of mice and men

When I tell people I used to work in veterinary medicine they usually turn to me to say, oh I could never do that. I love animals way too much. We will be standing in a hallway, in scrubs and white jackets, charts and clipboards pressed against our chests, waiting for the elevator. Or sitting at the central station, pouring over lab results, or waiting for the CT imaging to upload. And they tell me this. Each one of them repeating, almost precisely verbatim, what the others say before them.

And then I become extremely uncomfortable, and fidgety. Because, basically, I find it alarming, that they say this to me, because here we are, in human medicine. In a broke down hospital in New York City. Surrounded by people. Most of them severely, seriously ill.

The difficult part for me is gauging whether people actually know what happens in much of small animal medicine, how similar it is to what we do to each other. I cannot tell if it's that they know this and that's why they say they could never do that, they love animals too much, or if it's because they think animal medicine is something even worse than what we presently do on a daily basis, to one another, to our own.

What most people are apt, often adamant, to point out is that Fluffy doesn't understand what's happening. But that is the perfect, tiny, enormous distinction. Fluffy doesn't understand what's happening. What this means is, when you are about to insert a catheter up their urethra or clean off their diarrhea or take an xray or place an IV or inject them with awful, toxic chemotherapy agents or maybe just clip their nails, they have no predicitve idea of what the fark is happening. So you can just kiss them all over their animal faces and use really high pitched, squeeky voices (which we all know makes their brains explode) or hold them down and hug them while all the bad, awful stuff happens to them and then they get up and (usually) wag their tails and say "Hi!!!!!! It's so good to see you!!!!! I haven't see you in 3 whole seconds!!"

Or they bite your face off.

But people. People know. Whenever a dog or cat has intractable diarrhea all over its hospital bed, regardless of its pathology, it is only a few things for everyone involved. It's potentially disgusting, inevitably smelly and more than a little inconvenient. What it isn't is embarrassing, mortifying or humiliating. Cats are arguably an exception if only because they are born indignant. Yet, this also means they are equally appalled if you move their beds as they are if they crap all over it. They are, by and large, democratically disgusted.

People know, usually, when they've lost control of their bladders, their bowels, their last shreds of dignity and independence. They know when we all tromp in for morning rounds and they are rolled over on their sides, naked and exposed and helpless for everyone to see, unable to do anything until the nurse finishes her cleaning. People know. They know that this is it, this what we all universally fear and ultimately face: the complete inability to care for ourselves.

This, this knowing, the explicit understanding becomes far more painful and excrutiating for me. It is this precise aspect of knowing, of cognition, that leaves me agape whenever people say that working with, taking care of, animals would be "too hard". Harder, it would seem, than caring for people.

And yet, whenever an animal would come in, terribly ill, dying, gasping for air or crying in pain, no matter how wrenching, how difficult, how agonizing it was to watch and to care for and to try to ameliorate, no matter how much it collapsed my heart, I could never escape thinking: what if this were a person? What then? What if this were someone's daughter, son, husband, mother, father, wife? What if this being, this creature gasping for air beneath the mask of oxygen were me? What will I do when I can no longer opt for humane, merciful euthanasia, when the bitter end must be met, no matter the distance it takes to get there?

It was exactly their not knowing that made it possible for me. Because everyone else knew: the nurses knew, their families knew, the doctors knew and none of the emotion got diluted out, ever. (It doesn't make it better to be able to say, with words, "the reason you can't breath is because your lungs are filled with fluid from your worsening heart failure. We can't do anything because your kidneys don't work either. Don't worry, eventually you will die of respiratory failure but first you're going to panic through the feeling of being suffocated for a bit"). Every family is devastated, always. There is no escaping the heart stopping anguish of a terminal prognosis, a failed attempt at all measures exhausted. There is no way to soften the blow. But somehow, somehow, knowing that Princess and Jonesy and Sam and Beulla were never, could never be, aware that they only had a week, maybe, a month, or two, to live made it a little bit lovely in a way I couldn't appreciate then. Because it allowed me, by proxy, to just live in the moment. Just in the moment of a sweet, brave face lick or a dutiful wag of a tail; the joy of eating chicken baby food directly from the end of a spoon.

I have not found that yet, as it is for me, in our own kind of medicine. I have not found a way to escape the clear and undeniable pain that knowing brings those around me. It is infinitely and entirely different, infinitely and entirely harder than the sweet heartache of animal care and I do not know if I ever want it to get any better.