Mary C. is feeling blue. In the hospital for a series of tests, she looks forward to a visitor, Casey. When he arrives, Mary's face lights up in anticipation of his warm greeting. But first he has to go through the required alcohol gel routine—one paw at a time.
Casey, a black Labrador retriever, is a Caring Canine and a participant in the pet therapy program at Beth Israel Deaconess Medical Center (BIDMC) in Boston. Championed by hospitalist Henry J. Feldman, ACP Member, the program is in its third year.
“It's long been known that having animals around is stress-relieving. We're genetically programmed for cute, fuzzy things to make us happy,” said Dr. Feldman. “And who is most stressed and unhappy? Hospitalized patients—because hospitalization is a dehumanizing experience.”
Establishing the pet therapy program at BIDMC was a team effort. “Hospitalists are team players. We were the glue connecting various organizations and disciplines,” said Dr. Feldman. “The program runs automatically now, with the social work department—the program's primary sponsor—organizing the weekly schedule.”
Once a week, nurses on the medical floor ask patients if they'd like a visit from a dog. A doggie magnet is placed near the doorway of rooms to be visited. The hospital's social work staff coordinates with Caring Canines, a volunteer organization whose mission is to bring dogs into health care settings.
Dogs of all breeds and sizes, selected for their temperament and excellent health, come to the hospital with their owners. One dog at a time (up to three per day) visits each patient for about 10 minutes. Unlike cats, who can be aloof, “dogs are social animals,” said Dr. Feldman. “Pleasing people is their role in life.”
Dr. Feldman's own metamorphosis from computer systems programmer to hospitalist to champion of pet therapy is a bit of a shaggy dog story. It all started in 1983, in Cancún, Mexico, where Dr. Feldman suffered a dislocated shoulder in a body surfing accident as a vacationing college senior.
“Luckily, a guy on the beach was an orthopedic surgeon,” Dr. Feldman said. “He put my shoulder back into its socket, and suggested non-weight-bearing activity until I could get further treatment back home.”
The activity recommended by the surgeon was SCUBA diving, and Dr. Feldman ended up pursuing advanced training in the sport while he finished school and began a career in computer sciences. He eventually became a rescue diver and divemaster. Dr. Feldman also earned certification as an emergency medical technician (EMT) to supplement his SCUBA skills.
In 1993, Dr. Feldman married Lori, a veterinary surgeon. When busy schedules kept them apart, Dr. Feldman drew on his EMT training to assist his wife on weekends as a veterinary technician. Finding that “medical stuff is pretty cool,” at age 30 he applied to medical school at New York University (NYU).
His by then 10-year career in the computer industry was put aside, until he was a practicing physician at NYU. He balanced medical informatics research and clinical practice by becoming a hospitalist. Dr. Feldman now serves BIDMC as chief information architect for the division of clinical informatics.
It was at NYU that Dr. Feldman was exposed to an experimental pet therapy program. He brought the idea to the social work department at BIDMC when he moved to Boston in 2006.
Initially, the biggest concern regarding pets in a hospital was infection. Dr. Feldman worked with infection control physicians to research the literature, and they found that the risk of infection was small. “I'm just as much a risk to patients as a dog is,” said Dr. Feldman.
Rigid policies were established for visits, including patient eligibility standards and procedures for having dogs and handlers use alcohol gel between patients. Data collected since the program's inception have shown no increase in patient infections.
Participating patients report how much they enjoy being with the dogs, Dr. Feldman said. “Any time we can make an inpatient experience less stressful, it has to be a good thing.”
As an example, Dr. Feldman tells the story of a young woman admitted to the hospital for tests. Diagnosed with advanced-stage pancreatic cancer and told she was dying, she became depressed. She talked about her family and how she might never see her dogs again.
A visit from a Caring Canine brought her to tears. Initially skeptical, her physician was so moved when he witnessed a visit that he wrote to the hospital's medical committee explaining how the experience changed his mind about pet therapy.
“There'd been so much discussion about hospice, palliative care, tests, and none about her as a person,” said Dr. Feldman. “She said that when the dogs were there she felt like a person again.”