Things I Learned From Vet: Nuances to Grief, Part 1

This is a subject most people understand on an intellectual level, but experiencing it for yourself gives you a deeper, emotional understanding. And when I say "experiencing it for yourself," what I really mean is, "being involved in the grieving process of other families multiple times a week."

A lot of times, the first thing people say to me upon learning my profession is, "I don't think I could put down animals." (Seriously, that's the first thing most people think about). Truthfully, that's the end of the story, and that's often not a very hard step. When people bring pets in for euthanasia, they've made the decision, processed and come to terms with it, can allow their family member to pass with peace and dignity, and get to see the passing in a way that I feel provides a fair amount of closure. There are much worse situations to deal with...

1. When the pet is diagnosed.
Often, owners are expecting bad news. They know their pet, and they know something is seriously wrong. The worst two diseases to break this rule are osteosarcoma and lymphoma. There's nothing worse than a dog coming in for limping the past week, and having to tell them she has months left to live. 

In the first situation, where it's expected, owners usually nod, embrace their sadness, and move onto acceptance. Many, many times, they expected they wouldn't be bringing their pet home (and maybe delayed the vet visit), and when I tell them we can improve the symptoms and give them a few more days or weeks, they're grateful for the extra time. There are positive sides to the diagnosis: now we know what's wrong, we understand what we're dealing with, and we have a plan.

The second situation is much worse. The people haven't had time to process. It's a bombshell, and they're in shock. I have to explain the disease and the treatment options, while they're still coming to grips with a terminal diagnosis. This is a time when people may need a moment in private to think, or to go home and call back later with questions. And this is the time when my heart is pounding when I step back into the room after looking at the xrays or bloodwork. "I'm afraid I have some bad news..."

2. When treatment isn't working.
In small-town, low-income areas, it's not often that owners commit to textbook treatment protocols. Sometimes, all we can manage is a best guess and palliative care. However, even if we do everything by the book, some animals have diseases too serious to cure.

The worst, worst, worst, are cases where the owners are willing to do whatever I say is best, the pet is admitted for a several-day hospital stay, and it starts improving--only to take a turn. There was hope, things were getting better, they came to visit and he purred and cuddled, and the next day he's barely conscious and that hope is crushed under the realization he's going to die. Those phone calls can only be surpassed, I imagine, by my physician colleagues delivering similar news about human patients.

3. When a pet dies unexpectedly.
Anaesthetic complications. Unexpected turns in a disease course while hospitalized. Risky surgeries.

I once did a very high-risk surgery on a dog who would have bled out otherwise. He made it through the surgery, and looked fantastic when the owners came to visit. He stayed in hospital overnight, and at 10pm he started crashing. I sat with him for 2 hours trying to save his life as he bled out into his abdomen and died. 

 4. Euthanasia
Comparatively, euthanasia can be welcome. Barring complications, it's peaceful, intimate, and provides closure. The types of grief people display here are, in my opinion, the necessary and healing kinds of sadness. Your pet is going to die or your pet died unexpectedly are painful shocks. The emotions people experience in the above scenarios are acute, intense, and gut-wrenching. It's the blow that knocks the wind out of you, the crushing of your hopes, the rug pulled from under your feet. The emotions people experience at a euthanasia are the tears of love and farewell and acceptance. It's a choice, made out of kindness and empathy, a decision to prevent suffering. So many people comment that they would want to keep treating the pet, but that's selfish, and the right thing for their pet is to let them go.

How this relates to writing:
Characters die in fiction. A lot. They also receive bad news and life-altering injuries, lose their homes or their friends, get betrayed or deceived. Grief is a major player in fiction. Some writing advice suggests that the best point of view character for a given scene is the one who's in the most pain.

There are a lot of kinds of grief, like we've talked about. In fiction we often use the sudden shock, but they all make appearances. I think it's important to consider how characters will process these events, and what emotions they will be experiencing. Their hopes and expectations can influence how much harder they fall.

It's easy to gloss over grief in television and movies. Or, conversely, focus too much on it (sometimes people deal with it by trying to move on, trying to maintain some sense of normalcy). I think what I'm trying to say is that media sometimes portrays a shallow view of grief. It's present, but it's stereotyped, and it lacks depth. Think about scenes where the characters are crying, but you don't care. The ones that are effective... those are the ones that make the audience cry.

I want to mention a bit more in-depth about the wide variety of reactions and emotions I see during euthanasias, so tune in next time for part 2.