Saturday, June 18, 2011

First Lessons

I almost became a veterinarian. A horse doctor, as the cowboys called them when I was a young teenager, distinguishing between the large and small animal variety. Back then, I'd occasionally drop the "doctor bomb" on my parents, testing the waters to see if anything had changed in their perceptions of my future. For reasons I never understood and she could never quite explain, my mother felt my severe needle phobia disqualified me for human medicine but made me a perfect candidate for vet school.

Perplexing as her logic was, it provided the motivation to hang closely with the veterinarians who came to treat our animals, particularly Charlie Vail, DVM. who not only taught me how to administer sub-cutaneous injections (a skill that translates directly to human medicine) but to understand the mind of the horse as patient. A positive treatment outcome can depend as much on the doctor-patient relationship as the nature of the treatment.

You might think it's harder to establish a connection with an animal than a person because animals can't express themselves verbally. In point of fact, not all humans can either. For example, some who are in pain will only tell you, "It hurts." If you ask where their pain is located, how severe is it on a scale of 1-10 (not a very accurate measure, by the way), when did it start, what makes it better or worse, and does it refer to other parts of the body, they respond, "I'm telling you it hurts. What more do you want?" They can no more refine their complaint than a horse could put it into words in the first place. Excepting Mr. Ed, of course.

In psychiatry, you'll hear, "I'm depressed." When you inquire how your patient knows they're depressed, they'll say, "I just am, I know it, that's all." Explain how depression shows up with sleep disturbance, changes in appetite, concentration, memory, or the loss of interest in pleasure, and they'll look at you as though you had three heads. What's perfectly obvious to them ought to be to you. Verbalizing the nuances of feeling is not always within the realm of their possibilities and some of them think it's unnecessary. I'm depressed is equivalent to I'm sick, now fix me. Times like this, you envy the horse doctor.

Speaking of whom, I ought to write Charlie and tell him how his eager student is finally becoming a doctor. He probably won't remember -- it's been years -- though I'm sure he'll remember my father. Everyone from that era remembers dad. Maybe that's why I'm thinking about Charlie this morning, because tomorrow is Father's Day. Because my father was willing to spend the family vacation to make certain I had a horse. Because it was a veterinarian who gave me some of my first lessons in what it means to be a doctor.

(Creative Commons image by Peter Gene via Flikr)

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