Communicating with the crazies

Good communication skills are essential for a veterinarian. If you cannot communicate with owners about their animals, it doesn’t matter if you are a kick-ass surgeon or an internal medicine whiz…they won’t like you. In fact, they may even label you as a “bad” veterinarian. The reverse is also true…you may be the world’s worst surgeon, and may treat every ailment with a shot of Depo, but if you are a good talker, many clients will label you as a “good” or even “awesome” veterinarian.

I cringe and generally want to punch something when I hear people say “Oh, I always wanted to be a vet because you don’t have to work with people!” Sometimes I think that I actually deal more with people than certain human doctors do. I mean, if a client calls wanting to talk to me, if I am not busy I will get on the phone and chat with them. I don’t know many human doctors that would do that.

As a vet, I have to be able to extract an accurate history from an owner, explain to them my exam findings, get them on board with necessary diagnostics and explain the treatment plan. This can be extremely challenging at times. The following incident happened to me about six months after vet school, and taught me a very valuable lesson in communicating with a client.

It was a fairly typical day at the clinic. I was seeing appointments and the other vet, Dr. M, who was older and wiser than me, was doing surgeries. All of a sudden an older woman, who I’ll call Mrs. Roberts, came running in with her 14 year old shih tzu, Max. He was collapsed, gasping for breath and quickly turning blue. A quick physical exam revealed a raging heart murmur and fluid in his chest. I ran Max back to the treatment room and started him on oxygen. My technician placed an IV catheter, and we took x-rays of his chest. They showed he was suffering from severe heart failure.

At that point I brought Mrs. Roberts back to the treatment area. I explained what was happening. I showed her the x-rays and pointed out Max’s enlarged heart and the fluid in his chest. I went over the options, which were to admit Max for critical care, or to consider euthanasia. I have to admit I was very proud of myself for so quickly and competently making a diagnosis, and explaining it to her in such an awesomely clear, compassionate manner.

“What is THAT?” Mrs. Roberts asked. She pointed to the oxygen mask the technician was holding on Max’s face.

“It is an oxygen mask.” I said. “He is having a hard time breathing, so we are trying to give him as much oxygen as possible.”

“TAKE IT OFF!!” She screamed. “YOU ARE POISONING HIM!”

I was fairly stunned. “Mrs. Roberts,” I said. “We are not poisoning Max…we are giving him oxygen.”

“YOU ARE POISONING HIM I KNOW HOW THE GOVERNMENT POISONS PEOPLE AND PUTS LEAD IN THE DRINKING WATER. STOP POISONINING HIM RIGHT NOW OR I WILL SUE YOU MY BROTHER IS AN ATTORNEY.”

“Mrs. Roberts, Max will die if we take away oxygen.” I said. I was shaking at this point. “If you do not wish to continue treatment, then we need to consider the option of euthanasia so that Max doesn’t suffer.”

“I am going to take him home!” Mrs. Roberts said.

I shook my head. “If you take him home without treatment he is going to die a painful, stressful death.”

Mrs. Roberts shook her finger at me. “HE NEEDS TO DIE A PAINFUL DEATH TO GET TO HEAVEN!”

I was lost at this point, and getting angry. “What are you talking about?” I asked.

“I AM CATHOLIC. HE NEEDS TO SUFFER BEFORE HE DIES OR ELSE HE WON’T GO TO HEAVEN. GIVE HIM TO ME NOW SO THAT I CAN TAKE HIM HOME!!!”

At this point in the conversation I was very angry. I should have recognized that the client had jumped on board the crazy train. I should have taken deep breaths, given myself a second, and tried a different approach. Instead, I jumped on the crazy train with her.

“Do you know Saint Francis of Assisi?” I asked. I was referring to the patron saint of animals.

“YES.” Mrs. Roberts said.’

“Well, he would say it was BAD for an animal to suffer. He believed strongly in euthanasia.” I said. Of course, I had no idea if that was true, but it sounded good.

“How do you know he said that?” she asked, glaring at me.

“BECAUSE I TALK TO HIM AND HE TELLS ME THOSE THINGS!” I yelled at her. “HE WANTS YOU TO EITHER TREAT MAX OR END HIS SUFFERING!”

“HE DOESN’T TALK TO YOU, HE ONLY TALKS TO GOOD CATHOLICS!” she said.

“I TALK TO ST. FRANCIS ALL THE TIME!” I yelled.

At this point, the technician very wisely left and got Dr. M. I have a feeling she told him that his new, bright young veterinarian was arguing with a crazy woman about who really talked to a dead saint.

Dr. M walked into the room. He was the calm in the midst of Hurricane Insanity. He quietly told Mrs. Roberts that he understood that she was upset. He said he was sorry that Max was ill. He said that we either needed to treat him, or end his pain.

Mrs. Roberts at this point started to cry. She hugged Max and tearfully agreed to euthanize him. Dr. M. quietly walked her through the procedure, and ended Max’s suffering. There was no more mention of St. Francis.

I had definitely failed to communicate with her. I made an accurate diagnosis, and made very appropriate recommendations, but in the end my lack of compassion and sympathy unhinged the whole conversation. I allowed myself to get angry and irrational, instead of asking myself how this poor woman was feeling in the situation. Her dog went from being happy to dying in the course of a day, and here this young cocky vet was demanding that she make a decision NOW. I was more intent on being “right” and getting her to listen then I was on truly helping her make a good decision about Max.

Yes, Mrs. Roberts was crazy and yes she was being a wee bit irrational, but I reacted in a manner that made it much worse. I learned that day how important it is to stay calm no matter how the client is reacting, and to NOT join them in their craziness. I also learned to try to keep compassion and understanding at the forefront of all of my client interactions.

This is certainly not easy. There are certain clients that can be downright hostile, mean, abusive, non-compliant, rude and sometimes psychotic. I have had clients tell me that they don’t “trust lady doctors” or that I “don’t look like I know what I’m doing.” I have acquired a pretty darn good poker face, where I can smile and nod and NOT say the things I really, really wish I could say.

Now, as a side note to the Mrs. Roberts story…as she was checking out she informed me that she became Catholic because God saved her from being stung by 1000 fire ants that came after her, from being assaulted by a gang of Hell’s Angels that went after her, and from being injured even after she fell down a flight of 100 stairs and hit her head on EVERY single one. I nodded and said she was quite the survivor. What I REALLY wanted to tell her was that she needed to talk to St. Francis more.

 

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Posted on July 17, 2012, in Uncategorized. Bookmark the permalink. 4 Comments.

  1. good story, funny. Hang in there

  2. I had 2 clients tell me that oxygen and Lasix caused chf and it was
    My fault her King Charles was dying .

  3. You have a way with words! Enjoyable, understandable and humorous!

  4. You are too funny!! Love your blogs!

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