End-of-life care at home is a growing area of veterinary medicine. In Vermont, there are a handful of vets who will provide at-home euthanasia for pets, but only two have practices that focus primarily on end of life care.
Dr. Erika Bruner, of Berlin, is one of them.
Vermont Public's Erica Heilman spent a day talking with Dr. Bruner, and accompanied her on a house call in Johnson. This interview was produced for the ear. We highly recommend listening to the audio. We’ve also provided a transcript, which has been edited for length and clarity.
Erica Heilman: Dr. Bruner was in general practice for 16 years. But for the last seven, she has been focused on end-of-life care, making house calls to euthanize pets. She meets people and their pets in their homes, in fields, in barns — wherever they want to be. It's intensely intimate, delicate work. And she says it's all about love.
Erika Bruner: It's really sad and hard, of course. And there's a lot of guilt in there. You know, on one side, there's guilt because sometimes people feel like maybe they've waited too long. Sometimes people feel guilty because they worry that maybe they haven't waited long enough.
There's this sort of illusion that we have that we could actually figure out the perfect moment and that we could time this perfectly. Many times we don't have a specific diagnosis. Many times, especially with older animals, people don't want to put them through the process of testing and diagnosis. And yet, they often feel guilty because maybe they should be wanting to do that.
People feel bad for having limitations in terms of their ability to care for somebody, or to pay for the care of somebody. And we sort of end up leaving it to the people to say, ‘Oh, well, I don't want that.’ But I have not ever seen anyone make a euthanasia decision without really deeply considering it. And the fundamental important thing that I think everyone cares about is the quality of life and comfort of the pet.
Mike Patch: We got a better day today because we've been having treats all day. We usually don't get it. But she is not happy anymore.
Erica Heilman: Mike Patch invited us in and introduced us to Kona, a 13-and-a-half-year-old yellow lab. Along the wall were handmade dog beds with a view of the driveway. He described this place as Kona’s hangout. Mike pointed out paintings of all his dogs, past and present: Jessica, Enzo, Kona.
Mike Patch: Do you want her to get up on her bed? I could get you a chair and make it easier for you, ma'am?
Erika Bruner: So the first thing is, I want them to know that their decision is OK. And I also want them to know what's going to happen and how it's going to happen, what they can expect, that they know that it's going to go as peacefully as it can go.
Erika Bruner: So the injection that I'm going to give her first is the sedation injection. It's going to go in the muscle in her leg. It may sting a bit when I give it to her, but we're going to distract her by scritching on her and talking to her. And it's not going to sting forever. It's not going to be the last thing that she's aware of.
Mike Patch: We went through it before, but the biggest thing is, I'm one of these — never let an animal suffer. I just don't believe in it. I just don't.
Mike Patch: (To Kona) You're OK. 'Got tumors on my eyes now.' Yeah. We don't want no more.
Mike Patch: But anyways. Thanks for doing it. I know I paid you, I get it. But anyways, thanks.
Erika Bruner: They may tell me a lot at the appointment. Or they may tell me nothing, like they may barely be able to talk. But yeah, I'm really aware that that moment is just a really pivotal moment in their life with that animal because it's the end of their animal's life.
Mike Patch: Years ago, we started a bad habit. If we went out on Friday night or whatever night we go out, we'd always bring them back something. I'm going to tell you — you come back in the house and you didn't bring her something? She will whine like a kid.
Erika Bruner: They got us trained. (Laughter).
Mike Patch: Oh, wicked. When she passed gas, she'd look around for somebody else. Have you ever seen a dog do that?
Erika Bruner: Yes.
Mike Patch: She does. She'd pass gas. She'd looked around at her mother. And I'm like, Lisa, that dog knows. ‘I didn’t!’ But you could tell.
Mike Patch: (To Kona) Yes, you a good girl. Who’s a spoiled brat? Who is a spoiled brat? Yeah.
Erika Bruner: Yeah, they've been through things. Sometimes people will say, ‘He helped me through my cancer treatment,' or ‘She was right there for my difficult divorce.’
I mean, with people, it's complicated. Talking does not help us. (Laughter). We're trying to figure out what the other person wants. They're trying to figure out what we want. And it's so simple with animals. Like, we don't have to talk. We don't need it. There's nothing to say. It's just about love.
Erika Bruner: So I've got everything ready.
Mike Patch: Yep. So you want to put her in her bed? Because she loves her beds.
Erika Bruner: Well, I think she's fine where she is.
Mike Patch: Yep, she loves it.
Erika Bruner: It’s easy for me to be here, and then you can talk to her and pet her.
Mike Patch: And I'm gonna get some more treats.
Mike Patch: (To Kona) OK. OK. You're OK. You're OK. You’re a good girl. Kona? Treat.
Erika Bruner: OK, I’m just gonna go slowly.
Mike Patch: (To Kona) Shh. You're OK. Who is a good girl? You been a good, good girl. Yes you have.
Erika Bruner: Even if someone is talkative and they're talking to me through the whole appointment, things get really quiet right at that moment.
(Silence)
Erika Bruner: Her heart stopped.
Mike Patch: Hm.
Erika Bruner: Good girl.
Mike Patch: She’ll be up with her grandfather having dinner tonight.
Erika Bruner: Yeah, that's right.
Mike Patch: Well, thank you for everything you've done. You're very, very knowledgeable. It's really peaceful. Yeah.
Erika Bruner: Well, thank you for being such a good family for Kona. I'm sure she had a wonderful life with you guys.
Mike Patch: If she was an adult, she’d party like a rockstar. Oh my God, she was everywhere. But yeah, she definitely didn't need to suffer no more.
Erika Bruner: No, no. You saved her all that.
Erika Bruner: People say to me, ‘Oh, your job must be so hard.’ And there are things about it that are hard, but it's not what people think. And the part about it that is so great is that I get, like, the front seat, you know, for meaningful stuff. Where their animal’s lifetime — of the love that they have given them — is like, right there. And I am privileged to witness that. I feel so lucky to get to do this.
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