“This must be the worst part of your job.”
If you are a practicing veterinarian, I’m confident you field some version of this phrase often. It is a common “client-ism” that presumes a shared pain, one ostensibly expressed in search of a personal connection during a moment of intense emotional need. I would guess as many as 50 percent of my euthanasia appointments include some commentary along these lines.
At one time—earlier in my career—I would nod, smile, and offer some pithy bromide about how alleviating animal suffering is an integral part of our role we have long-since learned to accept. “Of course, it is,” they would agree. “Thank you for being able to do it, Doc. I could never do your job.” But someone must, right? What’s more, I happen to love doing it. Though it makes me feel more than a little heartless to say out loud and would likely seem darkly macabre to an industry outsider, I know I am by no means alone.
Many of us feel this way about euthanasia. We are in our element when we offer preambles to the process, perform the mechanics, report the final signs of life, and comfort the inconsolable. Indeed, some of us are in our most present “flow state” when we are euthanizing patients. I daresay most of us eventually develop an uncommon kind of pride in our mastery of the task.
Given so many of us feel gratified—privileged, even—to offer such a uniquely benevolent service, it seemed like a good idea to share this with the rest of the world. As a result, I was recently moved to pitch a book titled, Pink Juice Diaries. I figured it would offer insight into our profession’s special-ness.
Unfortunately (but shocking absolutely no one), my agent decided we should go in another thematic direction altogether. I hated to lose the opportunity, but he is probably right; normal people are unlikely to understand this part of our job (much less want to read about it).
We all cope in our own ways
Along these lines, I used to confess to friends and colleagues (and to the occasional client whose sensibility permitted an irreverent kind of close confidence) this was where my veterinary skills were best exhibited. “I give good death,” I would quip (with a conspiratorial wink).
In more philosophical moments, however, I would explain administering a beautiful death is doable because chronic, recurrent exposure to the process facilitates the development of unique emotional skills required to “wrap our heads around it just right;” which also explains the glib, off-color banter and self-indulgent dark humor. We all cope in our own ways.
Detachment
To be sure, euthanasia’s necessity is effectively spelled out in our Veterinary Oath, which most of us hold sacred; but “wrapping our heads around it” is also a commentary on emotional self-preservation, right? It is in our best interest to emotionally “detach”—at least to some degree—otherwise the more sensitive among us would not just burn out; we would self-combust.
I’m sure I do not have to tell you how it is: If we approached every patient as if undertaking our very first euthanasia or euthanizing our own pet, we would be lost to grief in short order. We can no more take on extreme empathy than a pediatric oncologist can imagine each patient their own child. I mean, I cannot even cut my own dogs’ claws, much less consider their death on a regular basis. (In fact, I would always prefer to euthanize a suffering patient than trim anyone’s toenails.)
An acquired taste?
Now, I have not always been so sanguine on the prospect of euthanizing patients. Very early in my career, when pre-euthanasia IV catheters were not the norm (at least not where I worked), I would enter the exam room with understandable apprehension. I was not always a skilled “venipuncturist”—not under pressure, anyway.
The anxiety was distracting and invariably detracted from the process. So was the client’s grief. Do I hug? Pat them soothingly on the back? The most helpful words often eluded me. It was a learning process, to be sure.
Fast forward to 30 years, I have learned to lean into euthanasia services. I have my way of doing things and, despite my young associates’ initial disdain for my “old school” approach (no IV cath, just a butterfly for most), they have to admit it works beautifully.
My way tends to mean more patient comfort, no separation from their people, and what is more, almost never fails (not in a way the client might discern, anyway).
I have even learned to prefer house calls, not just for patient comfort, but because it is so much more personal and private (especially when I can fly solo, which I’m sure many of you will frown upon, too).
None of the above should be construed as a boast. It has just been an evolution in how I practice; one I’m sure plenty of you can appreciate from personal experience. Offering a beautiful death is not just an acquired taste, it is an acquired skill. Moreover, I firmly believe the former is only possible after the latter is perfected (to the extent anything can be).
On that note, here are some euthanasia “myths” I happen to abhor:
- “Euthanasia protocols should be uniform and based on ‘best practices.’”
Sorry, but no. Learning how it works best is a highly personal experience you should not deny yourself just because “that’s how everyone else does it.” Everything, from drug selection to drug delivery and client communication, should be individualized. You do you. Authenticity shows and is always appreciated (even more than skill). - “The best veterinarians cry when they euthanize their patients.”
Some clients expect you to cry during the process. Even those who do not harbor the expectation will almost certainly take it as a positive sign of your supremely caring nature. Maybe you have even heard them speak in reverent tones about other veterinarians who cried when their previous pets died. Nevertheless, most of us rarely do. In my case, if tears do spill, it is either because I’m feeling wildly hormonal, currently experiencing a rare depressive episode, or because children happen to be present. (I do not know about you, but crying kids will almost always get to me.) - The strain of euthanasia is why we burn out.
Some of those who support this rationale go one step further; they argue offering this service makes us “too comfortable with death,” so when we do burn out, we are more likely to take our own lives. I call BS on this one, too. Providing a compassionate service will only make you a better person. Few human beings get the opportunity to be as helpful. As to any risks it may entail, I can name any number of professions carrying far greater risk of desensitization to death and dying.
You want to know the real risk that comes with doing our job? The biggest threat to the veterinary psyche is not over the death of animals. It has more to do with their humans. The worst part of our job? It is when clients behave disrespectfully, harbor unrealistic expectations, blame us for their own failures, and deny their pets neither the healthcare they need nor the peaceful death they deserve.
Euthanasia? That is a cakewalk by comparison. While death detail might not be your preferred veterinary function, I’m certain you will agree it is by no means the most distasteful facet of our chosen profession.
Patty Khuly, VMD, MBA, owns a small animal practice in Miami, Fla. and is available at drpattykhuly.com. Columnists’ opinions do not necessarily reflect those of Veterinary Practice News.