“I’ll never forgive you for this. Never.”

despair-nick-marshThe man whispered the words in my ear through his tears as I picked up the still-warm body of his companion of 10 years and turned to carry it back towards the practice.

A feeling was growing inside me, making my steps heavy and my head numb – a feeling that I was not just unfit to work, but that I was evil, tainted, and that maybe it would be fairer if it were my body slowly cooling now life had left it, rather than the dog’s in my arms. It was the worst feeling I could imagine.

I had felt it before. I wonder how many of you have, too?

Setting the scene

Weekends on call can stretch out like a prison sentence, either interminably slow or maniacally hectic. This wasn’t one of the slow ones. Morning surgery had finished 45 minutes late and during it I had collected a cat to stitch up, a dog chest x-ray and a rabbit dental.

The inpatients needed more care and more decisions, but every time I tried to sit down to look at blood results and think my way through the cases, the phone screamed again, and Sophie would hand it me with an apologetic look on her face. Something else to deal with.

The jobs stacked up and every few minutes I seemed to be further from the finish line. I was stressed, tired, and (not for the first time) wondering why I had picked this profession.

If that bastard phone rings one more time, I thought, I’m going to explode.

It rang again while I was anaesthetising the cat. A long-standing client of mine wanted to talk to me about his West Highland white terrier. I wanted to cry, but I swallowed it, and took the phone from Sophie.

“It’s Nick here,” I said. “What can I do for you?”

The client was relieved I was on call – he trusted me. He explained his dog wasn’t very well. She had been sick that morning and was just “a bit out of sorts”, not wanting her breakfast and not really wanting to move around. He just wanted a bit of advice, he said. He didn’t want to bother me.

Decisions, decisions

I looked at the ops board and the list of procedures I had to carry out – a list that seemed to grow every time the wretched phone rang – and I jumped at the lifeline. It’s probably gastroenteritis, I told myself, pushing the nagging feeling the diagnosis didn’t quite fit and that something more serious was wrong deep inside me and telling it to shut up. I had too much to do already.

“It’s probably just gastroenteritis,” I said. “I’d keep a close eye on her for the afternoon. If she worsens, of course, give me another ring.”

There was a pause at the other end of the line. “You… er… you don’t think it’s worth taking a quick look at her now?” my client said. I looked at the board again and ignored the warning bells ringing in my mind.

“She’ll be fine,” I said, cheerfully, looking at the wound on the cat and wondering how best to close it. “I’m on the end of the phone if you need me.”

Oscar Wilde
Portrait of Oscar Wilde by Napoleon Sarony.

I never discovered what was wrong with her. My guess would be acute severe pancreatitis, but it’s a guess because I never even got to perform a clinical exam on her while she was alive. A few hours after the phone call, she was dead, and my client was telling me he’d never forgive me while I walked across the car park with that black feeling in my gut. He did, of course, minutes later, apologising and telling me he was just in a state of shock – but I’ve never quite forgiven myself though. Not for that mistake, and not for the others.

Dirty little secret

That black feeling still comes around. Less regularly than it used to. Now years go by before it happens – but I know it will happen again.

I consider myself a competent vet, but here’s our dirty secret: competent vets have bad days too.

We make mistakes. Sometimes, when we make mistakes, our patients die. For that very reason, we don’t like to talk about it. We can’t afford to make mistakes, but we do anyway – it’s a paradox that seems best dealt with by ignoring it.

We read Veterinary Times for stories from the disciplinary hearings, hoping with each one we read that we’ll be able to think: “Well, I’ve screwed up, but I’ve never done anything like that.”

It’s good to talk

I think we need to talk about these things. I think we need to share. Not just to learn from our mistakes, because we do. We swear to ourselves that we will get better, that we’ll never make that mistake again – and we probably won’t, but there are lots of mistakes out there to make, and it’s far easier to be wrong than right.

No, we need to share because there is no feeling in the world like that black feeling of despair and taint, and I want people to know I have felt it too – and I’m willing to bet anyone who has worked in the medical field has felt it at some point in their career.

It’s normal. It’s secret. It’s taboo.

We’re human. We make human judgements. Sometimes we’re tired, or stressed, or worried about problems at home. Sometimes we’re depressed and can’t face the day, but try to anyway. Sometimes, for no good reason at all, we make the wrong decision on the wrong day and something dies because of it.

Oscar Wilde once said: “Experience is the name we give to our mistakes.”

I am an experienced vet, and I am in no position to argue with the man.

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