Potpourri of Stuff + Harper B + Little Soldiers

Last night I was again at the (health care) interprofessional seminar I attend as a faculty member and guess what we discussed?! Medical errors -- only we do not call them that -- the politically correct term is "unanticipated outcomes". Fascinating stuff -- and once again, my life with dogs and my professional life intersected -- at least in my mind.

Well, it also intersected in the seminar because we discussed what to do when the patient shows up with information that calls into question what we (as professionals) have done/recommend? This happens a lot now because information -- some good and lots of it bad -- is so accessible, and so it was an interesting discussion. In human medicine, the strategy is usually to educate/discuss  -- they do not man/person their battle stations and lawyer up. Just saying.

In my ongoing effort to understand what appears to me to be an incongruence between professional literature and Cadi's care, I am seeking consults with at least two outside, objective veterinary specialists.  This was an excellent suggestion from someone who "gets" that I am simply trying to understand what happened, but that I will need explanations from credible sources given that the contrary, concerning information is also from credible sources (professional literature).

And so all that is underway -- but the passage of time is good, because the emotions associated with it all are starting to come down. Yes, I still have bursts of grief but I can now (most of the time) talk about Cadi without crying and I no longer feel that horrible sense that nothings matters  -- these are signs that I am re-ordering the chaos that is grief, and finding my New Normal.

I appreciate the courage it takes to talk about what to say to a grieving person -- and the humility it requires in all of us. Cousin Carmen -- who is in fact incredibly compassionate and articulate with grief -- echoes what many feel/think: I do not know what to say and so I often say nothing because I do not want to say the wrong thing. 

Thank you for caring enough to be thoughtful! However, people like this are usually the ones who do not need to slow down and think about what they are about to say :)

In the spirit of community, let me share some additional thoughts on supporting our grieving members -- your thoughts are also welcome!

People in crisis do not process information well -- this is normal. And we know their Little Soldiers are all off on Operation Crisis so they are without resources. What do those two things mean? Well, I think it means we use less words, and we ask for nothing in return -- as in, we do not put anything out that requires the grieving person to respond to us (i.e., telling our own sad story -- which also tends to violate the aforementioned word count rule).

Here is the text I immediately sent to my friend who recently lost her dog so suddenly: "No words. Just hugs." In fact, I frequently start communications to grieving people with something like, "There are no words that can make any of this better -- but I want you to know how sorry I am that this has happened, and that I am thinking of you..." And sometimes that is enough. It is just fine to acknowledge the limitations of our words to convey what is in our hearts.

I also agree that sometimes it is good to share our experience -- early on it should be brief and only to provide context. For example, one might say, "I also lost a dog recently and so I am sorry that we have had to make room for you in the Dark Place of grief..."  As time goes on and more Little Soldiers return, there may well be a benefit in sharing stories but this is a sensitive area and we need to be clear about our motivations -- is it to support the other person or to tell my story?

There is usually great benefit in inviting a grieving person to talk about the one who has died -- saying that name and talking about her/him brings her/him back, and what a gift that is to someone aching to have a reason to speak that name ("Cadi" "Donner" "Jake" "Marshall"). Yes, there will be tears -- so what? Nobody ever drowned from tears -- only from unspoken sorrows and loneliness...

As I said, your thoughts on this topic are most certainly invited -- we learn from each other only when we share what is in our hearts and minds, and all of us have important things to say...

And now we shift gears -- because that is how life is -- one gear shift after another! I took this picture yesterday -- Zoey and Harper B for Big Girl -- doesn't she look grown up?!

I am not sure how Zoey can get any balder -- just in time for the Specialty! But Harper B for Big Girl Hair has a wonderful coat for a six month old puppy -- silky and long -- too bad she cannot share some with Zoey!

More pictures of Harper B later but I wanted to share some good news for a change -- and tell you why I am buying more lottery tickets. Yesterday our very own Most Favorite Auntie Heidi called from work with some great news -- I have been awarded tenure at the University of Montana. This is like joining a big polygamous family where they are not allowed to divorce you -- a.w.e.s.o.m.e. more than I have words to say. For a change -- Happy Tears.


Harper B's mom, Sydney...

Harper B...

Harper B got to go to work today and I have to say she has an incredible temperament -- loves everyone and nothing bothers her at all. Today there was a skateboard event and we visited Galen, who was working at it -- Harper B thinks everyone is her BFF -- all people and all dogs BUT especially Galen and Most Favorite Auntie Heidi.

We stopped at the vet on the way home and Harper B is 53 pounds now so probably still the runt -- but the perfect size for her :) She is a great tracker and very ready for the upcoming test - and just a fun, happy puppy. She loves to leap in the air and is still pretty mouthy (as in likes to nibble still) and the combination of those two things can be interesting -- I have a nice little bruise on my upper arm from a leap/grab combo. However, she is perfect -- that is what I have to say about Harper B for Best Girl!

And you will be happy to know that all the Little Soldiers came back -- in fact, I might have extras as they seem to have brought back friends -- my office was filled with them when I got to work today! See for yourself...

Yep -- Little Soldiers of all kinds -- EVERYWHERE!!! It was AWESOME! Even a pink soldier on my computer!!!! How perfect is that?!


by Lisa K on Thu, 04/26/2012 - 06:53

So glad to hear of this super exciting news!!!!! Congratulations! I have so many thoughts on this grief subject, but know I won't articulate them well, so will chat w/you when I see you again, which hopefully will be soon!
In the mean time, hugs to you as always! Give my girl a smoochy, too!

by Joan on Thu, 04/26/2012 - 07:22

In human medicine, we do use the term "unanticipated outcome", of which medical error is a subcategory, but certainly not the only source of an unanticipated outcome. We're talking about a biological system interacting with technology, experience, intuition, and human fallability, after all. And luck, fate, God's will, whatever you call it - that part of life that can't be measured or defined. However, if you (or your pet) are the sufferer of the unanticipated outcome, the cause is important to understand but the outcome is the same. Disclosure of unanticipated outcomes has been the subject of increasing research, and many hospitals have adopted "disclosure coaching" models, with a team of trained disclosure coaches on call to assist a physician through the sticky, tricky business of honesty in the face of a bad outcome. I am such a coach at my hospital. The message from research is that patients want an apology, and they want it early. They want acknowlegement that something has gone wrong, that an investigation will be undertaken to understand what, how, and why, and that something will be done to elimnate or reduce the risk of that same thing happening again. Much like at a crime scene, immediate accounts are inaccurate, and careful investigative work is needed to fully understand what has happened. That means needing hang around in an uncomfortable space for a long time. It's much easier to blame other people, jump to conclusions, or hide. Anyway, M-A, maybe this topic has been explored in the veterinary literature, or maybe it's an area ripe for study.

by Congratulations on Thu, 04/26/2012 - 08:04

What a wonderful thing...TENURE!!!
Truly, I have said, at least to myself, how much I wish I could be in your classes! I know I would be a enraptured student with our shared interest in all things behavioral AND positive...and then there is the grief. Unfortunately, that too is a shared topic, but
I continue to grow, understand and learn. Grief, much like depression, can almost be described as a color, very dark and rumbling with swirls within the darkness.
This blog continues to inspire.
Again, thank you M-A and others who share in the comments.

by Maddie's Mommy on Thu, 04/26/2012 - 11:49

Greatest of congratulations on being awarded tenure! Not only a validation of your efforts and professional successes at the University but--aha--huge sigh of relief.
So, it looks like you'll be in Stephensville for a while, eh?
And isn't Harper (I used to be B-is-for-Baby but now I'm a Big Girl) going to Sprague this weekend? Have fun and celebrate!

by Jennifer G. on Thu, 04/26/2012 - 18:01

OK, I LOVE the soldiers...how brilliant is that!? And Harper B for Beautiful looks gorgeous and SO mature in that head shot...love that too!!! And even being a big fan of the fluff...can't wait until you make Mesa's ears look like that!:)

by Jennifer Z on Thu, 04/26/2012 - 20:41

Huge congratulations!! on the tenure. That is wonderful news. And, I must say, you have some wonderful friends-whoever thought up the soldiers to fill your office is a gem. I had some 'dog therapy' today (being without a dog of my own for two weeks now) meeting the newly adopted dog of a good friend after she'd lost her most beloved canine companion in recent months, and sharing that with another dear friend and her puppy, after she too lost her beloved dog this past November to the same cancer that took Cadi and Rocchi. It is a good reminder that there is joy in the future, and that life goes on, leaving us with happy memories of the ones we've loved and lost, but making new memories with the dogs that will enter our lives.

by Toby E on Fri, 04/27/2012 - 04:15

What wonderful news! Congratulations! And now you have little soldiers of all shapes, colors and sizes to march forward with! Harper B- Holden and I are counting down the days until we see you!

by CA Heidi :-) on Mon, 04/30/2012 - 21:45

Clinical distance is an interesting thing, isn't it? We can't say, "oh, that horrible, God-awful, no-good result;" that just ends up getting everybody REALLY upset. But, it's often what we mean. I am hoping that your questions and your gentle persistence about your experience will help to cultivate a culture that can sit with a horrible, God-awful, no-good result, M-A, and learn from it. It might feel less like being assaulted by the event and more like something that is at least a tiny bit better. The conversation feels like a good place place to start.


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