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Worrying too much

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I THINK I worry too much. In fact, I know I do.

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I had a conversation with our new graduate today. She is doing very well but lives in fear of making a mistake due to her inexperience. I tried my usual reassurances with a smile: ‘You are fresh out of college and will never have so much up-to-date information in your head as you do now’; ‘You have three experienced colleagues next door or at the end of the telephone’; or ‘Remember, common things occur commonly’.

But I recalled how I felt at her age. It takes experience to learn what is common, and there is nothing like a triumph with a case for building confidence in oneself and winning the confidence of the client.

Frankly, I still enter the consulting room with a soupçon of anxiety lest something shows up that I will be unable to handle. Sure, I have my well established routine, logical work-ups for most presentations, and I know my surgical limitations. But then I start wondering if I have crammed enough webinars, congresses, talks and reading into the year to be as up-to-speed as I should be.

My heart still sinks when I'm faced with common stereotypes. Is there really nothing more than dietary management and antihypertensives for helping an ageing cat with chronic renal failure? What else can I offer the owner of an atopic dog who declines allergy testing, has a thing about steroids and won't have their dog on ‘drugs’ for the rest of its life? Where do I go with the hyperthyroid cat whose owner cannot afford radioactive iodine treatment, bluntly refuses surgery but can neither pill nor paste her psychotic bengal?

I worry about the welfare of these patients and I worry that the owner thinks I am useless for not coming up with a stunning new idea that will overcome all their objections, real or imaginary, to the treatment plan.

‘Knowledge dispels fear!’ I tell myself and, at the first opportunity, I rush to my books, journals and computer. Usually I quite quickly confirm that I've done most of the right things and certainly managed the case no differently than any of my peers might have done – a legal yardstick, I tell myself.

Oh, but then my attention wanders to neighbouring articles and different webpages. I start to read stuff about other conditions that I'm sure I have never diagnosed and must have missed. Was that weird skin lesion on Mrs Sprint's lurcher's leg yesterday a case of Alabama rot? Should I get it back in for blood testing? But it did look just like a lick granuloma over an arthritic joint.

Come to think of it, that podengo just rescued from central Europe looked a bit pale yesterday. Routine haematology was normal, but had I better go back and check for Babesia?

Enough of this! Take a break and read something that has nothing to do with work.

Crikey, the population of hedgehogs in our county has more than halved in the last two years! Wait a minute; our cases of lungworm are increasing. I wonder if hedgehogs are being wiped out by Angiostrongylus? I must look that up! It's all such a worry, isn't it?

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