Transcriber: Eunice Tan Reviewer: Tanya Cushman
The best part of being a veterinarian is when you get to send a patient home.
And I don't mean the ones that come in for a spay or a neuter or a vaccine.
I mean the ones that are carried in,
the ones that don't respond
when they are taken from safe and loving arms of their family
by a stranger.
I mean the ones that when you see them,
you are not confident
that you're going to be able to fix that patient and send them home.
So when they do go home,
it's like watching magic happen.
The dogs go up front to see their families,
and they are so excited.
They bark,
and they cry,
and they wag not just their tail
but their whole back end.
And cats -
the cool kids of the animal world -
lose their minds.
They're purring
and they're rubbing against the carrier
because they're so happy and they get to go home.
It's literally watching magic happen.
And every single time you see that,
and every time you think of it,
it makes you happy.
Because it doesn't always happen.
I don't get to do spays and neuters and vaccines.
I am an emergency veterinarian.
I don't work at a clinic; I work at a hospital.
That means good news doesn't come see me.
I perform euthanasia daily,
and sometimes multiple times a day.
Euthanasia is a kindness we are afforded in veterinary medicine.
I love my job
because whether I am saving a life or I am ending suffering,
I am making a difference.
"Euthanasia" -
the word literally means "good death."
Euthanasia is a kindness.
"Euthanasia is a kindness"
has been broadcast far and wide.
If it is a kindness,
why doesn't it always feel like one?
It doesn't feel like one,
because it is a kindness that comes with an emotional cost.
There are emotional fees to making that decision.
One of the most common fees that I see
is the hindsight fee,
where, after the fact,
people look back and say,
"Did I do the right thing?"
The answer is, "Yes, you did the right thing
because you put your pet's needs for peace
above your own needs to hold on."
A similar fee that I see is the crystal ball fee,
where people look back
at a hospitalization or a surgery that they had authorized
that didn't have the hoped-for outcome.
And then they beat themselves up,
and they lament that decision,
and they say,
"I shouldn't have put him through that."
What a treatment failure means -
what it really means -
is that you know in your heart,
you know to your core,
that you did every single thing you could for someone you loved.
And sometimes,
injuries are too severe to overcome
and little bodies wear out.
And if you had had a crystal ball and could have foreseen the outcome,
would you have made a different decision?
Yeah, of course you would have.
But nobody has a crystal ball.
You made the best decision you could at the time with the information you had,
and nobody can do more than that for someone they love.
The hardest fee that I see is the betrayal fee,
where people feel like the decision to euthanize
is a betrayal to all the love and kindness
their animal has showed them throughout their lifetime.
And I hear them saying goodbye,
and they say,
"I am so sorry, baby."
When your pet is in pain,
when they are struggling to move, struggling to breathe,
when there is nothing more that can be done,
giving them a soft goodbye
and sending them peacefully to heaven
is a kindness,
not a betrayal.
I learned firsthand
that these emotional fees cannot be separated from euthanasia
when I had to send my own dog to heaven last year.
Cooper was my 15-year-old beagle.
He would leave a trail of carnage
as he trampled the chihuahuas
to be the first one in the kitchen for bacon.
(Laughs)
And he had always been like that.
Until one day he wasn't,
and I knew something was wrong.
So I took him to the hospital, and we did the ultrasound.
And there on the screen, in black and white,
I could see everything I didn't want to find.
There was cancer everywhere.
Surgery wasn't an option,
and he was so far gone, chemo wouldn't have been fair.
So my choice was pretty clear.
So I told him goodbye.
And my amazing technicians made him a sundae:
McDonald's cheeseburger,
vanilla ice cream,
chocolate syrup,
bacon bits,
and a Snickers bar.
(Laughter)
(Laughs)
So they brought it to him, and his eyes lit up.
And even as sick as he was, he savored every bite.
And he was eating the Snickers bar,
looking at me like "Did you know this was a thing?"
(Laughter)
And so I took the opportunity to tell him everything I needed to tell him.
"Cooper, honey, I love you.
And remember the poem I read you about the Rainbow Bridge?
The one that connects dog heaven and people heaven?
I'm going to be on Rainbow Bridge for you.
I'll find you there.
I'm going to be on the green stripe -
on the green stripe, okay?
Yes, I get it.
You're a dog; you're colorblind.
I - the - the - the - the grass-looking stripe,
the - the - the cold stuff you roll on,
that's - that's where I'll be."
(Exhales)
So I told him goodbye,
and I sent him softly to heaven
(Sniffs)
with breath that smelled like chocolate and bacon.
(Laughter)
And I thought that was the end.
But for three days,
this little voice in my head kept saying,
"Are you sure you made the right decision?
Are you sure you did the right thing?"
And it drove me crazy
because it went against every single thing I knew.
I didn't need a crystal ball.
I had done the ultrasound.
I had seen everything right there in black and white,
and my mind accepted it.
And that was when I realized it wasn't my mind asking the question -
it was my heart.
Because it wasn't ready to let go
and it wasn't ready to say goodbye.
And it did the only thing it could, and that was question.
And that was when I had to recognize that this time, I wasn't just the doctor -
I was the family.
And I had to sit down, and I had to tell myself,
"Yes, it was the hardest decision,
but it was also the kindest decision.
(Exhales)
And I'm going to miss him too."
And with that, I was able to give myself peace.
Grief is the natural price we pay for loving.
It is always worth loving.
When you are watching your cat trying to bathe
and they're doing their bathing yoga
and they're trying to lick the spot between their shoulder blades
and they fall off the couch
and then pop up really quickly like nobody saw that?
That's hilarious.
(Laughter)
When you're eating salad and a piece falls on the floor
and your dog grabs it and chews it
and then - bleah - spits it back out
and glares at you like, "That is not food!"
(Laughter)
(Laughs)
Those moments make your life rich.
It is always worth loving.
But the grief is hard.
The hindsight fee,
the crystal ball fee,
the betrayal fee
can't be separated from euthanasia.
And what they mean is that you are normal
and you are grieving,
not that you made a mistake.
Those are the fees that the family pays.
But euthanasia takes a toll on the doctor and the staff as well.
Unfortunately,
the suicide rate of veterinarians is about twice the national average.
Those are the doctor's fees of euthanasia.
To deal with those,
I've developed three techniques
to keep myself out of those statistics.
The first one is I will not do convenience or revenge euthanasia.
If somebody's living arrangements have changed,
if somebody finds it no longer convenient to have a dog or a cat
and they bring that healthy animal to me and want me to put it to sleep,
I refuse.
If somebody brings me a dog that has chewed up the Jimmy Choo heels
and looked at the owner
with the high heel hanging from his mouth -
"These are delicious" -
(Laughter)
and they want it euthanized,
I refuse.
The cat that vomited on the Oriental carpet
maybe thought it was ugly.
(Laughter)
They want it put to sleep?
I refuse.
Euthanasia is too big of a responsibility
to be handled lightly for human convenience or human anger.
I advise those families to take their pet to the shelter
and get him a second chance.
(Chuckles)
Another technique I use
is I give myself permission to feel everything I need to feel in that moment.
When a professional Santa Claus came in to me carrying a dying kitten -
Santa Claus: red suit, white trim, beard, famous -
(Laughter)
and I had to tell him I couldn't fix his kitten,
it was sad.
You want to challenge your karma?
Tell a weeping Santa Claus you cannot save his kitten.
When I watched a police officer in his dress blues
lay on the floor and cradle the body of his canine partner
that I had just euthanized
because he lost his battle not to a criminal but to cancer,
it was sad
and it was hard.
Yes, I do cry.
And sometimes I cry a lot.
But it is better to cry,
to shed some tears and spend that grief currency,
than holding onto it
and stuffing it down inside me like a deposit
and pretend it wasn't really hard.
My grief vault is intentionally kept empty.
The final technique I use came to me as an epiphany early in my career.
One night, a woman brought in a gigantic dog to me for euthanasia.
He had very advanced cancer,
and there was just nothing more to do.
He was in pain.
And she told me that the night that she adopted him from the shelter,
he had saved her life.
She went into that shelter that day,
not with a plan,
just looking,
just seeing who she fell in love with.
And she saw this giant goofy face
(Laughs)
and knew he was the one.
So she took home a hundred pounds of fluffy love.
And that night,
she was awakened by the sounds of a dog snarling and a man screaming.
You see, she was a law enforcement officer.
And someone that she had put away discovered her address,
and he broke in that night
with every intention of doing something unspeakable to her.
And that was when he met her new addition.
(Laughter)
She got out of bed
to find a terrified man pinned on the floor.
And the giant fluffy face that she had fallen in love with
was curled into a snarl that said,
"Oh, no.
Not my new mom, and not my new house."
So he saved her life.
And we gave him a soft goodbye.
The very next night,
a woman came in with a little terrier
with very severe congestive heart failure.
He was old; it was advanced;
they had done everything.
His little heart had just worn out.
Even in oxygen, he was struggling to breathe.
There was nothing more I could do.
She tearfully told me
that he had saved her life and her family's life years before.
One Christmas Eve, they left the lights on -
the Christmas lights on -
and the tree caught fire.
And he barked and barked and barked until everyone woke up,
and they safely evacuated the house.
She said the paper the next day, the headline, read,
"Pepper saves family for Christmas!"
(Laughter)
So here I was again,
being tasked with sending a bona fide canine hero to heaven.
And that was when it came to me
that if I was going to send lives lived with this much purity
and this much sincerity and love,
I had better live my life up to their standards.
So that's when I decided I'm going to live my life like a dog.
(Laughter)
I don't just tell people that I love them,
I show them that I love them.
And when I go to the beach,
I chase the waves.
(Laughter)
And whether it is offered to me
as a gesture of affection or as a reward for a job well done,
I never ever refuse a cookie.
(Laughter)
(Applause)