Fear of the Unknown, or Fear of Saying ‘I Don’t Know’?
Originally, I was planning to write this blog about the current “mystery illness” that is popping up in random places around the United States. But when I sat down to research what I could, I kept getting stuck on the word “unknown.” It made me think about all that I haven’t figured out myself yet.
“I don’t know” is a phrase that you are likely to hear from me as your pet’s veterinarian. It is a phrase that I used to be terrified of saying when I first started practicing medicine over a decade ago.
I spent a lot of time (most of my 20s) and money (over six figures) learning everything about biology, chemistry, pharmacology, virology, physiology, anatomy (of multiple species, mind you!), really any animal-related “-ology” so I could avoid that very phrase.
Why I Say ‘I Don’t Know’
Now, with years of experience in the field, I frequently say “I don’t know” because I am so acutely aware that figuring out why an animal is sick (we call this a differential diagnosis) is often much harder than just making an animal feel better (we call this empiric therapy).
There are a few reasons why this is so:
- Answers often cost money. Even the best veterinarians can go only so far on a physical exam and asking good questions. Eventually we need test results, but this costs money—your money—and sometimes we don’t need an answer to find the treatment. We want to put your resources to the best use. If we use up the available budget to find answers, that may mean we have fewer resources to provide the care your pet needs.
- Answers often aren’t easy. One of the worst things that has ever happened to any medical professional is the show CSI. They always find the answer in a convenient hour (or 40 minutes if you’re paying for premium streaming). This is just not reality. Yes, sometimes tests to give you a precise answer, but a lot of times testing provides information and clues. Then I use my expensive degree to put all the pieces of the puzzle together.
- Answers often aren’t universal. This is what I mean when I say a pet “hasn’t read the textbook.” The same problem does not always manifest in the same way in every pet. (Not to put all the blame on cats, but it’s usually cats who haven’t read the textbook!) That can mean that even if we think we know what’s going on, we can get curveballs.
I know this may not instill a lot of confidence in what I and my colleagues do, but I say this because I want you to know that getting an answer isn’t my only goal. I want to help you and your pet in the best way possible. Often these goals are at odds with each other.
We Still Don’t Have an Answer
This brings me to the current “crisis” going on in veterinary medicine right now: the mystery respiratory illness that is affecting dogs. We still don’t have an answer as to what it is. It won’t be easy or cheap to figure out, but there are people working on it. As soon as we have verified information, we will let you know.
For now, we’re left with the general guidance of trying to keep your dog away from crowded canine events as much as possible (I will be boarding my own dog over the Christmas because that’s our only option), keeping them away from unhealthy dogs, and keeping up with the recommended respiratory vaccines like distemper, bordetella, and parainfluenza, and, for some dogs, influenza.
It’s hard accepting “we don’t know,” but to tell you anything more than that would be foolish. In all my years of practice, I would much rather say “I don’t know” than “I was wrong.”
—Dr. Alyssa Kritzman