Choose to be Confident In Your Competence

We have a choice.

It was 10 degrees F the other night when my phone rang. The words were what every vet doesn't want to hear, "I think her uterus is out, Doc." 

Rushing through the house, I threw on some clothes and coveralls and was out the door. When I arrived, I knew we were in trouble. It was the biggest prolapse I've seen in my 10 years as a vet.

But this cow was a trooper. A small nudge and a couple words, and she shakily stood up. We proceeded to get her caught up, and I went to work. I removed her cleanings and lavaged this massive organ with gallon after gallon of dilute disinfectant, hoping to prevent infection. 

Then the real work began. Hefting the 50-plus-pound uterus onto my chest, I began carefully massaging it back into mamma. It was slow but surprisingly easy to replace for its mass. Five short minutes later (and a couple four-letter words), and we had a replaced uterus. A miracle for its size and the cold! But mamma wasn't out of the woods yet.

Standing in the headlock I knew she needed more. She was shaking and looked pretty shocky. Knowing my helper didn't know how to IV, I returned to my truck for my trusty halter and some IV fluids plus calcium (Ca). 

When I returned, things were going downhill. Mamma’s eyes were almost touching, and she was struggling to stand. I slammed my simplex on the Ca bottle hoping it was a Ca issue and not a fatal uterine artery rupture. But it wasn’t to be. Try as I might, I couldn't get a jugular vein to pop. By the time I started to crawl into the pen in a desperate attempt via the milk vein, she had gone down and was agonal breathing. Her time and my time were up. She was dying.

Next to me my client says, "Doc, you did all you could." I'm crestfallen. In the last 5 minutes I've gone from the elation of getting that massive uterus replaced to knowing my patient is going to die. 

Now, I'm faced with the most difficult ending – a humane passing. You see, I'm a firm believer in the fact that we as veterinarians have been given the ultimate responsibility: to end suffering. No animal should have to suffer until its passing. Not when we can quietly and humanely end that suffering.

As I take my third trip to my truck, this time for my euthanasia gun, I'm hit with so many feelings. You see, I left my family’s dead cow business to avoid just this. I wanted to save lives, and I thought I had done just that a few minutes ago. Knowing this is the right thing, I steel my heart and perform this last right. 

As I pack up my truck my client tries to console me that I did my best. And although the outcome is not what we wanted, there was nothing more I could do. I nodded my head and washed the blood and fluids off my waterproofs, numb to a situation that has played out more often than I would have liked over my last 10 years in practice.

Getting in my truck I'm struck with a realization. I'm sad. I'm sad about the cow, about my client’s misfortune, and most of all about feeling like a failure at my career. I didn't get into this to put animals down. But here I am yet again, doing just that. 

Then, deep down I feel something else, too, a sliver of a feeling. Inspiration. When I saw that uterus, I thought there was no way I could get it in. I had thought, “this is so bad, so very bad.” In fact, those were the first words out of my mouth. But I pushed it in. Using my years of experience. Using months of personal training and weightlifting to stay in shape. Most of all, using my brain to try and save this life.

This is when I made a conscious decision. I could dwell on the fact that I had to put mamma down, and that I had failed her. Or, I could make the choice to think about the win, the progression physically and mentally I've made and, in my own way, find the positive in the moment. 

Thus the inspiration to share this story with you fellow vets – the same people who have lived this scenario and are similarly challenged emotionally and mentally on a daily basis. 

Sometimes it's not the case outcome that gets to us as much as our inability to savor the positive aspects of a case – to take a moment and realize just what we did and how far we've come. To realize we need to remain confident in our competence. 

The next time a case like mine comes your way, that’s what I encourage you to do. Choose to look for the positives in the situation. Value your competence.