Euthanasia is part of my job. It is a difficult part of the job, but it is one that I have to do frequently. I remember in my first year of practice one of my family members asked me whether I had performed a euthanasia yet. I had been working for about a month or two at that time, and I recall laughing awkwardly before responding that I’d performed at least a dozen since starting. I don’t think I’ll ever forget the look on their face with that answer. Admittedly, I did not exercise a whole lot of tact with my response, but they were shocked that the answer had been greater than one… by a long shot.
I work for a small animal general practice that sees urgent and emergent appointments as well as general wellness and vaccine checkups. So, I see a great deal of sick pets. Their illnesses are often expensive or complicated to treat, and sometimes there is no treatment at all. When people bring a pet in to see me they often do not realize quite how sick they are. They may not realize that their pet has been hiding the signs of severe disease for weeks or months. I hate being the one to break the news, but it is my job. It then becomes my job to work out a treatment plan that will not only address the illness but will also fit in the owners’ budget. If there is not an option that checks both of these boxes, then severe illness often leads to humane euthanasia.
In my job over the last three years I’d be willing to bet that I’ve performed somewhere between 200–300 euthanasia procedures. So, I feel, for better or for worse, that I have become proficient at steeling myself to these emotionally charged situations. I have become accustomed to fulfilling the tasks of a euthanasia procedure while being surrounded by the deep sadness they inevitably bring. I can tell you honestly that I have never cried while performing a euthanasia. It is not because I don’t care. Simply, I feel that I am in that room to perform a service, and I worry that my participation in the grieving process may be misinterpreted. I feel grief, empathy, and sometimes anger with every euthanasia that I do, but I try to avoid letting it take control of me. I seek to be strong for the patient and their owner first and foremost. I wish for the experience to be as peaceful as possible for everybody involved.
I don’t know what changed yesterday. Everything else was the same. I entered the exam room where owner and patient waited. My technicians had already placed an intravenous (IV) catheter. Syringes filled my hands, a sterile saline flush, a few milliliters of Propofol to help calm my patient down, and finally the euthanasia serum itself. I introduced myself to the owner that brought my patient in. We reviewed the disease process that we were fighting against, ensuring that we were on the same page before moving forward. I’d never met this owner before in person. In fact, I’d met his dog just yesterday, when I corroborated a terrible diagnosis given to their family by the emergency clinic. Treatment costs by the specialists at this clinic far exceeded their means. If I only could have been there for them sooner
I can’t tell you what it was about this patient. Seeing him with the IV catheter in his front limb, lying on his back, and gently being cradled by his owner’s arm broke something inside of me. He seemed so relaxed and so peaceful, perking his ears up as I began to run through the procedure with his human. The owner had been crying since I’d walked in. This is nothing new, but yesterday it felt different. He tried to calm his nerves as I discussed the procedure and what I was going to do. I could feel my own nerves building. Suddenly, as I went through my standard spiel with the owner, I felt something else. Something new to me… I felt deep, irrevocable sadness. I wanted it to go away.
I could feel a flush of my cheeks and the back of my neck; it had to be 100 degrees in this room. My voice broke as I finished my briefing to the owner, cracking a little as I mentioned the word euthanasia. My eyes focused on my patient, still cradled in his owner’s arms, unaware of what I was going to be doing to him and unaware of why. I looked down to place the needle into the hub of the IV catheter. My voice trembled a little as I asked if the owner was ready. A steady nod the response. My hands were shaking. They were shaking harder than I’d ever seen them shake, as if trying to fling away the emotion that was stirring inside of me. These were the same hands, the same steady hands, I used earlier in the morning to perform surgeries. I injected the Propofol, watching my patient slowly and peacefully fall to sleep. I knew that what I injected next would cause him to never wake up.
Fumbling with the port again, I secured the euthanasia solution to the catheter and began to slowly inject. Everything in the room finally still save for the shaking of my hands and the steady sobs of the owner. I watched the solution leave the syringe, with each number it passed on the syringe I witnessed a little more life leave my patient. This patient that I had met just one day before this… This patient that sat in my technician’s arms for close to an hour while recovering from sedation just 18 hours earlier. This patient that tolerated everything we put him through and did it without complaint. This patient that licked your hands when you pet him. I put my stethoscope to his chest and heard nothing. My hands still shaking my voice sounded meek as I said, “He’s gone, I’m so sorry…”
The owner shuddered again with a final sob and set his pet down. His beloved dog that was only with him for four years. This was a dog that should have lived for at least a decade more. He felt like a puppy to me. He’s gone now. Likewise, the owner quickly took his leave of the room trying to shield me from his own emotions as he made for the exit. He carried a collar and a receipt in his hand and pain in his heart.
There was nothing I could do…
I stood alone in that exam room. Me and my patient in complete silence. For one moment, nobody knew that we were in there. I placed my hand onto his small body, feeling his warmth. I dropped to a knee, pressing into the hard tile floor wishing for a secret door to open and whisk me away. I rarely question whether I’ve done the right thing when I euthanize a patient, but right then I did. Could I have done more? Maybe I should have presented the diagnosis differently. Maybe this would have given him a chance. What if I had been better?
I felt the tears coming. Rushing towards the exit of my eyes like a dam ready to overflow. Each one hitting the floor like tiny grenades exploding into smaller droplets then disappearing into the tiles. The feeling of cumulative despair seeming to compile all of the goodbyes I’ve had to help people say through the last few years. Emotions that I’ve kept buried suddenly hitting me like a truck.
Cheerful, unrelated discussion emanated from outside of the door- suddenly taking it all away from me. The tears retreated as if fearing their own lives. I tried to steel myself again, swallowing the lump in my throat, and wiping my eyes under my glasses. I opened the door and returned to the busy day ahead of me.
I don’t know, and I probably never will, if the owner perceived how significantly this particular euthanasia affected me. I don’t know if my patient did either. I do know that in that moment, I felt so close to them, I felt their pain on a deeper level than I’d ever felt before. Afterwards, I felt more drained than I’d ever felt before. It felt like I’d failed them. To my patient: I’m sorry I couldn’t have been stronger for you. I wish I had been able to do so much more. To his family: I know nothing will take his place in your hearts. Please know that nothing will ever take his place in mine.