Dear J-

More thoughts on suicide, which are not the same as suicidal thoughts: I’ll go ahead and assert there is a link between chronic pain and depression because it makes sense, logically: if being awake means you’re in constant agony, that’s bound to affect you and more likely than not in a negative way. Whether that results in clinical depression, though, is probably the difficult link to prove. It stands to reason that mental anguish can affect you just as much. I think certain professions are particularly prone to this; the very nature of veterinary medicine is an uncertain one. You see the symptoms, listen to the history, and take some scientific evidence and try to come up with a reasonable diagnosis.

I’ve told theVet I could (jokingly) prescribe a steroid shot and some fluids, which seemed to cover many cases (as my doctor said in late August, “Aquaphor is my Windex,” in reference to My Big Fat Greek Wedding). I think there’s a secondary prestige effect; folks will listen to MDs (for the most part), recognizing the years of schooling and specialization they’ve put in to become a doctor, while they’ll argue with DVMs, and second-guess treatments, bills, diagnoses even when the DVM has just as many years of schooling and experience. Veterinary medicine is always evolving — there are amazing treatments you can apply now (with commensurate cost) but ultimately it’s up to the owners to dictate what they’re willing to bear and handle, to evaluate the cost-benefit ratio.

In human medicine the costs are masked by insurance payments; when I had hernia surgery my out-of-pocket expenses were a few hundred dollars on a ten-thousand dollar procedure. When you get the vet’s bill the first instinct should not be outrage. Second-guessing the expert does not make you an expert, it makes you a skeptic and if you’re not polite about it, it can make you a jerk. I will never know what makes a person turn to thoughts of suicide, but I know enough to be aware of how my actions influence others. I imagine those last moments and can’t imagine them, too, like looking at the sun, too terrible to bear.



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