How a Trip to the Vet Made Me a Better Doc

Lexi!

A plain X-ray film appeared on the computer screen—a humerus, a radius and an ulna were all visible. My pupils zoomed around the screen, and on initial inspection, everything looked fine. However, this X-ray was unlike any film I had ever reviewed. You see, it was for my then 4-year-old puppy, Lexi.

My sweet little clown pup had begun to limp on her right front leg. It didn’t seem to bother her too badly but its persistence over four weeks made me very concerned about what was going on. And, like any rheumatologist would, I wondered if my dog could have inflammatory arthritis.

In the waiting room of the veterinarian’s office, I didn’t know what to expect. I was sitting rather uneasily between a man with a python in a cage and a lady with a pale-looking lizard. Frankly, the python and the lizard looked a little rougher than Lexi. I felt fortunate it was “only” a limp.

Lexi did not concur; she was hiding under my chair, whimpering slightly, probably remembering the many times that she had come here for her shots. Throughout all of this, as we waited together, I thought I could learn a lot today—not only about what was causing Lexi’s limp, but also what it feels like to be on the other side, as a patient.

Questions, Questions!

Soon thereafter, a veterinary technician came to get us for intake. The very familiar preparatory rituals of a clinic visit were taking place. The technician coaxed Lexi onto a scale to assess her weight and then brought her to a room so I could complete a general questionnaire. She handed me a clipboard with four pages, full of detailed questions that started with “Preferred name of domestic animal” going all the way down to a list of “prior surgeries without anaesthetic.” Particularly bothersome were impenetrable columns of checkboxes, which I suppose were meant to assist in quickly gathering data but just seemed repetitive. Somewhere in the middle of the second page, I noticed that I had started to pay less attention to the questions and more to the act of drawing X’s. Complicating the process were ambiguous questions that seemed to apply to different animals, like “the ability to ruminate.”

This exercise brought me back to our clinics, where our own questionnaires for disease activity are often filled with similar matrices of checkboxes, albeit a little less in scope. I started thinking: In the well-meaning desire to incorporate patient-reported outcomes, our clinics may be losing sight of the holistic nature of what it is to have a healthcare issue. Moreover, I felt like I wasn’t particularly in the right headspace to answer so many questions in an objective manner. Not only was I keeping a close eye on Lexi to make sure she wasn’t getting into trouble, but I was also juggling a sense of uncertainty and imagining the worst. I started doubting whether the clinic would even listen to my concerns in favor of collecting more and more data.