“It was the best of times, it was the worst of times…” ~Charles Dickens

Roller coaster

FreeImages.com/James Williams

The morning started pretty routinely. I saw a few appointments and did some surgery, just the usual life-saving stuff that’s ho hum these days (kidding). Our local board-certified radiologist  stopped by on schedule to do ultrasound exams on a few patients that we’d lined up. Just another day in paradise.

One case had me very curious. We’d done an abdominal ultrasound on this cat 8 or 9 months previously (when he stopped eating and started vomiting) and found some very abnormal tissue that most resembled an intestinal cancer. He was 10 years old, so cancer was by no means a surprise. We did aspirates of the abnormal tissue (stuck a needle in it and sucked out some cells) and sent them to the lab. The pathologist who read it out said they couldn’t be 100% sure it was cancer from the samples we sent, but all signs pointed that way.

His owner, much saddened, declined any further diagnostics or surgical intervention, and decided to take him home with symptomatic management of his GI signs. I was sad as well. We had some head bonks and purrs before I put him back in his carrier to go home.

Now, though, it was 9 months later and he was doing great. When you have a patient that outlives all of your expectations you celebrate, but you really have to question the accuracy of your diagnosis. In this case it should read “tentative diagnosis” because we never did confirm cancer definitively in this cat, which would have taken surgical biopsy samples. So he was one of the cases for the radiologist today, to see whether the abnormal bowel was the same, larger, smaller, gone, or what.

We did his ultrasound and found absolutely nothing. Nothing abnormal, that is. Perfectly normal intestines, no mass, nothing. I have seldom been so happy about normal results. The abnormality we saw on the original ultrasound and the abnormalities on the aspirate samples were likely from severe inflammatory bowel disease, which eventually responded to our symptomatic treatment.

I have never been so happy to make a phone call. I love this owner, who is one of the sweetest people I know. Giving her this news was the highlight of my year. You couldn’t find two happier people in the country at that moment. It was the best of times.

I walked back to the treatment area. My own cat was under the probe of the radiologist having a routine check of his chronic bowel disease (it’s a common thing in cats). I glanced at the ultrasound monitor and my world changed.

There was an ugly, meaty, tumor in his abdomen beside his liver, obvious even to me.

This couldn’t be happening.

No.

This is my best friend. I’ve had many cats over the years and loved them all, but two have really been heart cats, the ones you bond with from the moment you meet and love more than anyone else. There’s something about the personality, behavior, appearance, movement, the way they know what you want and need. And this is my heart cat.

The radiologist apologized for finding it. Her job is as hard as mine. Usually when she finds bad things it’s up to the vet to communicate this to the owner, so she’s at one remove. But she does ultrasounds for our personal pets, both vet and staff, and then has to be the one to break bad news to people that she knows, sometimes knows very well. It’s tough. It’s obviously not her fault, and there’s a Canadianness to the apology. And I know exactly what she means by it, because I say it to owners all the time in the same circumstances.

I deliberately put it out of my mind for the rest of the day. My buddy has a tumor. Remained detached. Didn’t think about it. Dealt with clients normally. But my buddy has a tumor. Luckily there wasn’t anything that required a lot of mental effort, mainly routine stuff, nothing dramatic, no dying patients. And then I got to go home to process what this would mean for the two of us, wearing both my veterinarian cap and my owner cap.

It was the worst of times.

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4 thoughts on ““It was the best of times, it was the worst of times…” ~Charles Dickens

  1. Reading this crushed my heart and reminded me so much of similar moments we’ve had with our own pets. The depth of the pit your heart falls into when you see something on the monitor you just don’t want to see, the disorienting feeling of being both glad and upset that you’re a vet at the same time – that you can help and make good decisions but wishing in some way you could still somewhat more innocent of what the news means. Will be thinking of you and your kitty and hoping for good news, easy decisions, little pain and happy moments for you both wherever possible.

    Liked by 1 person

    • It really is strangely disorienting. That’s a good term for it. This happened a couple of months ago, so things have settled down a bit (emotionally). Thanks for the good wishes going forward, though. Every day with him feeling well is a gift.

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  2. I am so sorry. Sometimes it is difficult being the doctor. Sometimes it is difficult being the owner. But being both, sometimes is almost unbearable. (I use the term owner lightly, for it can be hard to tell who owns who.) My thoughts are with you and your little buddy.

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  3. Thank you for giving voice to the roller coaster that is veterinary practice, especially when we face illness in our own pets. “Am I the rational professional now or am I the distraught owner?” You and your heart kitty are in my thoughts and prayers.

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