Stitches for Christmas

I hadn’t planned on the Christmas traffic and so I was a bit late for work.  “I’m not even on the highway yet,” I phoned my receptionist, “So you might want to call my first appointment and advise them to come in 15 minutes late.”

“Just be glad you’re not early!” she exclaimed.  “We had an emergency run in, and the poor thing was torn wide open from getting caught under a fence, and bleeding all over the place.”

“Are they waiting?” I asked as I sped up well past my comfortable speed.  “No, I sent them to Dr. Elsewhere.  Besides they’d never been here before, and said the dog wasn’t even theirs!”

I’d seen the schedule and knew we were slammed; it was good that they went down the road.  I had 18 appointments scheduled for the abbreviated 3 hour day, and that would be plenty.  Besides, it was Christmas Eve and everyone would be anxious to get home after just a half day.  I was glad I wouldn’t have to feel guilty.

I’ve  come to really enjoy my hour and a half commute.  I listen to lots of audiobooks and, now that I’m enrolled in University postgraduate classes again, I listen to my professor’s lectures a few times as well.  But it does make for a long 13 hour day, and there’s not much of me left when I get home.  My coping mechanism involves an hour of silence, contemplation, prayer early every morning.  And I find myself struggling, pleading, praying for peace and joy from each hectic day.

Some days it’s hard to find much joy.  I’m sometimes immersed and submerged in grief of lost life and love.  And so I plead with my Creator for consolation.  I want to know that it’s not all in vain.  That we’re here for a reason.  That I’m here for a reason.  Give me your eyes to recognize opportunities to love and serve as you would have me.  And that I am living my life as He would want – that the world is better for my having been here.  I’ve been having a bit of a dry spell, and feel like I’m just checking the box some days.

I realize I’ll never cure cancer.  And I’ll never make enough money to create a Bill and Melinda Gates Foundation to end a disease like rubella.  Or embrace the “humans discarded like garbage” as Mother Theresa did.  And so it would be easy to see my ordinary, everyday life as just that. But I strive to find Jesus with every encounter – every time I smile, touch, or open my mouth.  I pray for patience, and compassion, and the vision to realize who it is that is actually standing in front of me, and overlook their human faults.  I ask for wisdom to recognise those opportunities that I’m given where I can draw closer, but be indifferent to those which push me away.

Sometimes people aren’t very kind, or appreciative, or forgiving of my own faults – my forgetfulness, my schedule, my often sarcastic personality, my tardiness.

And so, I zipped into the driveway, with almost 20 cars already in it, knowing that the day would be another challenge.  My first two appointments were waiting, along with two unplanned emergencies; 6 pets had been dropped off for me to examine “in my spare time,” and over 40 charts were on my desk for me to evaluate lab results and to call to discuss treatment options.

After years of this script, my employees know I have a routine, and to only jump on me if someone is bleeding.  Since they didn’t, I made a dash for the baño and returned the three mugs of coffee I’d inhaled almost two hours ago.  I grabbed my stethoscope, and slid into the first exam room.

Soon I had dispersed, delegated, prescribed, and advised everyone waiting to see me, and was shocked to see no charts in front of me.  I looked at the clock and was confused that I had a little down time in the middle of a busy, busy morning.

As I turned to tackle my stack of charts, one of my receptionists spun me around and said, “Dr. K., the person that came in so early this morning, the one I referred to Dr. Elsewhere is back, and begging for you to look at the dog.  I know what you’re going to say, so I’m not sure why I’m even asking, but she wants your opinion. Remember, it’s not even her dog, and she has now told me three times that she doesn’t have any money.”  The other doctor had told her just to hose the dog’s wound off every day and it would probably heal fine.

I shook my head and smiled, “Tell them to bring the dog in, and I’ll have a look.”

“No,” she said, “They’re too embarrassed to come in with no money.  Can you go out to their car and just have a look to see if you agree with the other doctor.”

“Sure.”

The gash was deep, and blood was everywhere.  There was little chance this would heal on it’s own.  Not without antibiotics, and she really needed stitches.  I looked around and “for some reason” there were still no cars in the parking lot.  The little dog looked up at me and wagged her tail.  I looked at the wrinkled, worried forehead of the couple who had cared enough to bring in a dog that didn’t even belong to them.

Fence Gash

“Field stitches” are something that I learned from my boyhood mentor as I “helped” around the neighborhood vet clinic, a lifetime ago, working on cattle and horses, and most certainly aren’t taught in medical school.  They are fast, and require no general anesthesia.  I looked at the huge gash in the little dog, and realized that it most certainly wouldn’t be the best medical care, but one hell of a lot better than hosing it off every day.  Besides, I could shave and disinfect the wound, inject some lidocaine, place a drain, and “field stitch” the dog in about 20 minutes.  (To do it properly, with acceptable sterile technique would require anesthesia and over two hours of surgical time).

OK, so it actually took 30 minutes, and by then about 4 or 5 people were waiting. But, as I placed the final stitch in her neighbor’s dog who hadn’t even flinched, and gave her a shot of antibiotics, I knew it had been the right thing to do.

Her husband had looked at the floor most of the time we were in the exam room together, and finally, looking up, spoke with a cracking voice.

“I’m not sure why ya done this fer us, and I told you I didn’ haf any thing ta pay ya with. Would it be OK if we came back and paid you a little bit each week, when I get m’ check?”  He seemed to fear my response and was clearly embarrassed.

I was a bit moved by his offer.  I had known they couldn’t pay when I invited them in.

“No,” I said, “I only ask one thing.  Don’t go around and tell everyone that we work for free.  ‘Cause if I did this very often, (pointing to my nurse) she’d have to work for free, and then her family wouldn’t get to buy food.”

“What?” they were both clearly a mess now.  “You done all this fer nuthin?”

“Nope. We did it because we were supposed to.  Thanks for coming in today, and … Merry Christmas.”

I gave them each a hug, and high fived my nurse as I left the room.

She smiled bigger than I did.  She knew we hadn’t done it for them.  It was for me.  I’m selfish that way.

Clearly, a businessman can’t give things away on a regular basis, or he wouldn’t be able to pay his staff, and give raises, and pay for health care, or the mortgage.  But sometimes you can.  And it feels really good.

None of this is about “telling people about our good works so that others will know how good we are.”  It’s simply opening our eyes so we can see.

It’s not about doing good, or “giving back,” because others have been good to us.  No, that’s simply the “exchange” of Christmas gifts.  Tit for tat.  And as such, although trades are extrinsically good, they don’t really add good to the world.  The balance shifts when we do good where there is no possible way for the other to repay.

At the end of the day, isn’t that what Christmas is really about anyway?

For God so loved the world that He gave His only Son …

JN 3:16

The original gift of Christmas was one given with full knowledge that it could never be repaid, and clearly there has never been that expectation.  We don’t do good because we owe God anything.  Or because we’re afraid of Hell.  We do good because God is good, and in our design we are programed to enjoy doing so.  There are no mistakes in our design.  He did this for a reason.  We are here for a reason.

Centuries ago, Blaise Pascal (consider also Pascal’s Wager) formulated a concept later described as a “God shaped hole” in our hearts.  We seek and try repeatedly to fill this longing with things of this world, trying to satisfy the craving, and fill the void ourselves. Sixteen centuries years ago Pascal observed power-lust and self-centeredness, with the resultant narcissism and addictions.

This he tries in vain to fill with everything around him, seeking in things that are not there the help he cannot find in those that are, though none can help, since this infinite abyss can be filled only with an infinite and immutable object; in other words by God himself.”
– Blaise Pascal, Pensées VII(425)

Only by recognising what “fits” in this hole do we “satisfy that longing.” Only through love and service for others are we truly happy.  What we did on Christmas eve was really no big deal.  Everyone can, and must reach out those around them.  Maybe you can’t stitch up a stray dog.  But you can help someone fix a flat tire, or unload their groceries, or shovel their snow, or give a blanket to someone who is wandering and cold.  Or just stop and, with a conversation or a smile, show a stranger that they matter.

ed. note:  I considered for a week before I wrote this. Last year a similar post about Betty and her dog Baby (Rude) resulted in a considerable number of folks being put off by what they saw as “attention seeking, and patting myself on the back for doing something we should all do anyway.” But that was the entire point of She Wasn’t being Rude, if the reader had actually read it and made it down to the end of the post.  Of course we should do good, and what I (and every other veterinarian I know) am able to do sometimes, is a blessing – to me.

After tragedy enters someone’s life, they see the world through a much different lens.  Everything takes on a new color, with depth and detail that was never before noticed.  When the bleeding stops, everything has purpose;  life becomes deeper and meaningful, and appreciated.

My vision is with other eyes now.  Mainly those of my father and my son.

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She wasn’t being rude

My receptionist Ericka was in tears. The caller had said some pretty mean things, and she’s sensitive to what people say to her. She thrust the phone towards me, and pleaded for me to deal with it, “She doesn’t understand we don’t have any appointments available and, anyway, we’ll be closed in 45 minutes.” Some lady’s dog hadn’t “eated” in 4 days, and so she thinks she’s really pretty sick, and what was I gonna do about it? On such a hectic afternoon, I was glad to take the load off the front desk, and proceeded with the best defense being a good offense. “So he hasn’t eaten in 4 days? Wow, you rushed right in! What makes you think it’s serious now” The colloquialism of her words and accents made it difficult to understand, even for a small town Missoura hick like myself, but I did make out something about not having much money, something about only having a hunnert dollas. Knowing it sounded like a major medical workup, our lab equipment had an hour back log of tests waiting, and it had been a really long day already, I told her that I could see her at 9:15 the next day. My technician Jenny cringed, knowing full well that I had no openings, even for something minor, at 9:15 tomorrow, or anytime, all day. She also thought the front staff might not be very happy when I had allowed someone so rude and disrespectful, accusing them of not caring, to come in when they had been telling good, regular, polite clients that we were booked until next week. I had a funny feeling about this one. I knew this woman’s dog was pretty sick, and a “hunnert dollas” wouldn’t even get her in the front door of the emergency clinic tonight. I hoped it would wait. And that it wasn’t too serious to throw my schedule into seizures tomorrow.

Frankly, I forgot about her until the next morning, when I walked into the exam room. My flippant attitude about her apparent lack of concern for “Baby Girl” quickly dissipated. The “homeless person” stench was overpowering and was immediately telling as to why the visit had been postponed. This poor 12 year old dog couldn’t even lift her head. Indeed, she had not eaten in 5 days now, but was drinking lots of water. “She’s not spayed,” Jenny whispered to me, in case I missed the obvious. We both knew what it was from the history. A pyometra is an infected uterus, life threatening, and one of the important reasons why a female dog or cat should be spayed if she won’t be used for breeding. I’ll spare you the details, but it is typically fatal before five days, from internal rupture, much like a child’s appendix can rupture, spreading bacterial poison and toxins throughout the body.

The pre-surgical workup of confirmatory lab tests and X-Rays alone is about $300, and if it was a pyometra, could easily exceed $1200-1500. And the patient could die, regardless of our best efforts, especially if the uterus had already ruptured. She hadn’t come in because she had been scraping together, begging, and borrowing to get some money together to get her dog fixed.

Nor could I promise her that her little dog would live through the surgery. “So what are you telling me?” the woman shouted at me, with tears in her eyes. Deep down, I knew she had been rejected before, a lifetime of it. I knew she expected me to say to go away, that if she had no money she wasn’t welcome here.

I told her I wanted to run some tests, and that it would cost her “a hunnert dollas.” That wouldn’t fix anything, but we needed to know what was wrong.

Jenny was correct. The test confirmed a high white blood cell count (indicating infection), and the radiographs (X-Rays) confirmed a huge swelling in the area where the uterus would be.

As I delivered the news and the grave prognosis, her eyes reddened and became teary.

Having pets is a commitment. And an obligation. And owning pets is a choice that involves responsibilities and expenses. Therefore, keeping a pet is not a right, nor is it the grocery store’s obligation to feed the dog for free, nor the veterinarian’s obligation to care for it for free. Pets, like people, should have a basic minimum of care: annual examinations, inoculations, and other preventative health care, and the planning for the possibility/likelihood that something may go wrong – an accident or an illness.

So, are people living in poverty allowed to have pets? If she can share what she finds in the dumpster with her only friend in the world, or if she and her cat split a can of food, is that “good enough?”

As I spoke with my staff, receptionists, as well as technicians, I told them that this woman was not rude. The astonished looks of disagreement on their faces faded as I explained. “You can’t be rude if you don’t know what rude is. She doesn’t fit our picture of how we should behave or talk, but she’s not intending to be disrespectful or unappreciative. She just doesn’t know any better. She’s never had anyone give her the benefit of the doubt. How many times had she been excluded as a child, or looked down upon as an adult? How do you expect her to behave?”

I’ve mentioned in previous posts how high a value I place on the “human-animal bond.” That unconditional love thing is impossible to put a price tag on. Of course this dog is suffering now, but what about the past decade of loving relationship? Do you honestly think this dog’s life didn’t live a happier, worthier life for having met this woman instead of starvation on the street, or the animal shelter’s needle? As Pope Francis said in different circumstances, “Who am I to judge?”

“I can only promise you two things,” I told her solemnly. “I’ll do my very best to save your dog, and she most definitely will die without the surgery.” I was emphatic, because she needed to really understand how sick her little friend was. “Baby Girl” couldn’t lift her head, but her eyes followed my every move and she wagged her tail when I scratched behind her ears.

I told her that we had all discussed it and that we were willing to do surgery during our lunch break, and that it would only cost her the “hunnert dollas.” I’ve learned over the years that even if you work pro-bono that the client must contribute something, to take ownership, and to feel the value – something about pride, that they had contributed also.

I don’t take any credit. And I honestly do not write this story to look like some kind of a hero. My staff clocked out over the lunch hour and also donated their time. We’re all confronted with choices in life where we can make others’ journey’s better, or at least less miserable. I know pain, and anguish. We all do. We have a choice to be angry at God or whomever for allowing/causing crap to happen, or we can rise up from the ashes and be better for our losses. Is it to better to be bitter and angry, or realize what suffering feels like, and gain empathy?

“Really? No one’s ever done anything nice for me before,” this smelly woman wailed and wanted to hug me, so I embraced the leper. If you’re skeptical, of course this may seem disingenuous, and I do get it, I’m from Missouri (this is the origin of “show-me”). We are constantly barraged with cardboard signs on the off-ramps. Are any of them really willing to work for food? At the end of the day, does it make any difference? “I was hungry and you gave me to eat.”

It’s easy to puff your chest out when you do something difficult. But this wasn’t difficult. If I’m not there that day to fix the torn ACL knee ligament, the liver shunt, the heart defect, the broken hip … someone else would have. I’m truly not particularly intelligent or even very talented. But I sleep well tonight, knowing that no-one would have done this simple surgery for this indigent woman. This was truly no big deal, a very simple surgery that took just a few minutes. But after so many years, these opportunities to make a difference, make it all worth while.

I usually ask for comments, but not on this one. Please don’t leave any comments. Like it if you want, and share it. If you like this story, pay it forward. You think your life sucks? Look around. Make a difference. This isn’t even a story worth telling if you don’t use it yourself and think about it tomorrow as you look around. This story would have remained untold if I hadn’t had a couple of beers and like to write. Your life is charmed and blessed BECAUSE you are reading this, are capable of thinking about the big picture, and can make a difference. It’s not the big things we do that are heroic.

At the end of the day, this woman ran in, frantic about her dog. She didn’t have a phone so had no idea if her dog made it through surgery. Certainly, she thought the worst when she was escorted into the room, and told the doctor would be with her shortly … she stomped and shouted and cried for some answer, “How is my dog?!! PLEASE dear God, please somebody just tell me, did ‘Baby Girl’ die?!!” I ran from the appointment I was with when I heard the commotion, but Jenny beat me there. All I heard was, “She’s alive?!!! She’s alive?!! Oh dear God, praise dear God! My Baby Girl’s ALIVE!!!”

I’m sure they heard the shouting and crying next door.

Pay it forward. Much Love.

Please Continue with PART TWO

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