If the photo attached to this article does not make you smile, then I question whether you have a soul. The act alone contributes to such known positive health benefits. So, take a little look inside and find your joy - whether it is with animals or an activity. Your world and the one around you will be enhanced.
We always hear that pediatric and veterinary medicine are similar, but is this true? I often thought there were commonalities, but after becoming a pet parent and experiencing the other side I am certain. Let’s journey through the lessons I have learned.
I always wanted an English Bulldog. They made me laugh. I crossed the street and was perpetually diverted whenever I encountered one. But, the refrain was always ‘you are in medical school you won’t have time’ or ‘residency there is no time’ or finally an attending ‘where’s the time?’ Bulldog items from friends and family were plentiful in my apartment, but years went by and, still, no bulldog.
Not unlike many families’ narrative of when to become a parent.
After rearranging my schedule to accommodate one responsibly, I finally took the leap and got one. The experience is an allegory to life— and, what living really means. Time is a false perception, it is fleeting. We all have innumerable dreams we don’t realize out of fear, inconvenience, and intolerance of ambiguity or discomfort. The decisive action propelled me on a trajectory of fearlessness, it was the catalyst to my continued pursuit of many other dreams. Now is the only time that truly is meaningful. Tomorrow is promised to no one. So, go get your bulldog!
There has not been one day that I regretted getting Mollie. There is no inclement weather that makes me resentful of having to walk her. When you want something for a long time, you tend to value it more and not take it for granted. Not unlike the families I have counseled who struggle with fertility.
I had us certified as a therapy team and took her to kids impacted by cancer at Gilda’s Club, victims of violent crime at the district attorney's office and my former pediatric office, to name a few. This, too, was a dream of mine. Getting her, singlehandedly, propelled this cascade. The health benefits of animals are proven and well-documented. They reduce blood pressure and heart rate. Assuage anxiety and depression. Early exposure to dog in children reduces the risk of dog allergy. And on and on.
The medical road for this gifted and adorable canine shared many turns most of my pediatric families experience. Here’s why.
Finding a doctor Finding a doctor, albeit a pediatrician or veterinarian, is no different a task. Trust cannot be manufactured. I recall when she arrived and I had to take her for an initial evaluation with a vet to be assured of her good health. The convenient Manhattan office was sleek and modern. The ancillary staff abounded. The vet had two assistants to put her on the table. She received a decent dog exam. I was charged for disposal services and a litany of others that made no sense. When I inquired as to the expense of spaying, I was given an ambiguous response by the staff and the vet that I would be called with an estimate— the vet turns out was not even the one to perform it. When I expressed appropriate concern over anesthesia safety with the brachycephalic (aka shortened head—that is what gives bulldogs - English or French, boxers and pugs the smushed in nasal appearance) breeds, I did not get a sufficient response. He could not name the anesthetics used or convey the volume of cases. I was quoted a fee of $650 plus/minus roughly 10% if needed medicines or there is an issue. I had someone else call the office with the identical description of the animal, and she was quoted $750 +/- %10.
Know your animal, know your child I have always advised people to go to the person who has done the most cases in that particular field, especially with a surgery. Convenience is secondary as doing things right the first time is super important in health care, dog or human. A life is a life. Not doing this can send someone on a trajectory of complications that crescendos in emotional distress, ballooning cost and suffering. As in humans, any anomaly or compromise of the airway, needs to be addressed with caution, in particular, under anesthesia. This is often more risky than the procedure itself. So, why wouldn’t I go out to Staten Island to see the bulldog “expert” vet? He bred bulldogs, had bulldogs and treated every brachycephalic breed more than anyone.
Don’t be distracted by bells and whistles, it’s smoke and mirrors I walked into his waiting room. Stained glass of the breed as well as eight or so actual bulldogs, boxers, and pugs were in the room with me. Moments later, the vet called our name and personally walked us back to the room. No assistants. No modern embellishments. He, himself, lifted her onto the table. He utilized three pieces of ophthalmic equipment (aka eye exam stuff) because he knew the breed has a propensity to develop something called “cherry eye.” At the end of the exam, I realized how superior a bulldog exam she had. The prior vet gave an adequate dog exam, not good enough. I asked what he used to sedate and maintain with respect to anesthesia. He instantaneously named the two drugs I knew were safest for bullies. He was measured, not effusive. When he spoke, he said so much with so little. Quietly effective. I was at peace that I did everything I could to put her in the safest hands for a procedure that would lower her chance of developing uterine cancer, for example, among other benefits.
Like a parent, it was unnerving and stressful and I questioned my decision. His fee was minimal in comparison. His experience beyond compare. He clipped her nails, offered to remove an extraneous tooth and so forth all without up charging or for any additional expense. She had an uneventful, successful course. I found my vet.
Less is more with medications, proper holding essential In pediatrics, proper holding is essential to expediting a procedure and avoiding further injury. The same is true in animals. Mollie had an accident that prompted an ER visit. While there, I was upset and worried for her as she wasn’t walking normally and it was unclear what happened. Animals, like children, cannot convey with words their ails. Caregivers can be informative or entirely lack clarity too.
Being your own advocate is crucial in healthcare, ‘world renowned’ titles are often meaningless It is your obligation to question when something does not feel right in healthcare. An institution is only as strong as its weakest link. While in the ER, the person who identified herself as an attending was not confident in her approach, seemed green and deferred to me since she knew I was a doctor. This was unsettling as I do not claim to be a vet, and in this instance I was a scared loved one. The concern was a broken limb. She stated a CT Scan would be required. This warrants anesthesia. She said, “You know anesthesia with bulldogs is risky.” And, exhibited no confidence. Given Mollie’s physical exam, I responded “shouldn’t we just start with an X-ray which needs no meds and go from there.” She had no faith that this could be achieved which baffled me. “She won’t sit still” was her response.
Umm, clearly she never met me before as I have done limitless procedures on flailing children. The vital part is holding in any exam or intervention. You cannot be timid. When children attempt negotiation and parents indulge, this is when things escalate and anyone involved can be harmed. I called my vet and asked if dogs need sedation for an x-ray, the response “Never.” Alas, kids and pets were the same in this arena. I was decisive and told her to try. She came out moments later, “it was successful, no fracture.”
First do no harm First do no harm, is not a trite phrase. On discharge, it was believed to be a strain, so I was given a prescription for pain medication, an anti-inflammatory and told to follow-up with my vet and rest her. The latter drug warrants liver blood tests to make sure it was safe to give. The ER vet gave me the option of doing them. I said, “of course, I want to know for certain if a medicine is safe to give.” I wound up not giving the anti-inflammatory as it can be problematic. But, the pain med, given her intermittent moans of discomfort, would be therapeutic and aid in her resting the injured limb which expedites her healing. I googled the dose I was given and discovered it was the maximum one. The dog never took one before and when it comes to pain medicines in humans it is always critical to start at the lowest. You can always titrate up. I confirmed with her regular vet starting at the lowest dose. I gave it to her once and she slept nearly an entire day. Had I given her the max dose, it could have been catastrophic. Children and animals are dosed by weight. This is safest. Always remember: when something doesn’t seem right, it usually is because it isn’t.
As in all fields, there are good and bad examples of a professional with the in-between being a mixed bag. Being an exceptional caregiver has consistent traits whether a doctor or a parent. Dogs and humans go through parallel developmental stages from teething in infancy to adolescence and vaccination. Each benefits with positive as opposed to negative reinforcement. The treats and rewards may vary. Both groups do well with proper nutrition and exercise to improve longevity. And, yes, differences between the two pools certainly exist, but animals will always be excited to see you - each and every time!
