Personal Essay

No One’s Infallible: A Dog’s Tale

I suppose we’ve all heard the story about the terminal cancer patient who was sent to hospice to live out the rest of her life only she failed to die within the prescribed time and was returned with much joy and many hurrahs to her happy family.

Doctors have difficulty not only predicting how long you may survive a serious disease, but they also have difficulty with diagnoses. I volunteer for an organization called Arizona Victims of Valley Fever, and I can attest to the many patients who have written to tell me that their doctors first diagnosed them with bacterial pneumonia, chronic fatigue syndrome, bronchitis or lung cancer before they hit on the correct diagnosis: Valley Fever.

In fact the symptoms of Valley Fever are so similar to those of COVID that doctors now have an additional challenge: to differentiate between these two diseases. Make a mistake and treat Valley Fever, for example, with antibiotics instead of antifungals, and you may very well exacerbate the dissemination of fungal spores and make the patient sicker. Of course a mistake with COVID is just as serious if not more.

I’m not singling out doctors as bunglers. We all make mistakes that can have far-reaching consequences, but doctors’ mistakes are unique in that they often cause death. For instance, remember when newspapers ran stories about doctors who surgically removed the wrong leg or arm of an anesthetized patient. A lot of people woke up so traumatized that the first words that came out of their mouths was “Call a lawyer.”

Other fields also can have life-threatening consequences such as transportation — for instead, flying commercial planes, or being the engineer on a train.

The above facts represent a preamble to my feelings about veterinary diagnoses. For the most part, I’ve been lucky to patronize competent veterinarians who correctly diagnosed and treated my pets. A few times the diagnosis struck me as so odd or calamitous that I got a second opinion. Sometimes, however, the damage had already been done with aggressive treatments carried out by the diagnosis-challenged vet.

But the worst — and best — veterinary screwup I ever experienced happened to my 12-year-old miniature schnauzer. I must admit that I come to diagnostic issues with the preconceived notion that the dog may be suffering from Valley Fever. I can’t help it. It’s like a knee-jerk reflex. This is because I not only know more than the average person about Valley Fever but also because I attribute all weird symptoms to Valley Fever, which is a life-threatening respiratory disease that affects people and pets.

What follows is a lesson in fallibility that we all can learn from: Mork, my elderly schnauzer cited above, was brought into his veterinarian because he ran a fever and was somewhat lethargic. Since he hadn’t had blood work run for several years, I consented to that plus a full battery of x-rays.

I was nervously expectant waiting for the results of these tests, which were carried out on-site as I waited anxiously. I knew the problem with Mork might be serious mostly because he was an older dog. But he had never been sick a day in his life up to that point.

When the doctor came into the examination room to deliver the results, I still was unprepared for what he was to tell me. A young man who had practiced for a number of years in Florida and Arizona, he had performed surgery on several of my pets. They had always come through in good shape. Several times he had also dispensed medication to my puppies, who like mischievous children sometimes were in the throes of diarrhea with persistent vomiting.

But surgery was not the diagnosis that day. In machine-gun style, he spits out the following: Mork had autoimmune hemolytic anemia and his blood count was a mess. He also had shadowy shapes on his lungs and all the doctors in the clinic agreed that the problem indicated lung cancer.

I barely comprehended this torrent of information, and it took me a few minutes to articulate a few commonsense questions. What was I to do? I asked in a weak voice. Nothing much, unfortunately, said the vet. I was told that Mork would probably die from the anemia before lung cancer took him. So no meds, no special food. I was basically told to watch him carefully and think “hospice” care. He could die at any time.

I returned home in a state of shock and immediately moved my writing office from its usual place in a separate room of the house to the kitchen. The kitchen now would be Medical Central for observation of Mork. I tried not to rivet my eyes on him as I shuffled papers and tapped the computer keys, but Mork was my champion, still a strikingly beautiful dog, and a favorite of mine.

Every evening before I fell asleep I’d pray to God that Mork would live another day. And each new day I’d try to do my writing assignments while I kept an eagle eye on Mork. So far he was quiet but eating well. I called my friend who had been severely ill with Valley Fever and asked her what supplements she was now taking. I told her I needed a miracle for Mork, and she suggested the animal equivalent of a supplement she swore was giving her a better quality of life. I looked at the ingredients and thought they were okay — anti-oxidants that might possibly slow or cure disease.

This was in July 2018. That summer I remained in the kitchen ministering to Mork. And I continued praying every evening. Gradually I became less nervous since it appeared that he was doing fine, even improving a bit. But I wasn’t really sure — it could just be positive — or wishful — thinking and unrelated to the truth. I was aware of how powerful denial can be.

When I visited my vet with another pet, I’d report on Mork’s progress, and he was always congenial and supportive, but never inquired on the specifics. Once he said that he guessed his blood count was stable.

My god, I would think. Here he practically gave Mork a death sentence and he doesn’t even care about follow-up, much less revising his diagnosis. I thought an explanation was in order — some kind of doctor blather that would describe the difficulty of diagnosis, how you never know how an animal will respond, etc. I even would have settled for a joke about how doctors can’t ask their patients how they really feel.

More time passed, and more of my reports were made to the same vet. He never budged from his commentary. No apologies. No admission of an extreme diagnosis that put me in a state of mourning for months. No sorry, I didn’t mean to give you a horrible scare. No explanation on how four doctors — mind you — could so mess up the same x-ray interpretations?

Well, by now you’ve probably guessed what happened. This past July 2020 Mork and I celebrated his two years of living past a “death diagnosis.” If he makes it to February 2, Ground Hog Day, he’ll be 15 years old. And that is really pushing the bone-colored envelope, especially for a miniature schnauzer.

I’ve never taken Mork to any vet since that initial shocker I received from a vet whom I had liked and trusted for many years before Mork’s diagnosis. I didn’t even take Mork to a second vet — I was afraid that a second vet might either confuse me or again put the kiss of death on Mork. And to be truthful, I had lost trust in the medical profession. I even was being very sparing with my own visits to doctors. I just couldn’t take the stress.

I also couldn’t help thinking that perhaps Mork’s health improved because I acted counter-intuitively to monitor his health with periodic blood tests and x-rays. I began to apply this same theory to my own health care — for good or for worse.

Mork is not perfect, but then he’s geriatric by anyone’s standards. I’ve seen him run, eat well, beg for food at the table, and rest in his cuddler. He wears a Disney collar I bought for him two years ago before that fateful vet visit. Call me superstitious, but I keep it on him at all times.

What do I think caused the abnormal blood work and x-rays that convinced four vets he had anemia and lung cancer? You guessed it. Valley Fever, which is an ambiguously and idiosyncratic condition that is often misdiagnosed in people as lung cancer. In Arizona, where 70 percent of the cases occur, Valley Fever is not a zebra; it’s a horse.

Of course, I’m not certain he had Valley Fever for two reasons. One, I’m not a doctor, and two, his Valley Fever test came back negative. But false negatives are common with this disease.

I thank the heavens and all the gods on Mt. Olympus that Mork has had a good quality of life these past two years. But that warm feeling has not transferred to his vet. I now approach each veterinary visit with hesitation and a certain defensiveness. If I’m really honest with myself, I’d like to tell him off — tell him how he put me through hell for several months. But I know I’ll never do it. If I’m nothing, I am polite. Polite enough and sane enough to overlook the fallibility that he and every other person possesses.

I still resent him for putting me through the metaphorical wringer. The funny thing is, all he’d have to do is apologize and acknowledge what happened and I’d probably forgive him. Probably, but I’m not really sure if it’s in me. I’m ashamed to say I struggle with perfectionism and fallibility is the enemy.

But an apology can take the sting out of many a blunder.