hard to be neutral; give the percentages, the costs and the prognoses, in a level voice when you just want to try the myelogram, the splenectomy, the liver lobectomy, the thoracotomy or amputation. You can't very well say "I REALLY want to try this" when you know the prognosis isn't very good and the owner can't or won't pay for it.
Even so, I can consign myself to always hoping for the correct diagnosis, regardless of whether it is interesting or banal. Rather than hoping for the rare and wonderful and (often) euthanasia-inducing diseases, I have changed to hoping for the quick and accurate diagnosis. Rather than "Dr. Gregory House"-ing it, I find myself looking back retrospectively and saying: Contemporary knowledge taken in consideration, could I have possibly reached the diagnosis any sooner? Or with less tests?
I have found in recent times that this is always very satisfying.
Yes: your dog may have cancer, but at least we found it for less than $200 of tests, rather than you spending $500 trial-treating the non-pathognomonic symptoms.
Sometimes doing a blood test, hoping for some sort of a change, or just to eliminate a disease can seem like a waste of time. But that one time out of ten, you can end up saving a lot of heartache and suffering.
There's nothing more satisfying than serendipity. And Serendipity only comes when you've already put in the hard yards.
Whenever an interesting surgery or procedure pops up, it's hard to be neutral; give the percentages, the costs and the prognoses, in a level voice when you just want to try the myelogram, the splenectomy, the liver lobectomy, the thoracotomy or amputation. You can't very well say "I REALLY want to try this" when you know the prognosis isn't very good and the owner can't or won't pay for it.
Even so, I can consign myself to always hoping for the correct diagnosis, regardless of whether it is interesting or banal. Rather than hoping for the rare and wonderful and (often) euthanasia-inducing diseases, I have changed to hoping for the quick and accurate diagnosis. Rather than "Dr. Gregory House"-ing it, I find myself looking back retrospectively and saying: Contemporary knowledge taken in consideration, could I have possibly reached the diagnosis any sooner? Or with less tests?
I have found in recent times that this is always very satisfying.
Yes: your dog may have cancer, but at least we found it for less than $200 of tests, rather than you spending $500 trial-treating the non-pathognomonic symptoms.
Sometimes doing a blood test, hoping for some sort of a change, or just to eliminate a disease can seem like a waste of time. But that one time out of ten, you can end up saving a lot of heartache and suffering.
There's nothing more satisfying than serendipity. And Serendipity only comes when you've already put in the hard yards.
This happened to me today.
ReplyDelete12 year old cat with a big heart and thoracic mass.
Brain: I want to ultrasound it! It's probably cancer! I want to see a heart base tumour! I wonder if it's a haemangiosarcoma? That would be so cool! It's probably stupid lymphoma though. I still want to see what it looks like! Is it kicking around in the pleural cavity or actually in the heart? We could FNA it! Maybe later we could ask to autopsy it.
Mouth: It's probably cancer. There's not much we can do about it. I'm so sorry.