Familiarity is the gateway to empathy

In our line of work we not only confront, but make use of death as a means to an end – stopping or preventing suffering. But how do we know what we’re putting our patients through really is an “easy death”?

I qualified in 1997; it was quite a long, warm summer as I recall. I was on the committee of the Association of Veterinary Students and had been invited to the International Veterinary Students’ Association World Congress in Paris.

To get there as cheaply as possible I’d had to book my travel about nine months in advance, which was too far in advance to know when (or if) graduation would be. Not surprisingly, it did clash with the conference, meaning I graduated in absentia and my mum didn’t get a graduation robe photo for her wall.

However, while the rest of my friends graduated with medics and dentists in a warm hall in Glasgow, I was actually a few hundred miles away in Paris playing volleyball in a match that would affect my life in more ways than one.

Quite how I came to be playing beach volleyball in a kilt and Tam o’Shanter with a cute French vet student riding piggyback, I can’t really remember… I think it was some sort of bet. There was a lot of laughing, a lot of drinking, and a lot of messing around.

The next morning I woke up in agony and could barely move!

Somehow I got back to Glasgow and thence to my other home in Manchester. A few weeks later I wasn’t getting any better and the consultant ordered some x-rays and then an MRI scan. These showed that my previous life as a prop forward had taken its toll and the volleyball had been the straw to break my back and slip a disc. Surgery was scheduled.

Everyone I met in that hospital knew I was a vet – and in those days being a vet carried a fair amount of cachet and respect. The medical student tasked with taking a blood sample from me on my first day there swapped anecdotes with me while she tried to find my vein with a needle – and so I found out how painful it can be when you don’t hit it dead on. It turned out she had graduated at the same time as me.

It was the anaesthetist who I particularly remember, though. Because of what I did for a living he was telling me what he was injecting… Fentanyl produced a nice, warm floaty feeling – he said it was for analgesia during the operation and that he’d be switching to morphine after the surgery. Then he told me to count to three as he injected the thiopentone.

“One… warmth… two… dizzy… deep breaths…”

Fast forward a couple of years and an ancient, rather creaky Labrador just wasn’t able to get up any more. Zenecarp wasn’t enough for her, PLTs hadn’t been any better, and she was also unwell. The owners decided they’d rather put her to sleep. They asked how we did it and I told them what we used. They asked “It won’t hurt her, will it?” and I told them no.

Then they asked: “How do you know?”

I thought a second, then said: “Because I had a very similar drug to knock me out for my back op. All I felt was warm and dizzy and that was it.”

To this day those are the approximate words I use to convey what we do in most euthanasias. The drugs aren’t exactly the same, but they are so similar it is reasonable to think that the sensations are the same. There is no other way to know what it’s like for a patient, and I think it is a fear of owners that their animal will experience unpleasant sensations or feel fear in their last moments of consciousness.

I just hope they are as reassuring to owners as they were to me when I had to put my dog to sleep.