Veterinarians lie. All the time. In lots of ways. We don’t necessarily mean to –– except when we sometimes we do. But does this make us bad people? Bad doctors? Read on before making up your mind.
Last week I saw a new patient. After being adopted from a shelter, spayed and vaccinated (exactly once), this seventeen year-old domestic shorthair cat had lived an uneventful indoor life. Her owner was convinced that clean living, bottled water and yogurt every morning for breakfast –– not blind luck –– were responsible for her cat’s “perfect” health. Who was I to argue?
Clients almost universally adore their pets and want their veterinarians to adore them, too. So when they recount all their pet’s wonders and the miracles of their own home care regimens, veterinarians are like pediatricians with poker faces. We’ll tell you exactly what you want to hear about your beloved babies (and not just ‘cause they’re cute). That is, of course, as long as what you’re doing isn’t harmful to them.
In doing so, however, we’re lying. While not malicious, it’s an untruth, nonetheless. Which is only the first of many self-serving (however well-intentioned) lies we veterinarians indulge ourselves with on a regular basis. Here’s a breakdown of how it happens:
#1 The White Lie
This kind of well-meaning fiction is the number one reason veterinarians lie to their clients. I mean, what does it matter if clamato juice and ice cream have never been proven to improve a dog’s skin condition? If my client thinks it works, and it doesn’t hurt my patient (I’d probably ask a couple of key questions to be sure), why rain on their parade?
Sure, I might get on this particular client’s case because the cat hasn’t been seen by a veterinarian since the Clinton administration (and the condition of her teeth leave a great deal to be desired), but why make a federal case out of it? In fact, “lying” by omitting the stark truth of the matter is an effective tactic employed against those who need to be cajoled into understanding that veterinarians are there to help –– not judge.
After all, once the hard work is done there will always be time for some plainspoken language on the subject of preventative medicine. All in due time.
#2 The Persuasive Lie
White lies are the slippery terrain of those who prefer to catch their flies with honey instead of vinegar, whereas persuasive lies attempt to put the messenger on a rock-solid footing. Appearing self-assured when we’re not is a common attitude adopted by all kinds of healthcare professionals.
This approach may seem unnecessarily duplicitous, but that’s not always so. To secure your buy-in, enlist your compliance, and sometimes even save you money, veterinarians sometimes consider it expedient to adopt a position of secure knowledge and unassailable confidence. This, despite the fact that perfect knowledge is hard to come by in any field, much less medicine.
By way of example, consider the pet owner whose pet has just suffered an extreme physical event of some sort. This pet is recumbent, non-responsive, and positively agonal. In fact, she’s undeniably drawing her last breaths as her owner lays her down on the exam room table.
Given this uncomfortably common scenario, some veterinarians will elect to explain all the possible causes for her condition, offering diagnostic testing to fine-tune the nature of the problem. Others will enter the room, assess the pet’s situation, speak briefly with the clients to get a read on their emotional state, and quickly offer the likeliest possibility as the most likely cause –– in spite of imperfect knowledge.
Neither way is 100% right or wrong. Indeed, both are acceptable. After all, the presentation of an impending death’s harsh reality is a delicate thing that every clinician will doubtless approach differently. But, strictly speaking, a lie is what we might reasonably call any attempt to paint this complex reality more two-dimensionally.
#3 The Doubtful Lie
The corollary to the persuasive, self-assured lie is the one presented by veterinarians who purposely leave the door open for further exploration of a problem by expressing doubt –– even when they’re almost 100% sure.
This is a useful tactic typically considered the realm of specialists. It’s their job, after all, to take on the hardest cases and reach the most academically rigorous conclusions. But others of us employ this tool as well, especially in situations where utter confidence in a diagnosis might prove detrimental to a patient’s overall health –– or when other possible causes might prove catastrophic if they’re not investigated.
Think, for example, what might happen if your teacup puppy fainted. Her blood sugar was low when you arrived at your vet’s place. Nonetheless, your veterinarian didn’t conclude that hypoglycemia (a common cause of weakness and fainting in tiny breed puppies) was the cause of her condition. This, despite the fact that she’s almost 100% certain of this. Because heart disease can cause fainting too, your veterinarian purposely elected to treat your pup’s diagnosis as uncertain until the cardiologist could render an opinion.
Now, is this a “lie” or merely a sin of omission? Tomato, to-mah-to …
Me? I lie like this all the time. In all three ways. Like many other veterinarians, I may not lie purposely. In fact, unconscious and automatic as these lies sometimes are, I may not even be aware I’ve just uttered an untruth. The good news is that almost all the lies I tell are told with my patients’ best interest in mind. That’s what I tell myself when I sit down to dissect my obviously imperfect doctorly thinking. At least that much is true.
-Dr. Patty Khuly