Good Intentions: Stories about meaning well

In this week’s episode, both our storytellers set out to do the right thing, but you know what they say about good intentions.

Part 1: During the pandemic, science journalist Maddie Bender signs up to be a contact tracer.

Maddie Bender is an innovation reporter at The Daily Beast and a science journalist whose work has appeared in STAT, Scientific American, VICE, Smithsonian Magazine, and other outlets. She holds an MPH from the Yale School of Public Health in microbial disease epidemiology and lives in Boston with her cat, Maisy.

Part 2: Veterinarian Leslie Brooks decides to make an exception to the rules for one pet owner.

Leslie Brooks is a veterinarian by formal training. She is a writer, humanitarian, and advocate by informal experience. Her goals as a veterinarian are to contribute to improving human relationships through enhancing the human-animal bond and promoting the concept of One Health. She worked as a “cat and dog doctor” for a decade, including volunteering much of her time working with individuals experiencing homelessness or crisis who have pets. She is currently a Science and Technology Policy Fellow at the US Agency for International Development, where she is using her transferable skills as a veterinarian in the policy realm and a humanitarian context. A goal of hers is to talk more openly about mistakes and failures to change the narrative of how we view success. She lives in the DC-metro area with her husband and 5-year-old son, Mehdi. She loves to paint abstractly, bike around the city, being an amateur photographer, and dancing.

 

Episode Transcript

Part 1

I am the worst contact tracer ever. And if you know anything about me, you might be surprised by that because, until recently, I was in Public Health School getting a master's in Microbial Disease Epidemiology, which is a fancy way of saying that I majored in COVID. So when the pandemic hit in March 2020, I was raring to go. I was so excited. I wanted to do my part, help stop this pandemic, put what I was learning in the classroom into practice.

And so when I got an email asking if I wanted to volunteer for a contact tracing team, I was so excited. I didn't even go back home to my computer. I typed out a response on my phone. Didn't even delete the part that says ‘Sent from my iPhone’, hit send immediately and, a week later, I was trained up and ready to start calling people up and telling them they had been exposed to coronavirus.

I was given a script and told to stick very closely to it and do things like assess symptoms, recommend that people self-isolate and take their temperature, and then ask them if they had any questions about the whole process for me.

One of the first calls I had to make, I was given a list with names and numbers. I go to the top of that list. I call that number. I say, “Hello, I am a contact tracer. Can I speak to…” the name I was given.

And the person on the other side of the line says, “That's my two-year-old son.”

The thing about the names we were given is that they didn't always have ages attached to them. The data was inconsistent and often just plain out wrong. But this woman was kind enough to humor me and speak on behalf of her two-year-old when I asked about his symptoms, whether he had a fever or a cough, I told her. And he should self-isolate for 10 days.

And she said, “I don't think he can do that,” and that made a lot of sense.

Maddie Bender shares her story at The Anchor in Boston, MA in October 2021. Photo by Kate Flock.

At the very end, I asked the question that's in my script, “Do you have any questions? Anything I can answer.” And that quickly became my least favorite question because you never knew what you were going to get with that. People had all sorts of questions and they were rarely in my script.

So she says to me on one of these first calls, “Is hot water with lemon a good treatment for COVID 19?’ Thinking I got to stick to the script, I got to stick to the script, I look at it. I Command F ‘hot water with lemon’. Nothing. Nothing is there.

So I say, “Um, hmm. Yeah,” and then I hang up.

And let me tell you, in April 2020, we didn't know a lot about coronavirus. We definitely knew that hot water with lemon was not a great treatment. But that's kind of what calls were like.

It's hard, though, to encapsulate what was really going on when I was a contact tracer because every single call was so different. I had people that were flat-out mean to me. I had people who were surprised. Many more were not surprised at all, which is maybe a little more concerning.

I had people tell me that I was the third contact tracer that had called them and they just want to be left alone. And I had other people who said I was the first that had gotten in contact with them and they just wanted to know what was going on.

One time, I had someone who only spoke Spanish and so his son kind of had to translate back and forth my questions into Spanish, his father's responses back into English.

While this was all going on, I was at home in New York City. And when I say I was at home, I was at home, not leaving my apartment.

My father is a frontline healthcare worker and I was so terrified that he was going to come home with virus on his hands somehow and infect me and I would go out into the world and unknowingly infect people who then would be in the positions of the folks that I was calling, not knowing that they'd been exposed to a life-threatening virus. That terrified me.

So I was inside for over a month in my childhood bedroom, making these calls. After a while, I even had my blinds closed because ambulances were driving past it every hour of the morning and night and I couldn't bear to see the flashing, jarring lights.

Maybe because of that, I was going to bed later and later. I'd had to listen to podcasts to help me fall asleep. And then I was waking up 2:00 PM, 3:00 PM. One time, I woke up and the sun had already set. That was bad.

But while that was going on, I was making all these calls. And as I was becoming nocturnal, I started putting off having to do these calls which I kind of hated. So it would be 6:00 PM, 7:00 PM, and I knew people weren't going to pick up the phone when I called and it would go straight to voicemail, because that was the easiest call to make. I could just stick to my scripts and there would be no unpredictability. After three times of trying to reach someone, if they didn't pick up, I could move on to the next name on my list.

But one of the calls I made where the person actually picked up on the other end of the line was to this woman. I did my usual script. I said, “Hi, I'm a contact tracer and you've recently been exposed to COVID 19. It happened on this date.”

Immediately, she stops me and says, “Your information is wrong.”

Maddie Bender shares her story at The Anchor in Boston, MA in October 2021. Photo by Kate Flock.

At that point, I'd gotten that a lot. I was not even surprised to hear her say that. I said, “Okay, what'd I do wrong this time?”

And she says to me, “The date you gave me is wrong. I know that because, two weeks ago, my husband and I were having difficulty breathing. We both went in ambulances one after another to the hospital. I got better and he didn't. The date you just told me was my husband's funeral.”

Up until that point, I'd been able, as awkward as it felt, to go back to the script to say, “Oh, just self‑isolate and monitor your symptoms,” but when she said that to me I had nothing to say to her except that I was so, so sorry.

Soon after that call, I was having one of my normal nightly chats with a friend at two in the morning, a normal time to be awake. I was on my kitchen floor and it was pitch black, except in the corner of the kitchen there was this AeroGarden that I bought my dad for Father's Day. We were growing Thai basil and he'd been so diligent about snipping the branches back. But he'd been working long hours at the hospital and the Thai basil was growing everywhere, just these huge trunks and branches.

Through that, these LED lights were poking out, illuminating the room that I was on. I was sitting on this tiled floor, calling a friend, telling him I am miserable. I am crying all the time. I cannot stop crying when I do. I haven't been sleeping well. I've been listening to the same podcast on repeat so much so that I've memorized parts of how I built this. That's not good.

And he says to me, I'll never forget it, he says, “Why don't you quit?”

Truthfully, I hadn't even thought that I could. I wasn't a quitter. I'm not a quitter. But as soon as he said that to me, I felt like he gave me permission to do what I needed to do. A few days later, I emailed in that I was quitting. I was not going to be contact tracing anymore. And it felt like a weight lifted off me.

With all the time that I wasn't using contact tracing and stressing about contact tracing, I got to rediscover a passion of mine, which is journalism, science journalism. And the pandemic didn't feel so scary when I was talking to researchers who knew what they were talking about, when I was the one not knowing and asking questions.

And that question that I hated as a contact tracer, “Is there anything else for me you want to ask or you want to know,” soon became my most favorite question because everyone had such exciting, wonderful, unpredictable responses and it was just a wondrous experience.

So quitting contact tracing, most importantly, was the best thing I could have done for myself.

Thank you.

 

Part 2

So there are a couple of references of bodily fluids in this story, just a couple. All right.

It was my last appointment of the day. Thankfully, nothing too complicated. I'm a veterinarian and the last appointment of the day has the potential of keeping you there all night. But in this case, it was just the euthanasia of a cat that I had been working with for a number of months. I'd gotten to know the cat and her owner quite well.

Now, the word euthanasia means the good death. And the phrase ‘the good death’ might seem to imply a sense of ease, the absence of pain, maybe even a bit of perfection and predictability. But working with animals can be anything but predictable. After having done hundreds of Euthanasias over the years, it was really starting to wear on me.

Now, before I go on, I want to mention that euthanasia is not usually something that causes burnout for many veterinarians. There is a lot of burnout in the veterinary profession but it's usually not because of euthanasia. We see it as a privilege and a valuable tool we have to end or prevent suffering.

But for me, I just couldn't take it anymore. I was tired of helping navigate my clients on how to talk about death with their children and I was tired of the occasional client that would want me to lie to their family members about the euthanasia saying that the pet had passed on its own. And I tried really, really hard to make every euthanasia go as perfectly as I could for each unique family that I saw.

Leslie Brooks shares her story at Smitty's Bar in Washington DC in May 2022. Photo by Lisa Helfert.

It was wearing on me to the point that I started having nightmares. I don't remember when they started, probably a couple years after I began practicing medicine, but they became recurring, usually when I was stressed. And in these nightmares, I was trying to put a dog down but it just wouldn't die. It would get back up. In these dreams, I would feel like it was in agonizing pain and there was nothing I could do about it. It just wouldn't die.

Anyways, the cat's name was Alice and I had been treating her for quite a few months for an aggressive case of skin cancer and her quality of life started to suffer. After much intense discussion with the owner and back and forth, we decided it was time to finally put her down.

So I go into the exam room where I see Alice, her owner and her owner's two kids waiting for me. Alice's owner is sitting on a bench in the corner of the room and Alice, this small, frail, thin black cat was curled up blind next to her and she looked very, very weak.

The first thing I did was I went through my narrative, like I usually do, explaining the process of euthanasia so that the family would know exactly what to expect. So I let them know the first thing I'm going to do is give Alice an injection of a sedative. It is a poke but it's with a very small needle, just like I was going to give her a vaccine. Once she gets the sedative, she'll start to relax and get sleepy. It's the same sedative we use to help animals get ready for surgery.

Once she's drowsy enough, then I'll give her the final injection in the vein of her back leg and she shouldn't feel anything. She may take one last big, deep breath as she starts to relax and she may urinate or defecate as her body relaxes more.

“I'll listen to her heart and I'll let you know once it stops beating and you can stay with her through the whole process, if you want.”

Then Alice's owner asked me if she can hold Alice on her lap through the entire process. Now, there's no hard and fast rule for this. It may seem like the right thing to do because, after all, a good death, you need to be held by your loved ones. It's the compassionate thing to do after all. I wanted these last few moments to be perfect for Alice and her mom.

And Alice, I knew her personality well. We had drawn blood on her multiple times over the previous few months and she'd always been a perfect patient, never giving us any trouble.

So I struggle with my hesitations and I tell Alice's owner, “Yes, of course, you can hold her on your lap through the entire process.”

Leslie Brooks shares her story at Smitty's Bar in Washington DC in May 2022. Photo by Lisa Helfert.

So she picks Alice up and puts her on her lap and I come over to them and I kneel down and start the procedure. As I'm about a third of the way giving the sedative, all of a sudden, I hear Alice's owner scream the F-word. You can say it very easily. I can't.

So I look up and I realize that Alice has just bitten down hard on her owner's hand and there's blood streaming down her fingers. And mind you, the children are in the room as well.

Now, if you didn't already know, cat bites can be very, very bad. And while they don't cause a lot of damage on the surface, they can cause really bad infections underneath.

So as this moment is playing out, on the outside I'm staying cool and calm and collected, talking with an even tone, like this always happens, letting Alice's owner know that everything is okay. Let's go wash off your hand. We are in control. I am in control.

But on the inside, I am screaming. I am yelling at myself and dropping multiple F words. I'm so mad at myself. I'm saying why did you let this happen? Why did you let her hold the cat? And why did it have to happen now and with this family and the last appointment of the day? All I wanted to do was disappear and teleport away from the situation, but I couldn't. I had to finish the euthanasia.

So while Alice's mom is washing off her hands, I go back into the room to check on the kids and check on Alice.

Now, since I had only given less than half of the sedative, Alice was not drowsy at all and so I knew I had to give her another poke. This time, I go and get my nurse to come in the room and help me. And as she's assisting me with giving Alice the second injection of the sedative, Alice doesn't react at all this time.

So Alice's owner comes back in the room and the rest of the euthanasia goes fine, goes perfectly as planned. But I felt so horrible, because not only is the last thing that Alice's owner remember of her cat is that it bit her but, now, she has to go to a walk‑in clinic and get started on antibiotics, which is probably the worst thing you'd have to do after just putting your pet down.

As I was going to pick up my son from daycare that evening, I just started bawling. I couldn't do this job anymore. I put a lot of pressure on myself to make sure these situations went perfect, that when they were anything less than that I just felt like a failure. I was so mad at Alice for biting her owner. I was so mad at her owner for requesting something of me that was so hard to deny. And I was so mad at myself for not objectively considering the risk of allowing that emotional need.

I called Alice's owner very frequently over the next two weeks. I'm pretty sure I called her every day to check on her, to really make sure she was okay, but also to relieve my anxiety of a possible lawsuit. Because something I forgot to mention earlier is that when owners request to help in procedures, that's very nice but, if the animal bites the owner, guess who gets sued, the vet.

So my memories of that moment were that it was really my tipping point, my breaking point. But as I was looking in my journal entry from the time, I saw something that I had forgotten about, something that clearly made an impact on me. I had written about all the negative thoughts I had at the time, like the last thing Alice felt was pain. The last thing Alice's owner remembers of her cat is the bite. They could sue me if this goes wrong. This was not smooth at all.

But then I had written that it oddly seemed to work out, though, because I think Alice's owner really needed someone to talk to. Because every time I called to check in on her, she was still crying. Alice's owner really, really missed her cat and she felt all alone like she couldn't talk to anybody about it because, after all, it was a cat.

I remember being surprised that she would answer the phone every time I called her. it's really hard for us to get a hold of owners sometimes when we need to call them. And I remember the pauses in our conversations, the softness in her voice and the hesitations. She never once mentioned the bite except when she was remembering Alice as a feisty, young, healthy cat.

And I remember her asking me if she thought I was crazy for her feeling this way about a cat. It made me realize that sometimes bad moments can lead to good consequences. Alice's owner really needed someone to talk to in the aftermath of her death. And if the euthanasia hadn't gone so horrible, I would not have called her as frequently as I did. In fact, I probably wouldn't have called her at all.

And those check-in calls were exactly what she needed, more so than a perfectly smooth euthanasia. I had been putting so much pressure on myself to make them so perfect and so scared of making a mistake or of something going wrong that I was inducing my own burnout. What my clients needed for me wasn't perfection or perfect moments. What they needed was someone who cared. That I could do. I could continue being a vet that cared. I could not continue being one that was perfect.

Thank you.