Vet Talk

The Weekly Train Wreck

The default means of reacting to any event is to vociferously overreact

January 26, 2015 (published)

Photo by VIN

Life in the veterinary ER is usually either a hectic madhouse, with too little time to take care of the jobs at hand, or a boring, interminable wait for the next case. It’s rarely anywhere in between – we don’t usually get the luxury of cases coming and going home at the same pace as the staff can see and treat them. When we do hit that sweet spot between intake and throughput, we all look at each other quizzically, as if to say “Can you believe our luck?”

During the down times, many hands of Uno are played, many Facebook status updates are posted and read, and the countertops and surgery suite get very clean. During the busy times, we scramble, can’t pee, get splashed with blood and pus, get curt with each other, occasionally find patients dead in a cage and can feel the blood pulsating in our ears as we rush from room to room.

I distinctly remember one ultra-busy summer night shift during my residency. It seemed I didn’t even have time to answer routine questions from the staff (Hey, doc? Can Fluffy eat or is she NPO?), much less social questions (Hey, doc – did you catch that new show about the talking monkey on Fox?) and could only handle the immediate life-or-death stuff (Uhhh, doc – you should look at this cat, he don’t look so good), since everyone in town seemed to have agreed to descend on my ER at that particular moment. I remember wanting a little badge to pin to my scrubs that read “Stressed doctor - essential communications only." Alternatively, a lighted neon sign could flash on when I hit a big red button. (I guess I didn’t have time to provide adequate patient care but I could delve into Walter Mitty-style flights of fancy.)

No matter the pace of the ER, there is one phenomenon that I have observed to happen in every ER and every veterinary hospital regularly: the weekly train wreck.

The weekly train wreck is any event that takes your eye off the ball and steers you away from actually taking care of patients. It’s a life-sucking attention and energy vampire, and it’s usually only peripherally related to medicine or patient care. It often leaves staff morale low, is divisive, unpleasant, and unexpected. It actually sounds a lot like one of my famous break-dancing parties (invitation list: 1) that I would throw during those slow times in the ER.

Here a few examples of weekly train wrecks from years past. Given that I have been practicing for 18 years, I have likely been involved in 936 of these unpleasantries thus far in my career.

  • The missing dog leash and collar from 8 months prior that the owner must have right this very minute, despite that fact that it’s 11 p.m. on an ultra-busy summer night, and the receptionist (the one person who could possibly be spared to look for it) called out sick. The irate owners threaten legal action, poor online reviews, firebombing, and putting Nair in my jockstrap if I don’t get it back to them. Days of fruitless hospital searching later, they unapologetically call back to say they found it at home in the junk drawer. Luckily, I am able to return my merkin to the retailer, minus a small restocking and cleaning fee.

  • The urine sample in a dirty pickle jar that was left on the front counter without any identification during the ten seconds the receptionist was in the back helping me do CPR. The irate owners call two days later wanting to know the results of the urine test that "the doctor specifically told me we needed to bring in" and that if the doctor didn’t come to the phone right this very minute they would unleash a herd (hive?) of rabid honey badgers into our parking lot, start a Facebook hate group calling for our evisceration, and shove me in my high-school locker and staple a poster of Hanson to my forehead (again). After carefully explaining that the urine sample needs to be in a sterile container so we can check for infection, that dill pickles are better than hamburger pickles, and that Hanson was really quite underrated as far as pop bands go, I remember my combination and emerge from my locker.

  • The owners who call for a refill of the antibiotic that needs refrigeration that they left out on the counter overnight and that has surely now turned to the most potent poison since ricin. They demand to speak to the doctor about getting a no-charge refill, an act akin to storming back into Baskin-Robbins and demanding a new ice cream cone when you drop yours in the parking lot. (Actually, B-R did this for me as a kid and I’m eternally grateful to them for this and hope that any B-R executives reading this right now might consider some sort of small reward for product placement, something like a new Tesla or a Tony Little Gazelle. ShakeWeights are definitely out, though). In any case, you guessed it: they said that if the doctor didn’t come to the phone right this very minute, they would secretly place a small, Bruce Willis-proof thermonuclear device in the clinic, Tweet our malfeasance to the high heavens, and force Nicki Minaj to serenade me for 12 straight hours. After patiently explaining to them that 8 hours out of the fridge is insufficient time for the transition to ricin to take full effect, they realize unapologetically that they were actually looking at their kid’s antibiotics and that the pink stuff I prescribed to them was still safely in the fridge. Luckily, Nicki has laryngitis this week and the Decemberists stood in for her, so I had a great time.

I could go on and on. 933 more times.

Please note: The already modest humor level drops off precipitously after this point.

I think the motive force behind these incidents lies in the fact that people nowadays have lost touch with the idea of being patient and the concept of giving someone (me, my staff) the benefit of the doubt. The default means of reacting to any event is to dramatically and vociferously overreact, often publicly. The response to anything from miniscule where-did-my-ChapStick-go stuff to oh-god-that’s-really-bad is now a species of harrumphing indignation, a huffy tone of righteous injury, rather than a measured and more patient response. No one can wait to see if what they think happened really happened – they just want it all fixed right this very minute, and the backup plan is to take to social media and start a smear campaign, amassing online villagers to gather pitchforks and torches. In some notable recent cases, these campaigns have driven colleagues to suicide. Facebook is no longer just a medium to share pictures of your new kitten and grandkids – it’s become a tool to wear down the normal social graces that used to keep these events from happening in such numbers, and makes each person feel that their story is the only one that matters.

I know this all sounds very get-off-my-lawn-y, and I’m sure every business and all walks of life have unexpected events that throw a spanner in the works. And I’m sure that things have been this way all along for humanity, and that my perception that things are getting worse, that people are getting more demanding and less patient, may not be full-on correct.

Witness this quote from Aristophanes, Greek satirical playwright, circa 2,400 years ago: “Our youth now love luxury. They have bad manners, contempt for authority; they show disrespect for their elders and love chatter in place of exercise; they no longer rise when elders enter the room; they contradict their parents, chatter before company; gobble up their food and tyrannize their teachers.”

Maybe there’s nothing new under the sun. Or maybe Aristophanes was just cranky and had to listen to Nicki Minaj for 12 straight hours.


February 2, 2015

Oh my, I now have a name for what happens to me all the time,  particularly this last weekend. Another example being when you bundle the vicious (un vaccinated against rabies) cat back into the ancient cardboard carrier that the owners supplied, and the bottom of the box breaks and the cat drops out and runs away.

February 2, 2015

I agree with you...people are losing their civility.  I *try* to always stop and think about the complete opposite of what I think is happening.  It helps.

January 29, 2015

Thanks for the stress relief! I had a friend's elderly cat unexpectedly die on me last night, 2 days after I performed minor surgery. The part about unrefrigerated antibiotics turning into ricin had me laughing so hard my dog had to come check to see if I was OK. :)


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