OR WAIT 15 SECS
When a client won’t stop talking for long enough to allow you complete your diagnostic evaluation, sometimes you have to resort to strange measures.
There are times in practicing veterinary medicine that you just need to stop and think for a bit about the patient you are examining. It is during these moments that a little peace and quiet would be nice.
For me, unlocking the mystery of upper hind end lameness in a horse often requires a tremendous amount of contemplation. I enjoy these cases, but have been known to just sneak off to my office for a few minutes to assimilate the accumulated clues to make a logical decision about what the problem is or what should be done. The more difficult the case, the more quiet I require.
One of my clients is a 5-foot barrel racer who has some world-class horses and is a blast to be around. When Tera shows up with a lame horse, it usually and requires my full concentration. The problem is…Tera is a talker.
When I say she is a talker, I mean this little gal can’t stand a moment of silence. It is almost like she has a pathologic aversion to being in the presence of others with no conversation occurring. She will see to it that something is being said at all times, largely by asking questions. This means that you have to be involved in the process of stamping out quiet with her.
One particular day found me working up a very difficult lameness case for her. I was digging deep into my gray matter trying to piece together the clues to why her 7-year-old gelding was 0.3 seconds off, but the answer was slow in coming. Every time I began to ponder the results of the last portion of the exam, she would sense that things were too quiet and hit me with a volley of questions.
The last thing I wanted to do, of course, was hurt her feelings by asking her to be quiet, so I began looking around for something that would occupy her for a little while as I thought about the problem at hand. She was rambling on about some horse she had ridden 10 years ago that acted a little like this one when it occurred to me that her constantly moving hands were a vital part of her talking arsenal. I began to wonder if the talking would stop if I could somehow still those hands.
As she entered her fifth or sixth paragraph about the horse from 10 years ago, I simply handed her an empty syringe case. She never stopped talking or moving her hands; she simply accepted the case and continued on with the story without so much as a comma. Next, I handed her an empty bottle of carbocaine, which she gladly accepted with her other hand and just rolled right on with the story.
This was actually getting kind of fun. I was beginning to wonder how many things she would hold before she actually looked down to see what they were. So, I handed her a hoof tester, which is used to determine the location of a painful area in the foot of a lame horse. The tester was heavier than the other items and Tera had no readily empty hand to hold it in. This stopped the chatter momentarily, but she simply took the instrument and placed it under her left arm and continued on with the story.
I maintained eye contact with her and made occasional head movements to make her feel as if I was listening intently, all the while handing her more things: an earpiece from an otoscope that was sitting on the counter, then an extension set (still in the package), followed by a digital thermometer and the case it came in. She was still going with the story but her tempo had slowed just a bit. It was now becoming almost impossible to move her hands, which obviously was causing the conversation cortex in her brain to sputter a bit.
I stopped handing her stuff for a second to see if she would notice all the things she was holding for me. Nope. Time to hand over some more. There was little room left to accept things. She had arranged them in various places to make holding them easier, but still had no idea what she was holding. I handed her a package of 2-0 Vicryl suture material, still in the plastic, then a pair of rubber gloves I had just taken off. Not enough? How about a 3-inch stack of 4×4 gauze?
Finally, Tera lost all ability to move her hands. She was now holding enough stuff that she had to mash some of it between her arms and tummy. When this happened, all talking came to a standstill. But she still had not looked to see all I had given her.
A few moments passed with no noise coming from either of us. I just stood there looking at her and finally couldn’t maintain a straight face. She asked what I was giggling about.
“Thanks for holding all that for me,” trickled out the corner of my now laughing mouth. When she looked down to assess what she was holding, Tera started laughing, too. Pretty soon we were both laughing so hard that others in the clinic came over to find out what was going on.
“I guess you figured out that I can’t talk if I don’t move my hands. Well, I was just getting to the good part of that story when you handed me all this stuff,” she said as she started setting it all down on the counter.
“Oh no!” I bellowed before she could get her hands empty. “You have to hold all that until I have had enough quiet time to figure out what is wrong with your horse. Then you can set it all down and start telling me the story again!”
Every time she comes to the clinic now, I greet her with an armful of meaningless stuff and tell her if she can’t be quiet, she is going have to hold it all until I am done.
Bo Brock, DVM, owns Brock Veterinary Clinic in Lamesa, Texas. His latest book is Crowded in the Middle of Nowhere: Tales of Humor and Healing From Rural America.