Kitty's Near-Death Experience
S--- happens. This bumper-sticker philosophy of life has actually served me well at times. And, rest assured, even in the glorious profession of vet medicine there will always be times of extreme stress and overwhelming personal doubt when pithy sayings are all you’ve got. That’s when you really know whether you can do this job—or whether it’s one best left to those with skin far thicker than yours.
To illustrate, I’ll tell you a terrible story…about the time I was spaying a seemingly healthy, six-month-old kitten. The procedure went smoothly. It was one of those easy, routine surgeries lasting only about fifteen minutes. The kitten appeared to be recovering normally from anesthesia when she simply stopped breathing.
The experienced technician monitoring her recovery immediately sounded the alarm (thank God for good techs!). My response was to rapidly replace the endotracheal tube that ensured an open airway and begin supplying breaths of pure oxygen. She seemed to respond well when, inexplicably, her heart stopped. I paused to administer epinephrine intravenously while the tech continued to supply breaths.
During this CPR process, the tech had hooked kitty up to an EKG and a pulse oximeter (used to measure oxygen in the blood). Both devices were giving us pretty crappy news on kitty’s status. The drugs and chest compressions allowed for some blips in her EKG but, for the most part, her heart wasn’t doing much on its own. Tiny, zigzag fibrillations were the only visible evidence of her heart’s potential. Her oxygen level was dropping and the monitors were bleeping at us loudly—as if we didn’t already know!
Next up, more drugs. This time down the airway tube (sometimes this actually works better than an IV dose)—to no effect. Finally, I went for the epinephrine heart stick—á la Pulp Fiction. While not as dramatic as watching Uma Thurman sit up and violently yank the syringe from her chest, this did the trick. Twenty minutes later kitty was breathing well with her heart pumping under its own steam.
If you think it was time to celebrate you’re sadly mistaken. This is when the nightmare really hiked up its skirts and took off running. The parents had arrived. And kitty was alive but unresponsive. Coma (a horribly inadequate word in veterinary medicine) is the way we usually describe this state in humans; the lights are on but nobody’s home.
I was miserable, of course, but the drama queen I worked for who was connected to a huge network of drama queen friends and acquaintances of the kitty’s parents made this experience truly grueling. Hell hath no fury like a non-veterinarian employer in a situation where it takes one to understand the depths of despondency I was feeling…and the random nature of adverse anesthetic events…not to mention the skill and coordination it took to save the kitty. She just had no understanding of my position, my proficiency or the personal standards I had to defend vigorously while in her employ.
The kitty, though successfully (miraculously) revived, continued for three days in and out of high fevers and seizures. I spent my nights at the emergency hospital arguing with clinicians who had already given up on her—and who (in their defense) didn’t have much money to work with. It didn’t help that kitty’s parents refused to spend one dime on her care, preferring to allow my non-veterinarian employer to shoulder the financial responsibility. (Since the kitty’s condition was my fault, after all, my employer felt obligated to provide care—albeit the bare minimum.)
These are the times that try men’s souls. (Who’s the drama queen now?) I`ve always been that brand of sensitive person who takes too much responsibility for things beyond her control. I’m also one of those individuals hyper-alert to issues of injustice and fairness (Jane Eyre and The Count of Monte Cristo are among my favorite classics—get the picture?). This situation hit me squarely between my personality flaws—and hard.
Other than the technicians who understood the quality of my work from toiling beside me on a daily basis and observing my CPR skills first-hand, no one involved in the situation gave me the benefit of the doubt. Kitty’s care was taken out of my [perceived-as-negligent] hands by her irate parents and my distrustful employer. It didn’t get legal, but the situation continued to deteriorate. After the first day, when I expressed profound regret after explaining the situation, kitty’s owners had refused to speak to me or let me even touch her.
Adverse anesthetic events happen. I`ve had several of these frightening (though none so dramatic) experiences but all resulted in a complete recovery—save this severe case.
More than a year later, I receive reports that kitty is still not quite right. After a prolonged period of blindness and marginally increasing activity level (over a period of a couple of months) she seemed to become almost physically normal. Psychologically, however, I’m told she doesn’t seem to be all there.
Kitty’s parents still rail against my clinical inadequacies, but I don’t blame them for their emotional response—it’s normal to be angry when you can’t understand why something so simple could go so wrong. My employer is another story…
I, however, have made peace with the entire situation. Before you all write to me and tell me I did everything I could and how could anyone accuse me of doing anything less, let me assure you I agree. As my terminally supportive vet boyfriend has said, the only thing you did wrong was to actually perform the unexpected, the near-impossible task of reviving a basically dead cat after a bizarre physiological event none of us can really understand.
Almost all anesthetic cases involving sudden respiratory and cardiac arrest die—suddenly, inexplicably and unceremoniously. You’ve all heard about the dog that dies during a simple dental procedure? Because my tech and I managed better than average, we effectively made way for the saga to unfold as it did—with all the ups and downs of any prolonged neurologic recovery process. Death would have been easier to explain and, ironically, easier for everyone to accept. I’m proud of the proficiency and professionalism that made that impossible.
A month after this episode I was fired. In retrospect I’m surprised it took that long. Yet, as the cliché goes, it was the best thing that ever happened to me. I now work in a thoroughly rewarding, supportive environment where my peers praise my clinical skills and my clients respect my medical authority. See? Bumper stickers don’t lie. Sometimes even s--- happens for a reason.