Complicated, Part 3

My first week back at work after my nephrostomy and abdominal drain were placed, I had a major wardrobe malfunction. I was wearing a leg bag on each leg, strapped to the front of my thigh with elastic bands. I was kneeling on the floor, examining a large, handsome hound dog, and I felt a dampness spreading across my left knee. My vet tech and the shelter staffer who were helping us saw it too.

Of course, it’s not too unusual to end up with damp spots on my clothing at some point during exams. Puppy pee, slobbery dogs, wet or muddy paws.

I said, “That wasn’t the dog”

I could feel the urine still running out of the leg bag. It had been pretty full, and I don’t know if the dog had bumped it, or if my scrub pants had rubbed against and dislodged the end cap as I knelt, or if just the pressure of my flexed thigh against the full bag was enough to push the cap off.

I stood up, laughing, embarrassed, trying to kink the end of the bag to stop the flow, but to no avail. Immediately the urine ran down my leg and filled my shoe. Someone handed me a towel and I wrapped myself in it, asked my tech to get my spare clothes out of the vehicle (pro tip: always have spare clothes in the vehicle), and ran to the bathroom to change.

I emerged from the bathroom barefoot but dry, my urine-soaked clothes and shoes stuffed into a plastic bag to launder once I got home. I slipped my feet back into the snow boots I had worn to work that morning.

“Do you want me to run those through the wash for you?” the shelter staffer offered.

“Are you sure?” This seemed a bigger imposition, and more personal, than the initial, urgent cleanup. And I was just the visiting vet, only there a day a month, not her friend or co-worker or boss.

She took the bag back to the laundry room, and by the time I was ready to go home, the clothes and even the shoes and socks were clean and dry.


FortunatelyI’m not a leader who relies on dignity or control over others to bolster my authority. I’m confident, but I joke about my weaker points and don’t mind occasionally playing the fool (or being, accidentally, made foolish).

Like most veterinarians, I had never studied leadership when I got my first job with management duties, nor later when I started my own business (Spay ASAP Inc, a nonprofit MASH mobile spay neuter clinic). Later, I was introduced to organizational ergonomics during my ergonomics masters program, and then I attended a 2-day course at Emancipet called Surgeon to Leader.

One of the topics we discussed was the difference between management authority and leadership authority. Management authority is structural: it comes from a job title, and allows you to say, “because I said so.” Leadership authority is granted by each individual: it happens regardless of whether you have managerial power. With leadership authority, people follow because they want to, not because they have to. They follow because they believe that together, you will achieve something worthwhile that neither of you can achieve alone.

In my own workplace, I have management authority over only one other person: the veterinary technician who I’m paying to be there. But I strive for (and can only function with) some level of leadership authority, to inspire those who work for other entities and those who volunteer to believe that what I’m asking them to do is useful and worthwhile. I could aim to gain that leadership authority by inspiring awe, but like the awkward alien in the Gary Larson cartoon, I’d be bound to fail (or fall) eventually. Instead, I earn what leadership authority I have by working hard and allowing others to feel involved in and integral to that work.

A few days ago, a veterinarian friend emailed about how she had been fighting the perfectionism in veterinary medicine by admitting openly to staff when she didn’t know something, instead of sneaking off to look up the answers. She points out her mistakes and near misses rather than trying to hide them, seeking to emphasize that we’re all human and therefore not perfect. When she does this, she may be not only helping to break down the harmful self-imposed norm of perfectionism in the veterinary profession, she may also be making it safe for the other people that she works with to look at, talk about, and understand error as well. And by doing that, as I wrote about last time, she may actually be making her practice safer– all by being openly imperfect.

Like my friend, I also try to point out to my staff the things I could have done better when I’ve made a mistake or had a complication. Also like my friend, I find it’s easier to admit my shortcomings to others than to accept them in myself. It’s funny how, even knowing what I do about complications and coping, it feels far less shameful to be soaked in my own urine than to know that I have caused harm to an animal. And while that shame can be a short-term motivator to change (no more leg bags at work for me, only fanny packs), it’s not a productive or sustainable way to generate process improvement because it’s hard and painful to think about something shameful, so it’s hard to use the experience to analyze, reconstruct, and modify a work process.


As for me, I’m counting down the days until my ureter reimplantation surgery (3 weeks and one day!). Between now and then I’ll be working at a half dozen spay clinics and attending a couple of conferences, the 2018 International Symposium on Human Factors and Ergonomics in Health Care in Boston, and the New England Federation of Humane Societies annual conference in Nashua, and hope to bring back all sorts of interesting ideas (and avoid wardrobe malfunctions).