By Jennifer Shepherd, DVM
"I have been a small animal veterinarian for over sixteen years. In all those years, I have had a lot of successful cases. Along the way, I have also had my fair share of cases I would consider failures. However, there is one case that stands out to me as the greatest success story of my career. What may be surprising, is that some people may consider this case a failure.
It was a Thursday afternoon in August 2011 when Annie presented to me as an ADR. She was a twelve year old female intact mixed breed dog. It didn't take much of a physical exam to see that Annie had pyometra. The pyometra was open, but had been going on for at least a week and Annie was sick. The prognosis was guarded with surgery and grave without it. Annie's mom was devastated with the news, but what was even harder, was that Annie's mom didn't have enough money to pay for surgery.
It had taken her a few days just to scrape together the money for the office call. I discussed the seriousness of Annie's condition and told her surgery was the only option to try save Annie. I wanted to help them so I explored all the options - she couldn't afford emergency surgery at my clinic so I called the low cost spay neuter clinic. They said they would only perform surgery on Annie once she was stable. Annie's mom was not ready to euthanize but could not afford hospitalization so I advised oral antibiotics as an option, knowing that oral antibiotics alone were unlikely to stabilize her enough for surgery, but it was worth a try. Annie's mom didn't have enough money for antibiotics that day but said she would do what she could to get the money. I gave her two Clavomox tablets, one to give that night and another to give in the morning along with a price quote for a week of antibiotics.
Annie's mom came back Friday morning with the money for a week of Clavamox. Again we discussed Annie's condition and that immediate surgery was the best option. Annie was still not stable enough to have surgery performed at the low cost spay neuter clinic so I gave her an estimate for surgery at our clinic, cutting the cost down as much as I could. I discussed the case with my husband, the business manager, and he agreed to let me perform the procedure only if they could come up with a deposit of $150 - enough to cover our supplies and anesthesia - and a payment plan for the rest, knowing that we may never see the rest of the money.
Although I wanted to do the surgery on Friday, Annie's mom only had the exact amount of money needed for antibiotics. Annie's mom said she would do all she could to come up with $150 and would be back Monday morning, if she found the money. She was well aware of the risks of Annie's condition worsening over the weekend and that she may not survive but was determined to give us a fair deposit for the surgery.
I honestly didn't think I would see her again but the woman was there with Annie as soon as the doors opened Monday morning. She had sold her car and had $200 in cash. Annie's condition had worsened over the weekend and she was very sick. I discussed with her that Annie was a very poor surgical candidate but she wanted me to try. We immediately started Annie on intravenous fluids and antibiotics. After a few hours of fluids, I took her to surgery. Throughout surgery, her blood pressure was dangerously low. I performed the surgery as fast as I could while still being careful - it was probably the fastest pyometra surgery I had ever done.
I wish I could tell you that Annie recovered and went on to live another few years. Unfortunately, that was not the case. Annie had stopped breathing on her own during the surgery and the anesthesia technician had been ventilating her throughout the procedure. Even with the gas off, she would not breathe on her own and her oxygen saturation continued to decline. She developed ventricular tachycardia about an hour after surgery and we were not able to revive her despite aggressive CPR and emergency medications.
Even though Annie did not survive, her mom was extremely grateful that I had given Annie a chance. She thanked me with tears in her eyes when she picked up Annie's body. She promised to pay the remainder of her bill with monthly payments. The following month, we mailed her a statement with the balance on her account. I felt badly that she still owed money even though her dog had died and had little faith that we would ever see any more money from her. But a few days later, we received a check for $20. The $20 continued every month, with the exception of one missed payment. She called to apologize and explained that an unexpected emergency had come up. After about two years of $20 payments, her bill was paid in full.
Three years later, I walked into an exam room to examine a cat and saw a woman with a huge smile on her face. She said, "Do you remember me, Dr. Shepherd? You did a pyometra surgery on my dog Annie. She died during surgery. I just want to thank you for all you did!" She went on to tell me her story. The reason she could not pay for Annie's surgery the day she came in was because she had spent all of her money on drugs. She was a drug addict and did not have any faith in herself or others, Annie was all she had.
"You gave me and Annie a chance, and that chance changed my life," she explained. "Because you trusted me, I realized I needed to do something with my life. I entered treatment, became sober, and got a job! I have been working hard ever since, supporting myself and paying my bills. You changed my life!"
My jaw dropped to the floor. To be perfectly honest, I didn't recognize her or remember her until I went back and read Annie's record. At the time, she was just a distraught woman with a very sick dog and I wanted to try to help them. After the dog died, I grieved a little inside that my attempt to help them had failed, but, as we have to do to survive in veterinary medicine, I put the case behind me and went on to my next patient. Three years later, I learned what a big impact my little act of kindness had in her life.
Sometimes I have my doubts about my career choice. I hear stories of sick children and hurting people and wonder if I should be working in a field that would help them. How is treating a dog's ear infection or a cat's abscess making a difference in the world? Then I remember Annie's mom. I treated her animal with compassion and I treated her with respect and those two acts made a huge difference in her life. It reminds me that, although I may not be changing the world, I am making a difference in someone's little world, even if I may not realize it. My career choice is impacting people and animals in ways I don't see and never know. Even the times when the animals dies and I feel like I failed, I may have had a positive impact on someone's life and because of that, it was actually a success. And the successes are why I became a veterinarian."
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Author Jennifer Shepherd, DVM