Thursday, November 7, 2013

Work Hard, Play Hard

I had a great conversation with friends last weekend.  Both of the women that I was hanging out with are highly successful, and both have worked really hard to get there.  We were all talking about just that....hard work and how difficult it can be to find young people with our same work ethic. Luckily, I have found great people to work at Gladwyne Animal Hospital with me so far, and we are looking to hire more.  If any of the candidates coming to interview happen to read this beforehand, here is a piece of advice that will make me like you  more: do not say that you want "work-life balance".

I find the phrase "work-life balance" so annoying.  I feel like you could insert the phrase "do everything half-assed".  For example: "I would really like to find a career where I can have work-life balance."  You could also say: "I would really like to find a career where I can do everything half-assed."  I think that a much better phrase is "work hard, play hard".  That says to me, that you want to give 110% while you are working and do the absolute best that you can, then you want to focus 110% on whatever it is that you do while you are not at work the rest of the time.   Work-life balance is only achieved by working hard and playing hard.  If you are doing your best all of the time, whether it is at work or at play, then you have work-life balance. You create it, you don't ask for it in a job interview.

Could you imagine a working border collie herding sheep and then just thinking to himself, "Jeez, this is taking too long, I got most of them, I would really rather go chase a ball, I am going to stop now."  (Border collies are smart, they could possibly go through that thought process...)  No, he is going to work hard and play hard and be a happy dog.

Be where you are.  When you are at work, be at work, when you are at home, be at home. Don't think about what you need to do at work while you are at home and vice versa, then you have work-life balance.  Your boss cannot give it to you.

Now, a note to my husband: If you just read this and are thinking "What??? She just said all of that and she totally worries about work while she is at home!" You are right, but I am trying to work hard and play hard and not be half-assed.  I think that writing it down helps.

Thursday, September 5, 2013

Inundated with Information

I love back to school time.  Even more than New Year's Day, I find the beginning of an academic year energizing.  I have loved it since I was a little girl, getting new shoes, a new lunch box, organizing all of my notebooks and folders....it always felt like I was prepared to accomplish great things.  I loved being a student myself, and I love watching my children as students.  As they cover and decorate their books, sharpen their pencils, and pack their book bags, I am reading through the numerous documents sent out by the school district about their plans for educating my family.  Luckily, I have time to do this because of my amazing and competent team at Gladwyne Animal Hospital taking care of everything expected and unexpected that happens there day to day. 

Last night, though, after a full day of kicking butt in surgery and appointments (a topic for a future blog post), I nearly threw the whole pile of back to school papers away.  Here is why, and next is how it relates to veterinary medicine:

I was struggling through the most poorly written document on the introduction of a type of computer called Google Chromebooks to the tools that students will have access to during the school year. I didn't even get to the end of the letter, but on the last page there was a consent form to sign that had, thankfully, a bottom line: my child will need a username and password to be assigned by the school district.  Fine. I am sure that Google Chromebooks are a good thing, but the document was so poorly written that I was not only bored before finishing the first paragraph, I was wondering who the district staff member responsible for writing it was.  That person needs to know that I trust the district to make decisions on implementing new tools, and if I wanted four pages of information on Google Chromebooks, I would have gone to the internet and read some clearly stated information about it.  (I did that this morning.)  What I wanted from the district was about four sentences: "We have decided after researching the evidence to use "x" in the classrooms.  In order for you child to take advantage of "x", you need to do "y".  Here is how to do "y".  Please contact us or go to "z" web page if you have questions about "x" or "y"."  That would have been ideal, but if they really felt the need to give a large amount of information, they should have proofread it.  The letter was awful.

How does this relate to dogs, cats or veterinary medicine?  I hope that I have earned the trust of my patient's owners and that they know we are always there to answer all of their questions any time.  With that, I think that most of those very busy people really just want to know clearly and  concisely what I think the problem is, and what action they need to take to solve the problem.  At that point, if they have questions, I have answers. 

Lower Merion School District has earned my trust.  The teachers and administrators have not let me down.  While I still love back to school season, I do not have time to read infinite pages (nor do I want to see that much paper wasted) about policies and procedures.  I trust that the policies and procedures are valid, and if I have a question, I'll ask.

Thursday, February 21, 2013

Two ears and one mouth

I read a commentary article in a recent JAVMA (Journal of the American Veterinary Medical Association) issue that made me feel pretty good.  It was entitled "Reactive versus empathic listening: what is the difference?  Before I started reading, I was pretty sure that I knew the difference.  After reading, I felt grateful that I have been practicing empathic listening for most of my life.  I found the article both interesting and inspiring, and made me want to make sure that I do not forget just how important listening is.

It seemed funny to me, though, that an article needed to be written about listening as a way of coaching veterinarians who are practicing reactive rather than empathic listening. 

In a nutshell, here is the difference: Reactive listening is listening with the motive of formulating a reply.  Empathic listening is listening with the motive of understanding the concerns of the speaker.  Reactive listening will most often result in a response that is based on the listeners point of view, and usually involves interruptions and interpretations.  Empathic listening, if there is time, will usually be more rewarding, because the goals and problems presented by the speaker will be more fully understood and addressed. 

There were many times when I first started practicing that I felt like there wasn't enough time to really address the concerns presented in an appointment or I even failed completely addressing only what I thought the problem was.  When I opened Gladwyne Animal Hospital and could do things my way, I decided it was important to make my appointment intervals longer than the usual 15 minutes.  It is so important to me that people have enough time to get comfortable and remember everything that they wanted to say.  I am able to just listen without interrupting.  The funny thing is that I learned how to do that over thirty years ago!  I am the youngest of six kids, and my older brother Jeff has always given sage advice.  One of the things that he always used to say to me was that "You have two ears and one mouth for a reason. You are supposed to listen twice as much as you talk."  He is usually right. 

Interestingly, while I was thinking about writing this blog post, I was waiting for a Doctor appointment of my own.  I waited for 45 minutes with no interaction when I finally, politely, told the receptionist that I would have to reschedule.  She told me that she was sorry, but the doctor had 40 appointments scheduled for today, and was behind.  Of course he was behind!  How can you possibly see 40 appointments in one day!!!!  None of the patients could possibly be getting the chance to be empathically listened to.  I was glad that I had decided to leave.  I hope that nobody ever feels that way in my office, and it is my goal that they never do. 

I will admit, though, that sometimes after a full day of empathic listening in appointments at work my kids get the short end of the stick.  Sometimes they sound like the teacher from Peanuts, you know "wha wha wha whaaa, whaaa,whaaa...." and I may have said yes to some requests to which I should have said no!

 
This is me learning to sit quietly on my brother Jeff's lap.  Early lesson in listening skills....

Thursday, January 31, 2013

Informative and reassuring, or overwhelming and off-putting...

I ask myself this after nearly every new puppy or kitten appointment.  There is just so much information to share with a new owner, especially if they have never had a pet before.  If the new puppy or kitten came from a shelter then I feel like I am overwhelming and off-putting.  If the person went to a breeder or pet store, then I feel like I am informative and reassuring.  That is a bummer, because I really love when people can rescue their new addition from a bad situation, but I feel like they never get enough information.  So as frustrating as breeders and pet stores can be sometimes, they do make that new kitten and puppy appointment easier somehow. 

Here is some support for how I am feeling.  Yesterday, I saw a friend in an appointment with her new kitten. The kitten is absolutely adorable and she and her 3rd grade daughter are in love with him after only one short week.  They made an appointment for a check up just so that they could be sure that they knew what they were supposed to be doing even though the foster family said "that everything has been done already" at the adoption event where they went to rescue him.  Well, if "everything" means neutering and a Rabies vaccination, then sure, everything was done. I cannot even be 100% sure that the Rabies vaccine was done, the paperwork just didn't jive in some instances.   For example, his birth date was October 20th, and the first vaccine was given on October 27th.  I doubt it.  That would be pretty strange.  So, after examining this sweet thing and reviewing all of the paperwork, and checking for the microchip that was supposed to be there and wasn't, we discussed all of the findings and the to-do list. 

The findings:  He is an adorable kitten with a lovely disposition.  He has the usual complement of shelter/rescue cat problems which are; ear mites, worms, a resolving cold, and very stinky gas.  I can fix all of that with relative ease most likely by asking his new owners to employ my to-do list, but is that overwhelming and off-putting?  Do I seem like I must have some vested interest in a pharmaceutical company (nobody is mentioning Pfizer in particular, here...). 

The to-do list:  First of all, consider a Leukemia and FIV test and consider a series of Feline Leukemia vaccinations and installing a Microchip since he didn't have one like he was supposed to have had.  However, with the remainder of the must do items on this to-do list, maybe we should spend the money elsewhere.  Treat the ear mites, send out a few serial stool samples to ensure that we eventually eliminate the scary zoonotic (transmissible to people, even 3rd graders!) parasites, deworm him right away before even waiting for a stool sample, begin applying topical applications of Revolution monthly to maintain a parasite free environment, start a special diet with prebiotics to help eliminate the stinky poops while we wait for the parasites to go away and for his little belly to straighten itself out, and go from there. When I say go from there, I hope that it doesn't mean test him for FeLV and FIV because he isn't getting better.

Can I really expect this person to now have a discussion about routine care and wellness after all of this has been thrown at them?  Would it be ridiculous to suggest that they come back for another appointment in two or three weeks just to discuss wellness since we had to gloss over wellness so quickly? 

Why do foster families and shelters mislead people by saying that everything is done, you just need to make a donation and you are good to go?  Most often, these pets are far from "good to go" and the people end up spending about as much as they would have if they had purchased their pet in the first few weeks.   I am not suggesting that people purchase rather than rescue their pets, I just wish that they were made aware of the potential problems and expenses that they may incur.  In this case, I am lucky, because my friend wants to do the right thing, and without even knowing there was a problem, made an appointment.  But what if she had just waited until the Rabies vaccine was due next year?  Well, chances are she would have never made it that far before the diarrhea began, but if she did, that poor little guy would have suffered with ear mites for a whole year!  I am willing to bet that his ears would never recover to a completely normal state if it had gone untreated.

I hope that I was informative and reassuring, but I am afraid that I was overwhelming and off-putting. 

Thursday, March 15, 2012

I can finally get some sleep

Cats and dogs eat crazy things, and those crazy things can occasionally get stuck somewhere in the middle.  When this happens, we call it a Foreign Body Obstruction (FBO) and they can be pretty simple to remove or a total disaster.  If the foreign object hasn't been in there for very long and it is visible on an xray, that usually results in a good outcome, but if Fluffy isn't telling her owner just how sick she really is, and the item is not visible on an xray (metal, bone or some other dense object), then things can start running downhill quickly. 


This is Cookie, he looks like a good boy, right?


This is Cookie's story. What Cookie swallowed wasn't that big, but he isn't much of a complainer and didn't start to act like he was sick until about a week after eating a large bead from a child's jewelry making kit.  I have to imagine that most of the time, these things are swallowed by accident, I can just picture him playing with it, carrying it around in his mouth and then, GULP, down it went.  At first his owner wasn't worried,  she hadn't seen him swallow the bead. Eventually she brought him in and we were able to figure it out pretty quickly.  I didn't know what he had swallowed, but I knew that we were going to find something.  Well, that bead managed to get out of the stomach, but got stuck in the duodenum, right next to the pancreas.  Ugh, the pancreas is so sensitive, I don't even like to look at it.  Well, with it having been there for a week or so, that piece of duodenum was pretty grumpy.  If it is questionable whether or not a piece of intestine is going to survive, we just take out the whole section and put the good, healthy ends back together.  But in this case, I really wasn't willing to take out that section of duodenum because of its proximity to the pancreas unless it had already fallen apart, so I made an incision into the duodenum, took out the bead and closed it back up. I put in my usual "sleeper stitch", which is that last stitch that you put in when you are asking yourself or your assistant, "do these look like they are close enough together?" so that you can sleep knowing that the sutures were definitely not too far apart.  That didn't really work for getting sleep though, like its name suggests. 

I have a friend who is an amazing human cardio-thoracic surgeon, so as usual, I told him about the case and asked, as if he had a crystal ball, did he think that the duodenum would live.  His answer, of course, was that he didn't know, but he would have made the same decision and in fact used to go running from any procedure involving the duodenum and pancreas as a general surgery resident.  That made me feel better, but not better enough to sleep well for about 10 days.

It was finally at that 12th day when Cookie came in to have his sutures removed that I had a good night sleep.  Any problems from here on out couldn't be a direct result of my surgery.  I also let my kids off the hook during bedtime prayers, they could pray for whoever they wanted instead of saying "God, please let Cookie get better". 

This is the bead that Cookie swallowed.


Cookie is back to his playful self, as lovable as ever.  Now his owners are probably the ones losing sleep trying to keep their house Cookie proofed.  That is not going to be an easy job!
 

Thursday, November 17, 2011

Good Luck

Today I found a cat whisker while I was sitting on the couch reading a story to my son.  I love when this happens because there is an old wives tale that says finding a cat whisker is good luck.  I have always chosen to believe this, and so far, it seems to me that every time I find one something good happens soon afterward. 

I don't find them often, and you really shouldn't.  Cat whiskers, or vibrissae, do shed occasionally, but generally shouldn't break and shouldn't all fall out at once.  If they do, there is usually a problem of some type worthy of a trip to see me.

I save my cat whiskers in my jewelry box, but I could even buy a piece of jewelry designed for just such a purpose.  How surprising!    Cat Whisker Charm Bottle

Thursday, November 10, 2011

My cat's BFF is a dog


I adopted Teddy in 1999.  She was a pretty sad little kitten, rescued from a parking lot in Brooklyn known for it's population of feral cats.  She was only 4 weeks old, and not completely feral.  She tolerated being held and medicated for 2 weeks in the animal hospital that I worked at part time on weekends.  When I left her the first weekend, I felt sorry for her and thought that she was pretty cute.  By the second weekend, she was definitely a little less friendly, tired of being medicated for her upper respiratory infection.  By the third weekend, she was actually disgusting.  The cornea of her left eye had ruptured and what used to be an eyeball looked like nothing I could describe without turning the average person's stomach.  The busy staff did little more than medicate her and feed her as there were many other needy patients that were far more appreciative of their efforts.  So, as any young veterinarian would, I decided that I'd have to take her home.  I surgically removed the horribly infected eye, and a few hours later boarded the Amtrak from NYC where I was weekend moonlighting  to Philly where I lived. 

At only 6 weeks old, she made fast friends with my yellow lab.  She really could not have cared less about me.  For the first 12 years, she hung out with the dog, ate the cat food that I provided and politely used the litter box, but really didn't care for human attention.  In December 2003, her friend died.  I think that she was really sad, because that was the first time that she decided to try and make friends with me.  About 6 months later we adopted a dog, and I think that I heard her breathe a sigh of relief.  She just loves dogs!  She doesn't need me anymore.  Oh well.

video

Watch Teddy give Ozzie a massage, she does this several times daily.