Things don’t always go as planned. This is true in medicine and surgery as much as in any other avenue of life. This reality stands out a bit more in a professional sphere, however, because there is a (reasonable) perception that things should be well regulated and controlled in a setting so bedecked with science and procedure. But, no matter how meticulous, careful, or skilled a practitioner is, things do not always go as planned. These unplanned divergences are diplomatically referred to as complications, and when they occur there is always the unspoken (and sometimes spoken) question of who is at fault. Owners blame themselves as often as veterinarians blame themselves (and we do that quite frequently). Sometimes the cause is clear and blame and fault must then be dealt with honestly and straightforwardly. Over and over, though, I am continually amazed by how often there is no “fault” in terms of someone to blame, and that we are merely dealing with a complex system operating in the real world. It is worth pointing out that complicated and complex systems are very different.
From Google’s Gemini: “Complicated systems have many interacting parts, but operate linearly, allowing for prediction, disassembly, and expert solutions (e.g., a car engine). Complex systems are nonlinear, adaptive, and unpredictable, where the whole is greater than the sum of its parts and behavior emerges from interactions (e.g., traffic, ecosystems, biological systems.”
Dogs and cats of course fit in the complex system category. So, when a surgical closure fails there are many different explanations possible, but my tendency is to pick the one that involves a mistake on my part because of my own psychological make up but also because it is the easiest and closest answer. As I have gotten further along in practice (nearing the 20 year mark at this point) two things have happened: 1) I have gotten a lot better as a natural consequence of repetition. That confidence helps me rule out human factors–unless of course human factors are obviously to blame. 2) I have seen enough cases through to the end to realize that many times my first thought is wrong. Factors beyond my control or unforeseeable to any reasonable extent are often at play. For pet owners this matters. It matters because they often do the same thing. Blame is a human inclination. We blame ourselves for our pets getting sick. We blame ourselves when they don’t get better. We constantly ask,” what could I have done differently.” The answer, in many cases, is nothing. Life with complex systems is that way. We stand in awe of its beauty and meaning and a great part of that beauty and meaning is how little control we have over ultimate outcomes. In the end, being a little kinder to ourselves than is absolutely needed goes a good long way.