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Nick Trout, author of Tell Me Where It Hurts (April 14-30)

Author Chat

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Edited: Apr 14, 2008, 3:48pm Top

Post your questions for Nick Trout about his new book, Tell Me Where It Hurts here, and he'll be by to answer them!

For inspiration, check out Nick's YouTube video

Apr 14, 2008, 3:23pm Top

Do you own the Boston Terrier that's on the cover? I think he's adorable and his expression matches perfect with the book's title.

Apr 14, 2008, 4:09pm Top

I'm Nick Trout and absolutely thrilled to have this opportunity to try and answer your questions about my book Tell Me Where It Hurts. I'll do my best to get back to you in a timely fashion but I apologize in advance if my day job occasionally cuts into online chat time. And if there are any exciting cases developing over the next two weeks I'll be sure to keep you in the loop.
Looking forward to some entertaining Q & A.
Best wishes,

Apr 14, 2008, 4:12pm Top

I wish I could tell you that I did. Those clever folks at Broadway ultimately chose this picture and I agree, his expression says it all. I also like the fact that his breed seems appropriate for a Boston based story.

Apr 14, 2008, 5:01pm Top

Thank you for being willing to do this. I am sure it will be great fun.

I have not read the book but will be looking to buy it next time I am in a brick/mortar bookstore. My question relates to an on going discussion we have been having in LTers with dogs (one of the LibraryThing groups) - It has been asserted that Vets do not get very much education on canine nutrition and that most, if not just about all, dog foods are deficient. What are your observations about this assertion?

Apr 14, 2008, 5:52pm Top

I'm looking forward to reading your book.

I have a question about Water for Elephants by fellow vet. Sara Gruen. Did you read it? If so, what did you think about the treatment of the circus animals? The not-quite vet. in the novel seems to do a good job with the care of the stock.

Apr 14, 2008, 5:59pm Top

Dr. Trout,
My fiancee is a vet student from Tufts-Cummings, who has just started her rotations (last week she was on a dental rotation at Angell). Do you have any advice you would give to her on how to survive rotations, and about finding her way as a new veterinarian? I will shortly be receiving a review copy of Tell Me Where It Hurts, and I will be sharing it with her. As an aside, would you sign it for us if I had her bring it in for her next rotation at Angell?

Apr 14, 2008, 8:03pm Top

I would say that vets do get a good education in nutrition, however, it was, in my opinion, a dry subject compared to the excitement of medicine and surgery, and consequently, we may not retain as much nutritional information as we might like. I am comfortable with the products available with all the major pet food companies. If a pet owner wants to provide a home made diet, that is fine by me too, however, I usually suggest a consult with our nutritional specialist to make sure the diet is appropriate. Having a nutritionalist on staff can make me seriously lazy when it comes to diet!

Apr 14, 2008, 8:11pm Top

I did read Water for Elephants, although it was a while ago. I can't really remember any specific examples of veterinary care but I was uncomfortable with the beatings the elephant was subjected too, although I imagine it was accurate for the period and guaranteed to ensure empathy by the reader.

Apr 14, 2008, 8:13pm Top

Ask questions, be proactive and get involved. Enjoy yourself and have a sense of humor.
Happy to sign the book for you!

Edited: Apr 15, 2008, 12:41am Top

Dr. Trout,

I wasn't one of the lucky few to get an Early Reader copy of your book (although I did pick it!), but I am eager to read it and will look for a copy.

I always wanted to be a veterinarian as a kid, but ended up going to nursing school instead, thinking that it took too long to go through vet school. As it was, it took me a while to finish my degree in nursing!

Anyway, I wonder if books had any effect on your decision to become a vet?

As a kid, my favorite book was Lad: A Dog by Albert Payson Terhune who wrote novels about collies. I remember crying buckets over anything bad that befell a dog.

As an adult, I read every book by James Herriott, who wrote nonfiction books about life as a country vet, and enjoyed each one immensely.

So, were there any animal stories that you read as a kid that left a lasting impression on you?

Apr 14, 2008, 11:39pm Top

I am lucky enough to be expecting an early reviewer copy of your book, and am really looking forward to reading it!

Apr 14, 2008, 11:43pm Top

Dr. Trout, thanks for answering our questions.

Was it a challenge as a writer to have an artificial time line imposed on your narrative. Was this your idea? How did it affect the way in which you told your story?

Also, I must commend you for being so patient with the swarms of crazy pet people who seem to cross your path. Being a dog parent myself (of a lazy little shih tzu) I know that we can be hard to take sometimes. I must say that no character in the story was more unpleasant that the daughter of Sage's dad (Dr. Hancock?). It must have taken a lot of tongue-biting to deal with her.

Good luck in your future endeavors!

Apr 15, 2008, 10:09am Top

As a kid I confess to being a 'bad' reader (i.e. lazy). My inspiration came from spending a fateful day with a general practice vet in England. The story is in the book. I think most of us would have found the allure irresistible after my experience.

Apr 15, 2008, 10:10am Top

Hopefully it will arrive soon!

Apr 15, 2008, 10:18am Top

It was my idea to squeeze all the action into a single day. I felt like it was a good way to keep the reader interested, gave me places to hang my stories and also provide a framework on which to discuss 21st century vet medicine. I liked the idea of giving certain stories away in increments and others as a succinct bullet. I liked the ability to mainain present tense and then switch back to past for an anecdote.
I have come across the Dr. Hancock's of this world on several occasions. Obviously I don't agree with their sentiment but I wanted to include her opinion to offer some balance. She raises some important points but she also gave me an opportunity to point out that in so many cases these animals are our children.

Apr 15, 2008, 11:05am Top

Dr. Trout, I'm waiting patiently for my copy of your book, so I'm not sure whether or not you address this in those pages, but I have to ask about your relationships with your patients: do you often get attached to them? I imagine it would be harder to remain completely professional about ones that you see more often for treatment.

Thanks so much for coming and chatting with us!

Apr 15, 2008, 11:37am Top

I think by definition there is an attachment to all our patients but if you are asking do I have to 'defend' myself and try to be objective, try not to get caught up, the answer is yes. Some cases can be easier than others. I don't think I would be much use to patient or pet parent if I was an emotional wreck, and sometimes that can be hard.

Edited: Apr 15, 2008, 12:45pm Top

--> 14

The story is in the book. I think most of us would have found the allure irresistible after my experience.

Can't wait to read it!

--> 16

in so many cases these animals are our children.

I often encounter hostility against expensive veterinary treatment for pets by people who don't understand this concept.

Apr 15, 2008, 1:45pm Top

One of the main incentives for writing the book was to try to convey the intensity of the human animal bond. I wanted the non-pet people 'to get it'. Or, if not, to respect it and at least appreciate that they are falling into the minority.

Apr 15, 2008, 4:56pm Top

A couple of months ago there was an article in some fluffy woman's magazine about women who go to their doctors fully armed with the latest internet searches about treatments and procedures, and sometimes the really pushy ones would go in with their minds already made up about what their doctor should do -- sometimes even leaving in search of another doctor if they didn't get exactly what they wanted. Do you run into cases like that with pet parents, too? Does it help you, though, when parents come to you having done a bit of research and coming to appointments a little more informed about what's going on than they normally would be?

(I have to admit, though, I'm a little selfish in asking this question, as my pup was just diagnosed with lymphoma, and I've been doing my own library book reading and internet research. I'm a little worried that my new specialist vet might see me as overstepping my bounds, somehow.)

Apr 15, 2008, 5:21pm Top

You are hitting another area of the book, the impact of the Internet on veterinary care and precisely these points are covered. No, you are not overstepping your bounds. Personally I like getting owners involved in the diagnostic and therapeutic decision making process.

Apr 16, 2008, 5:55pm Top

Hi Mr Trout!

I can't wait to get your book...I've been looking forward to it ever since I saw it in BookList. (I'm a librarian).

I am wondering, in your experience, do you find that pet owners worry too much about their pets, worry just enough, or don't worry enough? In general.

I have 2 dogs right now(shelties) and we have a very good communication relationship. We read each other pretty well, and I'm usually pretty aware if they are not right. We have a way to ask and answer questions that the dogs taught me (which I've found with all my previous pets to be the best way to find communication). I found that they, as puppies, would kiss me to answer me or get my attention. So, one kiss is "agree, yes, good" and two kisses is "disagree, no, bad" (this was achieved through much reinforcement). It's not random, they are quite 'vocal' about their wants, needs, and concerns. :) I tell the Vet what they have 'said' to me, basically...what they have helped me to understand about their situation, through all of our means of communication. I know this goes beyond the normal: "my dog is limping" or "my dog is not running as much as normal" kind of concerns. I'm actually able to tell the Vet much more detailed information. Is this welcomed? Or is it just something the Vet perceives as "worrying too much"?

Thanks so much!

Apr 16, 2008, 10:30pm Top

I loved your book! I received it yesterday and finished it this evening. I cried and laughed at the same time. I kept waiting to find out how Sage was doing.

It was also therapeutic reading. It helped me to confirm that my decision to put an 11 yr old Siamese cat down when she was diagnosed with a mass in her belly (malignant) was the right decision. I couldn't see putting her through surgery and treatment. The vet let me stay with her during the procedure and wrote a very kind note a few days later.

I, too, read all Herriott's books and loved them. I also have a copy of Dr. Loius Caputi's book "All My Patients are Under the Bed"....entertaining and laugh out loud funny.

Again, I absolutely loved your book.

Apr 17, 2008, 9:01am Top

I love this stuff. Anything a pet owner can do to help with the communication issue is fine by me.

Apr 17, 2008, 9:03am Top

Thank you so much for the kind words. I always hoped that the reader might find a particular story that they could relate to. I'm so glad you found yours.

Apr 17, 2008, 6:56pm Top

Dr. Trout,

We've recently been adopted by a wonderful stray. We suspect he was just dumped on the side of the road. The vet estimated him at 7 or 8 months and a Chocolate Lab/Chesapeake Retriever mix. He is a great dog and eager to please; we have worked on the basics of sit, down, lie down, quiet, and walking on a leash (we live in the boonies so he is usually free).

Do you have any recommendations (book titles/authors, internet) for training? We will have grandkids here this summer, and he easily outweighs them. A more immediate need is that he will chase our car if we both leave. He used to give up and go back to the house before we reached the road, but occasionally he has persisted and we have had to take him back to the house and tie him up. None of us are happy with that!

I'm in line at our local library for your book. I am glad to hear that so many people practically read it in one sitting!

Bert Klimas
Rice, WA

Apr 17, 2008, 9:28pm Top

Hello Dr. Trout, I just finished your book about 3 hours ago :-> I have two questions that I hope you can answer:

1) Can you update us on Sage's story. How many more years did Sage live? Did she recover fully?

2) In the acknowledgments you say about your wife, Kathy, "Like so many mothers of children with chronic disease, she has quietly sacrificed her life for the greater good of our family." Does one of you daughters suffer from a chronic disease? If this is too personal, it won't hurt my feelings if you don't answer :->

Apr 18, 2008, 7:57am Top

One of my many flaws, as you will read in the book, is my degree of specialization. I often get asked many practical veterinary questions and find myself floundering for an answer because my knowledge of general veterinary care is not as strong or as current as it should be. That said, I grew up with British dog trainer, now deceased, Barbara Woodhouse - worth checking out.
I love the fact that your dog chose to adopt you. Be careful about the car chasing - you will find the story of one Staffordshire Bull Terrier who took the game to a higher and distastrous level.

Apr 18, 2008, 8:21am Top

Yes, from the early follow up after her surgery, Sage was making a full recovery. As for the rest of her and Mr. Hartman's story, I wish I had more to tell, but once again, here is another example of the surgeon, the specialist, playing the part of 'the one night stand', forming intense but flitting relationships because hopefully pet and owner only have need of our skills for a brief period of time (and hopefully never have need of us at all).
Yes, my youngest daughter has Cystic Fibrosis, the number one genetic killer of children and young adults in this country. You will see in the dedication that I include "all those who battle Cystic Fibrosis" becuase I wanted to acknowledge the other children, parents and all the wonderful health care workers and researches who share this battle.
When I was fortunate enough to be interviewed by Terri Gross on Fresh Air I was pleased that she, like you, picked up on this paragraph in the back of the book.
You never mentioned whether you enjoyed the read.

Apr 18, 2008, 8:46am Top

I definitely enjoyed the read. I gave it 4 out of 5 stars. I laughed SO HARD when you gave the plastic surgery speech in England and the reporter from the Times ended up with the human balls in her hands!! PERFECT! I'm a Librarian and my library system received your book two weeks ago. We only bought 12 copies, but there are 2 people waiting in line to read your book right now. Good luck with promoting your book, and my thoughts are with you daughter - thanks for sharing. Suzanne

Apr 18, 2008, 10:30am Top

I'm so glad you enjoyed that particular piece of the book, it was so much fun to write.
Thanks for the kind words for Emily.

Edited: Apr 18, 2008, 5:51pm Top

Dr. Trout, thanks so much for being willling to speak with us here. I was deeply disappointed that I wasn't chosen to receive a copy of your book, but will of course be reading it anyway.

I was delighted to hear your interview with Terri Gross whilst on my daily commute to California Veterinary Specialists Angel Care Cancer Center where I am an RVT in the ERCC. I'll never be able to explain why I love to read these books after working 10 plus hour shifts in the veterinary field, but apparantly ten hours isn't enough.

My question to you is two-fold. First did you find that the book was fun and easy to write while still working your normal shifts? Do you know if Angell has any internship/residency opportunities for VTS?

I don't know if you will be doing a book tour, but if you find yourself in the San Diego area, I would love to invite you to see our Angel Care Cancer Center, although I have to apologize up front because am certain you will get more than a few book signing requests. Will you by any chance be promoting the book at all at CVC/ ACVIM/IVECCS or any others this year?

Ok, that's more than two questions, so I will attempt not to hog any more of your time. Thanks again,

Edited: Apr 18, 2008, 10:25pm Top

I heard Dr. Trout's interview on Fresh Air and that is what originally led me to his book. Thank you for being so available to all your readers and to those just interested in your story.

Isn't NPR wonderful (for those few moments when you aren't reading)?

Apr 19, 2008, 4:34pm Top

The book was definitely fun to write, some parts easier than others. Editing was more like work. I commute about an hour each way to and from work and like to use the time to think about what I want to write, scratching down notes when crawling in Boston traffic. I also like to write in strange places - while my wife is driving the car or sitting under an umbrella on a beach.
I do not believe that Angell has internship/residency programs for VTS.
No, sorry to say I will not be promoting the book at vet meetings.

Apr 19, 2008, 4:40pm Top

Happy to have this chance to interact with so many readers. This is a great forum!

Apr 19, 2008, 5:48pm Top

Hi, after seeing you refer to them I couldn't help but wonder if the late, great Barbara Woodhouse (SIT!) and televised series such as Herriot's All Creatures Great and Small had an influence on your choice of career? Unfortunately I haven't got a copy of your book yet as I'm in the UK and it's only just released (I'm a page-bending paperback junkie so I expect I have a while to wait), but I was interested to read in this forum that you are a specialist vet.

I'm currently dealing with a referal vet who specialises in oncology medicine as we recently had the devastating news that our beautiful spaniel has cancer. She has also just undergone a major op with a surgical specialist who I didn't get to meet but who was very kind on the phone. My question is how specialists cope with weepy people and bad news on a day-to-day basis? Does not having a 'mundane' relationship with pets and owners, giving boosters and general advice and generally seeing healthy, happy patients impact on your own stress levels? I am full of admiration but wonder if there is a 'burn-out' period for specialists?

Apr 20, 2008, 9:30am Top

Huge fan of the All Creatures Great and Small TV series (my parents live in Wensleydale and, as a teenager I was fortunate enough to meet Alf Wight). Definitely an influence on my career choice.

Sometimes specialists are more detached, their relationship with animal and owner so much briefer than with your general practice veterinarian, but this does not lessen the impact of helping pet and owner through a difficult disease. Sometimes, compared to what you are trying to cure, guidance, reassurance and empathy can feel like the easy stuff. By definition specialists seek out the 'tough' cases. The highs and lows are part of that package deal.

Apr 20, 2008, 5:30pm Top

I truly enjoyed your book, and had a hard time tearing myself away to feed myself, my husband, and our five cats. I've read a lot of memoirs, and your book is gripping, but still well-written and very nicely paced. I appreciated not only your reporter's eye for what you saw and heard, but also your inner dialogue, including the things you wanted to say, but couldn't.

I don't really have any questions for you, but if you're interested, there is a James Herriot biography, The Real James Herriot, written by his son, which seemed to round out the corners of his life quite nicely.

Thanks for writing your book - it was a pleasure to read!

Apr 21, 2008, 12:37am Top

I've just found my way to LibraryThing and am delighted to "see" you here. I'm looking forward to reading your book.

Angell feels something like "home" to me. A few years ago I wrote, "The Angell Memorial Animal Hospital Book of Wellness and Preventive Care for Dogs," spending hours each week there for about a year. I know about the excellent care and the dedication of the staff. I wish there were a hospital for people that lived up to Angell's standards of care and dedication to patients.

Do you find yourself bonding with patients and their people? I know it's not necessary in order to do your job well but I'm curious about how you view the relationship.

Thanks in advance.

Apr 21, 2008, 10:34am Top

Thank you for your kind words. I'm glad you appreciated the inner dialogue. I had a lot of fun with it. I will be sure to check out 'The Real James Herriot'.

Apr 21, 2008, 10:41am Top

Yes, I think bonding with patients and their parents is essential in a relationship where we all strive to get to the bottom of a health issue or resolve a disease. As I have mentioned earlier in this discussion (and also in the book), my relationships, if the case goes well, tend to be fleeting (although frequently intense). Another theme in the book is defending against being caught up in the relationship in order to do my best, most objective work. It can be a delicate balance.
Wonderful to hear that Angell has a special place in your heart.

Apr 23, 2008, 10:33am Top

Greetings, Dr. Trout and many thanks for a fabulous read. As a grad student (for the second time, groan) I try to keep a "fun" book at hand to offset the dry texts. Yours was just the ticket to get me through finals this semester. I'm planning on getting a copy for my own vet to let her know she's got a kindred spirit in Boston. All the best and PLEASE keep writing!

Edited: Apr 23, 2008, 12:43pm Top

Dear Dr. Trout,
Thank-you for your funny and insightful book. Clearly,
your profession has the three "C"s: challenge, change,and care.
Our beloved cat was diagnosed with Mast Cell cancer
last Summer and we chose to have her treated by an oncologist. For my sister and I, it was an intense, challenging intellectual and emotional three months. From the biopsy to her last moment by euthanasia(we were present), we do not regret a minute spent on her care. We desired only her quality of life. We loved her enough to let her go.
Your candid account of your day(s), answers the layperson's question,"Who was that person in the white lab coat?"

Apr 23, 2008, 3:15pm Top

Glad the book could be your antidote to studying blues! Thanks for the encouragement to keep writing - I'll certainly try.

Apr 23, 2008, 3:18pm Top

Thank you for sharing your story. You and your sister are precisely the kind of reader I hoped to reach.

Apr 23, 2008, 5:50pm Top

I apologize for a rather mundane question but I am dog sitting and an elderly lab has a constantly running nose. The owners said to just keep cleaning him up with tissues which i have been doing.

Now my question - Could I catch some sort of cold or respiratory illness from this dog and his runny nose? I seldom catch any thing any more but I did catch a doosie of a cold with very clogged sinuses and then it settled into my chest with major coughing.

Can I blame it on the dog?

Really I am not going to do anything about that, I am just very curious.

Apr 24, 2008, 8:39am Top

If memory serves me right, and it has been a long time with the general practice questions, no, you cannot blame the dog for your cold.

Apr 24, 2008, 8:42am Top

Just letting everyone know I will be going to Jacksonville FL today and I will there until Saturday attending the 'Much Ado About Books' conference. I'll do my best to check in whenever I get a chance.

Apr 24, 2008, 9:41am Top

Thank you, doctor. Ben's owner also discouraged me from blaming Ben. She said the mucus I've been cleaning off his nose is probably due to an infection from something irritating in his nasal passage. Darn. It was so much fun blaming the dog for my cold. But I will cease.

Apr 29, 2008, 10:57am Top

Hi Everyone,
It's been a quiet couple of days on Author Chat - I hope my book has not stunned everybody into silence in a bad way!
Tomorrow is my last day in the hot seat (and then I will be off again, disappearing to Charleston SC).

Apr 29, 2008, 6:19pm Top

Dear Dr. Trout,
I have already posted a comment but I have a question today. In my experience, like MD's, not all vets are equipped with an appropriate "bedside manner". How are the issues of the client/patient/vet relationship being addressed in veterinary colleges? With specific course training i.e. general psychology and/or "real world" role playing? Also, you might be interested in the book, Dog Years, by Mark Doty(a poet). It's a beautiful example of the animal/human bond and the power of pet therapy to ease the dying and support the living. Thank-you.

Apr 30, 2008, 9:58am Top

When I was researching my book I did discover several articles regarding role playing in British veterinary schools, creating scenarios that address the need for patience, calm and empathy during communication with owners. I think it is a great idea. Sorry I missed out when I was at school. I don't know, but I imagine similar training exists in the US. When 80% of all complaints filed against veterinarians come down to communication problems, the profession should be finally getting the message that a decent bedside manner can count for an awful lot.
Thanks for the book recommendation - I will check it out.

Apr 30, 2008, 10:01am Top

As I head out the door for Charlston, SC, I am going to finish up here and take the opportunity to thank all of you who participated in this author chat, and for the opportunity to engage Library Thing readers in such interesting and diverse subject matter.
Hope I get the chance to do it again some time, perhaps with book #2!
Best wishes,

Nick Trout

Apr 30, 2008, 8:20pm Top

Thanks very much, Dr. Trout. It was fun reading this thread. I hope to read your book soon.

Jun 20, 2008, 2:45pm Top

I wanted to resurrect this thread long enough to tell folks that a story from Dr. Trout's book is included in this month's Readers Digest.

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