How I get through Post Mortems
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Post-mortems are an unfortunate fact of veterinary life. Although they can be gruesome and emotionally difficult they can help get a diagnosis, which may help save future patients and bring peace and closure for clients.
For the sake of explanation I have divided this post into three sections of preparation – the time before, during and after the Post Mortem. Many people just focus on the job itself, but preparing yourself mentally and physically before and then winding down afterwards is just as important. These tips and tricks work for me, but if you have any others please share them with our veterinary community! Being a vet is hard work and we often suffer from the emotional demands of our job so it is so important to help each other with these difficult tasks.
Preparation
In many cases when you perform a post mortem you have just performed euthanasia on the patient, and often you have known them for some time. Euthanasia is already very difficult, let alone performing such an act knowing you will soon have to search their body for disease.
I have found that distancing the euthanasia and the post mortem has helped me deal with the whole situation better. I don't even think about that fact I will do a post mortem until moment before I start. I also take a breather after the euthanasia, often having a cup of tea or going for a little walk just so my brain is in the right space. I also try to distance myself physically and emotionally from the patient, by the time I start the post mortem it is no longer the friendly bear, Koala or dog I once treated but a "body". Although this sounds callous it is the only way I can do my job professionally and get through it.
Finally I do some physical preparation. Post mortems are not only too emotionally but they can take a long time and are physically demanding! Not too be to gruesome but removing the skull to examine a brain requires some real technical skills and strength! I like to do some little stretches before starting and, this sounds gross, I always eat before a post mortem. There is nothing worse then being emotionally and physically drained and really hungry! It is a sure fire recipe for disaster.
During the Post Mortem
Post mortems are grousome but can often lead to a diagnosis or help educate you and others. It was only through performing post mortems on koalas that had been attacked by dogs that I realised how severe the internal damage could be when the koalas skin and body looked ok externally. This prompted us to do additional testing before treating these koalas to get a prognosis and prevent unnecessary suffering.
My first tip to getting through a post mortem is have a systematic approach. You want the post mortem process to be as automatic as possible so you don't have time to think about who the animal once was. I always start at the head and work my way down, and with out doing into gory details, I have set way I approach each body system. This allows me to be efficient and if I am upset or emotional it also guarantees I still do the job properly.
Another thing that really helps is doing the post mortem with a colleague. Not only is it nice to have a second opinion and a second pair of hands to reduce frustration and an ultimate boiling over of emotions, but having a distraction is nice. We will chat about our findings, weekend plans or anything really just to reduce the reality of what we are doing. Music also works and sometimes I will find myself singing along, or laughing at joke a nurse just made, and for just one second I think wow this not normal, how can I be so detached... but then I think no this is the only way to stay sane!
And finally when it all feels too much you have to remember why you are doing the post mortem. It may be closure for the owners who are grieving the loss of their family friend, or perhaps it is to further the cause of your organisation through research. What ever the reason it's for the great good of animals and the humans who love or support them.
The Aftermath
I always find the end of the post mortem the hardest part... you've gotten through the day, you've been busy and now you have time to think. Time to grieve their death, think of the life they have lived, or perhaps the life they have missed out on. This is when the emotional toll of being a veterinarian can be at its worst... so this is the important part!
Firstly I find it very cathartic to 'prepare' the animal for their burial, return to their owners or what ever after life they will have. I clean them down, I position them nicely and I say a final goodbye in my head. Its my way have ending the process and closing that chapter of my day.
Second thing is have a break after. Even if it's just ten minutes to yourself it will help centre you for the rest of the work day. Consider doing some cool down stretches as well, I know sounds crazy, but it will help prevent you waking up with the crook in your neck from all the hard work you had to do.
Thirdly talk about it!!! Talk to your colleagues about the findings, talk to your mum, husband, best friend or even your pet! But make sure you tell someone what you did and why. Get it off your chest, and if you need to have a good cry and let it out, do it! It's important that the emotional burden is off loaded so that we can return to work the next day, or after lunch, happy and ready for the rest of the patients whose lives we might save from the knowledge we have gained.
Do you have any tips on how you deal with post mortems? Or perhaps just an emotionally stressful situation? Please share them so we can help our colleagues through the tough times!