Kristina Kiefer
This has been haunting me for a while. I’d love your input on it, as I think many minds are needed to solve this problem. Here’s the case summary:
Daisy is presented to you for ADR (ain’t doing right). The family is very concerned, because she just isn’t herself. She’s been a member of the family long before the kids came along, but her behavior and quality of life has radically changed over an undefined period of time. The last few years, perhaps? She used to be a super energetic ball of energy- unstoppable. Herding the kids to and from the bus stop, as any good border collie would do. Keeping Jack company when he got home from work or puttered around the house on weekends. Making everyone laugh, and a super keen sense of intuition to know when someone was just “off”, and doing everything within her capacity to help them. But Daisy just hasn’t been acting like herself anymore. She has no interest in herding the kids. She’s up all night pacing and yelling at the moon. She’ll disappear for hours and come home and go straight to sleep. Her appetite is erratic. Sometimes ravenous, other times going days without eating. She’s had a few accidents in the house and doesn’t even seem to realize it’s happening. She’s snapping at the children. She even snapped at Jack a couple times. She’s just downright miserable and doesn’t seem to enjoy the family or anything else in life the way she used to! You’ve tried medications to try to alleviate any pain, because she is definitely no spring chicken anymore, but it just doesn’t seem to work. She gave the family a really big scare the other day when she was walking through the living room, growling to herself, and just collapsed mid-stride. Out cold. And within a few minutes popped up and snapped at one of the kids trying to hug her. The family is beside themselves. They love Daisy, but are frankly scared of her. Nothing seems to bring their Daisy back, and even more heartbreaking, nothing makes her happy anymore. To make matters worse, Jack just lost his job, and their youngest child is scheduled to undergo the fourth in a series of six operations to save his life. They are at their wits end.
Pretty sure we all know where this is going…. What treatment options are on your list to discuss with this owner? We all have this sinking feeling that we know the end to this story. The family is there to have that end of life discussion, aren’t they?
Take a few minutes and reread this entire history. Only now, pretend Jack brought Daisy, his wife, to you, her primary care physician, Dr. Soand Sew, MD. I’ll wait.
What treatment options are you going to discuss with this family? What are the big differences? Would you calculate their quality of life as significantly different?
Now, read it a third time. Read it knowing that Daisy is Dr. Daisy Doolittle, DVM, looking over the state of her existence. With the added secret knowledge that she is several months behind on the mortgage for her clinic hospital because there just hasn’t been enough revenue after the series of horribly false, but extremely shocking accusations made against her clinic and staff on-line. She has also started receiving anonymous death threats from some random person who read the on-line reviews and thinks Daisy “is the most incompetent, cruelest excuse for a human being that ever that walked the earth, and you should do the world a favor and die a death as miserable and painful as those you’ve inflicted”. And she just found out Jack has been having an office affair, and lost his job because of it, so finances are going to be even more scary than they were. And those pain meds she tried using to cope with her fear and pain? Her practice manager discovered them missing from the lock box, and conscientiously reported the missing drugs. Which probably means her DEA license is going to get yanked, and that’s the end of her ability to keep the hospital going. So, pretty much, she is sucking at life in all possible ways.
What quality of life do you think Dr. Doolittle is going to give herself, compared to our other two patients? What treatment options do you think she is going to consider?
What do you think we can do for our profession to reframe euthanasia so that it is limited to our clinical practice? What do you think we can do for our profession to try to stimulate looking at a problem from multiple different perspectives and generating multiple options to solving a problem? What do you think Dr. Doolittle (or you) would feel if Dr. Soand Sew was trying to treat Daisy, the dog? How do you think Dr. Soand Sew should feel knowing that Daisy Doolittle, DVM is trying to self-treat the one species she’s not licensed for?
My thoughts are we need to start shifting to a mindset of realizing their are multiple ways to treat a problem. And we need to be as protective of the human medical profession, as we are of our own. Let them treat their species. Let them treat us. And be as fiercely opinionated about making sure that Daisy, in any form, gets the medical help she needs and deserves, by the appropriate medical team. And if we start talking about this as a profession, maybe we can remind each other to find better solutions to temporary problems.
What are your thoughts? How are we going to solve this problem?
I just could not go away your site before suggesting that I actually enjoyed the standard info a person supply in your guests? Is going to be back continuously to investigate cross-check new posts
Hello there, just became alert to your blog through Google, and found that it is truly informative. I am gonna watch out for brussels. I’ll be grateful if you continue this in future. Lots of people will be benefited from your writing. Cheers!
Good article and right to the point. I don’t know if this is really the best place to ask but do you folks have any thoughts on where to employ some professional writers? Thanks in advance 🙂
Thank you for all your work on this site. Gloria enjoys carrying out investigation and it’s really easy to understand why. All of us hear all about the lively mode you convey vital things through this website and cause response from others about this point then our own child is without a doubt learning a lot. Enjoy the remaining portion of the new year. You’re the one carrying out a powerful job.
Great write-up, I¡¦m regular visitor of one¡¦s blog, maintain up the excellent operate, and It is going to be a regular visitor for a long time.
Undeniably believe that which you said. Your favorite justification appeared to be on the net the easiest thing to be aware of. I say to you, I definitely get annoyed while people consider worries that they just don’t know about. You managed to hit the nail upon the top and also defined out the whole thing without having side effect , people could take a signal. Will probably be back to get more. Thanks
Whats Going down i’m new to this, I stumbled upon this I’ve discovered It positively helpful and it has helped me out loads. I am hoping to give a contribution
Hello There. I found your blog using msn. This is a really well written article. I will make sure to bookmark it and come back to read more of your useful information. Thanks for the post. I’ll certainly return.
whoah this weblog is excellent i like reading your posts. Keep up the great paintings! You know, a lot of people are looking around for this information, you can aid them greatly.
I like what you guys are up also. Such clever work and reporting! Keep up the superb works guys I¡¦ve incorporated you guys to my blogroll. I think it’ll improve the value of my web site 🙂
Undeniably believe that which you said. Your favorite justification appeared to be on the net the easiest thing to be aware of. I say to you, I definitely get annoyed while people consider worries that they just don’t know about. You managed to hit the nail upon the top and also defined out the whole thing without having side effect , people could take a signal. Will probably be back to get more. Thanks
You made some good points there. I did a search on the issue and found most people will consent with your site.
Thanks for another informative blog. The place else could I get that kind of information written in such a perfect means? I’ve a project that I’m simply now working on, and I’ve been on the glance out for such info.
Someone necessarily assist to make critically articles I would state. This is the very first time I frequented your website page and thus far? I amazed with the analysis you made to create this particular put up incredible. Great process!
Its like you read my mind! You appear to know a lot about this, like you wrote the book in it or something. I think that you can do with some pics to drive the message home a bit, but instead of that, this is wonderful blog. A great read. I’ll definitely be back.
certainly like your web site however you need to test the spelling on quite a few of your posts. Many of them are rife with spelling issues and I in finding it very troublesome to inform the truth then again I¡¦ll certainly come again again.
It is perfect time to make some plans for the future and it’s time to be happy. I have read this post and if I could I want to suggest you few interesting things or tips. Maybe you can write next articles referring to this article. I desire to read even more things about it!
Wonderful site. Lots of useful info here. I’m sending it to several pals ans additionally sharing in delicious. And obviously, thanks to your sweat!
Thank you for the auspicious writeup. It in fact was a amusement account it. Look advanced to far added agreeable from you! By the way, how can we communicate?
I have to get across my admiration for your generosity supporting persons who really want assistance with the area. Your very own dedication to getting the message all over has been extraordinarily functional and has in every case enabled ladies like me to reach their endeavors. Your new helpful publication signifies a great deal to me and far more to my colleagues. With thanks; from each one of us.