Episode 8 – How We Care for Our Most Critical Patients with Dr. Pierre Charlebois

Our Richmond hospital offers Critical Care to some of our sickest patients. But do you know what the difference is between a Critical Care doctor and an Emergency Veterinarian? Dr. Pierre Charlebois, a board-certified Criticalist for PVESC in Richmond explains how the two are different and the specific care a Criticalist can offer patients who come through Partner’s doors.

What You’ll Learn?

Why he left Canada and came to work for Partner
What the difference is between a veterinary Criticalist and an Emergency Care Veterinarian
Who were his most memorable patients and why
What impact he wants to leave on the veterinary profession

But first, here’s a quick Q&A about Dr. Charlebois…

What was your first job? My first ever job was at a movie theater in a small town as a teenager (free movies!). My first real DVM job was working overnight shifts at a veterinary ER, where I worked for 4 years. 

What makes you laugh the most? Classic comedy movies from the 1990s and early 2000s, with actors like Adam Sandler, Vince Vaughn, Will Ferrell, etc. 

What’s one thing that can instantly make your day better? Waking up without an alarm to the morning sun on a cool, sunny, crisp fall or spring day! 

What’s your spirit animal and why? Felines are a perfect combination of intelligence, agility, cunning, ninja skills, and a good portion of goofiness. They are proud and clean animals and just social enough for my personality. 

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Narrator:

Welcome back to “Did You Know,” a podcast by Partner Veterinary. In this series, we explore all things veterinary medicine and all things Partner. In each episode, we answer some of the most common questions we are asked—from HR to emergencies and everything in between. If it happens at Partner, we’ll cover it. Dr. Pierre Charbo, a board-certified critical care specialist in our Richmond location, joins the podcast today to talk about the role of a criticalist, how it differs from an Emergency Care Veterinarian, and what having a criticalist at Partner means for the treatment of our patients.

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Dr. Charlebois:

“My name is Dr. Pierre Charlebois. I’m a veterinary criticalist that works at Partner Emergency and Specialty. Starting with Partner was fairly recent. The owners of the hospital—we’ve known them for many, many years, and through a very long, convoluted chain of people knowing people, we know them. We wanted to come to the area, and we knew Katie for a long time. My wife had worked in one of the hospitals that she was managing, and we knew that she takes care of everybody that works under her. We know that emergency medicine is, in some ways, a struggling field in terms of stress and quality of life, and there are a lot of obstacles associated with a 24-hour service. I know that’s something that I was hoping for—she did such a great job at her previous positions that I really wanted that to translate to this particular hospital. That was honestly a huge factor for us to want to come to Partner. We also knew a lot of people that worked at the hospital, which was another thing that made us say, ‘You know what? They seem very happy there, so why don’t we just join the team?'”

Jen Mellace:

“Can you tell me a little bit about how you got started in the veterinary profession?”

Dr. Charlebois:

“Yeah, so I think it’s probably a similar story to a lot of people. Growing up, you love animals, you try to have animals. My parents were thankfully very accommodating to that, so: cats, dogs, fish, lizards, all these things. Initially going through school, my thought was that I wanted to go into conservation marine biology, things like that, which has more challenging opportunities. After a while, I decided that veterinary medicine sounded like a pretty good alternative. My father was also a veterinarian—not that he pushed me into this, but it helped stimulate interest. That’s how I ended up floating towards veterinary medicine. After my initial degree, I decided that I wanted to specialize a little bit more, just out of interest. You do this for a couple of years, you think, ‘I really like this aspect,’ and maybe you don’t want to do some other aspects as much, so you have an opportunity to go and do that every day of your life.”

Jen Mellace:

“Your role as a veterinary criticalist—how is this different from Emergency Care?”

Dr. Charlebois:

“It’s a common question that people have, and I think there is a lot of overlap. The unique thing is, when you’re a criticalist—which is equivalent to what they call intensivists in the human world—you’re generally responsible for looking after the Intensive Care Unit patients. It’s a bit of a jack-of-all-trades situation, which is part of the reason I like it because you have to be able to manage these patients. My role, depending on the hospital you work at, has this dynamic that works for the hospital and its culture. Sometimes hospitals will have a criticalist look only after the intensive care patients, but sometimes they’ll do that and also receive some patients in the ER, and sometimes you’ll do shifts in one position or another. Our training allows us to hopefully be very proficient in both areas.

If you think about an emergency clinician—an emergency doctor—they will receive, assess, make a treatment plan, and then determine: can I treat as outpatient, or which specialty do you need? And if they happen to say, ‘You’re really sick, you need to go into the Intensive Care Unit,’ this is where I take over that case, that patient, and then I’m micromanaging. The unique thing that I like about my profession is that the ER doctors are just so phenomenal at seeing volumes of patients and juggling all this, whereas in my world, it’s more like I’m going to take fewer patients, but they require so much one-on-one time. You need to change treatments every couple of hours, and that eats up a lot of time. If I can look after those patients and free the ER doctors from that, they can be a lot more efficient in their world.

That’s the distinction between the two roles. My training also allows me to do things like dialysis or plasma exchange for dogs that get into toxic medications, to filter the toxin out of their blood. We might also be able to get a mechanical ventilator for really severe respiratory diseases like pneumonia. I’ve been trained and have used the ventilator multiple times, which is pretty unique because a lot of hospitals aren’t able to offer that. That’s our hope for the future—to be able to offer that to the community.”

Jen Mellace:

“Do you have any cases in your time that stick out and are really memorable for you?”

Dr. Charlebois:

“Yeah, there are always some that haunt you and some that you’re really proud of. I think some of the most rewarding ones—I have two in my mind over the last three years. One was a dog, my biggest patient ever treated. He was a Great Dane, and he was 120 kilos, which is about 240 pounds—massive, very massive. He was in a house fire and was very sick, his lungs very damaged, so he actually had to be on a mechanical ventilator. Thankfully, our ventilators are the same machines that people use, so you can use them in those big patients. He was just such a sweet dog, and after a few days, we were able to get him off the ventilator, and then he ended up going home. It was just such a rewarding thing to see him go home. That’s one of my biggest highlights from the last few years.

The opposite to that, funny enough, was a puppy, I think six or eight months of age, who got an infection in his kidneys called leptospirosis, which gives you very bad kidney damage and prevents you from urinating if it’s really bad. A lot of patients can die, but if you can do things like dialysis—so we did dialysis on this little guy, I want to say less than 10 pounds, little puppy—he did great, he went home, he was happy. Those are the kind of cases that stand out to me because even though this is a hard job and you don’t save all the patients, obviously, you take some of these patients and think, ‘Wow, they come in almost on fire, like a dumpster fire, and then you turn them around and they go home.’ It’s amazing that we can even do that. Those cases are the ones you hang onto and that push you forward and keep you going.”

Jen Mellace:

“Makes everything worth it when you can save patients like that and send them home with their families.”

Dr. Charlebois:

“Exactly, exactly.”

Jen Mellace:

“What impact do you want to leave on the veterinary profession?”

Dr. Charlebois:

“I think for me—I’ve been doing this for gosh, it’s going to be probably almost nine or ten years now—I’ve always worked either internships or emergency medicine, never done private practice, so I can really speak just to my world. One thing that I’ve noticed, and a lot of people will attest to this too, is that since COVID, there’s been a lack of resources for veterinarians, people burning out, and having this huge struggle with quality of life. I think what I’d like to do—and I think Partner is getting there as a model to shape into something like that—is to find a way that you can do your job. Yes, it’s a stressful job for multiple reasons: it’s life or death, you have to talk to emotional owners, there are a lot of finances involved, people have to make hard decisions, but it is a really rewarding job. How can you balance these roller coaster ups and downs with a good quality of life?

What I’d really like to do is contribute to a practice that says, ‘Let’s figure out a way to keep everybody happy.’ Do you need to work a little bit less? Do you have adjustable schedules that fit your lifestyle? Are they flexible to say, ‘Yeah, I’m going to work a lot for a couple weeks, and then I want a bit of time off to travel’? I would really love to be in a hospital that finds the way to make as many emergency staff—and I don’t mean just doctors, this is a tough job for technicians, for assistants, everybody involved—so I want to make sure it’s clear that I think that should apply to everybody involved in this service, because everybody works so hard and they get so attached to the patients and they take such good care. I think that’s the biggest thing for me: to say yes, you want to do good medicine, take care of patients and owners, but you’ve got to take care of the staff. I don’t think they’re mutually exclusive; I think it’s just more of a challenge than some other aspects of medicine.”

Jen Mellace:

“Thank you so much, I appreciate you taking the time to chat with us today.”

Dr. Charlebois:

“Oh, you’re very welcome.”

Narrator:

Thank you for listening to “Did You Know.” Is there something about Partner that you want to know? Email us at [email protected]. Who knows? We might turn your question into an entire episode! You can now find us wherever you listen to all of your other favorite podcasts. Subscribe now!

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