Thursday, 21 May 2015

Doctor of what?

Consulting is an art, not a science. No matter how well you know your medicine (and I am certainly not claiming any special expertise in that department), a consultation can often be spun in an unexpected direction by what we shall charitably call 'the human factor'.

Yesterday afternoon, I opened up the medical file of my next consultation - a booster vaccination for a cat. Something about the surname rang a bell, but I hadn't seen this cat before, and the client didn't seem to own any other animals. Something still nagged at me, however, so I clicked another button in the top right-hand corner of the screen. The button is marked 'Show deceased'.

Three more animals appeared under the clients name, all cats. The names all sounded familiar. Sure enough, I had seen all of them. Not only had I seen all of them, it was me that had been with them for their final consultation. I had put all of the owner's previous cats to sleep. The most recent had been several years ago, and try as I might I was saddened to find that I couldn't bring any of the cases to mind, or the client. Nevertheless, I was glad I had checked; I didn't remember the client, but it was a fair bet that they would remember me, having euthanised three of their previous pets. Now, at least, I could show a little tact, caring and diplomacy in the consulting room, even though I was just vaccinating their last remaining pet.

I stepped out into the waiting room, and quickly located a tall man sitting with his daughter, a cat box on his knee. I smiled at him, and with a quiet, respectful demeanor I called his cat's name.

The man looked up, smiled, and nudged his daughter in the ribs. 'Oh hello!' he called, cheerfully. 'It's Doctor Death!' He stood up and cheerfully walked towards me, while his daughter and I competed on which of us would rather a hole opened up in the ground and swallowed us up.

The man continued his own brand of peculiar gallows humour all the way through the consultation. 'Careful, Misty,' he said as I plucked the black and white cat from it's box. 'He should have a scythe, not a stethoscope!' I smiled politely while his daughter rolled her eyes and folded her arms, staring at the floor.

'Yes,' I said, trying to lighten the mood as I drew up my vaccination. 'It's a happier occasion, today, isn't it?'

'I'll say!' said the man. 'At least we won't need a coffin at the end of it!' I felt like saying that if he kept this up, then I couldn't promise anything, but I remained as ever, calm and professional. Still, it was a surprise that I had no memory of this man. If he was like this during a vaccination, God knew what he was like during an actual euthanasia.

'All done,' I said, putting his surviving cat back in it's box and closing the door behind it. 'There,' I said, smiling at the man, 'All of us made it through in one piece!' The man smiled and winked at me. His surprising attitude was growing on me. There was no malice at all in him. Why not be cheerful? The cats weren't suffering, and I had done a professional job. Doesn't joking about a dark subject make it something less to fear? Maybe we could all learn something from his attitude. I was starting to decide that perhaps I rather liked him.

I opened the door and let the man, his embarrassed daughter and his still-alive cat out to reception, where upon he announced loudly to the packed waiting room, 'This is the first time one of my pets has seen that vet and come out alive!'

I shut the door, and decided that maybe the best thing would be if a hole opened up in the ground and swallowed him instead.

Monday, 4 May 2015

Doctor, doctor, gimme the news...

Alright, I will. Because I am. A doctor, that is - as of last week.

You see, unlike many of our overseas colleagues, veterinary surgeons in the UK have long languished under tedious titles of Mrs, Miss or Mr. Not only do these titles call upon people to make a snap judgement on whether we're married or not, they simply don't sound quite as sexy as 'Doctor'. If anything, they make us sound more sinister - 'Mr Kildare' just sounds creepy, doesn't it?

There are those in my profession that will try to tell you that the vanilla title is right and proper. Human surgeons are known by them, after all - it's something of a badge of honour for them to go from Dr to Mr, in fact, and is a right granted them by the Royal College of Surgeons.

'Well,' say the misguided (and slightly less cool) vets of the UK, 'we're surgeons too, aren't we? So we should be Mr or Mrs too!'

Well, I disagree. For one thing, human surgeons undergo a metric craptonne more training than veterinary surgeons do - years and years more, in fact - so if they want to call themselves Mrs, I think they're quite entitled to. Secondly, as vets, we never got called 'Doctor' at any stage of our training, so it doesn't feel so much like a promotion as a, uh, nothing at all. Thirdly, I think I'd be more on board with it if surgeons had an entirely different title again, something like... I don't know. Powerman/woman? That would work. I could cope with being Powerman Marsh. (Pwn. Marsh - except if you're familiar with internet l33tspeak, that does sound a little like I just got my ass handed to me in an online game. I'll keep thinking).

Anyway, this particular powerman has strayed from the point a little. A couple of months ago, the RCVS - the august body that oversees veterinary surgeons in the UK - decided that vets are now entitled to use the title 'Doctor' - with a couple of caveats.

Firstly, when we use it in full we should add 'MRCVS' after our name, to signify that we are members of the Royal College, and not actually licensed to poke about inside another human being (well, not with surgical instruments, at least). Secondly, it is a courtesy title - it's up to us whether we use it or not.

When I heard about the news, this last point threw me into a dilemma. Was it really that important, I wondered, to be called a doctor? Is it something we deserve?

My point about training above wasn't just true of surgeons. It's a fallacy that it takes longer to train as a vet than as a doctor. The veterinary degree takes five years, just as the medical degree does, but then medical doctors have at least another two years of on-the-job training before they are fully qualified. Vets are just thrown in at the deep end, though the RCVS is considering changing this too.

In my career, occasionally a client would start a consultation with a 'Well, what it is, doc, is that...,'. Even on the rare occasions when I would point out that this title wasn't one that I had been granted, I would do it with a bashful grin (and possibly even come-to-bed eyes) that indicated I was not at all unhappy on being accidentally promoted, and it always gave me a little thrill.

But still. Doctor. I have been a veterinary surgeon for fifteen years, and a change in my title wouldn't change my experience, or my skills, or my simple honest-to-goodness dashing good looks. A courtesy title. If I actually changed it, would it just make me appear vain? Would my colleagues consider me so? Would there be two tiers of vets now? Ones that were secure in their own skills, and ones that needed something more? A veterinary surgeon, by any other name, would still smell of anal glands and hibiscrub, after all. This was a decision that required careful, considered thought.

Thirty microseconds later, I was logging in to the website of the RCVS, and ticking a box on my profile that indicated now, and forever more, I would be known as 'Doctor Nick Marsh MRCVS.'

Such decisions come at a cost. Households have been split on the issue. My wife, for instance, remains plain old Mrs Marsh - although this has less to do with any high-minded ethical stance, and more to do with the fact that she has forgotten her login details for the website.

As for myself, I find I am much the same person - with one added bonus. Thank you, The Simpsons. You have made me a very happy man.


Doctor Nick Marsh, MRCVS