Monday, February 20, 2006
Dropping the Ball -- A Vent
Pet owners who find themselves in the waiting room of the University of Missouri-Columbia Small Animal Clinic are die-hard animal lovers. They have traveled across state lines, cashed in stock to pay their bills and set up temporary residence in hotel rooms. They probably can’t tell you the late-breaking National news story, but can site every back-issue article of Pet-Fancy from the waiting-room magazine rack.
They talk to each other like incarcerated criminals: “What’re you in for?”
“German Shepherd. Cancer. MRI. CSCAN, you?”
“Lame Labrador. Ultrasound. Myelogram.”
“How long you been in?”
“Three 12 hour days, but might be getting out soon. Waiting for word from the main ward.”
Few enter this place voluntarily – doing so would be like making an appointment at the Mayo Cancer Center for a sliver. People come for the state-of-the art technology, groundbreaking research and the possibility of a medical miracle. In exchange, they get a lesson in the bureaucracy of a teaching hospital. Every procedure occurs on University time i.e., if it should take two hours, plan on ten and be grateful for seven. You’ll get an update on your pet if “your student” isn’t in class, on rounds, observing a surgery or having a bad hair day. Don’t piss off the secretary, who can make your life miserable by adding hours to your wait and be nice to the lady in the financial office. Very nice. Oh, and don’t expect to meet your veterinarian. They don’t always make an appearance.
Our Australian Cattle Dog was paroled two weeks ago, following surgery and time in ICU. Hemangiosarcoma – an aggressive and almost always terminal cancer - was our ticket in. But, compared to my battle-weary comrades in the waiting room, I was fortunate. Our veterinarian was Dr. Wonderful, a man who imbued compassion. He’d arrive at work early, just for a pre-operative snuggle with Scout, answer calls within the hour and e-mails late into the evening. He didn’t stick to a 9-5 schedule. If I was there for twelve hours, so was he. He was honest, dedicated and worthy of trust. Without him on board, we might not have made the series of difficult decisions allowing Scout’s last biopsies to come back negative. When we first arrived at the clinic – with a very bad diagnoses and a lot of uncertainty as to whether we were doing the right thing – the man grabbed the ball and didn’t let go.
So, when faced with the choice of where to bring Scout for chemotherapy, the answer was obvious. I wanted her under the watchful eye of Dr. Wonderful. He made University bureaucracy tolerable, if only because it annoyed him as much as his patients. But, during Scout’s recovery from surgery, Dr. Wonderful left clinical practice and entered a research project. No worries, he was still on campus.
I should have run when I met our new student – a pretty, petite woman with the personality of plywood. Our new oncologist couldn’t be bothered with introductions.
About the time I should have been getting the call that Scout was starting treatment, Ms. Plywood called to tell me she was sure Scout’s feeding tube had become infected – and that she could die. “Her abdomen is very painful, she screamed in pain when I picked her up.”
I reflected on the number of times I’d picked Scout up that morning, without a whimper; the daily incision inspections; the cleanings. “How’d you pick her up?!” I asked.
“With two arms, fully supporting her stomach.”
“Um, did you forget her incision from the still-healing spleenectomy?” When she called with the test results (negative for infection, of course) there was no sense of humility regarding the prior phone call, and in a quick attempt to minimize her mistake, she mentioned Scout’s drastic weight loss (with the implication, of course, we’d slacked off on her aftercare and round the clock tube feedings.) That, of course, was straightened out once it was realized she’d forgotten to translate her weight from kilograms to pounds, recording her as half her actual poundage.
Paging Dr. Wonderful! Help!
The secretary fended off my requests to consult with Dr. Wonderful. Dr. Wonderful failed to return my calls and our new oncologist couldn’t be persuaded to consult with us.
Ball. Dropped.
The next call came from the ever-illusive new oncologist. “We need permission to anesthetize Scout,” she proclaimed.
Huh? We were there for a feeding tube removal (Easy. Pull it out. We’d been told several times by several different vets it was an easier procedure than trimming toenails) and a chemo treatment. “Anesthesia for what?”
Evidently, a surgeon had been called in to remove Scout’s feeding tub via her esophagus. I didn’t buy the explanation, as it had never even been presented as a remote possibility. Logic dictated her tube had been lost inside her in the effort to remove it.
Ball. Dropped. Again.
Finally, ten hours from our arrival, Ms. Plywood escorted Scout into the waiting room. She was heavily drugged. She didn’t recognize me. And, when I went to put her in the car, she screamed, snarled and attempted to take a piece out of my arm as a souvenir for the day’s trauma.
Ms. Plywood informed me “Sometimes morphine has that effect on them.”
Morphine? Scout cannot have morphine. Scout has a warning in her chart not to administer morphine. MORPHINE?
Ball. Dropped. For the last time.
With quiet thanks to Dr. Wonderful for his previous care and roaring indignation to our next set of oncology team members, we left the parking lot vowing never to return. Ultimately, Scout is none the worse for wear. She is currently cancer-free and receiving chemo treatment locally.