Chapter 23: next in line

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Kaybri couldn’t fall sleep that night. She was angry at everyone and at the same time filled with self-doubt. She started to question whether she should even bother going into the clinic the next day. It wasn’t really her practice—it still belonged to Frank. And he was threatening to throw her out.

    Meanwhile, she continually checked her phone to see if there had been a response from Noah. There wasn’t. She felt sick to her stomach.

    She remained wide awake until just before sunrise and then slept through her alarm. When she finally woke up and saw that it was already nine o’clock, she realized she couldn’t bear the thought of leaving her staff—actually, Frank’s staff—and especially Frank’s clients in the lurch. Someone had to care for all of those sick dogs. This was one thing she knew she could do well. She got herself up, splashed some water on her face, and hauled herself to the clinic.

    When she got there, she found a waiting room full of distressed owners and their dogs.

    “We got a ton of calls this morning. It appears that we have an outbreak of giardiasis.”

    “Do we know where it’s coming from?”

    “Nope, but the dogs are passing it around. Just look at what is in our waiting room.”

    "Do all of these people have appointments?” Kaybri asked.

    “When our customers are desperate, they don’t wait for appointments. Frank understood that and didn’t require them.”

    “Call the dog shelters, groomers, and the dog boarding companies and alert them. We also need to get some distance between these dogs. Please ask the owners to keep their dogs in their cars until we’re ready to examine them. Some of them might not have giardiasis, but they will if they keep interacting with each other.”

    Kaybri deeply exhaled and then apologized to her for being so late, then added, “I suppose you heard what happened in court.” Autumn just stared at her. Feeling sorry for herself, Kaybri asked, “Can we reschedule these cases? I’ve had a tough morning.”

“No, we can’t. Erika is treating seriously sick or injured patients, and we’re going to be one person short. Noah can’t stay.”

    At that moment, Noah sprinted out of one of the examination rooms so quickly that he ran into Kaybri. He met her gaze for a second but didn’t smile or say hello. All he said was, “I need to leave. It’s an emergency,” before bolting out the front door. Kaybri didn’t have time to run after him. But her heart was in her mouth. The look he had given her was so cold. If she had lost Noah…

    Autumn nudged her toward one of the examination rooms. “There’s a dog in every one of our rooms. Better get to work.”

    “I don’t know if I can do this. I feel like crap. And Noah just ran out…”

    “You’re a wonderful clinician, Kaybri. Seriously.”

    “But I need to learn how to relate to the owners,” Kaybri added.

    Autumn took both of Kaybri’s hands and told her to take a few deep breaths. “No one is looking for a miracle. They want to know that you understand what they’re feeling and that they’re not alone. Their dogs are like babies that can’t tell their owners what’s wrong with them. Let me rephrase. These dogs are as much their children as their children are. You know that. They’re counting on you.”

“We didn’t spend a lot of time learning how to relate to owners when I was in school.” Kaybri hesitated. “Or maybe, for personal reasons I wasn’t paying attention.”

    Autumn thought for a bit and then said, “I have an idea. Instead of waiting for an examination room to open, let’s talk to the owners here and explain the situation. These people need to be reassured.”

    “In the waiting room?” Kaybri was surprised yet eager.

    Autumn nodded her head again. “I’ll get you a cup of coffee. I think it’s time these customers and their children found out who you are. There have been a lot of rumors flying around town about you.”

    “All bad I suppose,” Kaybri said sullenly.

    “No time like the present…”

    “One more thing,” Kaybri said earnestly. “Call Frank. Tell him to get down here ASAP. Tell him we have patients whose pets are in distress. I need him in the examination rooms. Do you think he’ll come?”

    What Autumn said made Kaybri smile. “It’s always dogs first with Frank. Don’t worry about what’s going on between the two of you. Just be honest with the patients. Let them see your authentic self. Let them see that you’re sensitive and you care.”

    Autumn was almost at the door to the breakroom when Kaybri stopped her. “Let’s see who else would like a cup,” she said loudly enough for everyone to hear. Autumn took orders as Kaybri sat down next to a young woman who looked like she’d been crying. She was holding a bichon.

    “What’s troubling this guy?” Kaybri said warmly.

    “This is Pepper. He’s not eating, Dr. Lynn.”

    “Please, call me Kaybri. And what is your name?”

    “Cathy Wood. Thank you so much letting us come in.”

      “My pleasure. Now tell me, how long has Pepper not been eating? What about drinking?”

    Cathy shook her head as tears formed in the corners of her eyes. “A few days...” 

    “Do you mind if I examine him here in the waiting room? We have an extraordinarily busy practice today. We’ve never had so many patients who need care.”

    Cathy nodded. Kaybri sat on the carpeted floor and asked the pet owners to gather around. When she had everyone’s attention, she demonstrated how she conducts an examination.

    “How old is Pepper?” Kaybri asked Cathy.

    “He’s twelve.”

    “Okay. Twelve is old for some breeds, not for others. For a bichon, twelve is mature. Bichons can easily live for sixteen or more years. However, almost every breed has issues, and some of those issues emerge when a dog reaches a certain age. We are going to examine Pepper’s eyes and his mouth. When a dog is in distress, there are tell-tale signs. Sometimes the mouth is dry or the eyes are dull. It’s a general diagnosis. Most of the dogs with giardiasis will have these same symptoms.”

    Kaybri could see from examining Pepper’s mouth and looking in his eyes that something was seriously troubling the dog. “How is Pepper’s energy?” Kaybri asked.

“He has no spark.”

    “So, what we’re going to do is to gently press on Pepper’s neck and body. Even though they can’t tell us what’s wrong, they do react to pain or discomfort.”

    Kaybri gently worked her way from Pepper’s neck to his abdomen. When she pressed near Pepper’s midsection, the dog reacted with a sharp yelp. Kaybri looked up and saw all of the people in the waiting room reflexively flinch. Then there was a collective grimace from the owners as the dog yelped louder when Kaybri pressed slightly harder. “I think that’s enough for now,” she said to the group. “Autumn?”

    “Yes.”

    “Please take Pepper with you and have Erika draw blood. We will also need urine and stool samples.”

    Kaybri then turned to Cathy and placed her arm around her. “I’d like to speak to you in my office.”

    As they started walking toward the office, others in the waiting room called out words of sympathy and support. Kaybri closed the door to her office and invited Cathy to sit down. “What do you suspect?” Cathy asked with a worried expression.

    “It’s not unusual in bichons for tumors to emerge in the digestive tract. If that’s the case, this is a serious situation.”

    “Can you operate?”

    “First we need to run some tests.”

    “I will do anything for Pepper,” Cathy said nervously.

    “Let’s approach this situation one step at a time.”

“I don’t want Pepper to suffer,” Cathy said through her sobs.

    Perhaps the stress of the earlier court hearing and speaking to Frank and Dorothy affected Kaybri. She started to cry. After a few minutes, Kaybri wiped away her tears with the back of her hand, apologized to Cathy for her emotionality.

    When she had collected herself, she faced Cathy and got ready to give her the bad news in as compassionate a manner as possible. “I suspect that Pepper has cancer. Although I can’t be one hundred percent sure, I believe I felt tumors when I examined his midsection. This type of cancer is a serious condition for bichons of his age. Surgery isn’t going to save his life. Even if it’s successful, we’re only delaying the inevitable for a month, maybe two. I’m sorry, but I want you to be fully informed.”

    “Will he suffer?”

“     The tumors will make him uncomfortable and make it impossible for him to live a happy life. Over the next few weeks, Pepper will become weaker and weaker. You might see blood in his feces. There will be days when you think he is improving. It won’t be true, but that’s the way dogs are. They want to please us.”

    Kaybri rose and embraced the woman and held her until Cathy was ready to disengage. During that time, Autumn returned and put Pepper in Cathy’s arms. 

    “Will his death be painful?”

    “Let’s run the tests first. We can control the pain. If it becomes necessary, it will be your decision when he leaves us.” 

    “Thank you,” Cathy said through her sobs. 

    “Let’s book an appointment for tomorrow morning. By then, we will have the test results,” Kaybri said to Autumn. 

    Kaybri led Cathy and Pepper to the waiting room, grabbed a business card, wrote her cell phone number on the back, and pushed the card into Cathy’s hand. “Call me day or night. We are here to answer your questions or if you just want to talk. Please don’t hesitate.” 

    Seeing Cathy's distress, the other pet owners embraced her as she was leaving. Kaybri could also hear Cathy telling the other customers that Kaybri was wonderful. It was just at that moment that Frank arrived, much to Kaybri’s relief.

    “Who’s next?” Kaybri asked Autumn. 

    Autumn pointed out a young man with a black lab. “I’ll work with this patient next. We’re going to give each of you my complete attention no matter how long it takes,” Kaybri said aloud. The tone and earnestness in her own voice surprised her.

    For the next three hours, Kaybri examined the dogs while explaining to the owners what she suspected was wrong with their pets. Then the animals were moved either to a treatment room where Frank and Erika did the testing or to her office if Kaybri thought her suspicions required confidentiality. Occasionally, Frank would come into the waiting room to ask Kaybri a question. The owners who had been with Frank for decades would try to get his attention hoping he would confirm that what Kaybri was telling them was reliable. Frank would defer to Kaybri so that it was clear to them that Kaybri was in charge and that her diagnosis shouldn’t be questioned – even by him.

    It was almost shocking to Kaybri that at six o’clock the waiting room was empty. She took a deep breath and leaned back in one of the waiting room chairs and closed her eyes. Her few seconds of peace were interrupted when Noah bolted into the room. She was excited to share with him what had happened with the patients. 

    “I’ve come to get a few things. I don’t know when I’ll be back. It’s my father. He’s in the hospital. It’s his heart.”

    Kaybri scrambled out of her chair and moved closer to Noah. “I’ll drive you,” she said.

    “No, you won’t. You’ve done enough damage.”

    “I’m sor…” She never got to finish her thought. Noah dashed off to his office but came right back holding his leather tote bag and a folder. As he headed for the door, he gave her more information.

    “The doctors suspect he’s had a heart attack. I’m leaving here, grabbing a few things at home, and then my mother and I plan on spending the night at the hospital.”

    “I’m so sorry. Please, let me come with you.” Kaybri hoped this time she wouldn’t be rebuffed.

    “I don’t want you to come. Diener told me you gave the list of the stores selling Amish dogs to HED.”

    “I…” Kaybri started.

    “That was a betrayal. I don’t feel I can trust you.”

    His comment triggered defiance in her. “You can trust me to do what’s right for the dogs we both care about so much.” 

    “You don’t get it. Thomas and Elizabeth are my parents. Frank and Dorothy are also my parents. They want what’s best for me. They’re trying to be patient with you…you seem to want to push away the people who care about you the most.” Kaybri’s positive day with her clients faded as Noah delivered even more condemnation. “I wanted to be…your…partner. More than your partner. I don’t think that’s possible anymore.” 

    Kaybri, desperate to find the right words, couldn’t think of anything to say. But once Noah was out the door, she whispered, “I love you.” That was all she could think of, and it was too late. No one heard her say it.