Mind Over Miller: A truckload of camels, and other nightmares

Every veterinarian has an individual nightmare, a particular type of case he or she dreads above all else. The veterinarian may have actually experienced the type of case in question, once, or many times. Often, the nightmare case involves a possible but improbable situation.

Robert M. Miller, DVM

For example, one of my associates, Dr. Larry Dresher, lives in dread of an emergency that has not yet occurred. In this bad dream, the police call him in the middle of the night. It is raining. A truckload of camels has overturned on the highway. Larry goes to the scene. There are camels that must be euthanized, by intravenous injection of course, in the dark, and in the rain. There are wounded camels that must be sutured and splinted. There are dead camels for necropsy. The owner of the camels, uninjured, is a notorious deadbeat.

You must admit that, as a veterinarian's nightmare, the truckload of camels is hard to beat. I don't know how Larry acquired this particular phobia, but in our practice we treat a fair number of camels. They aren't bad patients except they strike with blinding speed. They also spit, bite, kick, and make unattractive noises. Larry spends most of his time in equine practice, and all equine practitioners dread the highway emergency calls in which a horse van or trailer has overturned, so we can speculate as to the origins of Larry's personal nightmare.

Another of my partners, Dr. Bob Kind, has often expressed his personal terror. It is the middle of the night. It is raining. Bob is awakened by an emergency call. A huge, expensive, and notoriously psychotic thoroughbred mare is having trouble foaling. One forelimb and one hindlimb of the foal are presented, both with contracted tendons. The owner is wealthy but mean. He refuses to pay.

Bob seldom practices equine medicine anymore, but many years ago I had a case like Bob's nightmare, and my vivid description of it must have indelibly imprinted on his memory.

I have a private nightmare, too. I have never before told anyone about it. It is the middle of the night, and it is raining. I receive an emergency call—a dystocia. An enormous cranky sow is lying in a two-foot-deep morass of mud and pig manure, trying to deliver her piglets. I explain to the owner that I no longer practice veterinary medicine, having decided to study accounting only a few minutes before he phoned. And in my dream, the owner is too poor to pay.

I practiced with this phobia for 20 years. Because I rarely treat swine, I feel inept with this species. Yet, last winter, my nightmare came true. It was raining. It was night. I was called to attend a sow in labor. Interestingly, I relieved the dystocia and handled the case in a relatively routine manner. It wasn't nearly as bad as I had always imagined it would be, and as I hosed off my raincoat and boots, the owner said, "Good thing you've had a lot of experience, Doc!"

Notice the basic similarity in most of these stories? They express the practitioner's deepest apprehensions: Being called to attend a case against overwhelming adversity—inclement weather, difficult conditions, uncooperative patients, and a dismal prognosis. Of course, the owner can never pay the bill.

I don't know why such a routine challenge as a porcine dystocia should have intimidated me for so many years. And I did indeed get paid for helping the sow. I'll bet that when Larry finally encounters an overturned truckload of camels, he'll find the experience isn't nearly as bad as he expected.

Robert M. Miller, DVM, is an author and a cartoonist, speaker, and Veterinary Medicine Practitioner Advisory Board member from Thousand Oaks, Calif. His thoughts in "Mind Over Miller" are drawn from 32 years as a mixed-animal practitioner. Visit his Web site atwww.robertmmiller.com.