“Care is provided by people, not machines or lights”

16 April 2018, at 5:11pm

On a recent perambulation, I happened to chance upon three quarrymen. “What are you up to?” I asked. “I have to cut out these blocks,” said the first. “It’s backbreaking work – I can’t wait for the day to end.” The second one was a bit more positive: “I’ve got a wife and kids and this just about provides for them,” he said. “And what of you?” I asked the third. “I’m building a cathedral!” he said, and turned back to the quarry face with determination. OK, I’ll be honest, I didn’t meet these men on one of my walks, but rather in a recent sermon in the church I’m part of. But I thought it would be a good way to start the new year. 

Why are we working through another morning’s cases of cat claws clipped, dog anal glands squeezed and diarrhoeic gerbils dealt with? Just another day at the clinic? A way to make some money to enjoy when work is finished? Or do we have a greater aim in our work? When we stood there in front of the president of our Royal College, we stated that our prime concern would be the welfare of the animals under our care. Nothing about getting to some monetary target or reaching a financial goal. So why, when I travel round to the practices my ambulatory referral service visits, do I not see graphs of number of clipped cat claws, squeezed anal glands or gastrointestinally-challenged gerbils helped, each with their happy owners satisfied, but rather plots showing the takings for the month this year and last so we can all see how much more was made?

I understand that the practice has to be heated and lit, the receptionists and nurses and cleaners have to be paid – oh, and the vets too! And these days if you’re not an independent, the corporate’s head office has to be staffed and the investors rewarded for their financial input. But that means that the prices go up, even if the investment has led to brighter operating lights and more machines that should improve the veterinary care.

The machines should improve veterinary care, but not necessarily. Care is provided by people, not machines or lights, though they can certainly help. And if we have invested in machines and lights, we will want to use them, won’t we? When I see a 13-year-old cat with a black blob in its cornea, the temptation is to jump straight into surgery to remove this sequestrum, especially given that I’ve driven 40 miles to see the animal. But a second look at the eye and a chat with the owner shows that the cat is not at all bothered by the lesion – there’s no blepharospasm whatsoever. A squidge of Remend twice a day may well sort things out and allow the tissue to slough off, especially as the cat has a heart murmur and the owner is concerned about money just coming up to Christmas. 

I guess there is a chance that the corneal defect could get deeper and deeper with the eye eventually popping (to use a technical term!). We could certainly frighten the owner into parting with her cash or just mention that this is a possibility and that regular checks are worthwhile. How happy she was with that as a solution – “the best Christmas present you could have given me” was her response. To my mind, that is building a cathedral!

Associate Lecturer, Veterinary Ophthalmology at St John's College, University of Cambridge

David Williams, MA, VetMB, PhD, CertVOphthal, CertWEL, FHEA, FRCVS, graduated from Cambridge in 1988 and has worked in veterinary ophthalmology at the Animal Health Trust. He gained his Certificate in Veterinary Ophthalmology before undertaking a PhD at the RVC. David now teaches at St John’s College, Cambridge.

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