Doing "God's Work"

Originally, Amy Attas, a Manhattan veterinarian who had graduated from the University of Pennsylvania's School of Veterinary Medicine five years before, had assumed that she and her employer, a prominent Park Avenue veterinarian, would one day become partners. He had frequently encouraged the partnership prospect, but on the day they were scheduled to meet for an annual salary review—they had made plans to go out for a drink after the meeting—he called Attas into his office and abruptly fired her.

Attas was stunned. And, fearful that being dismissed in such a cursory and mysterious manner made it appear as if she had committed a crime or violated scientific or ethical veterinary principles, she hired a labor lawyer and sued her former boss, who was maintaining that Attas had not been performing in a satisfactory manner. But after a long wait, followed by a trial lasting three weeks, a jury reached a verdict in Attas's favor, awarding her more than $400,000. Amy Attas's reputation, not to mention her bank account, had been safeguarded.

Long before the Attas jury had reached its verdict, however, long before the case had even gone to court, Amy Attas realized that her former employer had inadvertently created for her the opportunity of a lifetime. The morning after being fired, Attas received a phone call from a client with a sick animal. She explained that she no longer had an office to treat patients, but the client was insistent, so Attas decided to visit the woman and the dog at home. From that point on, Amy Attas's business started to grow. She became a house-call veterinarian, perhaps the most successful and certainly the most prominent of the few hundred full-time house-call veterinarians in the world.

The lawsuit Attas filed against her former boss and the firing that precipitated it are not typical of the veterinary community in the United States. In Manhattan, however, with probably more veterinarians per city block than in any other large urban area, as well as the highest fees for veterinary services in the world, competition is fierce. And nationally, veterinary medicine is undergoing a gender change that is having a significant impact on the old-boy power structure, traditionally the dominating force of the profession. Two decades ago, fewer than five of one hundred graduate doctors of veterinary medicine were women. In 1935, there were only five female veterinarians in the entire country. Today, seven of ten students gaining admission to veterinary schools are women, thus signaling a new and important trend.

There are different schools of thought surrounding the sudden influx of women. A justification for excluding women in the past was because women were considered physically incapable of controlling large farm animals such as cows and horses, but today, such theories are brushed aside by men and women alike. In fact, the smaller size of women's hands may be more suitable for animal work.

Besides, small animal practices (dogs, cats, birds, etc.) in which women have been most comfortable, today dominate the profession. According to a recent survey by the American Pet Products Manufacturers Association, 56 percent of all Americans own a pet. The average pet owner is married, lives in a house (as opposed to an apartment or condominium), is under fifty years old, and does not have children living with them. Among dog and cat owners, the average number of pets per household is nearly two; the number increases to almost three among bird, small animal, and fish owners. Not all animal owners will consult veterinarians on a regular basis, but veterinarians in a variety of capacities will have contact with most animals in any given year. The majority of dog and cat owners will visit a veterinarian at least once annually.

Battle of the sexes aside, Attas profoundly appreciates the rewards of the veterinary profession and her specific role as a doctor who treats animals and their owners from both a physical and emotional perspective. "If you're one of the unlucky people who have to work for a living, there is no greater job than what I'm doing," she told me. "I take care of dogs and cats. My goal is to relieve them from whatever suffering they have. It's like doing 'God's Work.' "

She is referring to the fact that many clients have established a unique intimacy with animals and veterinarians. People are often frightened and panicked when their pets are sick. She is available to help talk them through a crisis—or come to their aid. "I do a lot of triage on the telephone.

"My beeper goes off at night. It goes off when I'm at the opera. It goes off on Saturdays, Sundays, and holidays. My work is much more time-consuming than most other people's, but also more rewarding. People trust me. In fact, people consult meabout their own health problems. I'll go into people's homes, and a woman will lift up her blouse, show me a mole and say, 'Do you have any idea what this is?' One of my clients called one night quite late. She said, 'My daughter has head lice. I'm embarrassed to call the family physician. I knew I could turn to you for help.'

"Another client said to us one day," referring to Arthur Carter, the publisher of the New York Observer, "'Montana is the only person allowed to eat off of my plate.' Now there are two odd things there. The first is, Montana is not a person, he's a cat. And the second is, I wouldn't let an animal eat off my plate. I really don't want anybody to eat off my plate, except maybe my husband. So the significance of the animal in this very important and intelligent man's life is really amazing." But in this regard, Arthur Carter is not unique.

I once accompanied Amy Attas to Arthur Carter's sumptuous apartment. Attas is a walking encyclopedia of East Side pets and the posh apartment buildings they live in. As we drove to the Carter home, she said: "Look at all these buildings. I can tell you about all the pets in each of them. I know the dogs who are friendly and the cats who are not." (Recently, a frightened cat bit her hand during treatment, an incident that rendered her incapable of doing surgery for five months.) Attas receives eighty dollars per house call (perhaps 25 percent higher than the average Manhattan veterinary hospital rates) and approximately two hundred dollars for a chemotherapy treatment, depending on the drug-treatment protocol being used. Cancer is a big part of her practice; six golden retrievers in the past two weeks had been diagnosed with the disease.

As we walked down the hall toward Montana Carter's bedroom, we passed the exercise room. Mr. Carter was on the treadmill. "For a long time he wouldn't acknowledge the fact that Montana was sick—and getting sicker." At that point, Montana, normally a twelve-pound cat, weighed only six pounds. "I said, 'Mr. Carter, this is cancer. And if you continue to delude yourself, the cat's going to die very soon.'"

After accepting Attas's diagnosis, Carter decided to put Montana to sleep. He had seen too many people suffer through chemotherapy; he did not want his pet to undergo such trauma—until Attas explained the vital distinction in approach to treatment between pets and people. "Our goal with chemotherapy in humans is to kill as much of the cancer as possible, even if we come very close to killing the patient in the process. But pets don't live that long. You can't explain to a cat that they will feel better later if they suffer now." Veterinarians attempt to extend life quality through chemotherapy without the promise of saving a life. "For pets, in the end," said Attas, "the cancer always wins." Attas assured Carter that Montana could be treated and proposed that she come once a week and administer the chemotherapy to Montana at home, in his own room. Carter agreed, but balked at administering the steroid twice daily as required with chemotherapy. George, the veterinary technician who works with Attas, thus visited Montana at 8:00 A.M. and 5:00 P.M., seven days a week to give prednisone. Montana went into remission; he lived comfortably for a year and a half longer.

Carter was so appreciative of Attas's service and her straightforward and intimate manner that he began recommending Amy Attas to his famous friends and colleagues who owned pets. Attas's client list includes the extended members of the Kennedy clan, who have become her friends. "I was a guest at the Kennedy Palm Beach house for a week. It was really an experience, just to sit in the chair that President Kennedy sat in." Another client, comedian Joan Rivers, has been equally influential in Attas's success by recommending Attas to all of her pet-owning friends.

Meanwhile, talking nonstop to Montana, George chased the cat around the antique chests and majestic four-poster bed. "You know, we don't actually expect Montana or any other cat to understand or talk back to us when we talk to them," he told me.

"We don't?" asked Attas.

George laughed. "This sounds like a recent conversation I had with my shrink. I told him: 'Even though I constantly talk to my cats, I realize they don't understand what I am saying.'

"And my shrink said, 'They don't?'

"'Well, no,' I said.

"'That's funny,' my shrink replied. 'Mine do.'"

Although there are significant cultural differences from place to place in this country and abroad, people who love animals are very much the same. There are more than a few Arthur Carters outside Manhattan—owners willing to allocate mountains of money to the care and treatment of a cat. And there are many thousands willing to invest as much or more in a beloved horse—or pig, parrot, or goat. They invest what they can afford—and often much more—in the health and well-being of their animals, for whom they frequently display a deep and unwavering devotion. There are those who might object to money "squandered" on pets, while ignoring the wealth invested in Mercedes-Benz cars, diamond brooches, Las Vegas gambling, and travel—considerably less worthy endeavors than animal ownership, which has existed nearly as long as man has lived in civilized society.

When a dog died in ancient Egypt, owners and their families shaved themselves as an expression of mourning. The Egyptians also venerated their cats—and embalmed them. A visitor can view a mummified cat at the University of Pennsylvania's museum, its wizened face illuminated behind mysterious layers of shrouds. There is something very basic and ethereal about an appreciation of pets and a love for animals in this society—an experience that offers a universal lesson in boundless compassion.

Humankind, according to the psychologist Erich Fromm, "is biologically endowed with the capacity for biophilia," which is the "passionate love of life and all that is alive." If Fromm is correct, says Elizabeth Atwood Lawrence, who is both a veterinarian and a cultural anthropologist, then love for animals is more than a frivolous emotion possessed by a certain group of people, such as veterinarians. "Rather, it is a natural manifestation of what it means to be human—a quality that not only enhances our species' well-being, but may be vital to the health and preservation of the planet.... Veterinarians, in their role of mediating between human beings and the animal world, are in a unique position to foster and facilitate the expression of biophilia."

"About a dozen years ago," said Amy Attas, "when I was a veterinary student, I saw a little pug dog tied to a tree. There was a note attached to the tree which said, 'I am blind. Please take good care of me.'

"I could not believe that someone had abandoned this little pug. So I took him inside the hospital. He was skinny. He was flea-ridden. I mean, he was a mess. I brought him upstairs. I bathed him. I vaccinated him. I put him in a cage, and I said, 'Listen, kid, I don't want a dog. Tomorrow, I'll take you to the pound. But just to be nice, you can have a home-cooked meal at my house tonight.' Then I went to work.

"He's totally blind, remember. But every time I went past his cage, he would recognize my smell and jump and bark. The rest of the time, he would stay there looking pathetic. At the end of the day, I scooped him up, put him in the car, drove him home with me. My apartment was fairly small, but he bumped his way around every wall in every room. Then he returned to the front door, lifted his leg and peed, as if to say, 'I'm home.'

"But I was annoyed. I didn't want a dog in the first place, especially one who peed on my door. So I locked him in the kitchen, gave him a home-cooked meal, and made up my mind I was going to find him a home. Went to bed that night. In the middle of the night, he found a way out of the kitchen, came into the bedroom, jumped on the bed, laid down next to me, and went to sleep. That was it. I was hooked. I named him Bumper because he literally bumped his way wherever he went. He had the sweetest disposition. He was one of the nicest dogs I ever met.

"And later when I went into practice and clients wanted to put their animals to sleep prematurely, I could introduce them to Bumper. 'Your dog doesn't have to be physically perfect,' I would tell them. 'Look at how terrific Bumper is.' He was a wonderful model to illustrate that handicaps don't matter. You can love animals just as much, even if they are a little different from what you expect. And Bumper was infinitely different. He could fetch. He walked everywhere. He'd go up the steps. I'd say 'Up, up, up, up, up,' and he'd keep jumping. When Bumper got sick and lost the use of his back legs, we had a cart built, and he'd prance around in that cart, using his front legs, and his back legs would just go along for the ride. And people would come up and say, 'You're cruel. You should put that dog to sleep.'

"'Thank you very much. But I think you should mind your own business.' You see, Bumper had no pain. He was very happy. One day, months later, he died in his sleep. Now everybody always asks, 'When are you going to get another pet?' It's sort of odd for a veterinarian to have no pets. Well, I tell them, I rescued my dog. And some time before Bumper, I rescued a cat who was with me for sixteen years. And some day, another beast will come along and need to be rescued, and I'll find it, and it will come live with me—forever."

Amy Attas's assertion that veterinarians do "God's Work" highlights a significant difference between practitioners of animal and human medicine—and may well isolate a vital contrast between the way in which veterinarians and MDs regard their patients. As I delved into the world of veterinary medicine, I found myself wishing repeatedly that sick people who went to doctors were treated like animals—that is, that humans were touched in a special caring way by their doctors, looked in the eye, and talked to with interest and compassion, as do most veterinarians with their patients.

Touching, petting, kissing, caressing are the easier and less complicated ways in which veterinarians treat and communicate with their patients; communicating with owners of the animals is the more difficult and frustrating challenge. Veterinarians are servants of two masters, whose best interests will often conflict. Practically and morally speaking, how does a veterinarian respond when an owner's decision conflicts with the best interests of the animal about whom the decision is made? Amy Attas successfully resolved this dilemma for Arthur and Montana Carter, but such conflicts are often not so easily and peacefully resolved.

The mitigating factor in the Montana Carter case was love for the animal, whereas in many instances the veterinarian's diagnostic and treatment decisions revolve around the owner's best interests for himself. Many people compare pediatricians and veterinarians because in both cases the patient group cannot speak for itself. Although there is a certain amount of variation in the parent-child relationship, parents generally value their children, whereas value in a veterinary milieu is often determined by practicality and economics—despite a veterinarian's personal feelings concerning the animal's intrinsic worth.