Imagine you wake up one morning feeling sick… your stomach feels slightly “off” and you don’t feel well enough to eat breakfast. You didn’t sleep well the night before leaving you tired and with the hint of a headache. You call out sick and head to the doctor where you quietly browse through the latest People magazine while waiting for your appointment. There are a few other people in the waiting room and when you catch each others eyes you politely smile and nod your head in a silent “good morning”. The nurse calls you into the exam room and asks you to describe your symptoms while getting your vital signs. You step onto the scale for your weight before sitting down on the paper-covered table. You stop talking and sit still while she listens to your heart. You take deep breaths in and out while she listens to your lungs. You hold the thermometer under your tongue while she gets your temperature and then roll up your sleeve for a blood pressure measurement. She uses a bright light to look in your ears and eyes and you follow her instructions looking up, then down, then left, then right. She types her notes into the computer and tells you the doctor will be in shortly, leaving you to sit on the crinkly paper table. You grab your phone and wait… maybe you check Facebook, play Candy Crush, or read a (fantastic) blog post written by your veterinarian. About 10 minutes later the doctor finally knocks on the door and walks in. She reviews your symptoms and asks a few follow-up questions… Describe your stomach ache – do you feel nauseous or is it actually painful? Where does it hurt? When did it begin? Did you eat anything unusual yesterday? Have you had any vomiting? Any diarrhea? After a litany of questions and answers she proclaims that she is going to run some blood work. You confess to the phlebotomist that needles make you nervous and she assures you that it will only feel like one quick pinch and will be over before you know it. She places a tourniquet and you sit perfectly still with your arm held out on the table, displaying a nice puffy vein in the crook of your elbow. She hits the vein on the first stick. The doctor tells you that you likely have a “stomach bug” and sends you on your way. At check-out you hand over your $20 co-pay and never worry about how much the doctor’s visit and blood work truly costs. You feel better within a few days, having recovered from a viral stomach bug. You later receive something from your insurance company detailing the charges from that day ($250 office visit, $200 bloodwork), but because it says “This is not a bill” you throw it straight into the recycling bin.
Now – things are about to get interesting – imagine how the same scenario might play out if you were a dog instead of a human.
Imagine you wake up one morning feeling sick… your stomach feels slightly “off” and you don’t feel well enough to eat breakfast, you didn’t sleep well the night before leaving you tired and with the hint of a headache. Your owner brings you to the vet. You walk through the front door and a dog immediately bounds towards you across the waiting room on a long retractable “leash”. The other dog jumps around in front of you barking and exuberantly trying to sniff your… well… you know how these things go. You aren’t feeling well and while you are generally friendly this attention is unwanted on this particular morning. You hear the other dog’s owner say “It’s okay, my dog is friendly” as if this somehow makes it acceptable for him to invade your personal space without asking. You softly growl at the frenetic dog in front of you to warn him away. The other dog’s owner is appalled that his dog was growled at and finally retracts his leash back to a reasonable length. The vet calls you into the exam room and asks your owner to describe your symptoms; your owner tells the doctor that you didn’t eat breakfast. You cannot tell the doctor “where it hurts” and so no one knows you didn’t sleep well or that you have a headache. Now the exam begins. The vet crouches down on the floor to listen to your heart and lung sounds as you wiggle around in circles, whining and panting. She cannot ask you to be silent and cannot ask for big deep breaths. She attempts to take your temperature while you continuously circle away from her with your tail tucked, playing a particularly unpleasant game of Ring Around the Rosie. She looks in your ears as best she can while you make an effort to burrow your head through the solid vinyl floor. She looks in your eyes as you randomly roll your gaze around the room looking at the door, your owner, the door, the ceiling. She feels your belly as you tense your muscles and walk away from her. The vet asks your owner some follow-up questions… Did he eat anything unusual yesterday? “I don’t know” Any diarrhea? “I don’t know, he goes to the bathroom outside and I don’t watch him”. Your owner approves blood work and it is time to get a blood sample. The vet can’t explain to you that if you sit still you will feel one quick pinch and it will be over quickly. A technician sits behind you and holds one of your front legs outward using her hand as a tourniquet to make your veins stand out. The vet can’t see your veins through your fur and has to rely on her sense of touch to feel them below the skin. The vet hits your vein on the first stick but you pull your leg away and she has to do it again. The vet tells your owner you likely have an upset stomach but does not know how it started; she prescribes a bland diet and advises your owner to wait and see how things go over the next few days. At check-out your owner is charged for an office visit ($68.00), blood work ($120.00) and a medical waste fee to cover bio hazard disposal ($6.00). You feel better within a few days, having recovered from a viral stomach bug.
Being a veterinarian is not easy. Our patients cannot speak to tell us what is wrong and so we rely on the (sometimes limited) observations of their owners. They do not sit quietly and follow instructions to facilitate an exam, so we crawl around the floor trying to see/feel/hear as much as we can on a noisy moving target. The effects of adrenaline and anxiety allow them to hide their symptoms from us. (How many times have you brought your limping dog to the vet only to have him walk through the front door as if nothing is wrong?) We join this profession because we have a deep-seated love for animals and want to help them to live long and healthy lives, but more often than not they see us as the “scary” vet who pokes them with needles.
I imagine the pediatrician-baby relationship is very similar to the veterinarian-pet relationship… we must advocate for patients who can’t speak and who are oftentimes unwilling/unable to co-operate with our examinations, all the while explaining what is happening to a very worried adult human caretaker.
Dr. Melissa Bisesi