Last summer, my wife, Teresa, got a Pomeranian puppy she named Quin’B; this was some time after losing a beloved dog. The puppy licked her way into Teresa’s heart, following her so closely around our house and ranch as to resemble furry toilet paper getting stuck on her shoe.

As with many veterinary families, we seem to collect pets, sharing our lives with many more than most other pet lovers. In 45 years of marriage, Teresa and I have had 16 dogs. You welcome a new four-legged family member, you lose another. Your heart breaks every time, but when it heals, it is ready to accept yet another best friend.

While it is easy to say we love our children all the same—both two- and four-legged—in reality, we have favorites. Quin’B is, without a doubt, Teresa’s all-time favorite (Mine is my current dog, QT Pi.).

So, when my ever-loving and generous wife asked me what I wanted on my recently celebrated 68^th birthday, I responded with: “For the entire day, I want you to talk to me in the same tone, the same loving way you talk with Quinny.” She gave me a shocked look, seeming to say, “I don’t know if that’s possible, but I’ll try.”

I honestly think Teresa could have been an actress. One of our favorite shows is Dateline, and, randomly, Teresa will hit the pause button and attempt her own version of the person who arrived home to find their spouse/partner dead or dying and called 911. Let me tell you, she’s good, but when she tried to mimic the love, tone, and frequency of her Quin’B communications for me, it was an abject failure. She tried for about 30 minutes and we both decided, stop. This is not working.

What does this have to do with veterinary medicine?

Recognizing disconnection

I received a year-end email message from Blake, an attorney for Fear Free, who is MENSA-smart, a force of nature, and a warrior girded for battle in correspondence and the courtroom. A part of his email reads:

“Most pet owners understand the emotional sensitivity of animals in a much more intuitive sense. The idea that anyone would/could not see that as manifestly obvious, is truly a shock to every pet owner I’ve met. On the flip side, professionals are desensitized to everything animal (and in some sense, justifiably so), so I have to assume it’s convenient to ignore something that is so intrinsically obvious to the rest of the world.”

Then, almost like a one-two punch, I read Dissolution Foretold by bestselling author and famed British neurosurgeon Henry Marsh, who wrote, “I lived in a world filled with fear and suffering, death and cancer. Like all doctors, I had to find a balance between compassion and detachment. This was sometimes very difficult. But rarely, if ever, did I think about what it would be like when what I witnessed at work every day happened to me. When I became the patient.”

In the article, Dr. Marsh had his own brain scanned as part of a wellness project. Marsh said he blithely assumed his own 70-year-old brain would be one of the small number of older people whose brains showed little signs of aging, thinking like a doctor—that diseases only happened to patients and not to doctors. However, his brain showed extensive areas of age-related damage.

Like Marsh, I am at the point in my life and career where I am besieged by philosophical and ethical questions that seem important; questions that, in the past, I had either taken for granted or ignored.

One such question is the reality of desensitization. While not hearing loud clinic barking may be one example of desensitization in veterinary medicine, a more problematic one is veterinary healthcare professionals can become insensitive to animals’ pain and suffering, both physical and emotional.

I also wondered about the effect of detachment. When doing a procedure, say surgery, you do not want to distract yourself with philosophical thoughts of the profound mystery of how a dog’s body works. Nor do you want to be distracted by thinking about the human family of the pet under your scalpel—waiting, worried, wondering somewhere outside the practice, hoping and praying they will soon be contacted with good news. Detachment makes this possible, but at what cost?

Finally, I struggled with dissociation, the disconnection of our mental functions from conscious awareness. As Blake points out, we are not like our clients who very much know the emotional sensitivity of pets in general, and their pets—considered family members—specifically.

Have we lost this awareness, if not intellectually, then emotionally? Yes, it helps us survive the emotional onslaught of illness and loss, but it also cuts us off from important information about our patients and, when taken to an extreme, our own mental and emotional balance.

Feeling human

Let’s go back to Quin’B, my wife’s puppy. Recently, the dog was drinking a lot of water and urinating more frequently, which are telltale signs of polydipsia/polyuria. Teresa was panicked, asking things like, “What do you think she has? Is it serious? Should we take her to Washington State University College of Veterinary Medicine? Is she going to be okay?”

I was comforting and calm, telling Teresa we cannot diagnose via Google, and that we have to run tests to not just find the ZIP code of the problem, but the address. I suggested we start simple:  take Quin’B to a specialist.  I assured Teresa Quin’B will be okay.

However calm I was with my wife, my brain was running the gamut of potential causes, from congenital abnormalities and diabetes to adrenal or thyroid issues. I was overwhelmed with a feeling of complete hopelessness and despair. I had a premonition of Quin’B having a rare kidney tumor: I had her diagnosed, dead, and buried, and my beautiful wife bereft of her best friend.

Forging hope

I was talking to my sister Cheryl, who is a doctor, about how we must be very careful in the words we use for patients (MD) or clients (DVM). We are all so suggestible it is easy to forget how patients or pet parents cling to every word, every nuance of what we say to them.

As Marsh points out in his article, “You can unwittingly precipitate all manner of psychosomatic symptoms and anxieties,” and confesses, “I usually told cheerful, white lies.” Marsh refers to eminent American cardiologist Bernard Lown, who has written about how important it can be to lie to patients, or at least be much more optimistic than the facts perhaps justify. Dr. Lown tells stories of dozens of patients who were close to death but rallied and survived when he was overly positive.

In other words, as healthcare professionals we must never extinguish hope. “Hope is one of the most precious drugs doctors have at their disposal,” says Marsh. To tell someone their pet has a 10 percent hope of surviving distemper, is like saying Sparky has a 90 percent chance of dying.

Hope is not a book, a lecture, or a pet insurance database statistical probability. It is a state of mind, a physiological state in pet parents and, by extension, in their pets.

This is not to mean being kind, optimistic, and hopeful is going to cure cancer or remove heartworms. Marsh points out human minds are always trying to reduce all events to single causes, but most diseases or conditions are the product of many different influences, and the presence or absence of hope is only one among many.

So, with Quin’B, I planned for the worst and hoped for the best. I took her to the practice I work at, and we worked her up just like we would any client’s pup: CBC, chem profile, and urinalysis. Honestly, I knew Quin’B could hold her urine for at least eight hours at night, so I was teetering between overwhelming hope and occasional panic. The diagnosis: simply drinking too much water when stressed. Prognosis: excellent, especially with the lab results. Treatment plan: limit access to water. Update: Like my dad used to say, “she’s running like a Swiss watch.”

The moral and actionable item of this article is to work hard to reduce the influence and effects of the three “Ds” (desensitization, detachment, disassociation) on your actions as a trusted healthcare professional. You have already walked in your client’s shoes as a pet parent yourself. Take it a step further and get into their hearts and heads with heavy doses of understanding and empathy.

Match science with soul. Become a place where state-of-the-art meets state-of-the-heart.

Marty Becker, DVM, writes regularly for Veterinary Practice News. Dr. Becker is a Sandpoint, Idaho, practitioner, and founder of the Fear Free initiative. For more information about Fear Free or to register for certification, go to fearfreepets.com. Columnists’ opinions do not necessarily reflect those of Veterinary Practice News.