Not Yet a Vet…dot net

When you first start veterinary school, you can hardly believe that fourth year will happen.  You sit through hour after hour of class and you study until you forget what time you started and then you go to bed and do it all over again.  Well, it’s happened for me.  I’m a fourth year.  I started my year off the easy way with a clinical pathology/parasitology didactic (a.k.a. class, but with a lot more discussion).  It was a great refresher on reading and interpreting blood panels and I was amazed at how much of the parasitology information I still had rattling around in my head left over from second year.  The half days weren’t bad, either!

Now I’m about 1/4 of the way through my second rotation and this one is much harder for me.  Large animal medicine.  I wanted to get into the barn as early as possible because a lot of third year was devoted to large animals and I wanted things to be fresh in my mind.  Apparently, I am good at large animal medicine on paper but not really in practice.  I’m OK with that.  It has never been my goal to do equine or production medicine and so I really just have to show up and do my best.  I did discover today that I am absolutely terrible at drawing blood on calves.  You’d think it would be easy with the size of their jugular veins, but that is definitely not the case.  I managed to do my two required calves, but I felt so stupid the whole time considering it took me about four times as long as my rotation mates.  Luckily, the resident is fabulous and extremely patient.  The whole time I was thinking “please, please, please just give me a cat and I can show  you that I have actually drawn blood before and I’m actually really good at it!” but alas, there were no animal transformations and I muddled through my two calves and apologized a lot.

After the calves, we moved to the sick barn and examined some cattle that were experiencing a drop in milk production.  It was a great experience to see some cattle that aren’t like giant puppy dogs like the blood donors in the hospital and I got to hear my first LDA ping.  I also got to reach in before the vet corrected the problem to see what it felt like.  That’s just not something I get the opportunity to do every day.  Speaking of new things, I am on call tonight for the first time as the primary student.  That means if there are any emergency cases that come in to the barn overnight, I am going to have to go in and help the resident assess the patient and get them stabilized as much as possible.  In the morning, it would either become my case (if it stays in medicine) or we would transfer it to surgery (if the case is purely surgical).  I’m nervous and excited all at once.  It was a really long day and I would rather not go back to school, but I know that being on call and going in at all hours is going to be a big part of the coming year and there is no sense in delaying the inevitable.

For now, I’m going to make sure I’m well-hydrated and I’m going to go to bed early in the hopes of getting some sleep in case I get paged in the wee hours of the morning.  And I’m going to cuddle with my cats.

I can’t believe that Spring Break is finally here!  This marks the beginning of the end.  My last day of finals is May 7th (coincidentally, that is also my 10 year anniversary with the Captain) and my first day of clinics is May 16th.  If I’ve done the math correctly, that means that there are 30 more days of class/exams and a total of 57 days (including breaks and weekends) until I start my fourth year.  Holy cow!  Time sure flies when you’re <s>having fun</s> overworked and scared and excited all at once!

I had a large animal surgery exam this past Friday and it was brutal.  I’d been preparing for the better part of two weeks and I still felt like I didn’t know anything.  Needless to say, I don’t think I have a future in equine medicine, much less in advanced equine orthopedic surgery.  I’ll stick to the animal the can visit the clinic in a standard-sized vehicle, thanks.  It’s really hard to keep from getting frustrated in some of the equine courses I’m taking this semester.  It feels as though the instructors are gearing everything toward the 5 people in my class that want to go in to equine medicine and they’re treating us small animal people like we don’t exist.  I might be a bit more interested in the material if I couldn’t always detect the air of “you like cats, you just wouldn’t understand” from the front of the room.  At least we are done with orthopedics and we will be moving back into the realm of internal medicine.  I find that interesting no matter what species is involved and the instructors for this portion are considerably more tolerant of the non-horse people.  Sometimes, veterinary school really seems like a war between the Sharks and the Jets.  Maybe I’ll start snapping my fingers in the hallway.

I started Spring Break by going shopping with Left-Side Friend.  We are required to dress a certain way in the clinic and there were some amazing sales that were great incentive to start stocking up on professional attire.  Goodbye jeans and vet school sweatshirts, hello black pants and button downs.  I’m going to make a trip to my favorite shoe store tomorrow to see about getting some professional, yet comfortable shoes.  I’d rather break them in now than nurse sore feet at the end of a long day.  Perhaps I’m getting a bit ahead of myself, but I am a planner and I like to be as prepared as possible.  Apparently, I also like alliteration.  In any case, this is a great excuse to go shopping and the shoe store is a 40 minute drive through the countryside and supposedly stocks over 300,000 pairs of shoes.  There are definitely worse things in life.

I’m going to spend the rest of my Sunday cleaning and perhaps I’ll venture outside to make a trip to the grocery store.  It feels strange to have a whole week to do whatever I want to do, whenever I want to do it.  My only responsibilities will include a take-home exam for my public health class and some studying for the next companion animal exam (equine neurology and foal care).  Oh, and sleep.  I have a responsibility to myself to get at least 8 hours every night for a full recharge.  Throw in a couple happy hours with some classmates and perhaps a quick visit to my parents and I’ll consider it to be a very successful (and much-needed) break!

I’m glad I had the chance to write about our most recent surgery cat before we actually did surgery. That was an eventful day. Ginger is fine but she tried several times to leave this world under anesthesia. Right-Side Friend did a fantastic job staying calm as the anesthetist on the outside even though I know she was shaking on the inside! Ginger took her pre-mess like a champ; she didn’t even flinch when we gave the injection. RSF put in the catheter and we attached all of the monitors. I shaved her belly and started scrubbing the surgical field. We sent Left-Side friend to the sink to start scrubbing in herself. Everything was fine then.

RSF noticed that Ginger had a really high end-tidal carbon dioxide level, meaning that she wasn’t breathing effectively. Oh, and her lungs started to sound really gunky. That’s the technical term, you know…gunky. We called the veterinary anesthesiologist over and she asked a lot of questions and listened to the gunk. She called over the other anesthesiologist and they decided it would be best to re-intubate Ginger before we started surgery. They suggested that LSF do the surgery as quickly as she could without being sloppy.

Fast forward to the end of the surgery. LSF was near the middle of Ginger’s body wall closure, the first of 3 layers of sutures we are supposed to do. I was scrubbed in and poised with the suture scissors, and helping to hold the guts in so they didn’t get caught in LSF’s suture line. And then RSF proclaimed that Ginger had stopped breathing and that she couldn’t put enough pressure on the breathing bag to get air through the tube. Holy cats! That is not something you want to hear in surgery. We got the anesthesiologists to come over and they yelled for a surgeon to take over for LSF and finish the body wall closure. The lab assistant was running all over the place to find the stapler because they throughout we were going to have to close the skin with staples to be able to flip Ginger over to reintubate.

In a matter of 60 seconds, the surgeon had finished the body wall closure, sewn the sub cutaneous tissue together (including a perfectly-buried knot), and put 3 simple interrupted sutures in the skin. He was like a human sewing machine! It was really cool to see someone like that in their element. I had a hard time keeping up with the suture scissors! In the meantime, the anesthesiologists and RSF managed to reintubate Ginger upside down and they got her breathing again. LSF got to finish the skin closure and we woke Ginger up after that. She was groggy, but she looked into our worried faces with her big, yellow eyes as if to say “That was a nice nap. Why are you looking at me like that?”.

Since her lungs sounded fine before surgery, we all decided that she had some sort of occult lung disease. We found out later that she had a parasite that hangs out in the lungs so that could have had something to do with it. We started treating the parasite and added in some antibiotics just in case she aspirated something during all of her intubations in surgery. She went back to the shelter on Thursday missing her uterus and looking no worse for the wear.

I would never wish that sort of surgery on any cat, but part of me is thankful I had the opportunity to see it happen. We were surrounded by professionals at the top of their game and they said everything they were doing out loud. I have the utmost respect for someone that can save a cat and teach at the same time. I never really had the chance to get scared because I was busy cutting suture for the surgeon and, well, there didn’t really seem to be a reason to be scared in the first place. I hope I can keep that state of mind when I see my first emergency on rotation next year. For now, I’m glad that Ginger is safe.

There are certain perks to being a 3rd year.  The classes are all medicine-based.  You’re taught by clinicians.  The exams (usually) focus on practical material.  And you get to do spay two animals.  Last semester, my group members (Left-Side Friend and Right-Side Friend) had the pleasure of meeting two dogs and a cat, each from a different humane society.  Abby, our first dog, was a feisty rat terrier mix who tried to chew my foot off the first time I tried to step into her dog run.  We took her for a 2 mile walk that day and she decided that we were all right.  She really was a sweet dog once you got to know her and since she was recently removed from her humane society website, I am hoping that she found a nice family.  Our second dog, Tempest, was a young boxer and that’s really all there is to say.  She was happy and ridiculous as once would expect from a boxer and she found a home with someone in the veterinary school.  Our only cat of the semester was a sassy tortie by the name of Loretta.  Loretta was in heat and thus was very, very, VERY happy to see anyone who walked in front of her cage.  All semester, I prided myself in not getting attached.  I know that I am going to come across hundreds or even thousands of adoptable animals over the course of my career and I also know that I cannot take them all home.  What I CAN do is make sure that each animal assigned to my group gets plenty of love and treats and good food while they are in our care.  But I don’t get attached.  After all, I only get the chance to care for each animal for one week’s time.

Here is how it works: Your animal arrives Thursday afternoon and it is your responsibility to examine said animal, collect blood, run a urinalysis, and do a fecal exam for parasites.  Your animal must be examined and fed twice a day for the duration of their stay at the veterinary school.  You have to take the dogs outside at least 3 times a day (but that seems silly to make them stay inside so much, so L-SF, R-SF, and I aim for 4-5 times per day when we have a dog).  You calculate anesthetic drug doses and plan for surgery.  On Monday, you do surgery.  One group member is the anesthetist and it is his/her responsibility to give the initial anesthetic injection, place an IV catheter, give the induction agent, intubate, and then monitor anesthesia during surgery.  The other two group members scrub in and one does surgery and the other assists (holds clamps and cuts suture).  Tomorrow, I am the assistant.

Our first cat of the semester is a timid little torbie named Ginger.  Once we got her out of her carrier, I started her exam and she got a clean bill of health except for some dry, cracked toe pads; she must have been an outdoor kitty.  And then she started purring.  I really didn’t want to have to go back in to school after the ridiculously long Friday I had, but when I got there and Ginger started rubbing on my hands when she recognized me, I forgot why it was I didn’t want to be there.  I went in Saturday morning and she actually let me take her temperature by myself.  I have to carry her to the sink to get her to stop purring long enough for me to get her heart rate and respiratory rate (you can’t hear a heart/lungs over the purring when you’re listening with a stethoscope).  Tonight, I couldn’t get over how timid she looks.  Her eyes are wide when you first open the cage, but you can see the recognition wash over her little kitty face when she realizes that you’re there to scratch her chin.  After her exam, I just stood by the table and let her cuddle with me for a while.  But I’m not attached.  Maybe if I keep saying it over and over, it’ll stick.  I’m totally attached.  Ginger looks up at me with her big yellow eyes and I can feel her saying “thank you”.  She sits quietly in her cage as I finish my charting and just stares at me from behind the towel I hung to make her feel more comfortable.  I really hope that she is able to find a good home.  It really breaks my heart that we will have to send her back to the shelter on Thursday morning.  Really, getting attached to a surgery animal was bound to happen and I know that I can’t adopt her (my apartment has a 2-cat limit and I promised the Captain I wouldn’t get any more animals until after we get married).  That’s not going to stop me from spending a lot of time with her in the animal ward.  Even if she has to go back to the shelter, I want her to be as happy as possible while she is here.  And I have to try not to cry when she leaves.

Over the past few weeks, more and more instructors have been reminding us that we will soon be veterinarians. All of a sudden, the references to when we start clinics are measured in months or days instead of years. On more than one occasion, I’ve heard the phrase “in a year in a half, when you’re out in practice…” at the start of a sentence. It is surreal.

All of this reflection has forced me to think about how often I can arrive at the “correct” answer when working through a case in class. In first year, we would have a case presented every now and then and it felt like pulling teeth. Looking back, I remember thinking that I would never get any better because there was no way all of that information was going to magically lodge itself into my long term memory. Luckily, I was wrong. However, some of my successes at working through clinical cases is knowing that there really is a finite number of things to think about. Yes, there is the errant zebra diagnosis, but the really strange and rare things can give even the most seasoned clinician some difficulties. I have learned that the answer to a lot of questions is one of three things: poke it with something sharp, take it out, or cut it off.

Think about it. You have a sick animal and the first thing you’re going to do it collect blood. If an animal has a lump, you’re probably going to get a fine needle aspirate. We try to surgically remove tumors and we take out nonfunctional organs (or at least pieces of them) on a regular basis. We remove diseased limbs, torn nails, and broken tails. The possibilities are endless. It is a gross oversimplification but it makes a lot of sense. As a first year, the cases were so difficult because it seemed like there were so many possible answers. If vet school has taught me anything, it’s taught me how to think. Each organ can only put up with so much stress before it stops acting how it should, and when things go wrong, there are only so many ways said organ knows how to respond. For me, some logic is much easier than trying to be a diagnostic ninja and remember every possible clinical sign from every disease I have ever learned.

I’m not sure why today was deep thought day, but it probably ha something to do with the fact that I have a large animal surgery exam tomorrow and I am quite terrified. I’m afraid that I won’t know any of the answers because the material seems to foreign to me. I’m going to try to keep my diagnostic strategy in mind while I am studying to see how many times I can use one of my 3 favorite answers. If that doesn’t work, I haven’t completely rules out the idea of flipping a coin while taking the exam. That’s scientific, right?

I think I can finally talk about  my classes now that I’ve experienced all of them at least once.  I think the theme for this semester is going to be “cruel and unusual punishment.”  I mean that lovingly, of course.  I will give 2 examples: my advanced dentistry elective and the radiology lab associated with my radiology course.  Exhibit A: Dentistry meets Monday afternoons from 1pm to 5 pm and it’s a pass/fail elective that consists of lectures and a lab each time.  We sit through 2 to 3 hours of lecture and then have a 1 to 2 hour lab that follows.  Monday makes me tired.  Don’t get me wrong, dentistry is extremely important and I’m learning a lot, I just don’t have a 3 hour attention span.  Exhibit B: Radiology lab.  We have a 3 hour lab each week.  This week, we had 3 hours of lecture with a quiz and a few cases thrown in for color.  Again, my attention span is nowhere near 3 hours.  Luckily, I am a huge nerd and I love diagnostic imaging.  I think I fared better than some of my classmates.  There were a lot of crabby people by the end of the lab.

The rest of my classes take place over a much more reasonable length of time (I’m happy to pay attention to a 50 minute lecture and then take a 15 minute break before the next one begins!) and do not belong in the “cruel and unusual” category.  Well, we’ve barely started learning about horses in one class so we shall see if I amend that statement a month from now…

I think the most interesting thing we’ve done so far was a chicken dissection.  I’ve certainly dissected chickens before (since I was an animal science major in undergrad) but it was nice to see it all again.  It’s funny when you think about how we took an entire semester to dissect a dog, we took another semester to dissect a cow and horse, and we completed and entire chicken in 3 hours.  I know a fair bit about birds, but I’m looking forward to learning more.  Who knows…I might end up seeing a few birds at whatever small animal clinic hires me when I graduate.

On the non-school front, I managed to steal a few hours for myself so I could go line dancing tonight.  I’ve been going off and on since I was an undergraduate and I went every week in the summer.  Sadly, I didn’t have time last semester, but I made time tonight.  For me, it’s a great sanity break where I can spend time with some people who are not veterinarians or veterinary students.  It is a way for me to stay connected with the outside world, and a way for me to see the sort of people I can help when I finish school.  I know I could have used those 3 hours for studying, but I think this was better.  I can work a little harder tomorrow to justify the time I took off tonight.  It was just really nice to move around and listen to music and hear conversation topics that did not include excrement, national boards, surgery approaches, or parasites.  That’s right, I am not only a veterinary student but a human as well.   On that note, this human has to get to bed so I can do the studying I have to do tomorrow.  Goodnight!

My last semester of classroom instruction has begun! I can’t believe it. Each year, there is a 3rd year countdown that gets posted in the lecture hall counting down the days until clinics. Each year, I’ve watched the days on the countdown tick down and I’ve thought about how I would feel when the countdown belonged to me. Well, the feeling is actually quite indescribable. I have been in school my whole life and I am now much, much closer to the end than I am to the beginning. Don’t get me wrong, I know that clinics are going to be tough (and don’t even get me started on studying for the national boards), but I also know that I will learn a lot and it will be a different kind of “tough” then I’ve ever experienced. And I’m excited.

It was hard to leave the Captain at the end of our respective winter breaks, especially knowing that it was the last one I would ever have. We certainly make the most of our 12 days together; it was probably my favorite break we have ever had. Quite notably, we now have a wedding date and we booked our reception site. We saw the place my cousin runs and I just knew that it was the place. We walked in and I could picture everything. My cousin was awesome throughout the entire meeting and I know that we will be in great hands. We can check something off the wedding list…now there are only about 579 more things to go! I have a feeling planning is wedding is going to be like a full time job.

I’ve been relaxing all day today with a little bit of cleaning thrown in for color. I figure that this is my last weekend of freedom before I have to study all the time so I had better live it up while I can. I do have to do some studying tomorrow so I’m prepared for the week but i don’t really have to buckle down just yet. It’s a nice feeling for now but I’m just not built for doing nothing. Luckily, I’m going to spend some time with Left Side Friend and Right Side Friend tomorrow evening and that should help. Either way, I’m going to relish in the fact that i can get a full nights sleep several nights in a row!

On that note, it is time for me to get to sleep. I will post more about my classes once I get a better feel for them. I have a lot of large animal classes and I’m hoping that I can let my inner nerd take over and I can enjoy the topics even if the patients aren’t my target species. Goodnight!

Hello, 2011! I can’t believe that 2010 is over. It really was a great year; my favorite so far. I’m hoping that 2011 is even better. I’m currently at the Captain’s parents’ house and we have a few more days together before we each have to go back to our respective lives in different states.

Winter break has been so incredibly relaxing this year. I packed up my things from my apartment, coaxed the cats into their carriers, and headed home for the holidays. In the days leading up to Christmas, I wrapped presents, decorated the tree, and just generally enjoyed doing NOTHING for a change. The Christmas celebrations were a bit more of a whirlwind since I started the day with my parents, spent the night with the Captain and his family, and then we headed back to my parents’ house for my family’s celebration the next day. On a side note, you know the Captain and I know each other too well when it turns out that we got each other the same Christmas gift. Either that, or we are both big nerds. In any case, I have the B&N Nook and he has the Amazon Kindle. Good times.

Today we started looking at wedding reception venues. Holy cow, this whole wedding thing is so complicated! I really liked one of the places we saw today. The space was so incredibly unique. The whole room was a temperature controlled tent so there was all this draped fabric and such. Plus, the staff seemed very nice. Tomorrow, we are going to look at a venue that is managed by one of my dad’s cousins. It is a beautiful space and it’s right on a river, but I have been to two family weddings in the same room and I might want something I can call my own. We shall see.

On that note, I really should get to bed. I’m pretty sure that the rest of the house is asleep and I have to be at the top of my game tomorrow if I’m going to think of lots of great questions to ask the reception coordinators. Everything seems so much more real now that we can start looking around and making decisions!

Goodnight, moon.

Tonight is Christmas Eve.  I can’t believe it.  It’s been a whirlwind of a year and it’s almost over.  Finals are done.  The semester is over.  I’m only waiting for one more grade.  Life is good.

I finished my last final (ophthalmology) on 12/21, drove to my apartment, and started loading the car.  4 trips later, I was ready for the final load…the cats.  Based on James’ seizure history, I know that the car can be a stressful place for him.  He hates the carrier and he can’t handle just sitting anywhere.  Thus, I already had the car warmed up so there would be no “sitting” in a strange environment.  I was just getting out of town when the fog started rolling in.  My parents’ house is only 2 hours away from school so I really didn’t have too far to go.  However, the combination of the thick fog and a very energetic “MRAAAAWWW!!” from Lily every so often made for an interesting trip.  When I pulled in the driveway, I grabbed the carriers and hurried to the side door.  I managed to get both James and Lily inside and I got the carriers open before James could work himself up into a frenzy (which is what sends him a-seizing).  I think covering his carrier was a really good move.  Both cats are settled in just fine and aside from being a little jumpy, they are acting like themselves.

I spent my day today having lunch with a friend from high school and her husband, wrapping presents, and making oreo truffles to take to the Captain’s family tomorrow.  I think this was the most low key Christmas Eve my parents and I have ever had.  I think it’s mostly to do with the fact that our family is celebrating Christmas on the 26th this year.  That means that this will be the first Christmas I’ll be spending with the Captain and his family.  I’m pretty excited.  His aunt has been asking for years when I was going to come over for Christmas and I’m happy to finally have the opportunity.  I like seeing how other people celebrate.  And I like seeing the Captain.

Well, I should get to bed.  Santa won’t come until I’m asleep (or so the songs tell me) and I don’t want him to skip my house.  I’ve been extra good this year.  Happy Holidays everyone!

A lot of people get into the habit of carrying the same things with them each day.  For example, I am always wearing my engagement ring from the Captain and I never leave my apartment without my watch.  I could extend that into other things that I don’t carry directly on my body like my bus pass, my keys, and my student ID.  These things are always with me, but do not really define who I am.  In 2008, I started carrying around something else.  Something I couldn’t take off even if I wanted to.

I’ve always been mesmerized by the veterinary caduceus.  I decided that I wanted this tattoo when I started undergrad.  However, I refused to be an 18 year old rebel and promised myself that I had to wait until I got an acceptance letter to veterinary school.  When the letter came, I found a picture online, chose a parlor, gritted my teeth, and walked out with my caduceus.  They say that tattoos are addicting and that once you get one, you feel compelled to get more.  I’m not.  I’m happy with the one I have.

My tattoo is in a place that people don’t see unless I want them do.  I have to wear a tank top or something similar to show it off.  But even under multiple layers of clothing, I still know it’s there.  When I have a hard day, it serves as a reminder of what I’m working toward.  When I have a great day, it makes me proud to be a part of this profession.  It’s amazing the kind of confidence a little caduceus can instill in an overworked and overtired veterinary student.  It’s like my own secret power source and even on the longest, roughest, most challenging days, it reminds me that there is always going to be a light at the end of the tunnel.