A Gracious Reviewer

Voice Card  -  Volume 20  -  Drury Card Number 5  -  Sat, May 18, 1991 1:54 PM

This is ONE OF 2 responses to VC 19 John 17 ("A Critique")...

Thank you for the review. Yumi had already suggested changes similar to yours and so the final product did actually answer the question, specifically (naming the fatty seeds) and much of the different species information was jettisoned.

I would like to be able to change the questions. Unfortunately I am unable to do so. The people asking them are looking for a "do it this way" response and that can be very misleading if not downright incorrect. I feel they should understand some of the issues involved in trying to find the "correct" answer. This is because the correct answer depends on some factors I am unable to evaluate, but the readers may be able to identify these factors and therefore find their own correct answer.

This is why you can't do phone call medicine. Good medical advice comes from a combination of history, clinical signs and symptoms, physical exams, and lab testing. Advice over the phone (or paper) such as "take two aspirin" could lead to the death of a patient. When I first started practicing, I had a late night call from a woman with a cat. She described her cat as having something wrong with his rear legs. The cat was very painful when touched on the hind end and was "walking funny".

I quizzed her again and again about the clinical signs. As she became more and more convinced her cat had a broken pelvis or legs, I continued to encourage her to bring the cat in for me to be sure that was the problem. Her basic question was "since he has the signs of a closed bone fracture, can he wait until morning before seeing a vet?" Basically, the answer is YES (given this and this and this - all things a lay person cannot evaluate). I told her to keep him confined, watch for difficulty defecating or urinating, and for increasing pain or depression. If she recognized these signs, the cat was in serious trouble.

Well, she kept the cat confined, the cat showed no interest in using the cat box, and he apparently slept quietly through the night. She brought the cat in mid-morning (no rush, after all a vet told her that closed fractures weren't emergencies). The cat was almost dead from a urinary blockage!! That cat spent an additional 12 hours dying because of a simple answer to the wrong question.

So, if I can't change their questions, I can at least make them think about the answer to what the question should be. I am trying to help these animals.

The cat, by the way, survived that episode. The next time he blocked, the owner did not wait. The cat finally had to undergo a surgery to prevent the urinary blockages.