What a Dog Named Casey Taught Me about Cancer Treatment
I met Casey’s owners about a year ago. I had just started working at my new hospital and was still knee deep in the tedious processes of learning my way around the long corridors, memorizing the names of the dozens of other doctors, veterinary technicians, and support staff, and trying to take over and manage the existing oncology caseload as smoothly and as seamlessly as possible. The cases new to the oncology service were typically the easiest part of my day, as these owners arrived eager for information, without any expectations related to their previous appointments at the clinic.
Believe it or not, I still experience a certain degree of nervousness every time I step into the exam room for a new consultation. I’m not sure if every clinician feels the same way as I do, and I’m not sure if this will continue after I’ve been doing this for many, many years. It’s not because I’m not confident in what I do, or what I know, or how to present it. But I definitely experience a healthy sense of apprehension just before going into the room simply because I never know how things are going to transpire once I cross over to the other side of the door.
Just as pet owners have expectations of what their appointment may bring, I have expectations of what information I hope to be able to successfully convey to my clients, and I want owners to like me and trust me. Most importantly, as someone who was diagnosed with "white coat syndrome" herself, I want owners to feel comfortable with their experience and leave feeling as though they had all their questions answered without feeling rushed or as if they were part of an assembly-line.
I worry owners will be so overcome with emotion they won’t be able to process the information I relay, or they won’t understand what I am trying to explain because the topic is too complex, but feel too intimidated to ask me questions. I understand that the act of simply scheduling an appointment with a veterinary specialist can be nerve-wracking. Let’s face it: If you are seeing a specialist, there is probably something serious going on with your pet. I also give consideration to how an owner might feel once they arrive at our hospital, taking in the sheer size of the building, the number of specialists working on any given day, or sitting among the many emergency cases that are seen 24 hours a day, 7 days a week.
Which brings me back to Casey. He was diagnosed with lymphoma by his referring veterinarian, but after reading through his record, I realized his case wasn’t completely straightforward and I knew this consultation would require some time to go through all of the important details. I remember feeling my typical pre-consult anxiety, but I moved ahead with fortitude. After knocking lightly on the exam door, I entered the room, and was immediately confronted with what was by far the loudest, most intimidating "WOOF!" I had the pleasure of experiencing. In front of me stood 180 pounds of solid Great Dane, with a head reaching near to my shoulders and a body taking up about three-quarters of the room! I nearly fell backwards with a combination of sheer adrenaline and shock. It was at that instant I realized that no matter how much time I spent fretting over how things may go with owners, sometimes I have to remember that my patients can actually be the most intimidating part of my day!
After just a few minutes meeting with Casey’s owners, it was evident we were all on the same page, and my anxieties lifted. They were quite a combination: one nervous and shy and cautious, yet able to challenge me with insightful questions, and one much more outgoing and jovial, cracking jokes (her partner being the butt of most of them), but both interested in learning as much as they could about Casey’s diagnosis and what options were available. I spent a great deal of time getting to know both of them and could sense this was the start of what was to be a long relationship.
Casey started treatment that same day and achieved remission very quickly. He completed his protocol in June 2012, and has been doing fantastic ever since. He returns once a month for checkup exams to be sure that how he is acting on the outside matches what is going on systemically. His monthly checkups also serve as a time when his owners and I can reconvene and discuss life outside of owning a pet with cancer.
Casey serves as an example of how I learn from my patients each and every day, and as a reminder of what a humbling experience I find being a part of my patients’ cancer care. Sometimes I feel frustrated when I experience those pre-consult butterflies, but then I look back on patients like Casey and remember nervousness can also equate with excitement, and every new case presents opportunities to help and heal; and maybe even make some new friends at the same time.
Check in with me next week when I’ll be covering specific information related to Casey’s diagnosis of lymphoma, including testing and treatment options for this common canine cancer.
Dr. Joanne Intile