Sophie’s Party Hat

Last week, a dog bit Sophie, our grand-dogger.  Now I suppose I could find some lesson in the fact that a creature other than man turns on its own, but frankly I was too upset.  Sophie, our son’s three-year-old Puggle, required general anesthesia, surgery and a post-op drain. Finally, so that she does not fester the wound, they gave Sophie what the vet calls an Elizabethan Collar, but my wife calls her “Party Hat.”

The collar, in addition to her injuries, cramps Sophie’s style.  She cannot lick her wounds, scratch her face, clean herself or burrow under her favorite blanket.  It is hard to eat, sleep or even enjoy a stroll, when the wind tugs at the plastic cone and you bump into objects normally passed with ease.  Cuddling up close to her buddy, my son, is tough.  Therefore, especially at night, when she cannot sleep, Sophie cries, begging to have the collar removed.

Who can blame her?  Here she was walking down the street, not even tugging at her leash, sniffing available derrieres and wham; she is full of holes, tubes, in pain and forced to wear a confining collar.  I would probably be crying, too. The hardest part of all is that no matter what I tell her, how carefully I explain the facts and the plans or reassure her that all will get better, I really do not think she understands what is happening.  In fact I suspect that our earnest attempts to sooth her come off as uncaring, simply because after a few minutes of “blah, blah, blah”, and maybe scratching her back, we really do not do anything to improve her situation.

In my frustration to comfort and reassure Sophie, there resonate feelings not unlike those I experience every day in working with patients.  When a person is ill they experience discomfort and often a loss of independence.  Things happen which are beyond their control and may make them miserable.   As with Sophie there is the feeling, “I was just walking down the street and wham.”  Every patient experiences, to a greater or lesser extent, both loss and the question of “why is this happening to me?”

For the physician there is a core desire to help each patient cope with this difficult change.  Fortunately, with humans one has some ability to communicate information through common language, which goes to long way, but often does not seem to be quite enough. No matter how much you try, there can exist a chasm of disbelief between doctor and patient, which can be a very challenging distance to cross.  There may be a barrage of nearly random questions, which seem to place the physician’s veracity in doubt or, worse, a blank stare of confusion and non-connection.  Personally, at those moments, I want to grab the patient by the shirt collar, give them a good shake and say, “Hey, listen to me! I care! I really care! Let me help take away your pain.”

The existential distance between human souls has been philosophical grist for thousands of years.  I believe people can bridge that gap.  Man’s altruistic ability to communicate deep feelings and ideas, to understand and care for the other, makes us special creatures.  It is one of the most remarkable things we do, but also, especially during life’s hardest times, one of the most rewarding and empowering.  The key is patience and time.  Time to listen, for both doctor and patient. Time to speak, to make feelings and ideas known.  Finally that extra step to say, “Yes, I hear you, I understand what you are saying, I believe you care.”  Those moments of connection make the practice of medicine one of the most gratifying things a person can do.

Back in our household, Sophie is stuck with the frustration and perceived punishment of the party hat, and is a sad faced dog who will no doubt cry through the dark hours of coming nights.  Despite attempts to distract her, Sophie has communicated emphatically that dog treats are a useless remedy.  I guess that makes sense because even human patients would probably not appreciate if all I did were throw them a bone.



  • Wonderful post! I think that sometimes the frustration of being unable to change things "immediately" can cause a doctor to pull back and a patient to become frustrated. Fortunate are those who are able to endure the discomfort (physical and emotional) and still connect in the midst of it all. Sometimes merely presence and that scratch on the back can soothe. I do appreciate your blog!
    • James Salwitz, MD
      I think sometimes it is hard for doctors to just be "a presence" ... they feel a need to "do something." Thanks for the reminder that at times just simple human contact can soothe. Merry Christmas. jcs
  • JK
    Merry Christmas, Doc!!!! JK
    • James Salwitz, MD
      And a Merry Christmas, a Happy, Healthy New Year, to you. jcs
  • O Lord, give me patience ... and I need it right away! [ Edit: in last paragraph, replace "threw" with "through". ]
    • James Salwitz, MD
      Happy Holidays ... editing greatly appreciated. jcs
  • Nice reflective post. And yes, normal treats are not treats during chemo! Best wishes for the holidays and the new year.
  • Bob Pinkin
    We'll have to stop meeting this way. I feel like we are spending time together, even when so far apart. Keep up the great work, you are the Man!
    • James Salwitz, MD
      A happy and healthy New Year to you and the West Coast crew! jcs
  • Gerda Yeskevich
    This is a wonderful story - you are truly a compassionate, sincere doctor.
    • James Salwitz, MD
      Thank you very much. I am blessed with compassionate, wonderful patients. jcs

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