Saturday, October 15, 2011

Beyond the Battlefield: What Soldiers Can Teach Us About Animal Hospice

     The Huffington Post is currently running a series of articles entitled “Beyond the Battlefield” by veteran war correspondent David Wood.  The series is about soldiers who have been catastrophically injured on the battlefield by IEDs (improvised explosive devices), some with multiple amputations, some with severe facial deformities, some with genital mutilation and extreme internal injuries, most who were not expected to live but were saved by the heroic efforts of military medics and surgeons.  On Thursday, Terry Gross interviewed David on NPR’s Fresh Air.  It was an incredible interview.  I highly recommend listening and reading the series.
     One of the things I found very interesting is the military’s new implementation of a family support program.  In the past, families have been left out of the rehabilitation process, but now are flown in to see their injured love one and participate in the rehabilitation.  Transportation, housing and childcare are provided.
      What are they finding?  Patients recover faster, families come together, hospital resources are more efficient, and patients do better in the long run.
     Perhaps without knowing it, the military has embraced a hospice model of care.  And found that it works.
     And yet, when soldiers go home, they face enormous hurdles.  Gone is the 24/7 attentive care, the multi-disciplinary approach, the world’s best specialists in dealing with catastrophic injury and trauma.  Gone is the financial support that enables the soldiers and their families to get the care and support they need.
     Many injuries don’t heal in a linear fashion.  Some get worse with time, some change, some nag with pain or incapacity to a point of becoming overwhelming.  Too often the solution is highly effective, highly addictive, and highly inadequate pain killers.
     But dull the physical pain, ignore the psychological, social and spiritual pain, and you have a recipe for misery, violence and suicide.
     David said that when he started his report, he was asking himself and others the extraordinarily hard and honest question, “If these guys are so badly wounded, wouldn't it be better if they died?
     Then he met with hundreds of catastrophically injured soldiers at Walter Reed National Military Medical Center and asked these soldiers themselves.  Without exception, every one of them said, “Yes – I am glad they saved me.”  Make no mistake about it, their lives are forever changed, they will never fully “recover” from their injuries.  Their mobility, physical appearance, and ability to do many of the things they once did are severely affected.  Many suffer from ongoing pain, day to day struggles most of us cannot imagine, depression and post-traumatic stress disorder.
     And yet, at that time, when receiving wonderful support and care, every single one said they were glad to be alive.
     When David asked one of the trauma nurses at Walter Reed, “But what kind of quality of life will they have?” she chided him and said, “It’s not up to us to define their quality of life.  It's a very personal thing for them to decide.”
     In many, many ways, I agree with that sentiment.  But with it goes a community responsibility to support the patient and their family – in a hospice fashion.
     Over and over again, the soldiers and their loved ones say they felt ALONE, abandoned.  Doctors might tend to their physical injuries as best they could, but there was no help for their other needs.  They didn’t know where to turn.  When they asked for help, they didn’t get it.  Their enormous problems and needs were ignored, minimized or deemed too difficult or too expensive to treat.
     Over and over again, when **I** meet with families in our work at New England Pet Hospice.  I hear the very same thing.
     And when we offer our families hospice care – care that extends to the entire family, care that supports not only physical needs, but also psychological, social and spiritual needs – there is relief, there is power, there is a belief that this can be done and this is worthwhile.
     While our animal patients can’t tell you what they think and feel about all of this, I can tell you that when their needs are supported and their family is peaceful, the animals are peaceful, relaxed and grateful.
     Maybe what these incredible soldiers, these survivors are telling us can give us insight into our animals’ struggles.    Are you currently suffering in immeasurable ways?  Yes.  Is your suffering something we cannot fully control, no matter how much we want to do so and despite all of our efforts?  Yes.
     Would you rather be dead?  No.
     But we must not attend to the immediate crisis, deal only with the physical injury, then fail to be present and available for all the days that come.  We must not leave our families out on a limb with only pills and vague advice about how to manage physical injury and pain.  In the veterinary field, as well as the medical one, we must not diagnose a terminal prognosis or an unresolvable condition and then leave the families to struggle through the many ways this impacts the patient and all those around them.

     Veterinarians are heroes just like medics and surgeons.  Their skills and compassion are not in question.  But our animals and our families need and deserve more support than any one discipline can provide.

     Our animals and our families need and deserve hospice care.
     This is a journey.  It is powerful, it is fulfilling, it is incredibly important, and it may be the hardest thing you ever do.  Don't be afraid to ask for help and know that you, your animal and your family deserve it.

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