A Bummer of a Week

Sadly this week was a bit of a bummer. Death is not something any of us look forward to and certainly unexpected death is more of a traumatic experience than a chronic illness.

Late last week I had examined two rabbits suspected of eating rat poison. The poison had been placed around the residence to exterminate vermin and despite the best attempts of the owners to remove all baited traps they missed a trap. Unfortunately, the rabbits did not. They were examined as soon as it was suspected the bunnies had found the deadly bait. We checked their vitals, and looked at the hematocrit of each rabbit. The hematocrit is a measure of percent of red blood cells circulating in the system. It allows us to assess if the patient is anemic or normal. The rabbits were both normal on that day. Rodenticides inhibit the body’s ability to clot so essentially the victim bleeds to death. These toxins have long duration of action so once ingested they can remain in the system for weeks making prolonged therapy a necessity. In an effort to treat these unsuspecting victims I prescribed oral vitamin K1 to be administered every 12 hours for a month. We also planned to follow up on the bunnies in 72 hours.

The day to recheck the bunnies came. They were doing well. No changes were noted on their blood work. I was pleased as was the owner. We planned to continue the treatment for the 30 days as previously discussed.

The following day I was reminded how fragile the body can be and how quickly all can decompensate and spiral downward. I received a message that the previously pleased and happy owner was now discontent and angry. One of the rabbits who had received a clean bill of health the previous evening was found dead that morning. What a difference a day can make. What had happened? That question was ringing through my head as well as coming over the headset of my phone. Would the other bunny die too? What should the kids be told? I had no answers at that point for any of these questions. All I could offer was an autopsy, but it was not with any guarantees that answers would be found.

As this saga was unfolding I was in the midst of another case. This was one which had a more personal aspect. My parents’ 15 year old cat had stopped eating, was acting lethargic, and off balance. The emergency hospital diagnosed renal insufficiency. After 3 days of intravenous fluids Sugar passed away. Again I was plagued with questions about how did this happen. Why did she decline so quickly? What should we have done to prevent this tragedy?

As a doctor, my role is to heal and save. When my patients die despite all efforts, often it feels like failure. If only we had caught the process earlier or was able to use a different medication. Could responses have changed the outcome of a case? Perhaps, but as I must continually remind myself and had to remind my mother, death is one of the certainties of life. It is not failure of my practice as a healer when a patient dies, only a failure in my inability to delay the inevitable and a reminder that I am only human.