You are all exactly right. I hate referring to someone, regardless of how good he or she may be, if they are rude. The other thing that really got me about the situation was my extreme disappointment with my alma mater. I remember school as one of my happy times in life and have always felt that if I ever moved back in the area that I would be comfortable and happy to send clients there, knowing they would be well taken care of regardless of who saw them. Now I'm far from certain about that. I spent my drive down Wednesday composing a lovely sarcasticly nice-sounding rude letter to complain about the situation. The great part is that I talked to one of my old friends who is a professor there and he told me exactly where to direct the letter for the best results. It's nice to know people who know things...
I fully intend to inform them that they are no longer the only choice available. I can easily send my clients to a private practice specialty clinic that has all the same bells and whistles and is the same distance from me or, assuming the animal can make a longer drive, I can always send them to the neurologist that I know and like who is a bit farther away. Given the fact that we have choices, the economy is far from good, and they may need to meet their budget, they may want to reconsider their attitude! I am really just so disappointed because it is not what I expected from them. On a good note, my visit went well and it was nice to see some of my old friends and find out that they haven't forgotten me.
As life would have it, I wound up bringing the neuro dog home with me. He was ready to discharge and it was easy enough just to add him to the menagerie traveling. At this point, his diagnosis is eosinophilic meningoencephalitis of unknown etiology. We have fungal cultures and tick / parasite titers pending but there were traces of zinc found that may indicate a heavy metal toxicity. If all of that is negative then we are left with idiopathic. Which brings me to another complaint. I hate the fact that people always seem to not listen to what I say. I really think it is something about how I communicate but I just don't know what. Wish I could figure it out because the response stresses the hell out of me! I put in a call to a colleague I worked with previously and stated, "I have a dog with a diagnosis of eosinophilic meningoencephalitis with no etiology identified yet but we are waiting on fungal cultures and titers. If these come back negative and we call it idiopathic, are you aware if there is any benefit regarding long term survival in using an additional immunosuppressive drug including a chemotherapeutic agent like we do with GME?" I got a call back with the message, "You can't put this dog on immunosuppressive drugs because typically eosinophilic meningoencephalitis is caused by a parasitic or fungal infection. You must culture and do titers and wait on those results first." Can anyone PLEASE, PLEASE, PLEASE tell me what I'm doing wrong???????
Then I got home and mom is surprised again that I'm working half a day tomorrow (told her minimally 5 times), states that she may just go up to talk to them about her retirement in the morning (she is slow as Christmas getting ready and will need all of the time that I'm at work then some to be ready to leave semi-on-time) because "time is running out" and somehow Friday is so much better than Monday (I'm sure the weekend will make all the difference in the world), she has done nothing to help prepare for our little foray this weekend, and she wants to know if I'm taking any of the kids to the clinic tomorrow (again, told her yes minimally 5 times already.) And I wonder why I spend so much of my time tired and frustrated.
One of my friends that I saw today took a tripod black cat from me last year and this cat has become the love of his life. Unfortunately, she has developed kidney failure but is right now stable and doing pretty good. He has now acquired another tripod black kitten but the original cat hates it. They are kept separate for now; I think he thinks the first cat won't be around too long and that is entirely possible but it would be funny if she fools him then he has two tripods. I think y'all will enjoy the names: Beatrice Oil Slick and Eugenie Blackberry. Beatrice and Eugenie because they are both princesses, Oil Slick because she is black and he got her around the time of the Gulf oil spill, and Blackberry because she is a small hand held device.
Got a lot of hugs, did some catching up, had some good visits, and discussed my annoyance with some folks I respect and trust. They, too, recognize there is a problem with the place and one of them, in his inimitable way, summed it up like this, "We have hired too many high-stepping fancy show horses that look real pretty but we don't have any Percherons, Belgians, or mules to really do the work and most of the old ones are about to retire." Yup, that pretty much says it all. And, unfortunately again, I feel like most programs are heading in that direction by choices in interns, residents, and even students so that we are basically training a bunch of showy folks with no staying power. I'm afraid they are about to become like the school where I did my internship which is not a good direction to move!
One last grump. I realize I'm picky and with my English background typos, misspellings, and poor grammar are a pet peeve. My students hated writing discharges for me because they came back so much for correction. The thing is, though, if you send crap out what does the client think of you? It's like the adage about shaving the hair neatly and suturing the outer incision neatly; that's all the client sees. The discharges I received for the neuro dog were mostly a piece of crap. The history was jumbled and incomplete. There were typos and grammar errors and misspellings throughout the document. One of my favorites was that the dog was sent as a "preceived emergency." Not only did spell check fail but it's insulting that it was worded that way. The student also struck me as one of those people who make up things rather than admitting they don't know an answer. I don't even trust what specialists tell me without double checking them, much less students. That said, I need to do a little research as well. And lastly, the fancy wonderful "precious" (read this like Gollum saying my precious in Lord of the Rings) neurologist didn't even take the time to come out to make sure there were no questions, meet me, or anything. I would have thought that professional courtesy alone would have been a reason to come out but, obviously, I was mistaken; not surprised, just mistaken. We must be beneath his contempt.
And, yes, Can't Spell, I did have some "truth drugs" prior to that other post. Meclizine does interesting things to me as do most other medications. With that I must close my gripe session and write at least the rough draft of my letter. If I wait, I won't be as mad and it won't turn out as good.
5 days ago