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Difficult clients

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ANY vet who has been in practice for even the briefest period of time is well aware that it's not the animals that are difficult to treat, it's the people who are the problem. From the pernickety poodle owner to the irrational horse-owner, from the pugnacious pig farmer to the contrary budgie fancier, we've met them all. There is also the person who swears they've given all the tablets yet makes a month's supply of treatment last a full eight weeks, the horse-owner who promises to faithfully change the pony's dressing every two days but leaves it on for a fortnight, or the farmer who claims that you never cure anything, yet wants you on his farm the instant his prize bull looks slightly tired.

Is it sheer cussedness or pigheadedness that makes them like this, or is there perhaps a bit more to it? I can never work out if I should be blunt to the point of rudeness or simply ignore this sort of behaviour when I encounter it.

The fact is that, as I get older, I realise that many people have others things going on beneath the surface of their lives. It could be that they are just having a bad day, which makes them irritable and stressed. Or perhaps it is more serious than that; they might be grieving or even maybe coping with a medical problem. Others still might be suffering from a mental disorder. And the bottom line is that, unless someone tells you, it can be very difficult to fathom why anyone acts as they do.

So if a client seems sweetness and light one minute and bad-tempered the next, or if there's something about them that just doesn't ring true, we should ask ourselves whether there might not actually be an underlying problem. While I fully appreciate that it's not easy for someone to tell all and sundry that they have a problem, in some circumstances, honesty and openness might just be the best option for everyone involved.

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Our city-centre practice is only a few minutes' walk from a large training hospital and we are fortunate to have free access to their extensive library; if I have a quiet hour before evening surgery, it's rather relaxing to wander down and immerse myself in the myriad of medical journals that sit on their shelves. The ones that catch my eye are the unusual case reports. I confess I can't make head nor tail of the learned articles detailing minute advances in specialist fields, but I do have a fascination for the one-off oddities that doctors come across, just as we can encounter the unusual or bizarre in our own line of work.

A recent example that really stands out was the report concerning a woman who had dreadful recurrent migraines, which were so bad that they were affecting her behaviour. The GP, unable to fathom what was wrong, had referred her to the relevant department at the local hospital, where survey radiographs showed a large orthopaedic screw lodged at the base of her skull. It turned out that the patient had had a spinal instability some decades ago, which had been treated via internal fixation; however, over the years one of the screws had worked loose and migrated upwards, eventually resulting in the chronic headaches she was experiencing.

So the next time we are confronted with a pet owner who comes across as being difficult or who behaves in a manner that appears to be irrational or inconsistent, perhaps we should pause a minute and consider the possibility that they could have a hidden problem and that they may well deserve empathy and understanding rather than anger or frustration. Jest not; everyone has their own tribulations and they are no laughing matter, but if we suggest that a client has a screw loose, it might just be true.

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