Love Is the Best Medicine (17 page)

“I told my mom how nice this hospital was and how Cleo was getting the best possible care and all about how great you were and we all did our research on you and we know everything about you right down to your pant size and we thought we were doing everything right.”

The words came out too fast, without a single blink, and when the outburst trailed off, it was replaced by tears and I watched her head dip, shoulders finding their weeping rhythm. There have been few moments in my professional career when I have felt more crushed or more of a failure than that day sitting with Sonja on the cold exam room floor.

“How do I tell my mom? She knows I am meeting with you. This is her baby. I can’t call her. I can’t tell her all is well.”

I offered to be the one to call her mother and break the news but she was unsure. I asked if she could discuss what to do with her husband, or a sibling, to get some advice as to how to proceed. Again she hesitated, but for the first time, behind bloodshot eyes, I glimpsed the cogs of accountability beginning to turn. She began to pull herself together, but not before delivering her coup de grace.

“I’m so sorry,” she said. “I can’t imagine how hard this has been for you. Do you have to be somewhere else? Is there something else you need to be doing?”

This, by far, was the low point. After all I had done to this family, Ms. Rasmussen was apologizing to me.

Time was all I had left, all I had to offer, and it was a relief to give it away. This was Sonja’s moment of grief and I would share it for as long as it took, knowing she needed to maintain the dialogue,
knowing that as soon as she stopped and left this room, she and grief would be spending a lot more time together alone.

At some point I asked about a postmortem examination and Sonja handled the question with calm and understanding. She said she would have to think about it and talk to her mother and I insisted they take all the time they needed.

I wondered what she would remember of this meeting, what little details would be forever imprinted—the smell of antiseptic, the sight of a Neiman Marcus logo like the one gracing the bag at her feet, the sound of animal footsteps parading just outside the door. I didn’t know but I knew this moment would linger for her in a visceral way, as it would for me.

When we stood face-to-face, about to say our good-bye, somehow the formality of a handshake seemed ridiculous. She had every right to be angry at me, to hate me, to blame me. Instead she leaned forward and opened her arms wide and we hugged. As we parted I made a point of locking eyes, wanting her to see that although I did not share her tears, she was not alone in her grief.

She picked up her bags, covered with now inconsequential names and logos of boutique stores from another world and another time, and I walked her into the lobby. Icy January air baited us as we stood too close to the blast from the automatic entrance doors. I offered to call for a cab but she declined, as though she had made up her mind to walk even before I asked, and I could tell it was the right decision. I promised to call first thing in the morning, and Ms. Rasmussen stepped out into the darkness.

H
E
decided to join me on the drive home from work, determined to carpool, that niggling, contrary little voice I get inside my head whenever I’m emotionally vulnerable. You know the one, the diabolical confidant that despises the distractions of talk radio or NPR or books on CD, insisting we proceed in silence, ready to strike with a viperous jab or a whispered innuendo. Oh, he was in fine form that night, savoring the crush and crawl of Boston commuter traffic to offer his highlights from the day’s audio and video, and long before I pulled into my driveway, simple melancholy and remorse had been superseded by his implication that there would be far more alarming ramifications following Cleo’s death.

Not to be left out, paranoia also hitched a ride and insisted on staying over for dinner with the family. On the outside I was poor company, distracted and monosyllabic, with no appetite. On the inside I was feasting on an “all you can eat” buffet of panic-inducing words and phrases—
lawsuit, negligence, punitive damages
.

Shortly after the plates were cleared, I excused myself to the office for a little online search and reassurance mission, beginning with a trusted favorite, the Web site for the Royal College of Veterinary Surgeons.

Mouse scurrying, I sent the curser arrow flying across the screen like a medieval warrior, ready to fight these demons with pragmatism. As I mentioned, this was not the first time (and sadly, it was unlikely to be the last) that I had been responsible for an anesthetic death. However, on this occasion, I had yet to speak to Cleo’s real owner. What if Sonja’s mom was far less understanding, but rather litigious and hungry for retribution?

“Get a grip, Nick,” I told myself. “Remember, there is a big difference between ‘things went wrong’ and ‘you did something wrong.’”

Then I clicked on a drop-down menu that said “disciplinary hearings” and heard a chuckle, courtesy of my copilot from the ride home.

Sure, Nick, live in that dream world if it helps you sleep tonight, but what if Cleo’s postmortem examination tells a different story?

I churned inside, knowing there was some truth to this notion, as I opened a series of press releases regarding British veterinarians who had landed in trouble with one of our profession’s governing bodies.

The concept of “when good vets go bad” is wholly unpalatable, unacceptable, the stuff of tabloid fodder and shock journalism. It is one thing to be outraged that your pet’s doctor has no veterinary education and has been found guilty of impersonating a vet, but quite another when the person you entrusted with the care of your pet has an addiction to controlled substances, or neglects the fundamental tenets of his veterinary oath. Vets are just as human as MDs, dentists, pharmacists, and chiropractors, just as flawed and susceptible to the same weaknesses and vices as all of us. So why do we feel so pained, so violated by unprofessional veterinary conduct?

Perhaps the answer lies with the victims, placed in harm’s way by us, the pet owners. Pets attain a heightened sense of innocence since their place in the health-care system is passive, at the mercy of their most trusted advocates, their owners. If we failed to spot a problem, were blind, conned, or worst of all, failed to look, the burden of responsibility will come back to haunt us.

To be fair, veterinary misconduct is extraordinarily uncommon, and I was thrilled to note that the disciplinary body of the Royal College of Veterinary Surgeons deals with only a handful of cases every year. On the whole, most of these transgressions are unpleasant but predictable: driving drunk, abuse of available narcotics, forging health certificates, threatening or aggressive behavior toward clients and staff. Back when I was in veterinary school in England, glaring lecturers would warn that the consequence of any professional misconduct would be that most heinous and damning conviction, the most definitive punishment of all—being struck off! More evocative than “losing your license to practice” or “being disbarred,” I believe this phrase was meant to strike fear in the hearts of cavalier veterinary students: I always envisaged a crusty, gowned gentleman in a powdered gray wig working his way down a ledger, fingering my name written in bold curlycued copperplate, and savoring his chance to take quill to ink before scratching it out as though it had never existed. The years of study, the credentials, the credibility—swept away in a single stroke. Indoctrinated by this image, no wonder I was flustered and questioning my professional liability.

I moved on to Google, and felt myself succumbing to all the endemic negativity of the Internet.

“When a pet or other animal is injured or killed by a person or another animal, the owner is often entitled to damages even if the animal was not harmed on purpose.”

“Malpractice lawsuits against veterinarians have seen nearly a seventeen percent increase in the last decade.”

It became apparent that the legal standing of our pets is a complicated and emotional issue. Many laws are outdated, and they vary considerably from state to state. Assigning the family dog the same status as inanimate property like a lawn mower or a hair dryer just doesn’t cut it in this new millennium. Pets are animate, they have feelings, they have the capacity to demonstrate pain and suffering. Pet death has the potential for significant emotional repercussions
for those left behind, regardless of how it came about. The problem lies in defining this loss of companionship and proving the degree of emotional distress that ensues.

Semantics have only complicated the picture. There are arguments for a label of pet guardian versus pet owner, for defining pets as sentient property (any warm-blooded, domesticated nonhuman animal dependent on one or more humans for food, shelter, veterinary care, or compassion, and typically kept in or near the household of its owner, guardian, or keeper), for pecuniary (replacement value) versus punitive (assigning emotional value and punishing the wrong doer) damages. I came away with the feeling that pets continue to be a legal work in progress, though progress seems to be inadequate, fickle, and highly dependent on jurisdiction.

Our twenty-first-century love affair with the animals in our lives appears to have placed veterinary medicine and the legal system at a crossroads. Today, almost half the law schools in the country offer courses on animal law, moving beyond the prosecution of animal cruelty cases to the kind of work that usually applies to human offspring, such as setting up trusts to bequeath money to a pet after an owner’s death and dealing with pets in divorce custody disputes. The arguments against punitive damages have so far held up and still pack a powerful punch. Will punitive damages encourage a flood of lawsuits, significantly increasing veterinary malpractice premiums? Will veterinarians seek the security of practicing defensive medicine, thereby reducing the overall quality of health care for our pets? Will vets be forced to raise their prices and make responsible pet ownership a luxury? These questions will need to be resolved because now that our dogs have discovered the family bed, they won’t be returning to the kennel anytime soon!

I logged off, haunted by one tidbit of information that stuck.

“The plaintiff has to prove emotional distress, to support the allegation.”

All I could see was the image of Sonja Rasmussen, collapsing to the floor when I told her about Cleo’s death, and I thought, “If that wasn’t emotional distress, I don’t know what is.”

T
HAT
night, hypnotized by the glow of red numbers from a bedside digital alarm clock, my mind refused to shut down for sleep, preferring to continue obsessing about thorny veterinary situations.

I thought about a colleague named Neil, as flamboyant and passionate a vet as you will ever meet. Thirty years of general practice had done nothing to quash his excitement for the job, his desire to connect with animal and owner alike. You would think he had discovered how to split the atom when he dragged an owner from his examination room and forced her to look down his microscope and gape at the magnified ear mites swimming on his oily slides, her cat’s head-shaking disorder unearthed. Determined to befriend a nervous rottweiler, convinced he had learned all the necessary pointers from an episode of
Dog Whisperer
, he would risk a reassuring pat even if it meant his hand was gnarled to the consistency of a spent rawhide chew. And faced with a surly dog in need of a nail trim, Neil would choose charisma over chemical intervention every time, growling as he took the patient’s scruff between his teeth, inciting memories of the dog’s mother and life as a submissive puppy before setting to work with his nail clippers.

His style was sufficiently unique that he either attracted clients to his fan base or repelled them to his partner in their practice. However, one client, the inimitable Ms. Adelaide, owner of a Persian cat, Arthur, began to seriously question her allegiance to Neil and his unconventional approach to his patients.

Ms. Adelaide was a former Broadway actress whose commanding stature, raptorial features, fulsome gray locks, and dramatic affectations dwindled to insignificance the moment she set foot inside
Neil’s clinic. It hit her in the manner of a third martini, creeping up on her, catching her off guard with its dangerous blend of antiseptic haze, confined spaces, blood, and needles. She lost all pretension, as though her part were being played by a timid understudy.

It didn’t help that Arthur insisted on making up for his mother’s infirmity in hospitals by morphing from a state of placid domesticity into feral savagery, swiping and hissing as soon as he was extracted from his carrier. Arthur’s indignation would build to a crescendo, his cry winding up from a low growl to a high-pitched scream like a high-revving motorbike.

I’m reluctant to use a weathered cliché, but a perfect storm had been brewing for some time, not least because Arthur’s illness made him a frequent visitor to the hospital. Arthur was infected with feline immunodeficiency virus, FIV, a close cousin of the notorious human retrovirus HIV. FIV only infects cats, but in many ways it behaves in a similar manner, hiding out for months or even years, biding its time, teasing the body with unpleasantries such as gingivitis, sores in the mouth, and fevers. A weakened immune system leaves its victims vulnerable to infections. They lose interest in food, they lose weight, and ultimately, they lose the battle.