Ch. 13 – Prem
B y day three of the All Paws and Claws re-opening, Prem could clearly see the error in his carefully designed schedule. For the most part, the practice operated smoothly. Yes, things could get hectic with only one vet tech on staff at a time, especially when appointments ran over, or they had to squeeze in an emergency. But, so far, with grit, custom shoe inserts, and a guiltily chugged energy drink around 4 PM, Prem had managed to make it work.
That is, except for the lunches.
Both Kate and Deja insisted on taking their lunch breaks at their appointed times, regardless of what was happening at the clinic. Prem imagined their surprise dedication to consistency was a silent form of protest for their reduced hours. The result, either way, left Prem managing things alone for half an hour in the late morning and early evening each day.
That would include today, when the bell above the clinic’s front door jangled as he carefully studied an iguana in Exam Room One.
“Excuse me,” Prem said to the iguana’s blue-haired, multi-pierced teenage owner.
Prem cracked open the door of the exam room just as a tiny woman with a cloud of white curly hair shuffled into the reception area. Dainty glasses on a beaded chain threatened to fall off the tip of her hooked nose, and she held a skinny chihuahua under her arm.
“Mrs. Moffat, hello!” Layla sang from the front desk. “And how is Princess? Oh my gosh, what a darling sweater she’s wearing!”
Right. Prem wasn’t entirely alone.
He had a lone soldier keeping watch on the parapets. Sure, that soldier happened to be decked out in a bright pink blouse and ruffled, flower-patterned skirt, but she was effective all the same.
Case in point.
“Dr. Dhawan is with another patient at the moment,” Layla said to their new client. “But I’ll get you and Princess set up in Exam Room 2.”
“Of course, of course,” Mrs. Moffat answered. “We don’t mind waiting, do we, Princess?”
Prem caught Layla’s eye and gave her a nod of thanks before closing the door to his exam room. Ten minutes later, he returned the iguana to its owner.
“The X-ray didn’t show any broken bones from the fall, thankfully,” Prem announced. “Though absolutely no more iguana skateboarding videos.”
“He has a helmet and goggles,” the teen whined.
“No. More. Skateboard. Videos.” Prem repeated. “In fact, I strongly suggest that Godzilla retire from TikTok altogether.”
“But he’s got over 12,000 followers,” the teen said, clearly horrified. “Okay, okay, no more skateboard videos. Can I still do silly hats and tiny little wigs?” The teen raised his eyebrows beseechingly.
Prem sighed. Godzilla stood stoically on the exam table. “Silly hats and tiny wigs are fine as long as he doesn’t eat the wigs.”
“Yes!” The teen pumped his arm. He picked up Godzilla and propped the iguana on his shoulder. “I’m gonna make you a top hat and one of them single eye thingies.”
“Monocle?” Prem suggested.
“Yeah, monocle. Your fans are gonna love it! Thanks, Doc.”
May the saint of involuntary influencers protect you, Prem thought to the unfortunate reptile. Out loud he said, “If you’ll just head to the front desk, Layla will get you checked out.”
After the teen left the room, Prem washed his hands then headed into Exam Room 2. There, he found Layla chatting happily with the old woman. Prem frowned. While he recognized the importance of providing good customer service, Layla took the concept to another level. She seemed to know everyone who walked through the door on a first-name basis, humans and animals alike. Prem had noticed how clients often lingered at the reception desk before and after their appointments, sharing their life stories with Layla. It was slowing down the pace of the clinic and interfering with his very carefully coordinated schedule.
Layla turned as he entered the room, her beautiful smile dimming as their eyes met.
“Dr. Dhawan, this is Mrs. Moffat,” she said, nodding toward the old woman. “And this is Princess.” She waved to a frail chihuahua drowning in a hideous purple sweater on the exam table.
“That’s him? The new doctor?” The woman squinted at him through her smudged glasses. “He’s too young.”
“I’m 30,” Prem said.
“See! A baby,” Mrs. Moffat declared.
“Oh, Mrs. Moffat, Dr. Dhawan is four years older than me, and you trust me, right?” Layla said.
The woman huffed.
Layla deftly changed the subject. “Princess has been coming here since she was a puppy. In fact, she was one of the very first patients I met.”
“I knitted the sweater myself,” Mrs. Moffat added proudly. “Princess loves purple. Don’t you, Princess?” Lopsided pink hearts covered the sweater.
“There’s a customer waiting to be rung up,” he told Layla. “If you could—”
“Of course. I’m on it.” Layla slipped out of the room.
“Where’s Kate?” Mrs. Moffat asked. “Kate always does Princess’s exams. Princess loves Kate.”
“Kate’s on her lunch break right now,” Prem said as he pulled up Princess’s patient file on his tablet. “But, don’t worry, I’ll take good care of you both.”
Mrs. Moffat pursed her lips, a dubious expression clearly written on her face.
Reviewing the file, Prem was impressed to see Layla had already started the exam. She’d weighed the dog and taken Princess’s temperature, actions typically performed by a vet tech.
“I see we have Princess scheduled for wellness exams every six months,” he said, scrolling through the dog’s medical history. “That’s a good precaution for elderly dogs.”
The frail chihuahua was pushing 20, right at the limit of the breed’s life span. Prem’s stomach tightened as he reviewed the dog’s history. Blood panels taken over the past three years showed increasing kidney stress as well as signs of congestive heart failure. The poor creature was on a bevy of medications.
“And how would you say Princess is doing?” he asked.
“She’s doing great!” Mrs. Moffat chirped. “Let’s see here.” She dug around a battered brown purse with chipped metal plating and carefully unfolded a sheet of paper filled with shaky script. Reading from the paper, Mrs. Moffat listed daily weights for Princess, precise timing of bowel movements, how much she’d eaten, and their walk schedule.
A soft knock sounded on the door, and Layla popped her head in. “Is it okay if I stay for the exam? We don’t have any appointments scheduled for the next 20 minutes, and I can run out if the phone rings.”
Prem was about to articulate the words, “Absolutely not,” but Mrs. Moffat beat him to the punch.
“Of course, dear!” She waved Layla inside the room. “I need a friendly face. I wish Kate were here.”
Prem swallowed his words as Layla entered the room, giving him a shy smile. He couldn’t help but notice how Mrs. Moffat seemed to immediately relax as Layla put a friendly hand on her shoulder.
Pushing down his irritation at Layla’s unprofessional conduct, Prem performed a preliminary visual exam of his patient. The little dog was missing most of her teeth. Her sight and hearing were limited, and she was down two kilograms since her last visit—weight she couldn’t afford to lose. He found severe arthritis in every joint he tested. From the dog’s movement patterns, he could tell she felt a significant amount of discomfort.
“You’re doing so good, my love,” Mrs. Moffat sang as Prem ran a hand down Princess’s shaking head at the conclusion of his exam. The knots in his stomach tightened. Here, shivering on his exam table was the ultimate cruelty of pet ownership; that loving a pet often meant watching them slowly fade away.
Prem took a breath. As a veterinarian, his job was always to serve the best interests of his animal patients, even if that meant delivering news their owners didn’t want to hear.
“Mrs. Moffat, I’d like to run a new blood panel on Princess to check on her kidneys and heart.”
“Oh, sure. Dr. Goldman always did the same thing,” the woman answered. “It’s a little costly, but it’s important, right?” She massaged the handles of her purse where most of the brown leather had peeled away.
“It is,” Prem confirmed. “I also think it’s time to discuss an end-of-life care plan for Princess.”
“What!” Mrs. Moffat gasped as if she’d been slapped.
Prem met the old woman’s gaze. “Princess is experiencing kidney failure and significant heart disease. Her quality of life is relatively poor.”
“It’s not poor!” Mrs. Moffat burst out. “Princess has a wonderful life!”
Layla took the old woman’s hand. “Dr. Dhawan, perhaps now isn’t the time—”
“She’s in pain, Mrs. Moffat,” Prem pushed on.
“That’s… that’s what the medications are for.” The woman’s voice cracked. Tears gathered in her eyes.
“The medication can only do so much,” Prem responded. “Her body is breaking down.”
“No!” Mrs. Moffat shook her head. “Princess is happy. She’s not in pain! I would know.”
“It’s okay, Mrs. Moffat.” Layla pulled the older woman into a hug. “We all know how much you love Princess. If you’re not ready to talk about end-of-life care, that’s okay.” She shot a fierce look at Prem, daring him to contradict her. “We don’t have to do that today.”
“Princess isn’t ready!” Mrs. Moffat insisted.
Prem bit back his words. He’d seen this so many times—pet owners who weren’t willing or able to acknowledge the truth of their pet’s decline. People like Mrs. Moffat truly meant the best, but too often, they kept their pets alive regardless of their quality of life. That resulted in animals put through unnecessary pain and suffering because a human wasn’t ready to say goodbye.
Prem hated watching his patients suffer. Truly fucking hated it. But he could only advise and recommend. At the end of the day, a pet’s guardian had to make the final call on their care.
He cleared his throat. “I see that Princess has been on the same anti-inflammatories for the past two years. I’d like to recommend a new medication that’s a bit stronger. There can be some side effects and it’s usually not recommended for long-term use, but considering the level of Princess’s arthritis, I think it’s the right call.”
“Okay, okay,” Mrs. Moffat nodded, sniffling. “Yes, of course. Whatever she needs.”
“I’ll perform the blood draw,” Prem said. “Layla, would you get Mrs. Moffat checked out?”
Layla simply nodded and led Mrs. Moffat out of the room, a protective arm draped around the older woman’s shoulder.
In the back of the clinic, Princess endured the blood draw in shivering silence, her huge dark eyes peering at Prem the entire time. While completing the draw, Prem scratched the dog behind her ears.
“I know you’re not feeling great, but I’ll do my best to keep you out of pain, okay?” he promised her. The dog licked his hand, and her tail wagged slowly. Maybe Mrs. Moffat was right. Maybe Princess wasn’t ready to go just yet.
Tucking the nearly weightless dog carefully under his arm, Prem re-entered the exam room from the back. The door to the reception area was open, and voices drifted into the room.
“...such a rude young man,” Mrs. Moffat was saying. “I’m so sorry you have to work for him.”
“Dr. Dhawan is stern,” Layla responded. “But he really does care about animals. I promise, Mrs. Moffat. I wouldn’t work for him if he didn’t.”
Something tugged at Prem’s heart.
“Well, be that as it may, I miss Dr. Goldman,” the woman insisted. “Now, there was a kind man. Always a smile on his face. He was an absolute ray of sunshine.” She sighed. “What a loss.”
“I miss him every day,” Layla agreed, pain clear in her voice.
Prem gritted his teeth. In all his copious, meticulous planning for taking over the practice, he hadn’t prepared for this. For living in the shadow of a ghost. Nearly every client mentioned Dr. Goldman, sharing fond memories unprompted. Just today, the mail carrier had waxed poetic about the previous vet, listing several of the doctor’s “greatest” (i.e.) worst puns on record.
Deja, Layla, and even Kate dragged the grief of his death with them like a ball and chain. The sour glances they sometimes threw his way when they didn’t think he was looking seemed to say, You’re not him.
“If it weren’t for you and Kate, I would’ve switched to the other clinic in town,” Mrs. Moffat was saying. “It’s actually closer to my house, but you two are like family. And Deja, too.”
“Well, we’re so glad you come here,” Layla answered.
Prem felt like an idiot, standing just inside the doorway of the exam room, listening in on their private conversation. He took a step forward, then froze at Mrs. Moffat’s next words.
“So, how are you and Calvin Junior doing?” Mrs. Moffat asked. “Isn’t the wedding coming up soon? I’m sure I put it on my calendar. Did you get my RSVP?”
“Oh, um…” Layla offered a small, soft laugh.
Prem strained his ears. The massive engagement ring had yet to reappear…not that he’d felt compelled to glance at her left hand every morning. He’d also caught Deja and Kate murmuring questions to Layla in the breakroom, but they always snapped their mouths shut the moment he entered.
It was none of his business, really. Not at all. Prem leaned against the doorway, desperate to hear Layla’s next words.
“Guess what, Mrs. Moffat?” Layla said suddenly. “I signed up for an ultra-marathon. Can you believe that?”
“A what?”
From his position, Prem could see Mrs. Moffat frown in confusion.
“It’s a running race,” Layla answered. “Thirty-two miles. I’ve only ever run twelve miles before, so this is going to be a real challenge.”
Mrs. Moffat shook her head. “You young kids. Always doing such crazy things these days. Is Calvin Junior running the race with you?”
Layla’s smile tightened. “Oh, no. It’s just going to be me.”
“Well, he must be so proud of you, regardless,” Mrs. Moffat said. “You two are such a wonderful couple. When is the wedding again?”
Layla looked down at her hands, her smile frozen on her face as a pink flush crept up her chest.
“Here we are,” Prem said, stepping out of the exam room. “Princess did great. She’s a real trooper.”
“Hello, my love!” Mrs. Moffat cooed, opening her arms for the small dog.
After handing over the chihuahua, Prem faced Layla. “Please go ahead and get Mrs. Moffat checked out.” He gave her a look that he hoped conveyed, No more chit-chat.
“Of course, Dr. Dhawan.” She released a short breath and seemed to recover herself.
Prem heard Layla tapping a few keys on her keyboard as he returned to the exam room. He grabbed a spray bottle and a clean rag to wipe down the table.
“Okay, Mrs. Moffat,” Layla said. “So, we have the wellness exam, a blood panel, a refill of the heart medication, and the new arthritis medication. The total is going to be $682.41.”
“What?” the old woman cried. “It’s never been over $500 before.”
Prem paused in his cleaning. They’d been running into shock, anger, and disbelief from their customers all week as a result of the new pricing structure. It was unpleasant but necessary, Prem reminded himself. His rates were more than fair even if they weren’t nearly as generous as the pricing under Dr. Goldman.
“I’m so sorry, Mrs. Moffat,” Layla replied. “But we’ve updated our pricing with the change in ownership.”
“Is that price before the friends and family discount?” the woman asked hopefully.
Prem heard Layla make an unhappy noise. “Well, unfortunately, we can’t give out the friends and family discount to anyone who isn’t a direct family member of the staff anymore.”
“But, but,” Mrs. Moffat sputtered. “It’s just so expensive.”
Layla’s voice sounded strained. “Well, if you prefer not to pay the entire bill today, we now offer payment plan options. The plans do include a fee, so you’ll pay more overall, but you can break the total into smaller payments that you make over time.”
“But I’m on a fixed income.” Mrs. Moffat’s voice caught. “How am I supposed to afford this?”
“I’m so sorry, Mrs. Moffat.” Layla sounded like she was close to tears. “I can go talk to Dr. Dhawan. Maybe we can put Princess on less expensive medication.”
“No,” Mrs. Moffat snapped. “The doctor said this was the best medication for her. That it would help more with her pain. That’s the one I want. I’ll just have to find ways to cut back somewhere else.”
Prem’s legs moved. Without quite making a decision, he found himself at the reception desk standing next to Layla. Mrs. Moffat’s face was red and flustered, and her hands worried the last flecks of leather from the handles of her purse.
“Layla, didn’t I hear you say that you and Mrs. Moffat were related?” he said.
She gave him a quizzical expression.
“Distantly related,” he pressed.
Her eyes lit with understanding. “Yes, I was just saying that.”
“Related?” Mrs. Moffat frowned in confusion. “We are?”
“Yes, I believe you’re, um, fifth cousins with my mom,” Layla said.
“Then, I suppose the family discount would apply,” Prem said with a rough shrug.
“I suppose it would,” Layla echoed.
“The 10% discount,” he clarified, just in case she had any thoughts of going back to Dr. Goldman’s 15% policy.
“Of course,” Layla said smoothly. “I’m sorry for that oversight, Mrs. Moffat. Let me re-calculate your total.”
“Related,” Mrs. Moffat mused. “I had no idea, dear. I’ll need to give your mother a call and update my genealogy tree.”
Prem turned away as the conversation continued. Several minutes later, he’d just finished cleaning the second exam room when he heard a soft knock on the door.
“Thank you for what you did.” Layla leaned against the door frame, her long braid falling across her shoulder and ending at her hip. Glancing up at her took his breath away.
Every. Single. Time.
“Mrs. Moffat’s on a fixed income,” she explained.
“I heard,” Prem answered gruffly. He looked away. He hated what she did to him. How she flustered him. Caused his heart to beat so hard. Drove heat into his groin.
“Mrs. Moffat’s husband died six years ago.” Layla’s voice floated to him. “Her two sons live out of state. They don’t visit often. Sometimes I think the only thing that keeps her going is that dog. She’s not ready to let Princess go.”
Prem grimaced and met Layla’s gaze. “Soon, she won’t have a choice.”