Humans in Adversity: Types of (difficult) clients, and why I forgive them

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It’s easy to look back at a scenario and see all the complicated little pieces of it, to objectively know that there’s something about those pieces we don’t truly comprehend, and that something is entirely human. Years of interacting with pet owners in the middle of their worst nightmares has taught me a few things about the human mind and where it goes when something terrible is happening. I imagine this lesson is something every healthcare professional discovers, and it’s hard to forgive the direction some minds take, but that’s exactly what we have to do.

In my brief time as an emergency veterinarian, I have learned the three most common types of personalities that are presented when an owner or loved one finds themselves in a situation that they mentally never thought they would have to be a part of:

1. The Amused Jokester
2. The Angry Blamer
3. The Emotional Distancer

The Amused Jokester often seems like the easiest one to interact with because they tend to take everything in stride- they laugh when I tell them their cat requires surgery for foreign body removal or a limb fracture repair; they joke about their this visit costing more than their mortgage when I give them an estimate for their diabetic ketotic dog to stay in hospital for 2 days; they smile and roll their eyes and easily hand my front desk staff a credit card, or they smile and shrug their shoulders and leave with their pet against medical advice. When an owner like this comes in, you just feel like you need to scream and ask if they understand the gravity of the situation there pet is in, but you also appreciate that rather than yelling at you, they are trying to make you laugh. This may be the easiest owner, but you always walk away asking if you did your job, and explained everything in a way that they understand how not-funny this situation actually is. You wonder when you are home at night if the prognosis you gave them didn’t quite click, if they didn’t truly understand their pets condition, if you could have done more to reach past their barrier of humor.

But right now, that owner is sitting on the sofa wringing their hands and wondering if their fur baby will still be in their arms three days from now. They’re asking themselves how they will pay for food, or their own medical bills, or the gas they will be using to drive back and forth from the clinic to visit their hospitalized pet. This owner, while smooth and calm on the outside, is still an owner with a pet that requires emergency care- this means they still need attentiveness and compassion, and most of all they need time to process. Give them that time, forgive them the questions they will (likely) ask you later that you already spent 45 minutes going through, and appreciate that all they wanted when they met you, was to make you smile.

The Angry Blamer is without a doubt the most complicated client, because they’re completely unpredictable. When their pet arrive after being bitten by a housemate, or is producing rancid diarrhea which unfortunately is now all over their house, or is anorexic and has just been diagnosed with liver disease- these are the owners whose anxiety and stress are already at a level 7. And you can see it when they cross their arms, when they stiffly greet you as you enter the examination room, when they answer your history questions curtly and with irritation. This will continue to escalate and they will reach a level 10 as you discuss finances, plans for their pet, and long term prognosis. They verbally abuse your nursing and support staff; they accuse you of caring only about the money as you desperately try to impart on them the severity of the condition and how vital hospital care actually is to this patient’s survival. But, no matter how hard you try and how much time and discussion you put into their consultation and into the care of their pet, their anger won’t hear you. These are the humans who need a target for their stress and confusion. They don’t understand how their pet, who had been healthy all of its life, is now so sick. You may never get through, you may never get past their anger to the person they are underneath, and that’s okay. This pet was there for them when their mom died, when they got divorced, when they were diagnosed with cancer. This pet has been there through every family get together, every painful goodbye, every moment of joy, and is now hurting. And the only ones who can help, are a bunch of people (doctors, nurses) they don’t know.

When you think about how hard it is to entrust someone else with the life of your loved one, their anger towards you becomes more understandable and bearable, because they don’t truly hate you (as hard as that may be to believe). The situation they are now in- that’s what they hate- and they need you to be like a god/goddess, they need to you to be all-knowing, all-powerful, and keep their loved one healthy, and alive. When you can’t be those things, they find blame because you didn’t live up to their expectations of you as a super-human medical professional. You have to forgive them, because for every cruel word they put towards you, for every tear you shed because of those words, they’ve shed more for their family member. They’re scared, and if they process this fear differently, all you can do is acknowledge and forgive their humanness, and do the best you can for their loved one. At the end of the day, their anger does not have a place in your day, because you have 10 more patients and their loved ones to care for, and if you allow that anger to permeate into your heart, the day is lost.

The Emotional Distancer is complex, a combination of the previous two- they are angry and confused, sad, and quite good at hiding it behind a face devoid of all emotion. Often times, they don’t appear to understand the information you give, and you always leave a consultation with these owners wondering how you could have reached them better, especially because they verbalize very little of what they are thinking. These are the humans that get a poor prognosis, nod their head, and ask only for a few moments alone, away from your searching eyes and the words you just threw into the room and their world. These are the owners that sit silently while you euthanize their pet, and only when you leave will you hear them crying. These are the humans that make your heart spasm because they show so little of who they are. 90% of this job is human interaction, and when you don’t get a human response- anger, sadness, laughter- you wonder where you could have done better. A small part of you is even selfishly grateful they hide, one less emotional piece of luggage to carry the rest of the day.

You have to forgive these clients, too, because that emotion is theirs alone- something they may not even show a close family member. I’ve come to realize that seeing any type of response from a client is an un-asked for privilege, one that I am not entitled to witness. Which is why, if their knee-jerk reaction to you is a dead-pan stare, let them have it, there’s a universe of responses underneath that you will likely never see. 

Sometimes when I’m at work, I start, without intention, putting my owners in a glass vase. That may sound weird, but by putting them in a visible place with a wonderful glass barrier, I protect myself from whatever response they have to bad news, so it won’t affect me. And really, I shouldn’t do this, no matter how much easier it makes this job. Because that type of human emotion is raw and real, we should always feel humbled to be around a person in their worst moments. We should feel that anger or joy or sadness, and let it drive us to remember those moments, to be in those moments with our clients. No matter what emotion they are throwing into that tired exam room, we have to be there with them on every level. If we put clients into a glass vase, we stop being human and stop understanding why they react the way they do to the things we have medically been tasked to tell them.

So, I forgive the owners of my patients for their cruel words, their inappropriate jokes, their silent stares of presumed incomprehension, their yelling and harsh Google reviews, their accusations of money grubbing and cold heartedness. I forgive them because at the end of the day, I would still do anything to get their pets back to their all-important jobs- rolling in the grass, snuggling into arms weary after a long day, burying that toy for the 235^th time, resting in that sunbeam.

Until next time.

Whitney