When do You Say When

D. E. Larsen, DVM

Nessie came out from under the feed rack, shaking her head vigorously as the small rat hung limply from her mouth.

Nessie was a small, straw-colored Cairn Terrier. 

“That’s the way to get ‘em,” Ayers hollered as Nessie discarded the dead rat and ran up the hill toward us.

Ayers laughed and stuck his hands into the pockets of his bib overalls. He looked at me with a broad smile, and his good eye twinkled.

“I love that little rag muffin of a dog,” Ayers said.

We had just finished working on a cow with pink eye. The white-faced cattle suffered a little in this dry and dusty weather of mid-August in the Willamette Valley. 

“Do you think that eye will be okay?” Ayers asked, his voice was more serious now.

“I know it looks terrible right now, but it will heal up and be back to normal when I come back and take those sutures out,” I said. 

“You always sound so confident in what you do, Doc,” Ayers said. “How can you be so sure of yourself all the time.”

“It is just a matter of knowing what you know,” I said. “I know what I know, and consequently, I know what I don’t know. When I was in the Army, I learned to express utter self-confidence when I knew something. I venture into gray zones of my knowledge at times. But when I do that, you will know it. I have no problem saying I don’t know something.”

“So, what do you know about cataract surgery in people?” Ayers asked. 

“I have never watched a surgery,” I said. “ But I know they are getting better and better at it all the time. I did a couple of cataract surgeries while I was in school. Luckily, we have a specialist in Oregon that does most of those surgeries. That is a surgery that you want someone who does a lot of them. Practice makes perfect.”

“Oh, I know,” Ayers said. “They say they are pretty good. But, you know, Doc, when you only have one eye, like me, it is a pretty big decision.”

“I can imagine your concern,” I said. “But, you have to consider the alternative. You don’t want it to get so bad that you can’t see.”

“I know that, but when do you say when?” Ayers asked.

“You are trying to get me to answer some of those questions that the eye doctor should be answering,” I said.

“I trust your opinion a hell of a lot more than I trust theirs,” Ayers said. “They spend a couple of minutes with me on every visit. They don’t know me from Adam.”

“Ayers, all I know is that cataract surgery is done when the cataract starts to affect your lifestyle,” I said. “That means that the neurosurgeon gets surgery a long time before grandma. But I would guess that with one eye, they would want to do the surgery pretty early. And I think you will be amazed at the results.”

“But what happens if something goes wrong?” Ayers asked.

“Pin that doctor to the wall,” I said. “You want to ask him about his record of complications. Now when you do that, he is going to respond with something out of the book. He will say that we see a 1% rate of serious complications. When he says that, and he will, you have to say that you don’t want what we see. I want to know what you see. That is very important. A good surgeon will not be bothered by that questioning. The guy with poor numbers will be upset with that question. You don’t want that guy. There are a lot of surgeons doing cataract surgery. You want to choose your surgeon well.”

“What do I do if he gets upset,” Ayers asked.

“You tell him that the appointment is over,” I said. “Then you ask him for a referral to somebody who won’t be upset with that question. He will know the best surgeon.”

It was several months later when I revisited Ayers. I made a call to his place to castrate a couple of lambs.

“I don’t know why I keep these sheep,” Ayers said. “Lord knows, I don’t make a penny on them anymore. I have an old ram who can hardly walk and only a handful of old ewes. And I am too damn old to do the most basic things.”

“I am guessing you are too soft to send them to the sale barn,” I said.

“Sale barn, hell, they would not bring enough at the sale to pay for the gas getting them there,” Ayers said. “I guess they have all earned their hole in the ground. My only problem is I will have to pay somebody to dig the hole.”

“How is your eye doing, Ayers?” I asked as I reached down to pat Nessie on her head.

“I wanted to thank you for your advice,” Ayers said. “I went ahead and had that cataract removed. The best thing I ever did, I wish now that I had done it years before.”

“That is good. I hope you can see better,” I said.

“I can see better than I ever have in my entire life. Hell, I can see that fly on that cow’s back,” Ayers said as he pointed to a cow standing about 20 yards out in the pasture.

“So surgery and recovery went well,” I asked.

“Surgery went well, but they had a patch over my eye for a day,” Ayers said. “I was blind as a bat. And the problem was everybody thought I should be able to see out of my glass eye. Even at the doctor’s office, they couldn’t understand why I was so helpless. And they had my records, dumb bastards.”

“I guess when you fill out your taxes this year, you should put Nessie down as a seeing-eye dog,” I said.

“She is already listed as a sheepdog,” Ayers said. “I should list her as a rat control dog. She is death on those things. Rats and those darn digger squirrels. Those squirrels can’t seem to learn that it is not worth it to clean up the grain out of the feed racks.”

“I have to run. I have a cow to look at over in Crawfordsville,” I said. “I am glad things are well with your eye. You call again if you need anything.”

“I’ll see you later, Doc. I think Nessie is due to come in to see you pretty soon. And boy, does she hate that trip.”

Photo by Lone Jensen from Pexels

Published by d.e.larsen.dvm

Country vet for over 40 years in Sweet Home Oregon. I graduated from Colorado State University in 1975. I practiced in Enumclaw Washington for a year and a half before moving to Sweet Home to start a practice.

4 thoughts on “When do You Say When

  1. I could write a book on this morning’s post. I won’t but here’s my thought for the day…I can honestly say I have experienced much better health advice from my Vet’s in the past. Both for my dogs and myself. Certainly more sympathy for whatever was happening at the time. Things have changed greatly. In many areas of life. But,sometimes health advice is most needed. No cute answers..Just someone who cares and has knowledge to share. Unfortunetly times have changed … and we are not a better society for it…Thank you and my vets from days gone by for caring so much for the health of my dogs..I hope you realize how grateful your clients have been.

    Liked by 1 person

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