Friday, October 31, 2008

Hands-on, and hands-in, animal care

kw: book reviews, nonfiction, animals, veterinary medicine

I'm always ready for another animal book. Not only have I read all the "James Herriot" classics, but other "Country Vet" type books like Fields and Pastures by John McCormack, all of the "Cat Who" mysteries by Lillian Jackson Braun, and about a dozen books that are reviewed in this blog, which covers about three-and-a-half years now. First-person accounts interest me most.

In Tell Me Where it Hurts: A Day of Humor, Healing, and Hope in My Life as an Animal Surgeon, Dr. Nick Trout has gathered sundry typical and not-so-typical incidents from 25 years in practice, to be the framework of a long day in his veterinary surgery. He is akin to a medical specialist. Just as we don't get much contact with a surgeon, at least while awake, Dr. Trout's encounters with pets and their 'parents' is typically brief.

I suspect that most days have fewer than the sixteen incidents he recalls here, and unless he is on 24-hour call (he states it is one week monthly), few days will begin at just before 3 AM and end at 10 PM.

The stories are all like Matryoshkas, nesting dolls that he opens one by one, then re-closes, as memory leads to memory. He has a tendency to philosophize about the lesson learned from each incident. For example, in the chapter "Long Shots and Underdogs", he begins and ends with a dog named Barron who is not at all pleased with him, and attempts mayhem. But Barron has a neurological problem (which is finally diagnosed much later in the book), and both Dr. Trout and the intern who brings Barron to him know these can be quite costly to both diagnose and to treat:
"The husband says he wants an answer but he would prefer not filing for personal bankruptcy or taking out a second mortgage".
This triggers a riff on the great disparity in actual costs of human and animal medicine, and the bigger, but reversed, disparity in perceived cost. Pet care insurance is rare in the US, so we pay full cost, up front, for the care of our animals. No $20 co-pay for the visit, no 90% discount off surgical fees. A $10,000 cancer resection costs you exactly that, though a better-endowed practice can offer timed payment plans. But no matter that the same surgery on your own body would cost $50,000, you'd pay at most $2,000, the 'ceiling' amount on your HMO or PPO policy. We hardly notice the lifetime cost of medical premiums (more than $40,000 so far in my case).

In the midst of a largely philosophical rant, the author brings in an anecdote of a dog who eats his leash, to the final tune of $35,000 in surgical bills. The young man who spent this amount later spent $32,000 for an engagement ring, so the doctor, at least, is clear on the priorities here! And this leads back to the rant, which closes with consideration of the very different prevalence of pet care insurance in the US versus the UK. The doctor does return to Barron to close the chapter, setting the scene for the later denouement.

Most of these Matryoshkas are no more than three deep, like this one. The engaging writing style keeps this repeated chiastic structure from becoming tiresome. The animals and people recorded here cover the spectrum. Perhaps in a few cases a man and his dog will resemble one another, but much more likely are we to find someone like the mainly sedentary fellow who owns a Jack Russel, a very, very active breed. The man tries a few techniques to control the dog, an accomplished escape artist. Finally, penultimately, he overfeeds him to near-catatonia. Later he backs off from using obesity as a control mechanism and gets out more with the dog. His own sedentary tendencies at least partly overcome, he finds his dog has become more obedient. Perhaps this is what the little Jack Russel was waiting for: "Get off your bum, you big dope!"

Another glimpse into the humanity of a pet's 'parents' is offered by a cat with an obstructed bowel. Thinking it might be string or dental floss, the couple agree to have surgical removal to save the animal's life. When the obstruction turns out to be a fishnet stocking, the action shifts from the animal to the marital dynamics of the couple. We may try to hide some things from our children, but how many of us remember that our pets are even keener observers, with agendas of their own?

The case of Barron turns out to be myasthenia gravis, an incurable condition that usually leads to an animal being euthanized. And such will be the case with this dog. You can't win them all, and the doctor's day is closing on this somber note. Yet there are triumphs aplenty. Most animal surgery is getting an animal out of troubles it gets into because of its association with humans. On the way home, he is musing over the need for an on-call surgeon to have a light bar for his car, so he, like an ambulance, can speed to the rescue. One more phone call comes, and with it the final case of the day, that ends in a success story. Like all of our lives: you lose a few, you win a few, and you spend lots of time holding your own.

1 comment:

Adin said...

I too love to read books on animal care, it's my favorite topic.