Grand Prize Winner: What I learned from my dog

Key Points

This isn't "Marley and Me." At least, I don't think it is. I haven't read the book. It's about my yellow Labrador retriever, Spenser, and how his illness gave me a slightly different perspective and validated some of my long-held beliefs about caring for patients.

In early July of his 10th year, Spenser started to bleed from scratching and had blood in his mouth. The veterinarian made a diagnosis of thrombocytopenia. From the very beginning, the vet told me that, even as a physician, I didn't understand the process, because taking care of animals' medical problems was completely different from caring for humans. I'm not certain that's entirely true.

1 Don't be afraid to give hope in the face of bad news.

I asked the vet whether Spenser could have idiopathic thrombocytopenic purpura (ITP) or some other immune-related disease. That was unlikely, according to the vet, because in dogs of his age and species, the symptoms he had almost certainly mean cancer.

An abdominal ultrasound revealed a mass in the spleen. The radiologist thought the mass could be a few things, but that it probably was cancer. We were told that Spenser would live a few extra months without chemotherapy but fewer than 3 months without the chemo. My wife, Susan, and I cried the entire July 4th weekend. Turns out that the splenectomy revealed that the mass either was not cancer or that the surgical treatment was curative.

THE MORAL: Often, I am afraid that I am being too optimistic and am giving patients and families false hope. In many instances, however, patients I thought would do very badly actually did surprisingly well. One nursing home resident's story springs to mind. He entered the facility tube-fed, bed-bound, and aphasic. One year later, he tapped me on the shoulder. He had been discharged and was standing in line behind me waiting to vote. It's unfair not to give a patient even a little reason for hope, or at least to admit that you're not certain what the outcome might be.

2 Trust your instincts.

One week after surgery, Spenser started having different, worrisome symptoms. I was out of town and told Susan to take him back to the emergency vet who had performed his surgery. She thought Spenser was better than he had been previously and wound up taking him back to our usual vet the next morning. She didn't agree with the vet's opinion but still waited until I came home that night. I could tell immediately that something was terribly wrong and that we needed to go the emergency vet right away. As you will see, that decision was the correct one.

THE MORAL: Don't doubt yourself. If you know something is wrong, get the tests, labs, or exams you need. Challenge people who are telling you things you know in your heart aren't true. My wife let herself be swayed by the "authority figure" (in this instance, our usual vet) with almost catastrophic results. Don't get angry with patients if they behave this way with you, either. I try to equate family members' anger with their concern for a loved one's welfare.