Connecting the Dots
“Again, you can’t connect the dots looking forward; you can only connect them looking backward. So you have to trust that the dots will somehow connect in your future. You have to trust in something — your gut, destiny, life, karma, whatever. This approach has never let me down, and it has made all the difference in my life.”
This advice was given to graduates of Stanford University by Steve Jobs, the co-founder of Apple, in the 2005 commencement address. We have all wrestled with the decisions of what direction we should go with our lives. Few of us were blessed with the God-given tools Steve Jobs had been given, but we all have our own talents. All of us, whether we are conscious of it or not, end up following our gut even though our choices may have been modified by our available choices. But when should we decide if the dots connect in our lives?
An important part of our job at the clinic relates to the intern program where new veterinarians join the practice for one year, the first year of their practicing veterinary life. The annual arrival of new graduates reminds us of the trials and tribulations associated with our first year of practice. As staff veterinarians, we act as mentors, advisors for medical conditions, advisors on client idiosyncrasies, and cheerleaders. I often tell them I have seen the condition they see in front of them a hundred times, and the first ten times I didn’t recognize the problem. I tell them the same thing I have told myself a thousand times: use your training to solve the problem and everything will be alright.
During a recent weekend, I was on stand-by for emergency calls. Since it was early in her first year, the very capable new veterinarian on primary call checked in with me on each emergency to discuss the examination findings and to discuss her treatment plan. One of the emergency calls involved a relatively young horse suffering from colic. As usual, her plan for treatment was right on. After our short conservation, the doctor treated her patient. It is customary to clean our equipment and make notes on exam findings and treatment necessary to complete medical records while the patient has a little time to react to our treatment. By the time our clean-up is done, the patient is often comfortable and we are able to go on to the next call.
As sometimes happens in veterinary practice, and for that matter, in life, things don’t always go as we hope. Our horse continued to remain painful in spite of proper treatment. Continuing pain in a colicing horse usually means the cause of the colic may require further treatment, hospitalization, or even surgery. At this stage when painful signs persist, we have to ask the owner to consider what escalation of treatments are possible based on the client’s personal experiences and monetary limitations. Many of the treatment choices can result in considerable expense with uncertain outcomes.
Our clients’ initial decision was to continue to treat their horse at home. The clinician administered longer acting pain control medications prior to departing the farm. As time went on, the patient continued to be painful. The clients decided to bring the horse to the clinic for further diagnostics and treatment, but limited their commitment to no surgery. As day turned into night, and night turned into morning, the horse remained painful. At the same time, vital signs continued to trend worse. Our young veterinarian had spent her night managing the deteriorating patient. She answered my morning questions by saying she was not hopeful this horse could survive. She feared a decision to give up would be made after morning treatments and after the client had an opportunity to visit the suffering animal one last time.
I received a call from my emergency partner later in the morning. As I answered the call, I expected to receive a message of the demise of our horse. Instead, I was greeted by an ecstatic voice. The patient had taken a miraculous change for the better! The pain was gone and the horse was eating small meals. I could imagine how the clinician who had spent her night under a dark cloud was now dancing in the isle of the intensive care barn. Her patient had received the best care we had to offer, short of surgery. Despite that care, his condition had worsened. There was no indication he would survive. But just as the sun rises in the morning to erase the darkness of night, the horse became pain-free!
Making a difference
Much of what we do as veterinarians is preventative medicine; we administer vaccinations and deworming products; we recommend feeds and management practices necessary to keep animals healthy. Although this is a very important part of what we do, one of the few times we see the results of our efforts is when our preventative programs fail, when the horse suffers from a targeted disease. We don’t know for sure the program actually prevented the disease in healthy animals because the animals may not have been exposed to the disease. When horses suffer lacerations or musculoskeletal injuries, many times we are only able to return the condition back to near normal, not to their pre-injury state. Common sense tells us our efforts are giving positive results, but many times there is no life-changing proof.
But on certain days, we are given a gift; we get to help an animal in a way there can be no doubt we made a real difference. It could be removing a nail from the hoof, or stopping the loss of life-giving blood from escaping through a cut, or helping an old horse rise from what would surely be its death bed in a snow drift on a snowy night. Or on a certain day the gift may be to buy a horse some time by supporting body functions until he is able to overcome his own medical emergency, to survive to live another day. That was the gift received by a new veterinarian on a long fall night. She had made a difference!
On those special days, it is easy to connect the dots. We are veterinarians because we want to make a difference to animals and their owners. On such special days, we have no doubt we made the right decision when we chose to be veterinarians, no matter if it was karma, destiny, whatever. I choose to think it was pure luck.