Saturday, December 15, 2012

Everything/Nothing

Everything is different.

The world is a different place tonight. Another town no one had ever heard of before today.  A point in time that will never be as benign as it should have been.  A senseless tragedy that leaves too many questions.  But at the heart, everyone is asking the same question.  There is really only one, although it takes a thousand forms.  Why?  It's the question for which there will never be a good enough answer.

Friends and neighbors are circling around those who have lost, shielding them from the outside world as best they can.  They will support them physically, mentally, and emotionally.  Some of them will be put in charge of removing presents from beneath Christmas trees.  Finding Santa's hidden treasures, and taking them away.  Putting toys back in the toy box and cleaning up the breakfast dishes.  Their hearts will break and they will break down and cry while they are doing it.  They will keep going.  They will keep their loved ones going, too.

There are others today that are dealing with their own demons.  The gut-wrenching ache of memories.  They have been where this community is now.  They know the fear that comes with waiting for names to be released.  They know the relief when the names are not one of theirs.  They know the crash when a name is.  They know the sinking feeling when the date draws near every year. They know all the words in the world will not help these people right now, but maybe time will ease the ache that never fully goes away.  They know that while the survivors will survive, is not what they want or need to hear today. 

The attacks are coming closer together.  Too close to put the last one out of your mind before the next happens.  Too close to feel secure.  So close that those without children can't even begin to imagine bringing a child into this world.  So close that those who are parents have trouble sleeping.  Today, people will call for change more loudly than they ever have before.  It's always louder than it has ever been before.

Nothing has changed.

The media descended.  They are as shocked and angered as the rest of the world, but they also have an agenda.  They have deadlines to meet and producers/editors to appease.  So they will push personal feelings aside to get the story no one else has found yet.  Even if that  means putting terrorized children on camera to get what they will describe as, "an eyewitness account."  The town will be an unwilling host to news vans covered in satellite dishes and photographers that never lower their cameras to look people in the eyes.  Reporters and news anchors will put together special broadcasts, conduct interviews... until the next big story comes along.

In just less than a year, the media will swarm the town again.  Notes will have been made on calendars so as not to forget.  The anniversary of this day will be newsworthy next year.  Perhaps the year after.  Maybe even the year after that. But soon, the only people who will remember will be those who lived it, not because of a note on a calendar but because they are still living it.

Lawyers will wait for the frenzy to pass before making their move.  They will see grieving families as a payday.  They will approach them oh, so cautiously.  They will point out the flaws in the system.  They will convince families that financial compensation will make things better.  Lawsuits will be filed against the school district, and any other entity they can tie responsibility to.  Years from now, settlements will be reached.  They will make the papers for a day.

Politics will come into play.  The right to bear arms versus the right to life, liberty, and the pursuit of happiness.  Gun enthusiasts will remind us that guns don't kill people; people kill people.  The debate will be opened again about if the spirit in which the constitution was written.  If giving people the ability to defend their homes and families with musket rifles is the same as the ability to purchase multiple assault weapons and thousands of rounds of ammunition without raising any suspicion.  But the debate will be between news program hosts and lobbyists.  The debate will never make it to any legislation.   

Everything is different.  Nothing has changed.

Thursday, December 6, 2012

The Art of Avocado Ripening

A couple weeks ago, on Black Friday, I turned 29.  I felt it was oddly appropriate because I'm about 99% sure that I am not going to handle 30 well. And for anyone out there that's about to hop on their, "Oh you're still so young, 30 is nothing," horse, please refrain.  Logic has no role here.  I don't know where I thought I was going to be at 29 years old, but I know I never dreamed I would be attached to an ice pack because of an alpaca.  He used his head to hit me with a right hook, giving me a swollen and bruised jaw.  I can't make this stuff up. 

Anyway, I think you should learn at least one big thing each year so that getting older isn't quite so depressing.  When I was in school it was easy.  One year I didn't know how to cut open a live animal without killing it, and the next year I did.  It gets harder when you have a job.  Not that I don't get to see some interesting things, but big leaps of skill aren't really part of the deal anymore.

Turns out what I learned this year, were avocados.

I love, love, love salsa (the hotter the better) so guacomole to me is very much a take it or leave it condiment.  I don't like that it turns brown.  Its texture is disturbing when it is warm.  I don't dislike it, but it's not by any means a necessity.  So I'm not sure why, but one day I bought an avocado and I decided to chop it up and add it to a salad.  It was awesome.  I became an avocado convert but the challenge was in the ripening.

Since I grocery shop once a week and it's a very organized event. Yes, I can hear you guys now:  "Julie?  Organized? Noooo."  Whatever.  The problem with an avocado addiction is that they don't ripen like anything else. So if shop once a week and you need (alright, want) an avocado available on any given day do you buy them already ripe?  Almost ripe?  Not ripe at all?  It took pretty much the entire year, but I finally figured it out.

I buy 3-4 avocados a week,  1 almost ripe, 2 not ripe at all, and the occasional 4th at my discretion.  I know exactly when to pull them out of the crisper and put them at room temperature.  In my kitchen, there is (nearly) always an avocado ready to go for salads, sandwiches, or whatever else I might desire. 

Necessary skill?  No.  Life changing skill?  Not even a little bit.  Something that makes me feel like I've got at least a little handle on my life?  Absolutely.

Saturday, November 17, 2012

Between the Lines

Hello, this is Dr. Dawson returning your phone call, what's going on this morning?

I need to have my mastiff put down and my vet can't be here until 3:30.

That's a big dog...

What exactly going on?

My mastiff has been having issues with urinary stones.  He's passed a couple on his own but now he needs put down.

So, he's been left to pass the stones on his own... means you couldn't afford surgery.  Which means the stones haven't been analyzed.  Which means there have been no dietary changes to prevent additional stone formation.  Poor dog. *sigh*

Have we ever been to your farm before?

Farm?  No, I live downtown.

Not a client.

We are really only a large animal clinic...

Oh, I didn't know that.

I am calling all the vets listed in the phone book.

He's just really in a lot of pain and I don't want to wait until this afternoon.

Big dog, big teeth, in a lot of pain...

I don't want your dog to suffer so I can come out if you would like me to.  Because I'm  giant sucker.  The cost will be...

You can't just bill me?!

You horrible person!  I cannot believe you would expect me to pay for your services even though I have had no prior dealings with your clinic and do not have large animals so you will never see or hear from me again!

No sir, payment is required when services are rendered.

And in your case, I will be requiring payment, in cash, before performing the euthansia. 

Well, I guess I will just wait for my vet to get here this afternoon.

They have billed me before and they will bill me again, regardless of my payment history.

Alright sir, you take care.

I'm going to go back to my book.  I feel bad for your dog.  And your vet.

Monday, September 10, 2012

Polamalu-ed

First things first - yes, I'm creating a verb for the title of this post and no, I don't care if you hate it when people do that. 

Now that we have that out of the way, I'm going to have to give you a little background about modern pig farming since I know most of you are pretty clueless.  Pig are identified using a universal ear notch system.  You use the set location of notches to add up to the number you need. Identification is important when putting pigs on a health certificate for transport to other states for sales or shows.  Technically this is not a completely unique identification because many pigs can have the same number, but when you add in age, breed, gender, and owner... you get the picture. 

There are two primary pig diseases that cause state veterinarians get their panties in a wad: brucellosis and pseudorabies.  The handy thing about these diseases is that they essentially do not exist in domestic swine in the United States.  They are so.... gone, that most states have attained the status of "Brucellosis and Pseudorabies Free," which means just what it sounds like.  These diseases do not exist in the state in question.  Now logically that should mean we should be able to transport pigs with minimal effort.  But that is not the case.

My biggest swine producers, (that's right, I get to manage more than one swine operation... how jealous are you guys??) have taken the steps to get their herds certified free of these diseases that don't even exist in the state.  So, we have uniquely identified pigs, in a herd certified by blood testing according to federal standards.  When it's time for these pigs to be moved I should just be able to examine for signs of disease, sign the paper, dot my i's, and cross my t's.  That's how I get them to literally every other state in the continental U.S.... but not Pennsylvania.  Maryland is a Brucellosis and Pseudorabies free state.  Pennsylvania is also a Brucellosis and Pseudorabies free state.  That's right, a state that shares a border with Maryland will not let pigs come in for any reason without jumping through an extra hoop.  The metal tag

How does one get one of these lovely little ear tags into a 200-300 pound pig you ask?  Well, believe it or not they don't just stand there and let you stab a hole through their ear with a large, jagged piece of metal.  So we snare them.  Now before you animal rights people jump on your high horses and tell me how cruel this is and how I'm a horrible person, let me say that while the pigs do squeal in protest at being caught, there is no lasting mark or pain from the snare.  I know this because after being released they go right back to eating. They just brace their feet and whatever we have to do takes less than 30 seconds.  Usually.  And this where today's story begins.

I was tagging pigs to go to Pennsylvania and a 265 pound duroc barrow took me out.  He was snared and I was bending down to clamp in the tag.  But this pig, oh this pig he was different.  He did not read the manual on how pigs are supposed to behave on the snare.  Rather than bracing his feet... he lunged.  Only he didn't just lunge, he jumped.  Turns out, pigs can jump. This pig jumped so high, he full on body-slammed me.  He hit me with everything he had right in the xiphisternum (solar plexus for those of you who didn't have Dr. Kent Scarrett as a professor).  This sent me flying backwards and since he was at an upward trajectory, his nose clipped me right under the chin in perfect uppercut fashion.  To add insult to injury, the force threw me backwards so far that I landed right on my ass in his mud-wallow.

I now know what people mean when they say they "got their bell run."  I pulled myself up and to be perfectly honest I wasn't quite sure what had happened.  I knew that my head hurt and felt fuzzy, my teeth hurt, my ribs hurt, I wanted to puke, and my ass was soaking wet and throbbing.  The owner filled in the blanks.  In his words: "Holy crap!  I've been raising pigs for over 40 years and have never seen a pig do that! I didn't know a pig could do that!  Man, you looked just like a quarterback being sacked by Polamalu!  His legs went around you like arms and everything! He took you OUT!" <pause>  "Are you okay? You don't look so hot."

I stumbled out of the pen, took off the muddy coveralls and ate 4 Advil.  Then we tagged the other 30 pigs, and let me tell you, I was pretty damn wary about it.  The owner just couldn't get over it.  Kept comparing the situation to a quarterback sack.  He had the nerve to tell me that now I  know how those poor guys feel when Polamalu hits them like that.

Troy only weighs 207 pounds, which means the pig has basically 60 pounds on him.  Without doing too much research, I'm estimating that the average NFL quarterback is 9-12 inches taller than I am and a solid 100 pounds heavier.  Also, they wear pads.  Considering those things, I don't care that they take a hit from a guy who is running at them full speed.  With those kind of stats (the pig and mine) if that pig had been running at full speed and hit me like that, I would be dead. 

So that was my Monday; I challenge any of you to beat that.  In the meantime, I'll be lying on a heating pad, clutching a bag of ice to my chest, and fantasizing about two things.  1) Prescription-strength pain pills and muscle relaxers, which I cannot have because I wouldn't able to drive myself home after taking them and 2) being a trophy wife. 

Sunday, September 9, 2012

Useful Items

During vet school, everyone discovers that there are certain things that they should have available in order to make it through the day.  An extra pen, notepad, chapstick, your glasses for the 20+ hour days when your contacts have begun to feel like sandpaper. In large animal land you also realize that things like sunscreen and bandaids should be in your bag. 

Once you are out in your own truck, you realize bandaids are not that important, after all you have access supplies for your patients and what's good enough for them should be good enough for you.  But there are some things that you will definitely want to have that you don't think about until you don't have them.

1.  Fingernail clippers.  There will be lots of  days when you get home that you will be too tired to do anything.  Even trim your fingernails.  The day after those days, you are pretty much guaranteed a colic, a dystocia, and/or mud wrestling pigs.  All things where fingernails are contraindicated.

2.  A spoon.  There will be a day  where absolutely nothing is going right.  Appointments/emergencies start an hour or more earlier than you expected.  The schedule will change your direction so many times that your GPS system will give you an error message basically telling you to go screw yourself.  And on one of those days, you will have diligently taken food with you, maybe some yogurt for breakfast or a salad for lunch...something sustain you.  But you forgot the utensil.  On that day, your on-the-go meal will mock you until you want to cry.  Keep a spoon in the truck.

3.  A roll of quarters.  Thing of it as your emergency money and keep it in your glove box.  Why coins? Well, paper money gets lost in the paper shuffle  And trust me, with the amount of paperwork that we have to process daily to keep the government, your clients, and your employer happy, you will lose a $10 bill.  And every value meal at every fast food joint in America costs less than $10.  Don't be caught at the drive-through window with no cash and your debit card still in the back pocket of your jeans from the day before.

4.  Extra clothes.  I'm talking more than the basic extra coveralls and/or scrub tops, those are a given and you already learned that in vet school.  No, I'm telling you that you need at least 1 full change of clothes - from the skin out.  Probably not such a big deal for the dudes but trust me ladies, there are few feelings in this world worse than spending the day wearing bra soaked with another creature's body fluid(s). 

5. Extra sunglasses.  Become a devotee of the cheapo sunglasses sale rack.  The ones that cost $5 or less.  Animals break them and trucks eat them (that's my only explanation for about half of the losses).

These are just the ones that work for me.  How about you?  What are some of your "make through the day" must-haves?  The more unusual the better!


Friday, July 13, 2012

Pulled Pork, With a Side of Braised Tongue

Once upon a time, a (young-ish) girl decided to be a veterinarian.  She thought that she would rather play outside all day than actually make what she was worth, so she decided that she would be a large animal veterinarian.  (Hey, I never said she was a smart girl).  She worked very hard (sometimes) and learned what she needed to know (mostly) to go out into the world and save the animals from themselves (and their owners). 

Not too long after she was set free in the world to do her job, in the depths of winter (and realizing playing outside was not all fun and games) she received (another) late night (alright, middle of the night) call about a pig in labor who needed help delivering her piglets.  Now this was no ordinary pig... she was a champion show pig (i.e: should never, ever, ever, ever, ever have been bred.)  She was long (but not so lean) and by the looks of her belly, plum full of piglets.  The problem with this brand new mama pig was, as I've mentioned before, was built for show (read: walking, oinking meat display), not for mothering.  For as wide as her bum was, (like a proverbial brick house) the pelvis inside was not even wide enough to let the young vet's hand through easily, much less let (big) little piggies out.

The vet lubed and wiggled, sweated and cursed (mostly under her breath, for there were impressionable children there) and managed to get a snare around the stuck little piggy (while it chewed the bejesus out of her fingers).  With the snare in place, she pulled and pulled, with all her might (seems a little big bad wolfish now), but the piglet wouldn't budge.  Never before had a stuck piglet not been able to removed from its mother in this method, so she decided to pull, One. More. Time.  And lo!  Something was giving: the piglet was on its way out into the world! 

All of a sudden, there was a swift release of pressure, and a bang!  The vet felt the air rush from her chest and there were shooting stars all around.  An exclamation from the farmer brought her back to her senses.  She was 4 feet behind where she last remembered being, and their was a goose egg forming on the back of her head. A little girl was staring at her in awe.  In her hands, the snare.  Tangled in in the snare, the head of a piglet. 

Through the haze of a (probably mild) concussion, the vet started to piece things together.  The bang was her head against the cement wall of the farrowing barn, which understandably knocked the wind out of her and caused (temporary) visual impairment.  The farmer's cry was disbelief (and probably a little bit telling his kids not to look.) Above all, one thing stood out... she had literally pulled the head off a living creature with her own brute (stop laughing) strength. 

I wish I could say the story had a happy ending, but facts are facts, and the fact was that a headless pig was totally stuck in the birth canal and nothing else was coming out that hole. A sacrifice C-section resulted in 7 surviving piglets that only actually survived for 2 days (not the her fault.)  But now, when the vet finds herself in a sticky situation (like shoulder deep in a uterus that is full of rotten calf soup while the cow squirts all over her), she reminds herself that if she's strong enough to pull the head off a live piglet, she is strong enough to do anything.  Which sometime means accidentally (really, it was an accident) pulling the tongue out of a dead calf (look, the top of a pluck!) and throwing it at the feet of a shell-shocked intern. 

The direction of the toss was totally just for funsies.

Wednesday, July 4, 2012

Fourth Thoughts

First things first.  A big thank you to the men and women of the armed forces who are doing what most people (including me) are unwilling to do. Also many thanks to their families to who give just as much as those in uniform.

Now, I have a few thoughts about the horrible storm that went through West Virginia last week and resulted in a state of emergency.  I'm incredibly thankful that I am not having to go through this and I'm truly sympathetic to those of you who are.  But, as bad as it is, I know West Virginia is one of the places that can handle it, for no other reason that it's still a place where people take care of each other. I'm sure the rest of the affected states will eventually figure things out as well.

On to the logistics.  Many of the structures that were destroyed are in difficult to get to areas and there are not "extras" just lying around to be put up in their places.  These crews are working 16 hour shifts, in 90+ degree temperatures, in direct sunlight... and a whole lot of them have been brought in from multiple states away.  They are away from their families, living in group housing, and you all have to admit that in these kind of conditions, no matter how much they are being paid, it's not enough. So that crew... that guy hanging off the electric pole a couple streets up from you?  The one that you posted a nasty message about because they left after finishing that street?  Shame on you.  He's probably not a local, and going to West Virginia to work over a holiday was probably not on his bucket list.  He's going where his bosses send him and fixing things (correctly) as quickly as he can.  And he would probably appreciate a glass of sweet tea.  So can the negative talk about the electric companies and how their workers are handling things.  Be grateful that more lives were not lost and that aid has been available for those who need it.  Oh, and when you're posting all your thanks to god for restoring your power, maybe send a shout out to the power crews too.

On a lighter note, I was very excited to have a holiday off.  Usually holidays land on my on-call days, so even though I don't have scheduled appointments, I do have to handle all the emergencies (and usually I'm covering for at least 1 other vet/practice as well).  To celebrate I decided to go out and check out some retail sales; you know, support the economy.   A dozen or so stores (and dressing rooms) later, I had purchased exactly nothing I was feeling pretty bad about myself because that's what stores do to girls who aren't 6 feet tall and weigh more than 100 pounds.  I really don't have time or energy to exercise more right now, so I came up with an alternative solution.  I got myself a low-fat frozen yogurt and went to Walmart.

Wrong? Probably.  Effective?  Absolutely!

Monday, July 2, 2012

Tears

Tears are a part of the job.  Some owners will cry at the drop of a hat, even on happy occasions, but usually it's a sad situations when the tears come out.  Euthanasia is part of the job but sometimes I think that veterinarians are very unprepared to deal with the owners when that time comes in an animal's life.  For me, it usually comes down to preparing them for what is going to happen to the best of my ability and then hoping I've read them correctly when it comes to offering support after the fact.

There are several types of tears, when it comes to an owner saying goodbye to a pet.  There are the quiet, dignified tears that trail down the cheeks and are gracefully wiped away.  The snuffling/snotting tears that make it difficult to understand what they are trying tell me . Hiccup tears aren't super common, but they happen.  Wavering-voice tears can be primary, or a secondary effect of quiet/dignified tears and usually mean that the person is struggling to hold it together, but is determined to at any cost.  Probably the most dramatic tears are the throwing themselves on the ground and/or body and screaming, "WHY??????????????" tears.  And no, I'm not joking about that last one.  I've had to deal with that three times - once in the middle of a muddy field in the pouring-down rain.  They don't teach that anywhere in the vet school curriculum. 

The last type of tears, is the one that is the hardest to deal with.  I'm still not sure what to do with the man-tears.  When my female clients cry, I feel that they appreciate me acknowledging their pain and talking with them for a bit after the fact.  Men are different - and I've determined that they are three rules of man-tears.  First, they absolutely do not want to cry.  Second, they really do not want to cry in front of a girl. Third, when they do cry (and they will), in front of a girl, they don't want it acknowledged.  That third component is what makes me feel weird because I'm never sure how to...exit the scene.

Today I made another man cry when I euthanized his first horse, and he held true to all three rules of man-tears.  I hated that I had to make him cry, but for personal (selfish) reasons along with the usual ones.  My client was single, around 30 years old, about 6 feet tall, dark blond hair, green eyes, a nice summer tan, and horseman muscles.  You know, Julie-kryptonite.  To seal the deal, he had a very light German accent.  That's right, not just hot - European hot.  But there is no coming back from the fact that I made him cry.  It is something that can't be overcome.  I saw him cry and he'll never get over that.

Saturday, June 16, 2012

Just Out of Reach

Wow, long time, no blog.  It's not that I haven't had ideas, it's just that none of them have... solidified.  I get brief thoughts while I'm driving that I can't seem to turn into a decent posts once I get home.  The worst part is that the wisps keep circling in there, and frankly, things are getting crowded.  So, I'm going to try and turn some fragments of thoughts into a group of "shorts" that will be worth reading, and also either 1) get them to go away or 2) help them firm up into something useful. 

Maryland drivers.  Probably the most frustrating part is their complete lack of understanding of the yield/merge procedure.  I think in the licensing handbook, it must explicitly state that moving traffic is required to yield by any means necessary in order to allow ramp traffic to join them in the fray.  And by "fray," I mean giant cluster***.  Seriously, these people are kamikaze pilots that will wrench their car onto a freeway with absolutely no regard for the fact that there is a 99.9% chance than another vehicle, going upwards of 70 mph, already occupies that space.  But I did not learn to drive in Maryland, and I drive a big ass truck with 243,000 miles on it and I would LOVE a new one... so bring it.

Geography.  I am not a Marylander.  I have been here for almost 2 years now, and I'm still a West Virginian.  My difficulty is that my dream job (6+ doctor,  large animal practice, that requires little to no horse work, no alpaca work, and with a haul in facility) does not exist in West Virginia. So I'm job hunting, hoping to find a practice close to West Virginia, with enough doctors that I can spend more time where I actually want to be AND actually develop a life in the new location.  Oh, and it can't be in Maryland.

Interns.  I just want to say that I am possibly the worst candidate in the world to shape young minds.  Seriously guys, I'm way too honest to be dealing with impressionable youth.  Because they ask me about things like, student loans and exactly how much I love my job.  And I don't tell them to pick another career path and sell a kidney if it means they won't have to take out loans (I'm not that bad), but I'm honest.  I have already had the world's worst (college senior guy, asked me why girls died after having sex with a horse) and candidate for the world's best (licensed vet tech with an ag degree).  My current intern is so sweet she makes my teeth hurt.  Eighteen years old, cute as a button, and so enthusiastic and happy that I'm really not sure what to do with her.  Should be an interesting summer.

Summer fun.  I'm doing a lot of traveling to see friends and family this summer.  I spent a weekend with my twin and her family to meet my niece, who is the most perfect, beautiful creature I have ever seen.  I spent a weekend with the travelers of my family who are currently living closer to me than they ever have.  We took a trip to see the space shuttle.  Incredibly impressive that something that large went to space, but I'm still curious about how they got it into the hanger where it's on display because the tail sticks up in the air way higher than the giant door opening.  Two theories.  1) The tail was taken off then reattached inside.  2) Smithsonian museums used some of the budget to buy a lot of pizza and beer and call up a bunch of friends.  Confused?  Think carrying a couch through a doorway.  Pick it up... tilt... finangle... curse... push/pull... PIV-OT (sorry, Friend's reference, had to be done). 

I think I'm going to stop here.  I'm not out of ideas, but it's like 11pm and I'm on call.  

Tuesday, May 22, 2012

A Broken System

I don't have a lot of dealing with the human health care system.  I tend to be a pretty healthy person overall (knock on wood), which is good because I have a massive case of White Coat Syndrome and a deathly fear of needles.  But last week I realized that it had been 3 years since my last rabies titer, and I'm actually supposed to get that checked every 2 years.  And so the journey began.

My first phone call was to the health department to set up an appointment to get the blood draw, which is where my boss had helpfully informed me was the best route to go for this procedure.  Leaves most of the health care system completely out of the equation.  I was informed that because their office was shutting down, they didn't do that anymore, and I would have to go to my PCP.

I don't have a PCP.  I got by with college health clinics for 8 years, and before that one of those one-stop "quick" care places did what I needed.  So I went to the insurance website and found a local doctor's office that was in-network.  Called them, asked if they could do the blood draw, and was assured that it would be no problem.  They worked me in the next day, which I thought was awesome.

Arrived at the clinic 15 minutes before my scheduled appointment time since I was going to be a new patient and anticipated some paperwork.  20 minutes later (5 minutes past my scheduled appointment time) I was called to the window and requested to present my ID, insurance card, and $30 co-pay.  The thing is... I was the only patient in the clinic.  I had the first appointment after their 2 hour lunch break (per the sign on the door).  And all the nurses and doctors were standing in plain view of me during this time, gossiping about other patients.

I thought it was a bit odd that I wasn't given any sort of form to fill out about my health history, but to each clinic their own.  I guess.  I was taken back to a room by a nurse and informed that the doctor would be right in to see me.  25 minutes later, I was still sitting alone in the room.  After another 5 minutes a PA came in to see me.  She asked why I was there, and then took the briefest medical history in history.  She told me a nurse would be right in to draw my blood.  20 minutes later the nurse came in and said that they could not pull the blood for the rabies titer at their office and that I would have to take a lab form to the local hospital.  Fine.

I went to the hospital outpatient lab.  The hours on the door said 7am - 6pm.  I got there at 3pm and was told that they did not draw blood after 2pm.  Um, what?  They told me that I would have to to to their off-site outpatient lab, but were unable to give me an address or any directions, just that "it's near the Rosehill Plaza."  I kid you not.  I was able to keep myself from smashing my fist through the wall, but unable to keep myself from crushing my lab request form into a tiny little ball and storming out, slamming the door behind me. 

Thanks to Google, I figured out where I need to go, so off I went.  At my next stop, I learned a very important lesson.  If you walk into a medical facility like you own the place, march up to reception desk, throw your re-flattened form down, and say, "Ma'am, I sure hope you're able to help me because no one else in your health care system seems to be able to," you go right to the front of the line.  Seriously.  They took me straight to a desk, with a very helpful young lady running the computer, and sent a person from the actual lab to personally find out if the test could be run.

I would like to take this opportunity to send many thanks to Casey, who handled the intake paperwork correctly, efficiently, and with a smile... in the face of an obviously upset person.  I send a million billion thanks to Jessica (my phlebotomist) who, seeing a terrified person, managed to get the necessary blood with a teeny tiny butterfly needle on the very first try, and then gave me a moment to regulate my blood pressure before asking me to get up and walk. 

After this, I was fairly certain that there was little to no hope for the human health care system, but a phone call this morning confirmed it.  I got a call from the initial doctor's office asking me, "Um, did we give you a green form to fill out with your medical history when you came to see us?  No?  Um, could you come by and do that?  Or I could mail it to you if you promise to mail it back?  Um... I'll do whichever is easiest for you, but I really need you to fill out this form."

I still can't believe the steps it took to get a blood test.  If I knew where to send it, (and didn't have that hardcore fear of needles thing going on), I could have drawn the blood on my own.  Seriously, I have the equipment.  There was just so much failure of the system... throughout the whole process.  Maybe I'm just naive.  One of the good things about my job is that I'm not limited by a government-based system when it comes to dealing with my patients, but still.  When someone makes an appointment with me, I know to check and be sure that 1) have the proper equipment/information, 2) that I know where to send any samples, and 3) that I will actually be willing/able to do the freakin' procedure!  I'm not even going to touch the blatant HIPPA violations, the complete lack of medical history for a new patient, or being charged a co-pay for being ignored, handed a generic piece of paper, and sent to the wrong location for follow-up.

Oh, and in case you were wondering, I still haven't gotten the results of the blood test despite being told that they results would be reported in 2-3 days.  I don't have the time (and definitely not the patience) to track it down.  I guess if I'm exposed to a potentially rabid animal, I'll remember to wear gloves, and keep my fingers crossed that the owner is willing to submit it for testing if it dies.  And if they're not, I'll just keep playing Russian roulette with not getting post-exposure vaccines.

Monday, May 7, 2012

Beyond Help

6 p.m. Friday
Dr. D: Hello, what's going on this evening?
Client: I have a baby goat with scours and I've already treated him.
Dr. D: Good job.

3 p.m. Saturday
Dr. D.: Hello, what's going on this afternoon?
Client: My alpaca fell over and had a seizure!
Dr. D: Ok, I'll started heading your way, try to keep him from smacking his head on the ground.
Client: Well he's not doing it now... this happened around 9 a.m.
Dr. D: What's he doing now?
Client: Eating.
Dr. D: Call me back if he has another seizure.

9 p.m. Saturday
Dr. D: Hello, what's going on this evening?
Client: I have sick kittens.  They are sick and I need medicine.
Dr. D: You know I only work on large animals, right?

7 a.m. Sunday
Dr. D: Hello, what's going on this morning?
Client: I'm leaving for a show in less than an hour, and lost my Coggins, so I need you to fax me a copy, right now.
Dr. D:  Well, I will call the office [at my boss's house] and see if someone is there to fax you a copy, but I'm not sure if anyone is home.
Client: Then you'll just have to drive over there and fax it yourself, won't you?
Dr. D: I live 30 minutes from the office and I'm not even out of bed and showered yet.  I can guarantee it won't happen in less than an hour.

10 a.m. Saturday
Dr. D: Hello, what's going on this morning?
Client: I have a heifer having trouble calving.
Dr. D: Alright, I'm on my way, go ahead and get her caught up, preferably in a chute.
Client: I don't think that's possible, she's down out in the field.
Dr. D: Can't get up down?
Client: No, she gets up and runs away when you walk over to her.
Dr. D: I don't think it's possible for me to pull a calf without touching the cow.

11 a.m. Sunday
Dr. D: Hello, what's going on this morning?
Client: I think my horse's hoof is going to fall off.
Dr. D: What makes you think that?
Client: Because of the way it looks.  He's fine otherwise.
Dr. D: I think it's highly unlikely, but I can come take a look.
Client: But I'm not there, and I won't be back until Tuesday.
Dr. D: Call me on Tuesday.

6 p.m. Sunday
Dr. D: Hello, what's going on this evening?
Client: I have a calf with scours, and I've already treated him.
Dr. D: Good job.

Monday, April 30, 2012

A Timely Fashion

I think one of the most common complaints about veterinarians is that (in the client's opinion) we play a little fast and loose with the clock.  I personally believe that there are some veterinarians who couldn't tell time if their lives depended on it, but believe me when I tell you that most of us really do try.  Because, let's be honest here, we do have lives outside our job *shock*gasp* and do like to get home at a reasonable hour. 

I can't speak for the small animal guys (but maybe some of them will chime in), but in large animal land the time we give you is very truly our best intention.  I leave everyday with a plan... some days things move right along and others I might as well have just rolled a dice to decide where to go and when. I can't control emergencies, traffic (but I do believe I should be allowed to have a flashing red light in order to make better time), or appointments that take longer than I expect.  More about this last factor in a bit.

I expect my clients with scheduled appointments (i.e. routine vaccines, health papers, herd work) to be a little flexible.  The rationale is that if they have to wait, it is most likely because I have gone to take care of an emergency.  That lets them know that if they ever have an emergency, I will reschedule non-urgent things in order to get to them as quickly as possible.  The vast majority of people are fine with this, and all they need is a phone call to let them know an updated time frame which I am more than happy to do.  They are great and I adore them for their understanding.

Emergencies are part of life, but too often my scheduling problem is with a scheduled appointment.  I always call when I'm on my way to an appointment in order to let the owner know a pretty specific time (thank you Garmin) for when I will be there.  When I get there, I expect them to 1) have their animals caught and 2) have a basic idea of what they would like me to accomplish while I'm there.  That's all folks. I really don't feel like I'm asking for a lot. 

Today I had two scheduled appointments that were given a 1 HOUR notice that I was on the way.  At the first, there was utter chaos since no one was sure what horses needed to be looked at, why I was there to look at them, or what sort of vaccines and/or blood tests needed to be done.  I was there for 45 minutes before I actually touched a horse, and even then everything took twice as long as it should have since none of the animals were ready.  The second problem place was to castrate a goat.  A "wild as a deer" goat (not an actual breed... yet).  Zero effort was made to catch this animal (in a huge pen) before I arrived.  None. Half an hour to catch the animal for a 15 minute procedure.

To anyone who has ever grumped about their veterinarian not being on time, realize that there are things out of our control and that we are doing the best we can.  And for the love of all that's holy, when we do get there, be prepared.

Saturday, April 21, 2012

Wimps Need Not Apply

No one has ever accused me of being one of those delicate flower types of girls; more than once I've been called tough as nails. Both of those are good things because vets need to be tough and not just mentally tough.  I'm talking about the physical stuff.  We are constantly bending, lifting, restraining, and dodging.  The small animal vets are dodging teeth and claws, and the large animal vets are dodging everything else.  Bottom line: I am more than capable of taking a hit and getting back up, but damn.  This week has been ridiculous.

Monday - Kicked in the ribs by a 200 pound calf.

Tuesday - Slammed into a barn by a horse. 

Wednesday - Kicked in the mouth by a 50 pound lamb.

Thursday - Worked through the pain from the first 3 days of the week.  By "worked through" I mean drove nearly 400 miles and saw 11 appointments, all in 12 hours.

Friday - Got my ass handed to me by an alpaca.  It was down, sedated... and then... well to be honest I'm not exactly sure what it did.  But one second I was standing and the next I was flying backwards, landing back first on my metal bucket 4 feet away, and had an alpaca tap dancing on my torso.

Today has been okay so far, but at the rate things are escalating..... *shudder*  I just ask that, for the rest of this weekend, the on-call gods be kind to me as I continue to move gingerly, that Advil continues to relieve pain without putting a hole in my stomach, and that any other sick/angry animals target uninjured body parts.

This job is hard.  Wimps need not apply. 

Saturday, April 7, 2012

Bad Moon Rising

I know what you're thinking.  You're thinking, "Did she mean to reference CCR in the title of this post?"  (That's Creedence Clearwater Revival for those who have been living under a rock.)  And yes, yes I did.  If you don't know me well, it might surprise you to find out that I have a pretty eclectic taste in music. My iPod looks like it belongs to someone with multiple personalities.  The last 5 artists that have played are: George Jones, Luciano Pavarotti, Ke$sha, CCR, and Maroon 5.

Anyway, back to CCR. I don't know if you've ever actually listened to all the lyrics of "Bad Moon Rising," but if you haven't, check them out here.

Now, I don't know if John Fogerty realized it at the time, but he was writing the story of on-call veterinarians.  Because there is absolutely no good that can come from being on call during a full moon.  Particularly a full moon that falls on a weekend.  Make it holiday weekend and you've got the trifecta from hell.

I would love to go into details and give you some examples right now from just this weekend so far (and I've got some good ones), but my phone just rang again.  I'm sure it's another disaster.

Monday, March 26, 2012

Pavlovian

Pavlov rang a bell and then fed his dogs.  He did this enough that the ringing of a bell caused the dogs to begin salivating, even if there was no food.  It's what's known as a conditioned response.

My boss went to a conference last week and left me in charge of the practice.  The whole practice.  The constant phone calls, the questions, the scheduling, the emergencies.... the whole nine yards.  It is the second time this has happened in about a 6 week period. 

Last week, every time I attempted to eat, the phone rang.  Tonight at 5pm when for the first time in 176 hours I was completely off the clock and ultimately free, I walked into my kitchen and realized that I wasn't at all hungry, and haven't been actually hungry in days.  I have eaten but.... eh.

Apparently my brain has started associating the presence of food with the ringing of the phone. When the phone rings my heart rate sky-rockets, my stomach clenches, and I swear I can actually feel the rush of adrenaline through my veins. The phone in my life rings so often that the sight, smell, or idea of food fills me with anxiety, so my brain has just decided to not want food anymore.

I heal the sick animals, maintain the healthy, and provide support to their owners, but at the end of the day I'm just one of Pavlov's dogs... in reverse.

Tuesday, March 20, 2012

Foodie

Many people consider a foodie to be someone who enjoys fine cuisine. You know, the kind of people who don't eat dinner until 9pm, expect the meal to have at least four courses, and want a specific wine to go with each dish.

In the circle I travel in, a foodie means something completely different.  Instead of being someone who enjoys fine dining it is used to refer to a person who would like to practice medicine on animals that make (or are made into) food.

Tonight I decided that there is a third definition for the term foodie.  For me, a foodie has become the teeny, tiny amount of sustenance that I manage to consume at one time.  Because I don't really get to eat "food," I get bits and piece.  Little foodies.

Breakfast (a meal I eat grudgingly because I don't particularly like food early in the day) is consumed as I'm running out the door.  Lunch, which I have to eat while driving between appointments (and so is always something blah like a boring sandwich that won't fall apart as I hold it and eat one handed) is almost invariably interrupted by another call "on the way" so that instead of having 20 minutes to eat, I have like... 4.  And by the time I'm back in the truck my body has given up hope of food and I'm not longer hungry.

Dinner I do get to eat the days I'm not on call.  Unless I get sent on a 5pm call an hour away from home that takes at least an hour to do, resulting in an 8pm quit time.  If I were a foodie in the first sense of the word that would be perfect, but alas, I am not a first type foodie and I'm sure as hell not cooking for one after 8pm.  Days that I am on call are just hit or miss.  I don't try to make an actual meal, just consume enough calories to keep going.  Of course that isn't fool proof either, usually because horse people are freaking nuts.

So it's almost 11pm. Today I managed to consume an English muffin, half of a sandwich, 2 bottles of Gatorade, and 8 strawberries.  I shudder to think what would happen if I didn't have this job and was able to maintain a balanced diet with regular meals.  I would probably weigh a ton.

Friday, March 2, 2012

Farming 101

Let me preface this by saying that I am not a farmer.  I can't tell you how to properly fertilizer your fields or what you should spray to kill thistles.  I couldn't fix a piece of machinery if my life depended on it and I have absolutely no desire to learn.  That being said, I feel as though I know more than a little about animal handling facilities.  Not only because I'm a vet, but because I grew up working with farm animals.  So to start off my Farming 101 course, here are a few definitions.

Hinge: Gates hang on them so that they may swing freely, in one or both directions.  A secondary use is for bruising arms, shoulders, knees, and shins. 

Gate:  Used to separate groups of animals. They can also be used to keep animals in a particular area, or out of an area.  Like your snooty neighbor's yard.  A third use is to allow people and vehicles to easily get in and out of particular areas without climbing over the fence.  Note: If not on hinges, a gate is simply a panel and should be considered immobile.

Fence: Stationary structure to contain animals.  May be present outside as a property boundary or indoors to make small areas (aka pens or stalls). Should be composed of sturdy materials (wood, not plastic) and attached firmly to both the ground and the other sections of fence.  Note: gates resting on the ground and functioning as panels can be placed as if they are fence but will not work successful if challenged by anything stronger than a ground mole.  All fences should, at some physical point, possess a gate (on hinges.)

Barn:  Large structure for containing animals, feed, and/or machinery.  Consists of walls, a roof, door(s) or gates (on hinges), and a floor.  Interior structures include, but are not limited too: sturdy stalls or pens (with gates [on hinges]), overhead lights (with bulbs), and at least one electrical outlet.  Configuration of these components is at the owner's discretion.

Concrete: A nice flooring alternative to M.U.D.  (manure, urine, and a little bit of dirt.) Can be scraped down, hosed out, and generally kept clean.  Not to mention it is solid and thus the animals (and humans) won't sink in to their knees making movement much easier.  This substance should be used both inside the barn and around the outside of the barn (aka the barn yard) where animals will be shuffled back and forth between sections of fence.

Roof: Part of the barn used to keep rain and snow off things (animals, veterinarians, feed materials, ect) inside the barn.  Anytime a hole appears in this structure, it should be properly repaired in a timely manner.

Squeeze chute: Metal structure essential for doing anything to a cow.  These are available for purchase fully functional and are worth the money.  Attempting to create on of these by yourself out of scrape wood will result in incorrect proportions, non-functional gates (aka panels or fence), and the inability to accomplish even the simplest task in a timely manner.

That is our lesson for today ladies and gentleman.  Next time we will cover basic signs of disease and distress, when to call the vet, and why you should not get your medical advise exclusively from the feed truck driver.

Monday, February 27, 2012

The Scorecard

I have worked for 15 straight days.
Of those days, 10 were regular appointment days. 
The other 5 were emergency only days.
I was on-call for 10 of those days.
I was a solo practitioner for 6 of the on-call days while my boss was on vacation.

Our practice radius is ~40 miles.
I have seen 41 appointments.
I have been on 13 emergency calls.
I have delivered 11 lambs, 3 (goat) kids, 12 pigs, and 3 calves.
I have answered 55 other phone calls from people asking/needing/wanting/thinking/whining.

Last night I had to to go to the farm owned by the gentleman featured in my last post.  He looks like Keanu Reeves and curses like a drunken sailor.

Sleep tonight is going to be amazing.

Monday, February 20, 2012

Doctor, May I?

2 a.m.

*ring ring*

"Hello?"

"Doc, I've got a ewe in labor, one hind leg out since midnight and she's not making any progress.  <lots more talking, blah blah blah, I'm sooo not listening to the details, but then I hear something that makes me tune back in> I don't want you to come out, I just wanted to know if it was alright for me to go in and find the other leg."

What I want to say, "Dude... it's 2 o'clock in the morning and you've just told me that you decided to wake me up even though you don't want my help.  I honestly don't care if you want to pick her up and try to shake the lambs out."

What I actually say, "Yes, you should definitely go in and get that other hind leg.  Wash your hands, and use lots of lube. Get that leg extended behind and then pull the lamb.  I'm sure she would be glad for some help after struggling for 2 hours. Call back if you decide you need some help."

*Lights off. Back to sleep.*

Thursday, February 16, 2012

Death and Taxes

"In this world nothing can said to be certain, except death and taxes."  ~Benjamin Franklin

I don't have much to say about death other than it's just a part of life.

Taxes on the other hand... ugh.  I had my yearly date with one of Uncle Sam's minions this week and now I need to vent a little. 

Per my W-2 form, the government took over 27% of my salary this year.  Most of it went to the federal government, a big chunk went to Social Security (that economists say I'll never benefit from), another piece went to Medicare (I pay for my own health insurance), and the last bit went to the state of Maryland.  Regardless of the breakdown, that's a lot given that I'm also paying the government a significant amount of money for allowing me to spend 8 years in college/professional school. 

Speaking of student loan debt... anyone still in school, listen up.  I know that all along the way they tell you that it's okay to take out student loans because they are tax deductible.  Which is true.  Kinda.  Here is the fine print.  No matter how much money you pay back in a year, you can only deduct $2500.  Sucks, right?  It gets worse.  For every penny you make over $60K, the amount you can deduct goes down. So instead of a refund, this year I am required to pay additional taxes.  Because, you know, I have spare money just laying around and no idea what to do with it.  

The most ridiculous part of the whole experience was that my tax professional took it upon himself to advise me of how to gain additional deductions.  His first suggestion was that I adopt a child.  That's right.  Knowing that I'm a 28 year old, single female who rents, and works the equivalent of two full-time jobs, he decided that best way for me to get a tax refund (and thus have a more money) would be to add a child to my life.  Oh, and apparently I don't look fertile enough to make one of my own.  Ugh.

Death and taxes.  Ben Franklin was one smart cookie.

Sunday, February 12, 2012

Random Musings From a Lazy Weekend

If I had a mini-fridge in my bedroom I would probably not leave my third floor sanctuary (aka my bedroom/bathroom) on my weekends off. And I have a spare walk-in closet that could house/hide one.

Kindle is the best invention ever. Period. 

It bums me out that authors never use the name "Julie" for the main character of a novel.  They might use it as the name of the hero's dead wife/fiance, but never for the main character.

If I could make a living reading chick lit (smut, bodice-rippers.... whatever you want to call them) I would kiss vet med goodbye.

If I were not a large animal vet, I would not need to rent an entire three-story townhouse in order to have access to a parking spot near outdoor electrical outlet (for the truck). I could rent a nice apartment for a much more reasonable price.  And I wouldn't wake up two flights of stairs away from the kitchen, so I wouldn't desire a mini-fridge for my bedroom.

Apparently I think in a circular fashion. Bummer.  I don't  like circles.

Wednesday, February 8, 2012

Compliments

I'm human, and humans like being complimented (it's an ego thing).  Since I spend my days covered in various bodily fluids, compliments directed at me are never about my appearance and tend to go something like this:

"Wow, you handled Mr. Crazy-Ass Horse with No Manners really well!  He only rammed you into the wall twice and last year he threw the vet into the wall at least 5 times."

"I really appreciate how sweet you were to Ms. Hundred Year Old Decrepit Goat.  It's like you understand how frail she is and that I love her need her to live forever."

"Did you grow up on a farm?  It seems like you've actually got some common sense and creativity about working with cattle, which is nice since I do not have, nor do I intend to get, a proper restraint system."

And today, during the most difficult calving I have ever had to attend I got a really awesome compliment.  A dairy farmer said to me, "Damn girl, you are strong!"  And my adrenaline was pumping fast and furious, so I was like, "Hell yeah I am!" 

In a world where the media tells us that women are supposed to be pretty first and then smart/strong/capable, it feels really good to be appreciated for my brains, strength, and abilities. I'm not society's feminine ideal, but that's okay.  I am woman, hear me roar!

Sunday, January 29, 2012

Alone

My truck broke down tonight.  As I was on my way home from an emergency, the intermittent rough grinding noise that I had been telling the mechanics about (but they couldn't recreate) got about 10 times worse and the truck would no longer shift into gear.

I put in a call to my boss, no answer.  Left a message and waited.  And waited and waited.  As I was waiting I had a sobering realization.  Other than my boss, there is not one single person within a 4 hour distance who would actually care that I was broken down on the side of a country road at night.  Not one.

I spend 50-60 hours a week seeing appointments.  I'm on-call for a week at a time, every other week, which means that I spend literally half of my life on-call.  It is not a situation conducive to making friends.

I'm good at my job, but I'm very alone.  Is this what I'm supposed to be doing?  Is this where I'm supposed to be?

Tuesday, January 24, 2012

I'm Not Your Sweetheart

I get it.  I look younger than I am.  I get carded at restaurants and the occasional rated-R movie.  Many of my clients have remarked that I look barely old enough to be out of high school, much less be a fully qualified veterinarian.  And those remarks have been made in both casual observation and dirty-old-man-leer form.

I'm also aware that I do not enforce a high degree of formality.  I don't object to my clients using whatever combination of title/name that makes them comfortable.  If calling me Julie instead of Dr. Dawson helps them ask questions while I'm there instead of 3 days later when they've completely screwed up my treatment plan, I'm all for it. 

But on some occasions I do have to make something clear.  It does not matter how many times I have been to their farm to take care of a sick animal or how comfortable they feel around me.  I am most definitely not their sweetheart.  I am the doctor, and I deserve to be respected as such.

Wednesday, January 11, 2012

The Same Pet... Again

Tonight during my late evening channel flipping I stumbled across a TLC documentary entitled "i Cloned My Pet," and naturally had to check it out.  The title was not a gimmick; the hour long show followed three individuals who sent DNA samples form deceased dogs to South Korea for cloning.  Turns out, you can have the "same" pet again for the low, low price of $50,000. 

There was the New Jersey financial adviser who had recently lost her job.  The former Los Angeles bad boy who literally started a string of business for the sole purpose of raising the money for the cloning.  Lastly, a woman sitting in a maximum security prison (location not revealed) awaiting trail for trafficking firearms. I spent most of her segments wondering if the reason for the trafficking was to raise money for the cloning or if it was a previous "business" venture.

Despite the geographical, cultural, and financial differences in these people, they were all definitely what could be categorized as "fur parents."  They openly admitted that these dogs were the loves of their lives, and far more important to them than any other living creature, including people. And they were all willing to wait years (3) and do whatever it took to get the money to make their dream of a clone come true.

I won't tell you the outcome of the situations, just in case you decide to try and catch this on a re-run. But I can't help but wonder how this will change veterinary medicine.  How will owner expectations of their veterinarian change?  What exactly ARE the owners' expectations regarding the life of this pet? Do we routinely monitor for problems that were seen in the original?  How will we explain to owners any medical conditions that occurs in this version of a pet that wasn't there the first time around?  But first and foremost, how far will this actually go and how common will it become for us to have patients that are clones?

Veterinary medicine is never boring, but the future could potentially be more interesting than I ever realized.

Monday, January 9, 2012

Superstitions

Prior to becoming a veterinarian I was not a superstitious person.  I walked under ladders, ignored black cats, and if a mirror broke I was more concerned about getting the mess cleaned up than a run of bad luck. But these days I don't just have a couple superstitions, I have multiple.  Here are the top 5:

5) Less than three gallons of mineral oil in the truck will result in an outbreak of impaction colics and/or grain overloads.
4) Less than two pairs of clean coveralls in the truck will result in multiple dystocias.
3) I don't turn the page in my appointment book the night before.  Doing so is a guarantee of an 11:45pm emergency.
2) I take my work phone to the bathroom with me.  If I don't, it will ring, even if it has been quiet all day.
1) I don't turn off my GPS until I'm parked and have turned off the ignition.  Premature GPS shutdown is the number one cause of a last minute appointment.

Yes large animal owners of Maryland and Pennsylvania, your sane, rational, talks-you-off-the-ledge-because-you're-a-nut-job veterinarian... is in fact a superstitious freak.  You made me this way.