Visiting Vet: Let’s talk telemedicine

Checking your pets on FaceTime and Zoom. 

Waiting for the crisis to pass. —Pixabay

“Do you hear that?” my daughter asked from where she sat doing “remote college” homework after dinner. “Hear what?” I asked, ensconced on the couch playing Words With Friends on my phone, trying not to turn on the news. My husband, Max, answering his email, didn’t look up. “That hissing noise,” she said. 

Twenty minutes later, our kitchen floor covered with towels and sodden piles of paper bags that had been stored under the sink, we still had not stemmed the flow of water spraying from the leaky pipe. Repeated efforts to shut off the kitchen water were in vain. We concluded the valve was faulty. The flood continued. Our next plan, to find the main water shut off in the basement, was also unsuccessful. We’re not a handy couple. What can I say?

What does this have to do with veterinary medicine? Well, it’s all about emergencies. Emergencies in the age of COVID-19. I am an avid proponent of sheltering-in-place right now. The less we have direct interactions with each other, the better. But what do you do if your dog is vomiting, or has a terrible ear infection, or funky looking growth? What if your cat is limping or has the runs? And what do I do when our kitchen is about to look like Five Corners during a nor’easter, and we’re not a handy couple?

We do what we have all been learning to do these past few weeks. Veterinarians, physicians, therapists. Plumbers, teachers, farmers. College students, grandparents, friends. Everyone. We’ve all been figuring out how to take care of each other while maintaining social distancing. Here are some of the things I have learned while switching over to using primarily telemedicine during these difficult times.

I have learned that many people need help when it comes to any kind of technology like FaceTime and Zoom. Ok, Boomer? Also, everyone looks terrible on Facetime. Even young people. My friend Trish told me you have to hold your phone up high if you want to hide your double chin or chicken neck. My arms are too tired to bother. I have learned that I should comb my hair first thing in the morning. Otherwise I will forget and look like Albert Einstein when I wind up FaceTiming with clients later in the day.  

I have learned that people are remarkably adaptable. You’d be surprised how many folks willingly sacrifice the thermometer in their medicine cabinet to take a rectal temperature on their dog when I ask them to. (I have yet to advise cat owners to try this. If you wonder why not, then you are clearly not a cat person.) I have decided that it is good to have “loaner thermometers,” which I can dispense with disposable plastic covers for pet owners to borrow if needed, and that knowing an animal being evaluated by telemedicine does not have a fever can be very reassuring to both owner and veterinarian.

I have learned that I can do a pretty good job of assessing many things remotely, but owners in general are terrible cinematographers. Hey, move the camera to the right. No! Flip the camera. I want to see Fluffy, not you. Closer. Closer. Closer. NO! Not that close. He’s limping? OK, let me watch him walk. Call him. He won’t come? Offer him cheese. OK, this time offer him cheese but keep the camera pointed AT the dog so I can see him move. 

Seriously, I’ve been pleased how well I can evaluate many things by remote, how it helps to see that puppy patient is wagging his tail and looking alert, or that older dog is breathing easily. We’ve had a lot of positive telemedicine interactions. But I miss my hands. Veterinary medicine is a tactile art. So much of what our patients tell us is communicated through touch. Today I tried to talk an owner through feeling for tiny puncture wounds, the kind that often occur in cat fights. I know she did her best but my fingers longed to reach into the phone screen and search delicately through kitty’s fur. Yesterday I wanted to reach out and palpate the abdomen of that vomiting puppy, to be able to gently poke and prod and locate any areas of tenderness. I wanted to run my fingers down the spine of the French bulldog whose owner reported was periodically “squealing like a pig” so I could press gently, one vertebra at a time, and confirm my presumptive diagnosis of back pain. But I am so grateful to all the pet owners who are working with us veterinarians to keep everyone as safe as we can during this time, and for understanding that we charge for our advice and time spent by telephone and telemedicine so we can continue to be here for your animals throughout this pandemic and, God willing, after.  

I am also grateful to the plumber who called us back when we left a message for him at nine o’clock that night. “Tell him we don’t expect him to come here,” I shouted at my husband. “Tell him it’s a bad leak,” I shouted. My patient husband nodded silently then, listening to the plumber’s advice, crawled back under the sink. “No, I can’t reach it,” I heard him say. “Ask him to tell you how to turn off the water in the basement!” I shouted. My still-patient husband nodded silently, still listening to the plumber, and walked out of the kitchen, returning moments later with a really big wrench and went back under the sink. 

The hissing stopped. I have learned that people are adaptable. We have no cold water in our kitchen sink but we have no leak. We will wait till things are better in the world to have this fixed. We feel blessed that we have running water at all and that we live in such a supportive community. And maybe we’re just a little handier than we thought. At least Max is.