Sunday, 18 October 2009

Jim Morrison said it best

'People are strange, when you're a stranger'

Quite right, Jim, they are. What the Doors lead singer neglected to mention, however, was they're strange when you're just about anything. They are especially strange, for some reason, when they are in a consulting room talking to me.

Now, the purpose of this post is not to make fun of anyone, or to suggest that I am in any way less strange than any of the rest of us - we're all human, aren't we? (Oh...except you at the back with the tentacles). It's more to jot these things down so that I don't forget them, as my life would be considerably less stressful but also greatly less amusing without the general public involved.

And what are 'these things' of which I speak? Well, they're all things that have said to me or a colleague at some time or another in a consulting room, usually with a straight face and an earnest expression. I'm not mocking any of the people involved. It's cruel to mock the afflicted. (Ooh no, stop it! Ooh.) (That was supposed to be a Frankie Howerd impression, if you're confused. It might not work so well via the medium of the written word)

(And we'll skip over the basic cliches that everyone is allowed to say, and in fact do say to me on a regular basis. I'm sure every profession has them - the comments that come straight out of people's mouths when they hear what it is you do for a living without way of their brains, but that somehow they seem to feel is original. You know what I mean - for doctors it would be to automatically list everything wrong with you at the current moment as if the doctor cares. For builders it's the same, only with houses. For archaeologists it's to make some highly amusing comment along the lines of 'oh, you'll have to come and dig up my garden, ho ho ho'

(Note - I am sadly not immune to this curse. Upon meeting a marine cartographer when I was slightly the worse for wear with drink, I am ashamed to report I honestly said 'Oh, that must be easy then, it's all blue.' Not only this, when he didn't laugh I assumed he hadn't heard my witticism, so I said it again, louder. I'm sorry.)

Well, for vets you get either one of two responses. Please avoid either of these, as they will make any vet to say it to want to sneak into your room at night and sterilise you sans anaesthetic. Firstly 'A licence to print money, that is.' No, you seem to have me confused with the Royal Mint. Now kindly drop dead.

Secondly, (and by far the most popular)....'Huhuh huh huh you put your hand up cow's bottoms heheheh hehe he huhuh huh'. Yes, yes I do. It's my job. I have also wanked off a dog for the same reason. Yes, rubber gloves and lubricant were involved. Are you over it now? Oh no, you're still laughing. Tee hee. Now drop dead.)

There is something about a consulting room which... you know, I was about to write something along the lines of 'turns otherwise sane people into gibbering lunatics' but I'm starting to question the usage of the phrase 'otherwise sane people', so I think I'll just leave it. Here are some situations I have been in whilst talking to the dreaded 'general public'.

- Once, not very long ago, whilst I was kneeling on the floor examining a dog for its vaccination, the owner asked me if I could have a check of its bladder. I felt it from the outside and it felt fine (not the easiest organ to check, the bladder, in fairness - you're much better going off clinical signs initially). The owner didn't seem entirely satisfied with my response that it all seemed okay, so like a good vet I proceeded to procure an anamnesis.

(That's 'get a history' to mere mortals who are not blessed with the wondrous Latin language of obfuscation so beloved of doctors and medics. My favourite word - Idiopathic. It means 'I don't know.' So idiopathic vestibular syndrome means that there's something wrong with your dog's brain, and I have no idea what that is. Fortunately, no-one else has any idea either so I can't comfortably, and quite officially, say 'I dunno' and still sound clever. The next best word is, of course, iatrogenic. That means 'caused by your dumb-ass vet'. an iatrogenic ruptured tympanic membrane would mean I poked my otoscope too far down your dog's ear)

I asked what the clinical signs were in this case to make the owner worried about her dog's bladder. There were none - the dog was peeing absolutely normally. However, the client told me, she knew there was something wrong there. I asked how, and looking slightly sheepish, she said 'Well this might sound a bit strange but...'

(Always a worrying phrase to hear!)

'...well, I have this horse whisperer comes round to see my horse, you see. And she told me that my horse had been speaking to my dog, and my dog told my horse that she's got a pea-sized lump in her urethra.'

Quite how this cross-species conversation got started, I do not know

('Alright Dobbin?'
'Yeah, not so bad. Yerself, Fido?'
'Well, now that you mention it....')

but I love the idea of them standing in the stable like old women waiting for their hair appointments, discussing their various ailments. I never found out how much Doctor Doolittle charged the client for her 'services', but I checked the dog's urethra rectally (hehe, yes yes. It's my job.) and funnily enough no such pea-like lump was found. The annoying thing is, I bet the client still believed her wondrous horse-whisperer over me. I wonder where the dog learned the horse word for 'urethra'?

- A colleague of mine recently saw a dog with a small slice wound in its paw, next to a little wart. When she asked how it happened, the owner told her that her daughter had been trimming the dog with scissors. Thinking that she had misheard, she suggested that the client would be better taking the dog to a grooming parlour to cut its hair.

No, the client said, she was trimming the dog, not the hair. She liked to cut warts off. The owner thought it would be okay, because she trimmed warts of her brother as well, and this usually turned out fine. It lead to the memorable line in the clinical notes 'Advise owner not to allow daughter to use scissors on dog in future.'

- My wife was on a house visit to examine a week-old litter of bulldogs (born via caesarian, of course). Aside from the owner not having a great grasp of basic maths...

(Five puppies, two boys. The repeated question (at least three times) 'So how many girls?')

...she soon demonstrated a rather limited understanding of genetics too. Whilst my wife was examining the pups, it became clear to her that the dog and the bitch who had produced this particular batch of dogs both had the same mother and father.

' mean they're brother and sister?' My wife asked, nervously.
'No!', said the client, obviously taking some offense at the fact that anyone would be as stupid as to breed brothers and sisters together. 'They're from different litters!'

- I was once asked by a rather creepy looking gentleman whilst I examined his cat 'Would there be any problem with him eating a lot of human hair?'

- My wife called a client in to the consulting room, a rather large and somewhat hairy woman, who plonked the cat basket on the table, and then announced before she had said a word

'Just so you know, I'm a TS, all right. A trans sexual. I don't want there to be any question of that.'

Sadly, for comedic purposes, my wife did not then ask to examine the client's pussy. Oh what the hell, it's my blog, I can say what I like. She politely asked to examine the client's pussy.

- Just last week, I had a regular client of mine come in for an appointment for a vaccination of their cat. I was sure I had vaccinated it relatively recently, so was slightly confused. As she came in, she put the basket on the table, and said

'I hope you don't mind, there's nothing wrong with him, but I got a cotton bud stuck in my ear this morning, and the doctors was full. Can you get it out for me?'

- Not really the client's fault, this one, but I once did an unexptedly smelly fart during a consultation and succesfully blamed it one the dog's anal glands

- Honourable mentions must of course go to the numerous times I (and I'm sure every other vet) have had to examine dogs because they have developed two large lumps around their penis whilst playing with the owner (um... your dog has an erection, Mrs Smith) and the many many hamsters I have examined with a pair of large lumps just underneath their bottom (erm... your hamster has a pair of testicles, Mrs Jones)

Well, I think that'll do for a start. There are more, but they'll have to wait for another time. Thank you to all the weird, wonderful, and very ssstrange people who make my day job just a little more bearable, and certainly a whole lot funnier.

Thursday, 1 October 2009 there anyone else working today?

I finished work today and confidently strolled out of the back door of the practice, whistling a merry tune and secure in the knowledge of another day's work done well.

(Okay, that's a lie. It was a horrible evening surgery, I was in a rotten mood, I'm struggling with man flu and one of my favourite vets to work with handed their notice in. But otherwise it's all true)

On my way to my car (a shiny newish red Fiesta of which I'm inexplicably proud, especially considering that it's a red Fiesta) I passed the clients (a nice young couple) who I had just finished seeing, waiting at the entrance of the practice with their cat, Peanut, presumably waiting for a taxi to come and take them home. I nodded and smiled at them, and they nodded and smiled back (expect for Peanut, who was in a mood with me on account of the fact that I had just stuck a needle into him) and approached my car.

Balancing an 8kg bag of dog food on my shoulder (it had just gone out of date. Nothing but the best for my pooches!) I manuevered the car keys from my pocket into my hand, and pressed the button which is supposed to open the boot.

(Or trunk, for my American readers. I would complain about the Americanism, except that, really, if you think about it - doesn't calling it a trunk make more sense than calling it a boot?)

Still pleased with the whole dog-food-balancing-on-shoulder thing, and glad that I hadn't dropped it and so made an idiot of myself in front of the clients, I failed to notice that the boot had not, in fact, unlocked. I only noticed when I tried to open the boot, was thwarted by it's still firmly locked state, and dropped the bag of dog food on the floor.

Undaunted (okay, a little daunted), I pressed the button again. No reaction from my car. Again. Nothing. Changing tack, I decided to press the button that unlocked the doors to the car, not just the boot. My Fiesta remained stubbornly inert.

Losing patience with the stupid car now, I pointed the key fob directly at it, and very very obviously pressed the 'unlock' button, not once, but twice, leaving my car in no doubt as to what I wanted it to do. Unbelievably, my car ignored me. I stared at it, angrily. The bag of dog food lay reproachfully on the ground at my feet, a constant reminder on the client's eyes boring into my back.

I couldn't resist it. I turned round to see if they were looking at me. As I did so, I pressed the unlock button three more times, just to show my car I meant business.

The clients were staring right at me. Why wouldn't they? What else would they look at in this car park other than a vet making a tit of himself? However, as I glanced, a flash from next to them caught my eye.

The flash came from the car that they were sitting next to. A Fiesta. A red Fiesta. My red Fiesta, that had been frantically flashing me to step away from the random person's car that I had somehow decided was mine.

Recovering my cool, and trying not to think about how many times I had pressed the button on my key fob to an answering click and flash from the car right next to the nice young couple and Peanut, I picked up the bag of food, approached my car, nodded and smiled once more, slid the bag into the by now very open boot, drove around the corner, and sank into a deep pit of embarrasment.

(On a side note - why is it you can remember embarrassing moments in your life with near-perfect clarity? Happiness, misery, depression all flit by in my mind as vague feelings, but I can remember perfectly when Sarah Hawkins turned me down in front of all of my mates in the first year of college. Thanks, brain.)

I suspect those clients probably won't want to see me again (and Peanut certainly won't) but the whole incident reminded me of something I've known for a little while. Which is this - clients really don't care how good a vet you are. They don't care how many textbooks you've read, or how much you know about the immune system, or kidney disease. If they like you, it's because they think you're a nice young man (and not the kind of idiot who can't even work out which car is his). And if they complain about you, it's not because you've made some major medical mistake. It's because you got off on the wrong foot with them.

I'm not blaming the clients for this at all. I mean, what else have they got to go off? All they know is whether they trust you or not. The sad thing is, this has got very little to do with how much you know about veterinary medicine, and everything to do with how charming you can be.

I have known absolutely terrible vets, with a client following that would eat their own pet's head if their hero vet told them to. I personally have made some dreadful mistakes medically, admitted them to the owner, and not been blamed for them because the owner trusted me. I (like most vets) have a string of clients that will 'only see me', despite the fact there are far better medics and surgeons than me in the practice I currently work in.

But, in all things there is a balance, and in this case, it's with the complaints. When someone complains about you, it's a fair bet it will have absolutely nothing to do with your skill as a veterinary surgeon. The astute amongst you may have noticed I have removed the first blog I ever wrote - this I because the case I talked about in it has been referred to the Royal College, a complaint of negligence against myself and a colleague. Now, I am normally phenomenally good at beating myself up about making mistakes (rivalled only, coincidentally, by my aforesaid colleague) but I can genuinely, wholeheartedly say that neither of us could have done more in that case. Royal College aside, this is not an unusual situation - complaints come from poor communication, or (rather more frequently since the credit crisis) from the bill.

So, there you have it. A brief rail against the vagaries of fortune, that reward undeservedly, then just when you start to celebrate, turn around and bite you in the ass without warning.

I can understand what it's like seeing a vet, and building up a trust - but please remember that all the other vets in the practice passed their exams and qualified too, and a small part of them dies when they call you through to their consult room and you say 'Oh, I only see Tim.'

And, most importantly, if you see a man struggling with a bag of food behind someone else's car, when he works out what he's done, just nod and smile as he walks past, and try and let him leave the scene with as much dignity as possible.

Thank you. Goodnight :)