Telling Hard Truths

By Anne Chiruvolu, DVM

There are some nights I finish up at the hospital at 6:00 PM. My medical records written and patients discharged, I arrive home around suppertime. As I open the door I’m greeted by my children rushing to give me hugs and tell me about their days, and my dogs barking and wagging their whole bodies with joy. I’ll tell my kids about a cute puppy I vaccinated that day, or a tasty treat a client brought. And when the sun goes down I give them hugs and kisses as I tuck them into bed.

Tonight was not one of those nights. An urgent care visit for a cat who refused to eat turned very serious when I discovered she had lost half her body weight in a matter of months and diagnostics pointed toward neoplasia. Then a “recheck skin” appointment turned into a cardiac workup with a possible UTI, and another pet presenting for a Cytopoint injection wound up needing thoracic radiographs for a chronic cough and a long discussion on allergic skin disease and diet trials. Meanwhile, messages, lab results, and callbacks piled up and the technicians were rushing around trying to keep up with the diagnostics and treatments I was ordering. At 6:30 PM, instead of sitting down to dinner with my children, I sat with the owners of the hyporexic cat as they tearfully decided to humanely euthanize her. She was their first cat, and as we talked she purred softly on a blanket between us—painfully thin, dehydrated, and disheveled, but still a sweetheart. It was a difficult goodbye.

I never rush a euthanasia, and by the time they said their goodbyes and left with their keepsake pawprints I was ready to face the mountain of unfinished charts on my desk. When I finally arrived home, well after dark, my toddler was fast asleep, but my six-year-old was awake in bed and expecting an explanation. I told her there was a very sick kitty who needed my help. “Did she die?” she asked, never one to mince her words. I told her that she did. “Did you make her die?” she asked. “Yes, she was so sick that she couldn’t get better. So I gave her a special medicine to help her die peacefully.” She asked me how the medicine worked, and where the cat’s remains would go. We talked about it all. Then she asked me, “Will you tell me the truth about something, even if you don’t want to?”

I thought, suddenly, of the owners of that cat. In a way, they had asked the same of me, tearfully, looking for hope, looking for a way to save their companion who had brought so much joy into their lives. And even though I didn’t want to, I did tell them the truth: that based on the diagnostics I had run and the history they had given me, their sweet cat was likely beyond saving. In fact, at work I am often telling the truth even when it hurts—when a pet presents for an annual exam and I find a worrying mass or heart murmur, or when I fear a recommended course of treatment may be beyond an owner’s financial means. The truth can be heart-wrenching to tell, but it’s my duty to tell it, both as a doctor and as a parent.

Snapping back into the moment, I responded to my daughter: “Yes, of course. What is it?”

She looked up at me with her small, serious face and asked, “Are you the tooth fairy?”