by Laurie Hess
I slipped out of the examination room and found Marnie in the break room, sipping a Diet Coke and snacking on pretzels.
“What’s wrong?” she asked with her mouth full. “You look like you’re gonna blow.”
“I might.”
Though I can almost always help my patients, humans are an altogether different animal. “I just need to take a moment and remind myself that I’m a vet, not a marriage counselor,” I said.
“Oh, that,” Marnie said with matched irritation. “He’s not going to let her do it, you know.”
I looked at her sideways.
“I heard her on the phone earlier, in the waiting room—pleading with him for the money to treat her. Reminds me of Jim.” She rolled her eyes, referring to her ex-husband. “The man wouldn’t even buy toilet paper without first checking the monthly budget.”
Marnie had often griped about her ex’s control of the household finances. It was one reason they’d split.
I sighed. “Well, it’s not going to be cheap.” I slumped down beside Marnie and popped a few of her pretzels into my mouth. “I don’t know when I’ve seen a guinea pig in worse shape. She desperately needs surgery.”
I worried that Marnie was right. In the face of a looming mortgage, I could guess that even if the figure to treat Rosie were nominal, Susan’s husband would refuse.
Marnie and I returned to the examination room together just as Susan was getting off her phone. She stood pressed against the back wall, the posture of someone who’s accepted defeat.
Marnie and I exchanged a concerned look, and then I said, “Rosie needs extensive repair. I cannot make her better without performing surgery, and this will likely be costly. I’m sorry.”
Susan nodded and took in a choked breath. I imagined she was confronting the choice before her: saving Rosie or saving her marriage.
I thought about Susan’s dilemma now as I watched Bob’s interplay with Lily and Mathilda. He gave Lily another slight tug on her tiny ear and drew in a deep breath. “Lily has been the source of relentless arguments between Jeanne and me over the years. The deal we ultimately made was that I can have whatever kind of pet I want—as long as it doesn’t cost us any money.” Bob leaned forward in his chair. “But as you and I both know, Dr. Hess, pets cost money.”
Yes, they do, I thought. And especially when they’re sick.
9:42 A.M.
AS I CAME out of the examination room with Lily and Mathilda nestled in my arms, Marnie stopped short in the hallway to look at them. “I’ll admit them to the ICU and start them on antibiotics for possible bacterial infection,” she said. Marnie often knows what I’m going to say before I say it—the result of working together for over a decade.
“Yes, and run blood tests to check organ function. Catch me up on their status in an hour.” As Marnie tore down the hall, I looked at my watch and sighed, realizing that Peter had already gotten the boys off to school and I’d missed them. I made myself a promise to make it home in time for family dinner. Just then, Colette, my associate vet, turned the corner, clipboard in hand, and nearly knocked me over. I’m barely over five feet tall, and she’s close to six.
“Time to start rounds, Laurie. Ready to go over the schedule?” Colette was working double duty this week, standing in also for the hospital’s receptionist, and I was impressed by how naturally she performed both tasks. She exudes authority, which she uses when addressing the hospital staff, but she can also slip into a sweet maternal role with clients. Perhaps it’s because she is a new mother herself, having recently given birth to a baby boy. Her natural warmth was evident when she greeted owners and their pets in the waiting room, creating a calm and welcoming atmosphere that is of paramount importance in making our visitors comfortable. Depending on the day, the hospital could be rife with a multitude of emotions, running the gamut from happiness and relief to grief and despair.
“I’m ready,” I said. “Lay it on me.”
“First, you’ll check in with and prep Sally, a ferret in for a cystotomy later this afternoon. But before the actual removal of the bladder stone, we have appointments stacked every thirty minutes, starting with a lop-eared rabbit that is new to the practice and in for gastrointestinal issues.”
“What’s the new patient’s name?” I asked.
“Peter,” she said with a smirk.
“Naturally. Okay, who else?”
“Next we have Chilly, a chinchilla in for a possible foreign body ingestion; a bandage changing for Masey, an umbrella cockatoo with a fractured wing. After that you have a short break before the McNeal family brings in their family of rats for their yearly checkups.” Colette added, “Morris, you may remember, is the youngest in the family and an expert escape artist. Watch out for that one.”
“Noted,” I said, remembering the day a gecko had escaped from my grip and crawled up the wall of the examination room, using the suction cups on the bottom of its feet to cling to the ceiling. There he had stayed until I climbed onto a step stool and coaxed him down the wall with an umbrella handle.
“After that, you have three back-to-back ultrasounds and a short break before the cystotomy surgery.”
“And when do we eat lunch?”
That was our joke. Most of the time, the staff ate in short shifts, running from one exam room to the other, stopping along the way to grab a few bites in the lunchroom before running back out. On any given day, our lunchroom looks as though a tornado swept through a convenience store. Cups of yogurt, open bags of chips, and half-eaten sandwiches lie abandoned on the counters and tables.
“Three o’clock as always,” Colette said with a wink, “if we’re lucky.”
Our banter always helps to remind me to keep my spirit light, especially on days like today, with the shadow of Georgie’s passing and Lily and Mathilda just admitted to the ICU.
Colette said, “I better get you some more coffee. Half-and-half, no sugar, right?”
“Thanks, Mom,” I smiled.
4:50 P.M.
I TOOK FIVE minutes to cram down an egg-salad sandwich and check in with Vets Connect. The postings from earlier in the morning had nearly doubled. I choked on my sandwich. The first one read, “I have a glider in-house right now who is only about 50 grams, seizuring, and non responsive to aggressive supportive care. Any evidence of contagion?” The next post, written by a vet in Massachusetts, read, “Help; sugar gliders sick and unresponsive. If anyone has any diagnostic and treatment suggestions for these guys, I would appreciate hearing about it. I need all the help I can get.” This was followed up by a recommendation from another doctor in the tristate area. “I would recommend contacting Dr. Laurie Hess at the Veterinary Center for Birds & Exotics in Bedford. I will cross post your message to the exotic animal board.” I froze in my chair. Other veterinarians were seeking my help, and while I wanted to offer a treatment plan, my specialized expertise hadn’t helped my little patients either. Four gliders placed under my care were now dead, and Lily and Mathilda lay huddled together in a tiny polar fleece blanket in my ICU incubator. Since he’d left them with me that morning, Bob had called me at least a half dozen times to check in, and my report hadn’t changed.
“We’re syringe feeding them formula so they don’t become hypoglycemic, and we’re keeping them warm,” I told him. “They’re lying low in their incubator, and so far, I haven’t seen any more seizures.”
These were good signs, but I knew that my treatment plan wasn’t a solid remedy or a cure. I wasn’t treating Lily and Mathilda any differently than I’d treated the others. I was simply buying them time, and I wasn’t sure for how long. I suddenly felt the urge to cry, but I willed myself to hold it together. I couldn’t add tears to this situation. That wasn’t going to help. There had to be a treatment plan that would save Lily and Mathilda—I just didn’t know what it was yet.
I logged out of the online group and looked at my schedule. I hadn’t made any breakthroughs in the glider case, but I’d somehow juggled an afternoon of back
-to-back appointments. I had only one more, and if there weren’t any sudden changes in Lily and Mathilda’s status, I’d be able to sneak home for dinner with Peter and the boys before returning to the hospital to keep an overnight watch on Lily and Mathilda. Peter would likely be disappointed in my plan to boomerang back to work, but once I shared the news of Georgie’s death and Lily and Mathilda’s emergency admittance to the hospital, he’d understand. Well, he’d be supportive. My husband freely admits that he’s not a science guy and even jokes that the only medicine he knows how to prescribe is children’s Tylenol. Peter might not fully understand the severity of Lily and Mathilda’s symptoms or the expanding glider crisis, but he would listen to me, which is all I ever really need.
5:30 P.M.
I SWUNG OPEN the examination room door.
“Howdy, Doc!” said a friendly and familiar voice. My extern, Elliot, greeted me with a broad, toothy smile, the kind you expect from a kid who has just had his braces removed. He stood up and extended his hand.
“Come here. I could use a hug, kiddo.”
Elliot obliged and leaned in, wrapping an arm around me. He smelled like coffee and snow. Unlike interns, who have already graduated and are fully licensed as veterinarians, veterinary externs like Elliot work at hospitals like mine for a short time while still in school. Elliot had been a first-year veterinary student at Cornell when he enrolled in my summer program. He was already familiar with the hospital because for years I’d routinely cared for his childhood pet, Trixie, a gray-feathered cockatiel with orange-feathered cheeks and a yellow tail. Cockatiels are perhaps the most popular birds kept as pets in the United States. Interactive, friendly, and outgoing, they often love to be handled by or simply hang out with their human “flock mates” (and can even learn to speak a limited vocabulary). Cockatiels also can be silly and playful, bobbing their crest of yellow and gray feathers up and down when they are excited. The right pet brings out our best, brightest self, and that’s what I’d seen between Elliot and Trixie. They had drawn out each other’s sunniness and playfulness and appeared to know each other intimately.
While Elliot was away at Cornell, he left Trixie at home with his parents. When he returned to Bedford for his summer externship, he noticed right away from his veterinary training that something was off with his childhood friend. She sat quietly in her cage, hunched over, her feathers fluffed up. Birds fluff up their feathers to try to trap warm air next to their bodies when they are cold or sick. Elliot lectured his parents for positioning Trixie’s cage in front of an air-conditioning vent and moved it to a warmer part of the house. But after a few days, Trixie’s feathers had not smoothed out, and Elliot knew that she needed more than a temperature boost.
Birds are a prey species, and when they show any sign of weakness in the wild, they are hunted and killed. For that reason, they’re masters at hiding illness until it’s very advanced. Basically, a bird will mask sickness until it’s impossible to hide. Under my supervision, Elliot ran a series of blood tests on Trixie and diagnosed his childhood companion with kidney failure, or gout. This commonly occurs in birds as they age and is often associated with a lack of essential vitamin A in the bird’s diet (which occurs if they have been eating nothing but seeds their whole lives). Gout is diagnosed in birds when the main kidney by-product, uric acid, builds up in their kidneys and sometimes in their joints, causing painful inflammation. Elliot asked me to prescribe allopurinol, the drug used to treat both pets and people with the disease, and he started her on injections of vitamin A.
Elliot carefully treated Trixie for several weeks in the hospital until it became clear to both of us that she’d become too sick to treat further or save. When caught early, gout can sometimes be managed with lifelong medication, but Trixie no longer had the benefit of time. Gout is progressive and ultimately fatal for birds.
“Trixie is in pain,” he said to me one afternoon as we scrubbed in for a dental surgery on a chinchilla. “I don’t want her to suffer anymore, and I’d like to stand in as your technician if you’ll let me.”
I looked over at him methodically scrubbing, soap dripping down his arms into the surgical sink as he stared ahead. He hadn’t explicitly said the words—that he wanted to put Trixie to sleep—but I knew that’s what he meant. I said, “Elliot, if you’re ready. Of course.”
“I am.”
I watched him for another moment until I caught his eye. He turned off the faucet and faced me. I said, “Now is when I tell you what I tell every pet owner in this situation—this is the most unselfish thing you can do.” I’d said those words many hundreds of times throughout my career, and I meant them wholeheartedly in each instance. “This will be very hard, but it’s the right thing for Trixie.”
Elliot nodded. “I know that, Dr. Hess. I can do this.”
It struck me in that moment that Elliot had the very qualities that my mentor, Dr. Miller, had taught his students to cultivate.
I WAS FIFTEEN years old, standing alone, cold and shivering on the corner of 85th Street and First Avenue in Manhattan, struggling to prevent my knees from buckling under me after finishing my very first day as a high school extern at a local animal hospital. It was the first time I’d seen a dog having surgery. In his tiny surgical suite the size of a closet, Dr. Miller, the veterinarian who would eventually become my chief mentor, had cut into a large liver tumor in a small Westie. In that moment, more blood than I had ever seen exploded all over my scrubs—and the walls—and the floor. The room started to spin, and I was overcome with nausea and terror. Not only did my visceral reaction to the procedure scare me, but I worried that I might throw up in the surgery room. Running for the exit, I pushed open the door with one hand, my other hand clamped over my mouth, willing myself not to vomit. I vaulted through the door and onto the sidewalk, into the bright light, cold air, and loud traffic noise of the city, and I stood there, gasping for breath. Then I backed up to lean against the building, trying not to slide down and end up on the ground. I held my head in my hands, slowly taking in deep breaths.
As the cars sped through the busy intersection, it occurred to me that maybe I couldn’t do this, maybe I wasn’t strong enough. My long-held dream of becoming a veterinarian started to evaporate.
Just then I felt a firm hand on my shoulder. Dr. Miller had come outside and was standing next to me. I hadn’t even noticed he was there.
“You should come inside and watch the rest of the procedure. This dog is going to be okay.”
“I can’t,” I said, swallowing hard and trying to regain some composure. “I thought I could handle this, but I can’t.”
“Laurie, I want you to look at me. I know the initial shock is hard, but it goes away with time. Most everyone struggles at first, but you learn how to handle it. The best vets handle it with sensitivity, decency, and good, old-fashioned courage.”
MY EXTERN, ELLIOT, had all three of these qualities. When he finished his veterinary training at Cornell and sent me news of his acceptance to a paid internship program at a large veterinary hospital in Rhode Island, I was proud of him and honored he’d soon be joining the veterinary community. I sent him a new laptop sleeve with his name stitched on it.
“So, big-time intern,” I said, as I sat down across from him now in the examination room, “are you in town visiting your parents for the holidays?”
“Yep, and also”—he paused dramatically and opened his messenger bag—“to bring my new pet back to school with me.”
Elliot pulled out a three-foot-long king snake.
He smiled. “Meet Scarlet. Isn’t she gorgeous?” The snake curled up in the crook of Elliot’s arm, and her tongue darted in and out of her mouth to assess the situation around her. She was strikingly beautiful. Prominent black bands set against vibrant red distinguished her from the venomous coral snake, whose red markings are always married to yellow. Red on yellow will kill a fellow. Red on black is a friend of Jack. She began to travel up Elliot’s arm, and I could tell by the way she resp
onded to his gentle touch that she felt safe with him. Yet I was bewildered. Hadn’t Elliot always been a bit squeamish around snakes? Like many veterinary students, Elliot gravitated toward a particular species and class of animal. For him—unsurprisingly, given his relationship with Trixie—it was birds. But as an exotic animal doctor, you’re required to handle and treat all classes—feathers, fur, and scales. Not until Elliot was a visiting student at my hospital was he exposed to the wide range of animals I treat on a daily basis, and that was when he had his first real contact with snakes. I remember the first time I asked him to assist me as I examined Henry, a thirty-pound python, for a possible skin infection; Elliot had actually recoiled into the corner of the examination room. “Come back over here,” I’d encouraged him. I understood his common misconception that snakes are slimy and prone to bite. But Henry was neither. “This old guy is absolutely harmless. Look, he even gives kisses.” I lifted Henry up off the examination table, and right on cue he stuck out his forked tongue and flicked my cheek. (In actuality, reptiles use their tongues to smell and sample their chemical environment—this is called tropotaxis—and Henry was likely getting a whiff of the Paul Mitchell hairspray that I use liberally to tame my curls, but I think Elliot understood the point I was trying to make: pet snakes are most often gentle and friendly creatures.) It took several introductions in the supervised and controlled environment of the hospital to allay Elliot’s fear and allow him to relax. He admitted one day as he swaddled a bearded dragon that even the “cold-blooded” were quite cuddly. Still, I had been sure that when he was ready to adopt another pet, he’d get another cockatiel, much as another client, Rose Adler, had done after she’d lost Charlie, her parakeet of many years.