Terminal

9 September 2008

Terminal

The veterinary world (the whole world, if you’d rather be a bit morose) is full to the brim of ironies and unfairness.

A healthy two-year old cat is put to death because his owners can’t afford the relatively simple procedure required to unblock his urethra and return him to good health. Across the room, the bill for a 14-year old blind, paralyzed retriever climbs past $17,000 because his (wealthy) owners can’t bear to let go and say goodbye. Dog breeders flourish. Every day, approximately 27,000 cats and dogs are put to death in shelters across America. I’m only two years and two weeks in, and my educational loans are rapidly approaching 6 figures; yet I’ll spend the rest of my career trying to convince owners that I’m not a crook, that I’m not overcharging them. More than anything, i want to be help owners be better owners, help pets be better pets, and improve the health and welfare of animals, whenever and wherever I can. And yet the one thing I will probably do more than other is euthanasia.

Some of the inconsistencies are man-made; some are just the natural order of things. Consider a wildlife shelter, for example. In one ward you have the animals that you’re tending to – squirrels and possums, owls, ducks, foxes, eagles, hawks, rabbits. And then there is the smaller ward, the one towards the back, by the laundry – the one with the mice and rats. It’s a fine line that separates the patient from the prey. But go to any major animal hospital in the U.S. and there will be a separate ward for the mice and rats, and it may also include bunnies, a reptile and bird or two, but they’ll all be equals, they’ll all be much loved pets, that aren’t, excuse the expression, about to be thrown to the wolves.

It’s nobody’s fault. It’s everybody’s fault.

Tomorrow, our surgery lab begins in earnest. And it’s not just any surgery lab, but it’s a terminal surgery lab. Which means that upon completion of our surgery, the patient will be euthanized. I hate even writing that.

I believe my school is fairly unique in this respect – most schools have done away with terminal surgeries (I think??? Vet students feel free to correct me!) in favor of non-terminal spays, neuters, and other simpler procedures. But my school argues that you just can’t get this experience without really doing it, and so terminal surgery is something the school is extremely proud of (which seems strange to me…I’d be proud of finding a way to really really educate my students that DIDN’T involve killing animals AT A VET SCHOOL, but whatever.), almost to the point of being defensive.

And just to be clear: this is a junior class, the class is in groups of three, one surgery a week, and actually only four of the 12-15 surgeries will be terminal – they rest are all survivals. Also, any one can elect to take a different surgery class that basically has you doing spay and neuters all semester. (Guess how many people opted for that option? Guess???)

But it’s a good program. When I’m done, I’ll have done or assisted many different types of surgeries, even orthopedic ones, and I should feel relatively competent as a surgeon, and I can say from first-hand experience with a lot of interns, this is not true of all new graduates.

When I first heard about this class well before my first year, I knew it was something that I’d really have to think about. Because really, I think it’s rather awful. I shouldn’t benefit from killing the very animals that I am building a career in order to protect. It feels so selfish to me.

But then I think…these animals are going to die anyway. And I remember the dog we dissected our first year, and how she was also from some shelter somewhere, and I think, shouldn’t someone benefit from the inevitable deaths of these animals?

It sucks, but it’s true. These are dogs that are likely never going to be able to find a home. The research dogs are from colonies that have lived their entire life in a lab, and are no longer of use to the lab (for whatever reason). Because of their sweet nature, they are procured by the university for practice patients for students (and quite possibly for other research going on in the hospital). The shelter dogs have been given a fair shot in the shelters, but just aren’t finding a home. (Research dogs outnumber shelter dogs about 10:1, by the way.)

Last week we practiced just anesthesia: selected a dog, performed a physical exam, drew blood, calculated the drugs required to anesthetize her and drew them up, gently knocked her out, intubated her so that we could keep her down, practiced monitoring her blood pressure, oxygen saturation and other vitals, then backed off the gas and woke her up. We extubated her, warmed her up, got her prancing around, and returned her to her cage. And even though she trembled at our touch and had no idea how to walk on a leash, she would prance around like mad with other dogs in the room and would lick our noses affectionately if we got close enough – she was SO freaking adorable.

And tomorrow, we’ll do the same thing, just with a surgery in the middle and euthanasia at the end. It’s my choice, so any holier-than-thou-ness I may be conveying is pure crap, but still, it makes me really sad.

Yet on the other hand, it will be my first surgery, which I am totally excited about. Full of ironies, aren’t we.

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