Nick Trout: Animal Medicine from a Vet's-Eye View

DATE March 20, 2008 ACCOUNT NUMBER N/A
TIME 12:00 Noon-1:00 PM AUDIENCE N/A
NETWORK NPR
PROGRAM Fresh Air

Interview: Veterinarian Dr. Nick Trout, author of "Tell Me Where
It Hurts," on being an animal surgeon
TERRY GROSS, host:

This is FRESH AIR. I'm Terry Gross.

Animal surgeon Nick Trout has noticed that many pet owners feel more like pet
parents. The people who bring their animals to him want him to know how much
they love their pets. He loves animals, although the cats and dogs he treats
might not return the sentiment during his examinations. We're going to talk
about some of his more unusual cases and how the whole field of veterinary
medicine has changed in the past few decades with interventions that were once
reserved for people.

Dr. Trout is a staff surgeon at the Angel Animal Medical Center in Boston,
which is part of the Massachusetts Society for the Prevention of Cruelty to
Animals. He's also the author of the memoir "Tell Me Where It Hurts."

Dr. Trout, welcome to FRESH AIR. Now, the name of your book is "Tell Me
Where It Hurts," and of course that's a great title because you can't ask your
patients to tell you anything. I mean, you can ask them but they can't speak.
Of course, you can talk to the people who live with the animals, but how else
do you compensate in trying to diagnose, you know, a cat or a dog?

Dr. NICK TROUT: Well, I think one of the appeals of veterinary medicine is
it's a very hands-on experience. We are obviously going to, for want of a
better word, interrogate the pet parent in an attempt to try to get the
information, the subtle changes, the nuances that really they see far better
than us in their daily lives, the things that have triggered them to want to
make a veterinary visit. And then I think we move on to an experience in
which we are trying to hunt for clinical signs. Unlike our human
counterparts, the MDs, we don't get the gift of that unambiguous
communication, the opportunity to describe a little twitch or a pain or a very
subtle problem. And so I think we have to be more interactive with our
animal, and sometimes that's an easy thing to do, and then certain patients
will make that a little bit more challenging. We don't have that luxury, of
the `open wide and just say ah,' the `deep breaths only, please.'

GROSS: So what are some of the things you do to diagnose a pet to compensate
for the fact that you can't talk with the animal?

Dr. TROUT: Well, I think--there are obviously instances in which the problem
are so blatantly obvious it sort of hits us upside the head. But if not, then
we're going to move on to, you know, potentially X-rays, radiographs, CTs,
MRIs, blood work, urinalysis, just a whole--ultrasound--a whole wealth of new
technologies that we as people take for granted and that have now permeated
veterinary medicine, to become sort of the normal standard of health care for
our animals.

GROSS: I want you to tell us about one of your more challenging cases, and
this is a case--I would describe this dog as almost a hermaphrodite.

Dr. TROUT: Yeah, yeah.

GROSS: It's a male dog that had become feminized. It had--why don't you
describe what it had.

Dr. TROUT: So we had--this wasn't an easy story to convey and get across,
but I try my best to basically describe a boxer dog who, on the outside,
appeared to be male. This dog only had one descended testicle, and the
remaining testicle inside had succumbed to a tumor, a tumor that was secreting
feminine hormones. And those feminine hormones were making this male dog
become somewhat female in nature. This dog would stand to be mounted by other
dogs, had somewhat pendulous breasts, and it had this real sort of hormonal
turmoil going on inside of him.

The other problem was, unbeknownst to both me and the owner, that he had a
remnant of an embryonic uterus that should've disappeared during his
development as a puppy and yet had persisted, and so this increase in female
hormones had sort of turned on a female reproductive organ within his body;
and as a result, he had developed what's called a pyometra, which is not an
uncommon infection of this male dog's uterus. And so this gave me this very
unique once-in-a-lifetime opportunity to end up actually neutering and spaying
one and the same dog.

GROSS: That's just really bizarre.

Dr. TROUT: It was quite bizarre, and, you know, occasionally these cases do
get reported in the veterinary literature. What is more entertaining is how
you explain this to a somewhat chauvinistic owner.

GROSS: And how did you?

Dr. TROUT: Well, I like to think that the feminine side of his male dog
brought out the feminine side in him.

GROSS: How so?

Dr. TROUT: Well, because, you know, he did find it difficult. He was just
insistent that this was a male dog and that this couldn't be happening, this
hormonally-induced ability to be attractive to the other male dog in the dog
park. And so what I ensured the end of the day was that he should understand
that the male side of this dog actually shines through and was the dominant
party, and he seemed to be comfortable with that.

GROSS: You know, one of those supermarket tabloids seems to specialize in
bizarre animal stories. I wouldn't have been surprised if they picked up on
this one. But, you know, they just have a lot of stories about, like, the
biggest cat in the world or half-cat, half-dog.

Dr. TROUT: Right. Right.

GROSS: You know, and they kind of combine the photos together so it's half
cat and half dog.

Dr. TROUT: Yes.

GROSS: Do you ever run into that, where a tabloid picks up on one of the more
unusual medical stories?

Dr. TROUT: You've got me worried now. I'm wondering if I'm going to be
inundated with phone calls, but I mean, I think the closest I've come to it
was the very real story of a 40-pound cat that, you know, I remember someone
showing me a picture of this animal that had come in, and just being both
shocked and appalled by its size. And it led me into an opportunity really to
discuss this epidemic that animals face in a society today, which is--not only
for us, but also for our pets, you know--obesity and overweight.

GROSS: What did this 40-pound cat look like? That's a lot.

Dr. TROUT: I mean, just like carrying a bean bag that you would sit in. I
mean, this is just a ridiculous amount of fur and flesh, and almost to a point
of hardly being able to see where the limbs and head were. I mean, it was--I
mean, a 40-pound bag of potatoes or whatever is a significant weight to be
carrying, let alone to be carrying around with you when your little skeleton
is so small and relatively fragile to that body mass.

GROSS: What kind of advice do you typically give to a person about their
overweight pet and how to get their pet to lose weight?

Dr. TROUT: Well, I think the first thing is an acceptance that there is a
weight problem, you know. I think some owners are shocked and appalled when I
say, `I think your pet could stand to lose some pounds.' And I always
encourage owners to put a piece of paper on the refrigerator with a magnet to
write down the date to actually put down the accurate body weight, and to
first of all to do their best efforts of not giving the treats and see if that
makes a difference. And if it does and they actually see objectively on a
week-by-week basis that the weight is falling off, then fabulous. And if not,
then I think they need to maybe seek nutritional or veterinary advice, but
also should be an increase in activity, an increase in exercise.

GROSS: Well, what are the medical problems involved with being overweight,
you know, with cats and dogs? I mean, your concern isn't that they look too
fat. You're concerned medically.

Dr. TROUT: Right. No. Yes.

GROSS: So what's the problem?

Dr. TROUT: Well, I mean, me personally, you know, doing surgery, the biggest
thing I see is significant risk of arthritis and worsening of arthritis.
There was a study some years ago that showed something like an 11 to 18
percent weight loss of overweight pets could produce a statistically
significant improvement in lameness. And to actually achieve statistical
significance is a big deal. And so I've had many cases over the years, dogs
that are overweight, the owner comes in, we talk about a more conservative
approach to their dog's hip problem, say, a problem that they originally came
in for an expensive hip replacement surgery. We get the weight off over a
couple of months, and I get phone calls saying, `I don't need to do that hip
replacement surgery. My dog is doing great. I'm very pleased. Losing that
weight made all the difference.' And so that's one way in which I feel the big
impact of improving animals' body weight.

GROSS: So carrying around all that extra weight affects the hips and the
legs?

Dr. TROUT: Well, it's just, you know, it's intuitive. You know, the more we
load these joints, the more these joints are going to have to adapt. And
sadly, for the most part, that means that building arthritic bone and trying
to reduce range of motion and, you know, we see it in these animals. You
know, the more you carry, the less you exercise, the less you move your joints
around and lubricate those joints, and it's like this vortex that we're sort
of spiraling down and into.

GROSS: You must see that a lot, where people are just like so close...

Dr. TROUT: Absolutely.

GROSS: ...to their animal and are therefore so unsure about what to do
because they don't want the animal to die, you know. In a situation like
this, do you do the surgery, do you not do the surgery, will it work, will the
animal die? What are some of the like kinds of really emotional conversations
you end up getting into with pet owners when their animals are in jeopardy?

Dr. TROUT: Yeah, I mean, it really varies dependent on the nature of the
problem; but I think, the first thing I try to do is to sort of step back from
being sucked into the emotion of the relationship because my first
responsibility is to try to tell the owner what the problem is and what
options we have to deal with it. I'm just trying to give them their
information because there's obviously so much from their side of the
examination table that I don't know, you know: the depth of this
relationship, the importance of the animal in their life, their previous
experiences with loss, their own health issues, their thoughts on natural
death vs. euthanasia. And, you know, last but not least, their ability to
pay for whatever care would be required. And so I think, first of all, I try
to say, `This is what's there for us. These are the potential medical
scenarios that we might have.'

And then, invariably, in these difficult situations, so many times people will
say to me, `So what would you do if this were your animal?' And then I have
that sort of chance to be more subjective, to try to put my spin on it, you
know, to sort of dig up from my personal experiences with animals and my own
sort of bias on what I think is right to put an animal through and what we may
expect on the other end.

I think one of the things I, you know, we need to convey is the fact that,
whatever we're putting our animal through with some of these difficult
decisions and these potentially life-threatening problems, that animal really
doesn't have an ability to appreciate that, `I'm going to have to go through
something negative because I have that notion of extended life. I have an
understanding that this is all for the good for me because there's that other
end of the equation at which life will be improved for me.' You know, they're
living in the here and now, and so that responsibility of what decision we
make very much falls with us as pet owners. And I think we need to look at
that carefully and say, `Whatever we put our animal through, are we going to
get--is it reasonable, what we're going to ask?' And also, on the other end of
this, `Are we going to see enough upside and benefits to see it worthwhile?'

GROSS: This must be one of the more frustrating parts of being a vet. You
know, again, you can't talk to the animal and you can't explain to the animal
that this is going to help the animal in the long run.

Dr. TROUT: Right. But I think there is that wonderful silent communication,
you know, when we are working with these animals, this sense of their
understanding that we are doing and trying to do the right thing by them, if
only in the fact that so many of them sort of accept it. They appreciate what
we're doing, and it's so easy to convey in the silence between us that we mean
well and we want to do right by them.

GROSS: I'll tell you, not my cat. My cat is so terrified of going to the
doctor; and when we put her in the carrier and then take her into the doctor's
office, she starts howling like a wolf. It sounds like the beginning of a
vampire movie. It is so pathetic to hear her. And then one doctor actually
refused to treat her because she'd just gotten so wild. It's like she was
possessed. One doctor put her in like a little pussycat straitjacket...

Dr. TROUT: Right, right.

GROSS: ...so he could kind of get to her without being, you know, fought by
her.

Dr. TROUT: Sure.

GROSS: I think she doesn't feel that special, calming presence that you're
describing.

Dr. TROUT: Well, I think, at least from our side of the table, we're trying
to convey that. Whether it's reciprocated or not is another matter.

GROSS: Well, what do you do in a situation like that, when you're facing a
cat that's just terrified?

Dr. TROUT: Well, yeah, I mean, it happens; and I think, if you can achieve
what you're trying to do in order to, you know, find out what's wrong with
that animal and you can do it somehow around physical restraint, then that's
what we'll do. But there are instances where you just have to say `I'm going
to cause your animal far more distress battling away here than if we could
just give a little chemical restraint and be able to get to the problem more
quickly and without distressing the animal in the process.'

GROSS: Yeah. I think some sedation wouldn't have been a bad idea in this
instance.

Dr. TROUT: Well, it probably makes you feel better, as well, that, you know,
at least they're relaxing into the experience. Because, I mean, it does
become silly after awhile because they're very talented with their teeth and
claws and, you know, for a good reason; that little fight and flight mechanism
from way back in evolution still happy to kick in.

GROSS: Yeah. Veterinary medicine has changed so much in the past few years.
I remember the first time I heard that a pet was going to get chemo for
cancer, and I thought, `Wow, that sounds so extreme.' And now it's just kind
of standard, I think.

Dr. TROUT: Right.

GROSS: For a lot of animals, if you get cancer, you get the treatment. And,
you know, animals get MRIs now and, therefore, veterinary expenses have just
skyrocketed. And it's very difficult for pet owners to keep up with those
expenses, and they sometimes have to make very difficult decisions about how
much they're capable of spending to keep their animal alive.

Dr. TROUT: True.

GROSS: What are some of the interventions that you use now that would've been
unheard of 10 or 20 years ago?

Dr. TROUT: Well, as you rightly point out, I mean, MRI is sort of the
standard of care now for all these dogs that come in with potential brain
problems, spinal problems, CAT scans, ultrasound, bone scans and, you know,
chemotherapy, radiation therapy. We will do, you know, hip replacements,
arthroscopy, endoscopy, thoracoscopy, brain surgery, spinal surgery. They're,
you know, if you're doing it on a person, you're pretty much doing it for an
animal, or at least you have the opportunity to. Renal transplants, open
heart surgery--all of these things are becoming increasingly the norm when it
comes to our pets because--I think it just comes down to the fact that not
only are these options available to us, but also, you know, the shift of the
importance of the animal in our lives, you know. Pets are family. `This is
my child' is the standard comment I get from the vast majority of my clients.
`And if this is my child, then I want the kind of care that I would expect
from my child.' And sadly, in the new millennium of veterinary care, we are
becoming not limited by medical advances or surgical advances, but really the
ability to pay for those.

GROSS: One thing that you're really opposed to is cosmetic surgery for
animals, unless it's medically required. What are some of the typical
cosmetic surgeries being done now that you think should not be done?

Dr. TROUT: Well, I like to think this goes back to my British sensibilities
as a member of the Royal College of Veterinary Surgeons and, you know, being
educated in England. The Royal College does not approve of any kind of
cosmetic surgery like ear cropping or tail docking, and so the UK is full of
floppy-eared Dobermans and Great Danes and Rottweilers with long, sweeping
tails. And so if the blame lies anywhere, it lies with my upbringing and
education; and also now that I work at Angel, which is part of the MSPCA, the
Massachusetts Society for Prevention of Cruelty to Animals, in which we
perform no tail docking or ear cropping or declawing of cats. And that's fine
by me. I think, you know, one of the things I mention are these things called
neuticals, these testicular implants that can be inserted into dogs at the
time of neutering and castration, and so...

GROSS: What's the purpose of that?

Dr. TROUT: The purpose, as far as--again, this is my personal opinion--is
entirely cosmetic. It is to give them an outline, an anatomical outline that
looks like nothing had happened, that they retain that outward appearance of
being male. It serves no medical or hormonal benefit. These are inert
inserts that just go into the vacated scrotum. They are purely cosmetic, and
I have a problem with that.

GROSS: Now that there are so many more interventions that you can use to deal
with pet problems, ranging from spinal issues to cancer, have the questions
changed and the ethics changed surrounding when to put a pet down, when to put
a pet to sleep?

Dr. TROUT: Yes. I think that, you know, one of the things that we fear is
that because we can take an animal longer into their life, because we have
these options, should we be doing this? Who are we doing it for? Are we
doing it for ourselves more than we are for the animal? And I think it is a
very difficult issue. From time to time, we'll see cases whereby an owner
just refuses to put an animal to sleep. And I know I've had situations in my
career where I've done surgeries, removing tumors only to find that they've
grown back two weeks later. At the time of suture removal, saying, you know,
`I just didn't achieve anything here, you know, what is the upside?' And I
think those are difficult issues; but, again, you know, veterinary medicine is
a service industry. We are working with animals but for people. And I have
to step back and somewhat respect their decisions, as long as, of course, the
overall welfare of the animal is not being jeopardized. And sometimes that is
a tough call.

GROSS: Can you give us another example of a tough call that you helped a
person make?

Dr. TROUT: Yeah, absolutely. I remember an old poodle coming in to see me
many years ago, something like a 15-year-old dog, which is, you know--I joke
about 15 being the new 11 in dog years, but I think, you know, 15 is a
fabulous age for a dog. I mean, if you got a dog to 15, that's a great life.
And this dog had malignant melanoma, which is, you know, should raise hackles
in the same way as that label does in you or I. You know, that's a serious
cancerous tumor with a pretty poor prognosis, despite treatment. And the
problem with this dog was it had an orthopedic problem, a knee injury. And at
the time, the dog was doing great on its chemotherapy. All the blood
parameters were great, the owner was thrilled with the way that the dog was
doing and sort of said to me, `Look, you know, my problem is my dog's knee.'
And despite me sort of lecturing her with all these sad and negative
statistics, she said, `I feel like I want to go ahead.' And, you know, the
bottom line is fortunately, as in people, age is not a disease. It's not
going to say, you know, `Your dog is 15, therefore we should stop at this
point.'

And I did the surgery; and to our mutual delight, the dog lived another two
years of wonderful, quality life, able to run around and not being limited by
a gimpy knee. And so it's like this slap upside the head saying, you know,
even when you least expect it, even when you think, you know, or question, `Am
I doing the right thing?' There will always be those cases out there to sort
of scream back at you, `Look, look, I made it. Why be so negative for another
animal in the future?' And so it does make some of these difficult cases tough
calls.

GROSS: In the human world, if somebody's sick and in a great deal of pain and
they want to end their life, that's not accepted right now. A lot of people
think it should be accepted, but it's not. In the animal world, it's always
been more accepted to put down an animal, whether it's a large animal or a
small one, if they're in a great deal of pain and there's no hope for that to
improve. Do you think the standard has changed at all with animals?

Dr. TROUT: No, I don't think so. I think that euthanasia is still a very
important part of what we do. You know, people have religious, spiritual,
moral issues with euthanasia; and that's, you know, that's obviously a very
personal decision on their part. And, you know, some of it comes down to the
fact that, for veterinarians, we still have that oath and there's still that
thought of, you know, first do no harm. And if that harm is actually putting
an animal to sleep, you know, are we going against that oath?

But I think--the way I look at it and what I mention in the book is the fact
that, you know, I think all of us aspire to that death in which we died
peacefully in our sleep and, you know, and that holds some appeal. And that,
you know, veterinarians have this responsibility, or at least this option, to
cause a loss of consciousness, to alleviate pain without the application of
pain, that we can bring to bear a dignified and graceful end to an animal's
life. But it is a very difficult and emotive issue.

GROSS: What do you tell people about what to expect if they're watching the
lethal injection?

Dr. TROUT: I think I've learned the hard way to very much prepare them
because a whole variety of things can happen. I've come to very much prefer a
catheter, a plastic tubing into a vein, so that we can deliver the injection
without the act of a needle when they witness the event. I've told them that
dogs may take a deep breath, a sort of final sigh. They may pant, they may
paddle. They may lose control of bodily functions. I do warn them that, for
the most part, dogs and cats leave this world with their eyes open; that sort
of Hollywood ending of laying on of hands and their closing their eyes
sometimes doesn't happen.

And I've learned, you know, make sure you tell them that this is, you know,
you're just flushing the catheter with a saline solution because you give them
the injection, they look at you surprised that their animal is still alive.
I've also warned them, it's very quick. It's very painless. Some people are
so surprised that it happens so gracefully and so quickly. You know, they
really expected something more. And, you know, there's some solace to be
taken in it actually being a sort of quiet and peaceful event.

GROSS: Do you usually recommend that the owner be in the room with their
animal in those final moments?

Dr. TROUT: Yes, absolutely. I give it to them as an option, and the vast
majority of people will take that. They want to be there. They want to share
that final exchange in the eyes between them and their animal as they slip
away. And it's such a tough moment; but when you, you know, if you put it
into the context of a horribly debilitating and life-threatening disease, how
many times have we seen loved ones slip away slowly and painfully and be, you
know, just a husk of their former self? You know? I talk in the book about
my recollections of my own first dog and how I felt a party to keeping an
animal alive too long, and in doing so, the guilt of that sort of weighed on
me and fill my memories more then all the good times for the vast majority of
the animal's life.

GROSS: If you're just joining us, my guest is Dr. Nick Trout. He's a
veterinarian who's written a new book, which is called "Tell Me Where It
Hurts," and he's a surgeon at the Angel Animal Medical Center near Boston.

On the dust jacket of your book, "Tell Me Where It Hurts," there's a photo of
you with your two dogs; and one of them is a big labrador, who's sitting next
to you, and he looks very large, and then there's a little--what is it?--a
Jack Russell sitting on your lap.

Dr. TROUT: Correct.

GROSS: And, you know, he's really small, particularly compared to the big
lab. Did you intentionally get a really large and a really small dog?

Dr. TROUT: That's my youngest daughter's doing. When Emily said she wanted
a dog, what am I going to do? We got the terrier initially--Sophie is 11
years old--and I, you know, incredible dogs, very smart dogs. You know, she's
got that sort of Red Bull running through her veins; and she actually now, 11
years old, has slowed down just slightly. And so I like to think that that
gives me an opportunity to empathize with the terrier owners. And then I, of
course, have the labrador, which is another pick by my daughter. And this
gives me the orally-fixated, happy-go-lucky retriever and gives me a chance to
empathize with the retriever owners. We've, for many years, had cats; but my
daughter is allergic to cats and so, sadly, we don't have any cats in our life
right now, but I'm sure that will change.

GROSS: What do you miss most about not having cats in your life?

Dr. TROUT: Oh, it's that independent quality for me. It's that, you know,
`You live by my standards. I'm going to do what I want to. I'll let you in
when I want you to come into my life.' We've had some fabulous cats. One
particular cat called Reginald was just such a character, and did live with
these two dogs and completely dominated them. He was the boss. And, you
know, I really, I miss that aspect of having a feline in my life.

GROSS: What about in your house now? Who's the dominant dog? Is it the big
lab or the little Jack Russell? Yeah?

Dr. TROUT: Oh, the Jack Russell. Oh, yeah, the terrier's completely in
control. She just rules the roost, and the goofy labrador seems quite content
to live on her terms. So, yeah, it's a nice mix, actually. I was very
surprised that it worked out as well as it did.

GROSS: Let me read something you write in your acknowledgements at the end of
your book. You write about your wife, "Like so many mothers of children with
chronic disease, she has quietly sacrificed her life for the greater good of
our family." What is the disease that your daughter has?

Dr. TROUT: My daughter has cystic fibrosis, which is the number one genetic
killer of children and young people in this country. And she was diagnosed at
about two and a half years of age, and, you know, there was no way not to pay
homage to my wife in this acknowledgement because, you know, she has
sacrificed a lot for our daughter's care. And, you know, it's funny. When
you first get this diagnosis, I'm sure as with so many parents of children
with chronic disease, there's all the anger and frustration. And I think at
that time, I did question, you know, `I'm here treating pets, yet this child
with my own, you know, sharing some of my genes and DNA is so sick. Should I
be reconsidering what I'm doing? Should I be thinking about becoming a human
doctor? A research scientist trying to find a cure?' And all that anger sort
of builds up in you.

And then, you know, as the time goes by, you start to realize that you are so
blessed and so lucky to have this child in your life, and she's such a great
kid. And you start to accept your situation and the good fortune you have,
despite what she goes through. And I think some of that has been beneficial
to me in my dealings with pet parents, because I see in them the same kind of
fear and concern when they're faced with a similar crisis for someone who is a
child to them, whom they love just as much as I do my daughter.

GROSS: It must be hard for you to be a doctor who can cure so many animals'
problems, but your daughter has a condition that can't be cured.

Dr. TROUT: Yeah, but I'm an optimist. The glass is always half full for me,
and I hope that is reflected in the way I practice veterinary medicine. And,
you know, again, cystic fibrosis is a disease that is on the cutting edge of
medical technology, and people want to cure this disease. They're working
very hard with gene therapy; and to me, it is on the cusp. And there are so
many other diseases out there that are so far away from a cure, and, you know,
I just am again so fortunate that I have a daughter with a problem that is
sort of in the medical limelight and is being addressed.

And so I have to believe that a cure is around the corner, and I just have to
hang in there. She has to hang in there, and I'll do everything in my power
to make that happen. So I, yeah, I'm a very fortunate person.

GROSS: Is she the daughter that chose the two dogs?

Dr. TROUT: Yes, of course. I mean, again, she--to be honest, with regard to
Meg, the labrador, she and I were in the critical care unit at Boston's
Children's Hospital. It was about 2:00 in the morning, and she said to
me--and she must've been about eight or nine at the time--and she said to me,
`Daddy, are you going to get me that yellow labrador I want?' What are you
going to say? She's got you completely cornered. So I said yes. She was
quick to remind me when she came out of hospital, and so it happened.

GROSS: Now, let me ask you, you know, you mentioned that you know that some
of the pet owners who bring their pets to you love their animals as much as a
parent loves a child. That will sound offensive to some people. Some people
think that, you know, animals can't possibly have the weight or be worthy of
the same depth of feeling that a child can be.

Dr. TROUT: I would have to disagree. You know, obviously everybody's
welcome to their own opinion; but, I mean, I've seen it with my own eyes, you
know. There can be no question in my mind that the depth of love and
affection for the animals in some peoples' lives, it is no less than I've seen
with people with children. You know, I talk in the book about--one section,
in which I refer to the chapter as "Dangerous Liaisons" because some people,
you know, just get so invested in their animals. I mean, one gentleman who
legally changed his middle name to that of his dog because he just felt that,
at the end of his life, he wanted his dog to be buried with him, the dog's
ashes to be buried with him, and that for people to look at his tombstone and
say, you know, `That's how much that dog meant to me.' I mean, that's intense.
That's so deeply rooted.

And you know, a woman who's so obsessed with the dog in her life she'll
happily endure injections on a twice-weekly basis and live with an inhaler
because she's horribly allergic to the animal, but it still sleeps in the same
bed, shares a pillow. I mean, this is deeply rooted.

And I think the other thing to take away is the fact that when these animals
that we bring into our lives, we consider them to be our children, you know,
the natural order of things is such that we should not bury the children in
our lives, you know, they should outlive us. And yet we embrace them with all
that love and commitment, full well knowing that probably in our lifetime
we're going to have to let them go and live without them again. And that's
what's so hard, you know, that you love a creature so much and yet you're sort
of living with this anticipatory grief.

One of my friends just got a new Shih Tzu puppy, and, you know, she is so in
love with this animal. She's saying to me already, `I don't know how I'm
going to cope with losing this animal.' I mean, something 15, 16, 17 years in
the future, and yet there's already that sort of niggling fear that this is
going to have to come to an end.

GROSS: Well, Dr. Nick Trout, thank you so much for talking with us.

Dr. TROUT: Well, thank you for having me.

GROSS: Nick Trout is a veterinary surgeon at the Angel Animal Medical Center
in Boston. It's part of the Massachusetts Society for the Prevention of
Cruelty to Animals.

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *

Review: Rock critic Ken Tucker on Adam Green's "Sixes and Sevens"
TERRY GROSS, host:

One of the high points of the movie "Juno" is a duet sung by its stars, Ellen
Page and Michael Cera. That song, "Anyone Else But You," was written by Adam
Green and Kimya Dawson, co-founders of the New York folk music group The Moldy
Peaches. Adam Green has recorded a number of solo albums, and his new one is
called "Sixes and Sevens." Rock critic Ken Tucker has a review.

(Soundbite of "Homelife")

Mr. ADAM GREEN: (Singing) Home life is so innerving
I'd like to be lost in a crowd
My home life is disconcerting
I've got to keep my money down

Home life, home life
Anyways, there'll soon be little kids
Just like my old life

(End of soundbite)

Mr. KEN TUCKER: The 26-year-old singer/songwriter Adam Green sings in a
pleasantly deep voice. What he sings about over the course of "Sixes and
Sevens"' 20 songs is open to a lot of interpretation. That warm voice and his
often-lovely melodies are frequently at odds with lyrics filled with surreal
or disjointed or intentionally banal images. Take this excellently odd tune
about seduction and its aftermath set to a Memphis soul rhythm.

(Soundbite of "Twee Twee Dee")

Mr. GREEN: (Singing) This matching underwear
I'm going to take you there
To see my body, twee dee dee
No one ever gets a break,
I'm not about to make
You enjoy them, twee dee dee

I want you to hear my voice
I want you to make me laugh
All the lipstick on the world...

(End of soundbite)

Mr. TUCKER: That song is called "Twee Twee Dee," and indeed it is a bit
twee--that is, both pretty and precious, cleverly knowing without being
completely willing to let you in on what he's being clever about.

For an extreme example of this, listen to this song, which Green has referred
to as an anti-folk take on the blues.

(Soundbite of music)

Mr. GREEN: (Singing) And this is how we go to school
And know how to butter your bread
Travel to 80 miles high
And get shot down like a duck
And show me how to dig my hole
Show me how to get down slow
Butter your roll just like Nat King Cole

Unidentified Man: Yeah, stick it to 'em!

(End of soundbite)

Mr. TUCKER: Elsewhere, this arty, poker-faced experimentalist--and I intend
all those descriptions as compliments--comes close to the folk music with
which we're most familiar. You know, the '60s kind, with a little protest-y
message. That's one way to hear this song, called "Getting Led." Led, as in
being led by the nose, about being drawn into foreign engagements against
one's will. And, oh yes, it's sung from the point of view of America itself,
talking to us, justifying itself.

(Soundbite of "Getting Led")

Mr. GREEN: (Singing) I was a nation
Bound to my station
Getting led, getting led, getting led
You saw beyond me
Pounding down on me
Getting led, getting led, getting led

A man fills his quotient,
He changed his notions
Now you see a glimpse of liberty
But fame could be garish,
It ends his marriage
To all that you could want for him to be

We...

(End of soundbite)

Mr. TUCKER: The music Green makes with The Moldy Peaches has aligned with
the so-called anti-folk or indie-folk movements centered around New York City;
but more often on this solo album, Green breaks with The Moldy Peaches' folk
or anti-folk and works in other genres with great skill and fluidness. His
resonant voice is perfectly suited, for example, for the pop-soul music of
"Morning after Midnight," backed by a gospel chorus.

(Soundbite of "Morning after Midnight")

Mr. GREEN: (Singing) Maybe things won't be strange any day now
They change every day
Maybe things won't be bad all the time now
Stay bad all the time

But hey now, little lady,
This is a tragical sign
It's the sign

Mr. GREEN and Unidentified Singers:
Morning after midnight,
Things don't ever go right
Morning after midnight,
Hey, bye bye

Not so sad to wake up,
But I took the...(unintelligible)
Morning after midnight
What's going on? Yeah? Oh!

(End of soundbite)

Mr. TUCKER: Hepatitis, an easy pass, strangulation, Robin Hood and Stagger
Lee all make appearances over the course of this album, and Adam Green
fractures narratives without abandoning a consistent tone. He's a skeptical
romantic, a crooning doubter, a wise guy who knows that irony is no substitute
for well crafted sincerity, or at least a seductively urgent tone that tries
to pass itself off as sincerity.

GROSS: Ken Tucker is editor at large for Entertainment Weekly. He reviewed
"Sixes and Sevens" by Adam Green.

You can download podcasts of our show on our Web site, freshair.npr.org.

(Credits)

GROSS: I'm Terry Gross.
Transcripts are created on a rush deadline, and accuracy and availability may vary. This text may not be in its final form and may be updated or revised in the future. Please be aware that the authoritative record of Fresh Air interviews and reviews are the audio recordings of each segment.