One thing that makes CVC special is our Team. Which is not a random coincidence- it is very intentional on my part. You see, I have always loved being a part of a good team. There is nothing more motivating than having a tribe of people who have your back. You accomplish things that are impossible on your own, you have multiple brains to work through a problem, you have steadfast support group, you have people who save you from making mistakes.
Mistakes. It might as well be a four letter word when you work in the medical field. But they are inevitable, as we are only human.
And we all know: “To err is human…”
Recently I was reminded how a good team can save you from making some pretty big mistakes. Because they are the eyes, the ears, the brain that you don’t have because you’re only one person.
A few weeks ago I had a feline patient that was brought in by her owners because she hadn’t been eating. (We will call her Maddie because that is her name.) This had been going on for a couple days and the owners knew it wasn’t right, but they just couldn’t pinpoint why.
Here’s one thing you need to quickly know about cats and especially sick cats- they break alllll the rules! Basically everything we know about how and why animals get sick and the clinical signs they show us when they’re sick- cats don’t care. They’re going to get sick in their own, individual way.
So I started examining little Maddie, she was very cooperative despite not liking all the attention. The owners and I chatted a bit… we discovered that although she wasn’t eating, she was trying to eat, but then food would fall out of her mouth or she’d run away from her food bowl like it was going to bite her. She was also pawing at her mouth.
Lightbulb! Maddie’s mouth hurt! And although there wasn’t any severe dental disease or ulcerations noted in her mouth during the exam, we discussed that sometimes painful abscesses or other problems could be hidden, only visible with dental x-rays or after the animal is anesthetized. So, after making sure that her lab-work looked good, we scheduled a dental procedure. I was *confident* we would find a hidden problem that we couldn’t see during physical exam that would explain why Maddie wasn’t eating.
But… we didn’t. The x-rays were normal. We all checked and double checked. I even texted them to a friend who specializes in dentistry in North Carolina- she agreed, they were “boring”. Maddie’s mouth was not the reason she wasn’t eating.
Well… crap. Now what???
“What about taking x-rays of her abdomen?” suggested my (rockstar) LVT.
“Well, it can’t hurt. But I really don’t think we’re going to find anything.” said yours truly.
One of my favorite quotes from vet school: “You will miss 100% of the things you don’t look for.” (I can’t credit who said it because we heard it alllll the time)
If I didn’t have my TEAM of assistants and technicians by my side, I would have missed Maddie’s problem. But WE didn’t!
Because my team took awesome x-rays of the cat’s abdomen: 3 views, perfect positioning, beautiful technique. And I could see that all of her organs are where they need to be…there weren’t any tumors or skeletal abnormalities… There WAS something in her stomach that was NOT FOOD!?!?! Oh and there it was on the second view! And you could actually see it more clearly on the 3rd view!
And so then I said, “Holy Sh@%… there’s a foreign body in her stomach! You guys! Look!!!!”
Let me repeat my favorite quote from vet school: “YOU MISS 100% OF THE THINGS YOU DON’T LOOK FOR.”
I would have missed it. If it was just me. If my technician didn’t care as much as I did about figuring out what was wrong with Maddie, she wouldn’t have suggested the x-rays (especially because they meant she had to do more work). Our patient would have gone home and continued to not eat because we didn’t find the problem. We all would have continued to wonder… We finally would have taken x-rays because she likely would have started vomiting (which is the most common clinical sign when a patient eats something they’re not supposed to and it is stuck in their stomach), and THEN we would have found it. But by then Maddie’s condition would have worsened. That would have made her are bigger anesthetic and surgical risk, more susceptible to infection and other post-operative complications. It would have meant a longer, more painful recovery… But my TEAM saved Maddie (and me) from all of this!
So, after a quick phone call to Maddie’s owners to let them know we found the cause of her anorexia and it was not dental disease. She was prepped for surgery. Surgery went very smoothly, we removed the ripped up toy from her stomach, stitched her all back together, and she was all cozy and comfortable in recovery within an hour.
Honestly, I had a hard time not beating myself up about this- about my mistake of not thinking about the x-rays myself, about not probing into the history with enough questions, about the fact that I would have missed it if it was just me.
And then my team, my tribe, made me stop beating myself up and reminded me I just did a great job in surgery and that WE fixed her TOGETHER. Because it’s not just me. It will NEVER be just me. I will always have my TEAM.
Update on Maddie: she is doing fabulous and her owners have removed all suspect toys from their home.