My Other Patient Population
Just a few weeks ago, I ran into another volunteer at our town’s animal shelter. We chatted and joked about how low the cat census was. There were only three cats up for adoption. Ha ha, he said. We joke now, but wouldn’t it be funny if there was an explosion of kittens and cats tomorrow?
Well, Murphy’s Law. The following week I walked in for my Thursday morning shift in the cat room, and there were: a sleek and lovely mama cat nursing five adorable tiger kittens; several new cats, all sweet and friendly, crying for food; and one tiny, lonely, desperately mewing kitten alone in a small cage.
Of course, I had had my whole day off planned out to the last five minutes. But as soon as I saw all those new kittens and cats, I knew my plan was shot. Never mind spinning at the gym, forget the Target run. Regardless, I was kind of excited.
Let’s face it, kittens are cute. And the tiny runty one, crying so loudly (amazingly loudly, considering the poor cutie was the size and heft of a little bird), I just wanted to HELP.
Now, I may be a passable physician, but I am a crappy nurse. All through training, moonlighting as a hospitalist, or even in the office, when a patient has needed physical help getting to the bathroom or onto a bedpan, a glass of water or a straw, or whatever basic bodily-needs issue, I have tried, but I am so painfully clumsy. We don’t get any training in the proper patient-maneuvering techniques in med school; we don’t now where anything on the floors is kept; and this kind of thing is generally discouraged.
Well I remember being on patient rounds with the “team” as we residents did our self-concious presentations, the attendings asked probing questions, and we all pretended to meaningfully auscultate the patient’s heart and lungs. As soon as the patient would ask for help- Please can you move this tray, or Please can someone hand me the urinal, or Please I’d like a cup of water, the whole team would evaporate, ostensibly to “get the nurse”. This always bothered me, as we were all capable of making the effort, of taking the small amount of time to concretely help a patient with a basic need. I knew it could take ages and ages for the “right” person to come to the room. And it was obvious that the patient could care less about the differential diagnosis of elevated liver enzymes. They just needed to pee, dammit.
One of these times, when a weak and elderly patient asked for help to sit up, I stepped forward, and then fell behind on rounds as I (clumsily) boosted her up in bed, adjusted the bed, and strategically placed some pillows. Afterwards, the attending took me aside, and said, not unkindly: You paid a ton of money and endured a hell of alot of training to be a physician. You should not be doing nurses’ work. If you keep doing that type of thing, that’s all anyone will expect you to do.
So I was never quite sure what was the right thing to do.
Whereas, at the animal shelter, that’s all I have to do. It’s my job one measly morning a week to take care of the very basic needs of these deserving kitties. I am not a vet and have no clinical responsibility, or clue. I do not make decisions and am never on call.
It’s so wonderful!
I let them out of their cages, one by one, and sweep, change the litter, plump the cat beds. I dutifully cut and crush pills and hide them in food (there are a couple of animals on Methimazole for hyperthyroidism, and one on Buspar for aggressive behavior). I pet them and, time permitting, wiggle a string or cat toy so they get some exercise. When my kids accompany me, that’s their job.
When there’s kittens, they need to be socialized. So it is part of the job description to pick them up, cuddle them, pet them, talk to them, love on them. So cute!
But this runty little kitten was extra concerning. I tried to give him a bit of kitten chow, and he promptly stuck his face in it and tried to suckle at the mound of mashed tuna, confused. Hmm. I called the animal control officer who is in charge, and she told me he needs kitten formula. Huh? New one for me. She mixed it up and showed me how to bottle-feed a kitten. You hold them on your chest upright and stick the bottle nipple in their mouth. She showed me how this little guy has some issue with his hind legs- “Swimmer’s syndrome”, splayed hind legs that don’t work very well. That may be why he was found all alone, possibly abandoned by his mama. After she left, I spent extra time holding him, and he purred and purred, kneading at my chest, warm and well-fed.
This week, I came in and found the little runt in the big cage with mama and her five kittens. Though her own kittens are a few weeks older than the little guy, she seems to have adopted him. Still, I held him and offered him some formula, and he took it, happily, his mouth and whiskers all milky, purring and purring.
I didn’t have time to hold and play with all the older kittens, but I petted them and scratched behind their ears. Mama too.
So nice to have this very different patient population, and a very different set of responsibilities!