Nick Trout: Vet Extraordinaire

Q&A with Veterinarian, writer, reader and advocate Nick Trout
By Susan Tasaki, October 2014, Updated February 2015

Unless you lived in or near Boston, Mass., and had a reason to visit the Angell Animal Medical Center (AAMC), you were unlikely to have heard of veterinarian Nick Trout. That is, until his first book, Tell Me Where It Hurts, came out in 2008. Since then, his visibility has risen exponentially, as has his literary output. Born and raised in England, he is a graduate of the venerable University of Cambridge, a Diplomate of the American and European Colleges of Veterinary Surgeons and an AAMC staff surgeon. In addition to his work and his writing, Trout is an avid reader and a passionate advocate for the Cystic Fibrosis Foundation.

Bark: Are there differences between vet education in the UK and the U.S.?

Nick Trout: Probably the biggest single difference is the age at which students go to school. In the U.S., training to become a veterinarian is a post-graduate pursuit. In the UK, most British students go straight from high school to vet school, meaning you can be a fully qualified veterinarian by the age of 23. Over the years, I have come to appreciate the American approach because I believe it selects for candidates who are potentially more driven and have enough maturity to embrace a lifelong career more clearly. In a recent Royal College of Veterinary Surgeons Survey (2010), only 52.5 percent of respondents said they would still choose to become a veterinarian if they had to do it over. I’m betting that percentage would be a whole lot higher in the U.S., thanks to a career choice made later in life.

B: How about vet practices?

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NT: They’re similar in terms of technology and services offered, but roughly 40 percent of UK pet owners have pet insurance, compared to less than 3 percent in the U.S. My sense is that pet insurance can offset much of the financial awkwardness on both sides of the examination table and free pet owners to pursue optimal care. However, it should not become managed care; vets cannot have financial ties to insurers, and we have to prevent third parties making payments with few to no restrictions on skyrocketing costs.

B: How did you choose your specialty (orthopedic and soft-tissue surgery)?

NT: There’s the physicality of using your hands to fix a problem. There’s the potential for instant gratification (yes, totally self-serving, but no less rewarding) when viewing the postoperative X-ray of a shattered bone you’ve somehow managed to pin, screw, plate and wire back together. There’s the responsibility of knowing you might be a dog’s last hope. For me, the most important message I will ever convey to a dog owner, the only thing I will guarantee, is my unwavering, unequivocal determination to do my best.

B: How do you build communication skills with patients and their people?

NT: I don’t wear a white coat during consultations; for many dogs, a visit to the veterinarian is a stressful business, so why wear a uniform associated with rectal thermometers, needles and rubber gloves? Whether the patient is a Great Dane or a Chihuahua, I almost always get down on the floor with them, down on their level, to socialize and better interact prior to the physical examination. The best advice I can offer new veterinarians on the art of good communication is to simply listen. You need to appreciate the intensity of the bond you are attempting to sustain. When communication works, everyone’s on the same page, formulating a plan, weighing the options, considering the budget and fighting for a common cause.

B: Do you do time in AAMC’s ER? Any takeaway lessons for dog owners?

NT: I only get to cover emergency cases one day a week, but I love the unpredictable, chaotic potential of that day. From spinal surgery on paralyzed Dachshunds to the bizarre objects ingested by orally fixated Labradors, anything can happen. The only consistency is the dog owners’ shock, stress and fear. By definition, emergencies require owners to make quick and oftentimes costly financial and medical decisions when they are at their most vulnerable. My advice is to, while your dog is healthy, mull over what you would do during a variety of emergency situations. Consider how far you would go, how much money you would be prepared to spend. That way, if the unthinkable happens, you’ve already got a plan.

B: Are you getting more questions from your clients—do they have more interest in being heard and having their thoughts considered than they did, say, 20 years ago?

NT: With the advent of the Internet and ready access to Google, there was a time when pretty much every dog owner came into an appointment carrying a hefty wad of printed pages telling me what I should already know. Over the last five years, I’ve seen a decline in this physical show of information. It feels like there has been a transition from wanting to catch out the vet to wanting to enhance what can be done together for the animal. Personally, I much prefer it when an owner comes in having done their homework. Decision-making can be tough, and the options are seemingly endless. Anything a dog owner can do to be better prepared to discuss their animal’s health is fine by me.

B: What made you decide to write, first memoirs and then fiction?

NT: Few professions provide better material for a wannabe writer than veterinary medicine. Think about it: my working days are filled with mysteries, drama, conflict and extreme emotional highs and lows. Most veterinarians accumulate a wealth of heartwarming and heart-wrenching stories during their careers, but no one ever has, or ever will, capture the essence of my vocation better than James Herriot. However, we’ve come a long way from England’s Yorkshire Dales of the 1930s. Companion animals are now essential and central members of the American family.

In the spirit of “write what you know,” I have tried to capture the joy, emotional impact and enduring legacy of sharing our lives with animals. My “voice,” for better and for worse, is not the product of creative writing classes; my formal education in English ended when I was 16. I’m lucky to have a job that necessitates strong powers of observation and people skills, a job that strives to restore and maintain a deep relationship between a human and an animal. The switch to writing fiction was originally based on the chance to cherry-pick some of my more quirky and amusing cases and bend them in a direction I wanted them to go. Writing fiction is as liberating as it is difficult!

B: Are there more books on the horizon?

NT: I’m working on a totally new piece of fiction about a boy with a severe illness who discovers that the decline in his health comes with a unique and paradoxical gift—an ability to interpret the pure, unwavering and positive emotions of his dog. For fans of Dr. Cyrus Mills and Bedside Manor, I have a plot outline for a third book in the series.

B: If you weren’t a vet, what would you be?

NT: If I weren’t a veterinarian, I’d like to be a pediatrician. I see significant overlap between the professions, especially with infants, who, like dogs, cannot “tell me where it hurts.” I’m also drawn to human health issues because my daughter, Emily, has Cystic Fibrosis (CF), an incurable chronic lung disease that relentlessly threatens to steal her breath. Over the years, there have been times when I’ve wondered whether I should become a human doctor and help try to find a cure for CF, only to realize that such a radical career change would take me further away from what Emily needs the most—a father who is there for her.