Saturday, 19 September 2009

Red in tooth and paw

I'm writing this particular edition of my blog nursing a large bruise on my right forearm. I have this blemish on my otherwise pristine and perfect body because during a consulation on Wednesday with an especially bouncy springer spaniel, I managed to stab myself in the arm with a mixture of steroids and antibiotics. The needle plunged in right up to the hub, and when I pulled it out again it was enthuisiatically followed by a lot of surprisingly dark blood.

(Feel free to wince at this point. I did. Well, okay, I ran out of the consult room, and tried not to try. But manfully.)

As I stood over the sink washing my arm and wondering if I was brave enough to pour surgical spirit onto the wound to disinfect it...

(in case you're wondering, I did pluck up the courage. Stung like a bastard. And then my boss pointed out that I had stabbed myself with a sterile needle and antibiotics, so it was probably unecessary. I may have sworn a bit at that point)

...I started reflecting about the perils of the job, and in particular about difficult, or aggressive animals.

Now, before I say too much more, I would like to let you know that I am a fully subscribed member of the 'No bad dogs, but bad owners' school of belief - it really is true that owners who don't put any effort at all into controlling their animals are the ones that end up with the difficult to manage animals. Of course, it's usually not the owners that suffer for this, it's every other poor person that the animal meets, and ulitimately it's the animal itself, when it find itself on the wrong end of one of my needles for taking too many chunks out of the general public (but that's a whole different blog). It is not the dog that is to blame here!

However...(and I'd like to point out for the record that my wife has just read this blog, and would like to respectfulyl disagree with the 'no bad dogs' statement...)

There are some breeds of dog that, before you have taken too many steps along the road of veterinary medicine, you learn to dread setting paw in your consult room. Call it a pavlovian response. Once youve been attacked by several dogs of the same breed, it tends to put you off them a bit.

I'm looking at you, German shepherds! Though not directly in the eye, obviously, because I need all my fingers for my job.

(Y'know, when I was growing up, I'm sure German shepherds used to be called Alsations. Perhaps they've undergone a re-branding. Max Clifford was probably involved. Either way, I'm going to refer to them from now on with their veterinary abbreviation - GITS...sorry, GSDs)

My wife used to have several GSD's when she was growing up, and she loved them. She liked the breed right up until the point she faced a few in her consult room, and I can assure you she's gone right off them now. GSDs are a dog that's been traditionally bred for the same kind of temperament as a nightclub bouncer - short on temper, high on aggression. Add to the mix that GSDs are amongst the most nervous dogs you'll ever meet, and that their response to fear is generally to bite whatever they're scared off, then put that personality into a stressful, anxious environemnt, like, oh, I don't know, your friendly neighbourhood veterinary surgery, and you end up with a recipe for violence only rivalled by Tony Blair becoming a middle-East peace envoy.

I'm not saying all GSD's are horrible. There are several of them, patients of mine, that are lovely. There are many over which I have shed a tear when their hips have given out and I have done the only thing left to do for them. But what I am saying is, if a GSD walks into my room, and doesn't immediately cower in the corner, looking at me with trembling eyes and snarling lips, I breathe a deep sigh of a relief.

The sad thing is, we see a lot more of GSD's than we'd like to, on account of them being one of the least healthy breeds I can think on off them top of my head. If their chronic skin disease, vomiting, diarrhoea of eye problems haven't put it in a really bad mood by the time they come through my door, the hip arthritis and degenerative spinal condition probably will.

So, GSD's top my list of dogs to be nervous of. Bubbling under in my top of the chops are -
border collies (most are lovely, but they give you virtually no warning at all before attempting to remove your face with their incisors. Beware the ones thay lie on their back as soon as they come in the door!),
Rottweilers (again, in the main very nice, but you haven't lived until you've been pounced on by a nasty one. Oops, sorry, wrote that wrong - should say 'You won't live long once you've been pounced on),
Jack Russells (the bad ones are ornerier than a rattlesnake with it's tail trapped under a horses hoof, and twice as quick)
Skye Terriers (thankfully,its a rare occurence when one of these comes in you room. Really, just write your will when one does. There's no hope for you. I have never, and I am not exaggeratimg here, met a nice one. Never. One to contest the 'no bad dogs' saying, I think)

All the above said, I have never, so far, recieved any injuries from a dog anywhere near as nasty as those I've taken from the feline contingent of my clientelle. I would far, far rather be faced with a nasty dog than a nasty cat. Why? Because a dog has precisely one weapon - it's mouth, and you can stick a muzzle on it. A cat has five, - including four paws with claws as sharp as bloody hell. They've also got much faster reactions than me.

(Also, cat scratches and bites tend to have pus coming out of them a few days later. They're like the titular Rats in James Herbert's novel - get bitten by one, and you know in a day or so you're doomed...)

It's also partially a pride thing with cats. People don't tend to think any less of you if you're nervous of a 50 kilo slavering Cujo-alike. If you're scared of cat - well, that's a teeny bit wussy, isn't it? Owners tend to think so, anyway - even if they won't go near the feline horror themselves. Give me a violent GSD any day. Trying to extract a vicious cat from a box when it doesn't want to come is like sticking your hand into a blender, and about as good for you too...

(Which is why I favour the blitzkreig approach to vaccination fractious cats - in and out before they even know you've invaded their territory. Sadly, the owners of such cats tend to try and pet them during the procedure, something I tell them not to because if their cat bites them in my consult room, it's me that's liable for it. Another perk of the job that James Herriot neglected to mention to me in his books)

...Other animals can also do a fair bit of damage to my fair surgeon's fingers -Rabbits can prove surprisingly violent (well, surprising to anyone who hasn't seen General Woundwort in Watership Down) and do a fair bit of damage with a back leg stroke, and Gerbils/Hamsters (it's a terrible, terrible admission for a vet but I will be totalyl honest, I always always get them mixed up - even though they don't look anything like each other) can also chow down on fingers pretty effectively, and really, really painfully...

(Leading to the infamous-in-veterinary-circles 'hamster-flick' where rodent bites vet, and vet reflexively flicks said hamster off his finger, usually into a wall in front of horrified owner. I tend to adopt the grin and bear it approach, it's better for animal welfare, and you get sued less)

...So, at the end of this mammoth blog, and after a long string of ways to get injured by animals...

(and I haven't even started on sheep, cows, pigs, and (shudder) horses)

(Horses - here's a good idea. Let's get an 800 kilo animal that an already kick you through a wall, and nail iron shoes to its feet, so it can cut you in half whilst it does it)

...I would like to reiterate that, despite all this, I still love animals, and love working with them, and sometimes, just sometimes think that I'm in the right job. Yes, animals can be scared, and aggresive, and sometimes dangerous to the unwary veerinary surgeon.

But not nearly as dangerous as he can be to himself with a bouncy dog and a syringe full of steroids.

Thursday, 3 September 2009

The busy in business

It feels strange, indeed possibly downright rude, to be complaining about how busy we are at the practice given the global economic situation at the moment

(which, while we're on the subject, I'm heartily sick of being blamed for. The next time some smug newsreader tells me that its 'everybodys fault' that we're in this crisis when I don't even own a credit card, I'm going to throw my telly out of the window. (Don't worry, I'll get the next one on hire purchase))

...but man, we're busy. I mean don't get a chance to stop and phone people with lab results/come up with new plans for long-term cases/wonder whether you've just given the right injection/go for a pee kind of busy.

I've held off posting this for a while (partially because I've been to busy ha ha) but partially because it's stupid. Lots of people aren't lucky enough to be in work at the moment, and becuase I work in a business, the busier we are, the better we're doing, right?

My problem is I find it hard to see the connection between the amount of people I see, and my wages.

(Unlike most clients. I say this with sympathy - many of the people reading this blog will have spent ten minutes in a vets consulting room and then been in need of resucitation equipment when the invoice comes through. I can understand that. One thing I've learned over the years is that it always looks like someone is making more money than they actually are. Of that forty quid that you fork out for ten minutes with your friendly neighbourhood vet, about forty pence goes on paying their salary. The rest goes the nurses salary, the receptionists, the practice managers, the gardeners, the rent of the building, the phone and electricity, the syringes, the needles, the disposal of sharps bins, the ordering of drugs, and many other administrative charges that I won't bore you with further. But bear in mind there are two sides to every story.)

The work in the last few weeks has been relentless - unstoppable, like a time-travelling super-cyborg sent from the future, and about as damaging to my health and well being. The last weekend I worked on call, I was called out sixteen times on Saturday alone.

(a personal record! Call outs can range from lasting twnty minutes to two hours, and these calls ran the full gamut, including a call to put the dog belonging to an elderly lady to sleep. As I examined the dog, lying in it's own mess and no longer strong enough to howl in the pain from it's severe arthritis, trying to be polite about the fact that it had been like this for over a week, the lady told me that if I killed her dog she would then kill herself and all her other animals after I left. That was a fun one.)

It's been so busy that if you come in with your animal tomorrow and say to me 'Well, he's just not right. I don't really know what's wrong.' then I may well burst into tears on the spot. Pleasse ignore me if I begin beating the ground in frustration and misery, and politely turn away when I start howling 'Why, God? Whhhyy?' at the ceiling of my consulting room.

Thing is, I know I shouldn't be moaning. I'd be a hell of a lot more depressed if the practice went bankrupt and I was out of a job. The credit crunch has affected us a little - we're still busy, but there's a marked increase in the people who aren't paying their bills

(and despite my urgings, the practice probably won't go with the 'Do not ask for credit as having your animal taken off you and euthanased sometimes offends' sign above reception. Seriously, why do people take advantage of us especially? Try telling the lady at ASDA that you have forgotten your purse, and that you'll pay next week when your benefits cheque clears, and you'll be leaving the shop a hungry person.)

...but I find it hard to connect the horrible, vaguely organised chaos of another day where my brains feel like they have been put through a tumble drier, with the notion that the practice is doing 'well'. It has reduced better vets than me to tears. It has, on occasion, reduced me to tears.

So, what is this rambling blog about? It's about the fact that we are a business, not a public service, and we are in the unfortunate position of making money out of pain, and suffering. The bad side to this is that, however much we'd like not to, we care.

As vets, I think it's fair to say only a very few if any of us joined this profession to get rich, and as such we get very uncomfortable and awkward about asking for your money, in a way that a car mechanic is never going to, and behind the scences there's an awful lot of undercharging goes on because we either don't feel we're worth it, or we feel sympathy for your animal's condition, or we underquoted because it was too hectic to do a proper quote. We're never going to turn away an animal in distress because the owner cn't pay the bill, because we can't bear the thought of it. Yes, we're easy targets.

The plus side, if it can be called that, is that in the world we live in, there is a near-endless supply of pain and misery. There's certainly a lot of it about where I work.

So, perhaps you can see why I find the busyness of the business deeply conflicting. It leads to tired staff, stressed vets, bad decisions and poor client service, and it means more animals are suffering.

It means the practice is doing well.

I wonder if it's not too late for a career change?