Our stated goal for “Travels with Kathi” has always been to bring our clients a realistic view of the life of one veterinarian as he and his wife- technician, go about their daily tasks. One comment we frequently hear from clients relates to our treatment of horses where the outcome is ultimately not happy. Clients communicate their doubts they would be able to handle those situations. All such cases are difficult, but some are especially memorable.
The first such case I remember actually occurred during my first year of practice during my internship at Colorado State University Veterinary Teaching Hospital. We had a racehorse that had fractured several small bones in his knee. This young stallion was a son on the famous racehorse Easy Jet, and the staff at CSU performed a surgery to attempt to fuse the knee so this horse could breed mares. The injury had left the knee unstable so our patient had to be continually confined in a stall and the leg had to be supported with several external support devices. The largest problem normally encountered with such cases is controlling the behavior of a young, fit stallion. This young horse was just the opposite. Over the several months I was involved in the care of this young horse, I never saw him not taking care of himself. He would lie quietly in his stall while we adjusted the wraps on his knee. This horse quickly won the hearts of all the female students, and though the guys were a little hesitant to admit it in 1979, we all loved this very special horse. After several months we took radiographs of the knee that clearly showed the bone was breaking down. The salvage process was a failure. He had to be put to sleep. It was a dark day in the clinic. We all felt a very great loss.
I remember another special case, a grey middle-aged Arabian gelding that belonged to a couple who were good friends of ours. We had gone on pack trips and trail rides with this great little gelding. So when he became very sick with a liver disease, we quickly started intense treatment at the home of our friends. For several days we ran large volumes of intravenous fluids into this sick gelding while the four of us had a picnic under a shade tree. Within a few days our patient was much improved and I foolishly predicted a complete recovery. The next day we arrived for our evening treatments to find our old friend severely foundered. Foundering after enduring a severe illness like he had usually was a harbinger of a bad outcome. Over the next week he became more painful. We had the conversation regarding what was the best thing for our little friend. We decided to give him one more day. The owner left him near a pond because the ground was soft there. The next day Kathi and I arrived to make the hard decision. Our patient was nowhere to be seen. He had walked out into the deep pond and drown. We were crushed. We couldn’t imagine a worse outcome.
All of our patients are special to us. But there will always be those cases that are particularly difficult. We try to balance difficult outcomes with good ones. Sometimes it works and sometimes it doesn’t. Kathi and I are lucky such cases are somewhat rare in our practice even though as long as we practice there will always be those special cases. We also have developed life skills that help us deal with such cases and the emotion associated with them. There is a term that defines a condition created by constant exposure to such high-stress situations, compassion fatigue. This condition applies to both human and animal caregivers. Symptoms associated with this condition are detrimental to caregivers living a happy life. Examples of job descriptions where a larger number of nurses are susceptible to compassion fatigue include providing hospice care. People working in humane society facilities are also susceptible to compassion fatigue. I worry about our staff at LEQMC who work with the intensive care patients because many of these equine patients have protracted illnesses. I also worry about our younger staff members who deal with many more stressful situations associated with forming new lives while also dealing with difficult veterinary cases. We all have to be aware of the existence of compassion fatigue and address prevention strategies.
Veterinarians do deal with personal stress as we offer our patients the best veterinary care we can. It is a difficult part of practice. As with most things in life the best help I can give others struggling with hardships is often a small bit of understanding along with a generous dose of kind words.