There is no sugar coating death. It is a natural part of life, and comes for us all some time or another. It is life’s antonym, immutable, unavoidable, permeant. The lungs stop working, the heart stops beating, and the electrical activity of the brain ceases. Regardless of your belief system, it represents the final end of a form of existence.
Veterinarians deal with death routinely. Euthanasia is the humane killing of animal. It is necessary to end suffering of animals with terminal and painful conditions that cannot be further remedied. It is a kindness, a release from pain. There are other less kind reasons why people euthanize their pets, but for now I’d rather not depress you further.
“I will strive to:
promote animal health and welfare,
prevent and relieve animal suffering,
protect the health of the public and the environment, and
advance comparative medical knowledge.”-The Canadian Veterinary Oath (CVMA 2018)
The procedure is simple. The animal is sedated and an intravenous catheter is placed. An overdose of pentobarbital is then intentionally administered. Within minutes the heart stops beating and the animal dies painlessly. The body may be sent for cremation or taken home for burial. When I tell people I want to be a veterinarian I often get the response of, “Good for you, I love animals but I could never be a vet because I couldn’t bear having to put an animal to sleep.” Indeed, the concept of putting an animal to death is unpalatable. Euthanasia is heartbreaking. I’ve seen my own animals euthanized, and I’ve had to see many other’s animals euthanized during my time volunteering at clinics. Much like other things, you grow somewhat numb to it. It’s not that it no longer bothers you, but I’d describe it as more of a tolerance. You develop a professional separation between yourself and the client. You don’t generally cry as veterinary staff, but you can still feel the gravity of the moment. This has been true for the majority of euthanasia’s I’ve seen excluding my own pets. I thought that when the time came for me to perform the “final injection” as it were, that it wouldn’t affect me. After all, I’d seen the procedure performed countless times , I understood the rationale, and I’d accepted its necessity in the role. I thought I was prepared, although I never imagined I’d be doing it so soon.
My patient was a calico with terminal cancer and was unquestionably ready. They’d tried everything they could, but it wasn’t responding to chemo, and had already metastasized when they removed the initial tumors. He unnatural posture, slightly narrowed eyes, lack of appetite and the trembling of her body on abdominal palpation demonstrated her pain. Her people could not in good faith allow her to continue suffering, it was her time. They had already said their goodbyes, but couldn’t bare to watch which made this the perfect practice scenario for the student vet.
The supervising veterinarian gave her the initial sedation, I stayed with her until she fell asleep. As the sedative took hold and the tiny body relaxed, I stroked her head and told her what a good cat she was. I knew she couldn’t understand, but I hoped the soft intonations of my voice and the gentle patting might ease her fear a little. I was no replacement for her family, but in my opinion she didn’t deserve to be coldly gazed at in a strange room. I wanted her passing to be as gentle as possible. She seemed at peace as she drifted off to sleep, so I hoped I had done her some justice in that at least. I was instructed on catheter placement. I clipped the forelimb, placed a tourniquet, and felt the cephalic vein rise under my finger. I sterilized the site with alcohol, a somewhat puzzling procedure given she would not be surviving to get an infection, but it is always good to reinforce the habit. I then entered the vein with the needle of the catheter, and once I had established blood was flowing back through the catheter, I pulled back the needle and slid the flexible plastic tube easily into the vessel, capping the end and taping it in. My supervisor complemented my work. To maintain the sedation, I administered a small amount of propofol. I checked her pupillary reflex, and felt her pulse, and then it was time.
“Like all vets I hated doing this, painless though it was, but to me there has always been a comfort in the knowledge that the last thing these helpless animals knew was the sound of a friendly voice and the touch of a gentle hand. “
-James Herriot
I drew up 0.5 ccs of pentobarbital sodium, removed the needle, and administered the drug through the catheter. I placed my stethoscope on her chest and listened to the sound of her heart get fainter. The beats became slower, then barely audible. I gave 0.2 ccs more just to be sure. I listed with all my might to the quiet and slow ‘lub, dub’ and then there was silence. No respiration, no heart beat, no pulse, just the sound of my own shaking fingers on the stethoscope. I checked, double checked, and triple checked. Then I stood up and my vision swam with tears. I stared at her body in silence for a few minutes while the tears flowed down my face. I had ended her life.
I wiped my eyes, but the tears continued to flow as I gingerly formed her body into a ball, as though she were merely sleeping, and placed her into a plastic bag. I set her body into the freezer with the other corpses destined to be cremated. I then came back to the room, sprayed down the table, and cleaned up my workspace. When I was done, I washed my face, and dried it with a paper towel. I took a deep breath and went about the rest of my day at my placement, restraining pets, taking temperatures, giving drugs, and looking after those who were alive and who needed to be kept that way.
Although euthanasia was warranted, and it proceeded without issue, there is something about taking a life that feels so intrinsically unnatural to a person. I felt as if a part of me had broken, and could never be put back together. It wasn’t guilt, I knew this was right, and if I had to go back in time I wouldn’t have changed anything. But the sadness was palpable. I did not know this cat, I had not spent years with her, I didn’t know her uniqueness, her mannerisms, her likes and dislikes. I was not attached to her in any way. Yet she will forever be etched into my memory as the first animal I ever euthanized. Nothing prepares you for how it feels to euthanize an animal, to hear their heart stop beating, and then to stand back and proclaim, “she’s gone.” I felt as if an irrevocable line had been crossed. I was no longer a hopeful undergrad. In that moment, despite my student status, I was fulfilling the role of a veterinarian. It was a somber feeling. One that I expect will follow me for the totality of my career.
I expect that as time goes on that it will get more tolerable. I will become capable of holding back my tears, and I will go about my day. But today I learned what it means to be a veterinarian. The subtle burden of the having to take a life when necessary, and I imagine that when I discuss euthanasia with my future clients, I will think back to that small calico body laying on an exam table, silent and still, never to suffer again.
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