New Directions

Wow, what a whirlwind this past week has been.  I maybe should have taken a little more time between ending one job and starting another, but on the other hand after 3 days of "unemployment" was literally about to bounce off the walls from lack of activity.  Anyway, after that I experienced more social activity in the past 3-4 days than I've had in the last 3-4 months.  Let me catch you all up:

Monday: finished my old job, then movers
Tuesday: cleaning service
Wednesday: carpet cleaners and landlord checkout
Thursday: met the staff at my new job
Friday: dinner with some South Carolina midshipmen, then out for drinks with their lieutenants
Saturday: regatta in the morning, football in the afternoon, out for dinner in the evening, night tour of the observatory and wine overlooking the best view in the city
Sunday: Julie and Sherrie take on D.C. (or at least one metro line, one museum, and one restaurant)

Then today was my very first day  as a small animal practitioner.  And it. Was. Great!  First of all, my commute takes me past the national monuments on the other side of the river, which is just cool.  I get to drive against traffic which makes the trip not that bad.  Everyone was so incredibly open and friendly and helpful.  They purposefully scheduled a light morning so they would have time to get me acclimated rather than just throwing me into a whirlwind.  The staff is scarey efficient and get this: doctors just do the doctor jobs, just like they talked about in vet school.

The funniest moment was finding a lab coat for me to wear since the ones they had ordered from my have not yet arrived.  The closest size they could find to fit me falls to below my knees, I had to roll up the sleeves, and you could have put another person inside the jacket.  I'm sure you can imagine the good-natured comments that were made.  At the end of the day, I feel good; I'm not tired and run-down or beaten up.  I feel excited to become more hands-on with patients as I re-learn the ins and outs of small animal medicine, and I feel hopeful about the future.

Freezer Balls

If I've learned anything in my career, it's to pay attention when the client uses the word "crazy."  Doesn't matter who or what they are talking about.  Doesn't matter if it doesn't turn out to be true or relevant.  When they say it, tune in and pay extra attention.

My first call today was a simple one.  Go neuter a 2 month old pygmy goat for a new client.  That is an awesomely easy start to any day.  Got the farm, introduced myself to the client and met George the Goat who was getting a bit too familiar with his sister.  Everything was completely fine and routine.  George was sleeping peacefully with no idea what was about to happen and I was about to begin the procedure when his owner said, "Now you're going to think I'm crazy but... I need you to save the testicles for me."

I haven't had a single person ask me to save testicles since I left southwest Virginia and I've been quite happy about that.  But, she said the magic word so I carefully replied, "Okay, that's not a problem... any particular reason?"

"Well, I know you're going to think I'm crazy but I save them until the animal dies, then bury them with the rest of the body.  I've always done that for my animals.  You can just wrap them in a glove for me and I'll take them to get cleaned up and put in their special bag."

I took a slight pause, which I felt was reasonable under the circumstances.  Then I replied, "Alright, that's an easy enough thing for me to do."  And she kept talking, and it just got better.

"When the power goes out there is always a bit of a frenzy... you know, save the balls!  It's a priority in this house."

Naturally, I had a LOT of questions, NONE of which were appropriate to ask a woman I had known for less than 15 minutes in a professional capacity.  In no particular order...

• Are you shitting me?
• How many sets do you have?
• Do you realize that horses can live for over 30 years? Goats over 15?
• Do your family and friends know you have testicles in your freezer?
• How do you plan to explain this to your children?
• What exactly is the special bag?
• What if the power goes out when you are on vacation?  Do your farm/house sitters have instructions?
• Is freezer burn a problem?
• Where exactly in the freezer to you keep them? Hidden in the back? Tucked in the door? Front and center like a shrine? 
• Do you thaw them out before burial?
• Have you ever forgotten to throw them in the hole and have to dig again?
• Do you have the pieces of your female animals too?
• What have your other vets had to say about this?

In the end I stuck with just one, pertinent question. I began the procedure and after I cut off the bottom of the scrotum, I held it up for her to see and asked, "Do you need this part too?"

She replied, "No no, only the parts he would care about, but thanks for asking!"

Greener Pastures

I haven't written in a while because I've been very tired, very frustrated, and haven't had anything nice to say.  But things are changing so I figure I would let anyone who cares to know in on the changes.

As you all know, I have spent 3 years since graduating from veterinary school as a large animal vet.  It was what I always wanted to do and I was so excited to find a job that allowed me to actually do it, particularly in this economy. I have gotten to see and some some amazing things.  I have met wonderful people.  I will never regret taking this job, but I may regret staying this long because following the dream came with a price.

In a 2-doctor practice, in addition to seeing my share of the appointments, I have had to be on-call every other week.  For the mathematically challenged, that is 26 weeks a year.  I have spent literally (in the traditional sense of the word) half of my life on-call for the past 3 years.  I have averaged 60 hour work weeks and the vast majority of the time has been spent alone except for client interactions.  I've seen my friends and family only a fraction of the times I would have liked to, missing holidays and life events.  The most frustrating part is that... even when I'm off -call, I'm so tired that I don't do anything.  I haven't gotten involved in anything outside of work, which contributes to stress and feelings of isolation.  The few activities I have tried to be involved in haven't worked out because I never get home from work in time to go.  We won't even get into the injuries (both short term and ones that will haunt me forever) I have sustained on the job.

So decisions had to be made.  Did I continue to follow a career path that I had dreamed of since I was a child (but left a lot to be desired in the real world), or did I choose a different path.  My Uncle Rick once said, "If you don't like where you are, change it." And then I read an article called, "Success Is the Freedom to Say No".  I'm not turning down fame and fortune, but I AM saying that I have the right to enjoy my life.  To actually have a life.  That I am more than my job.  To be happy and healthy.

So I'm changing it.  I am moving to Alexandria, VA to work as a small animal veterinarian in a brand spanking-new stand-alone Banfield hospital. It was not an easy decision to leave because I feel a little like I'm letting down clients that have grown to depend on me, the people who supported me on the long journey, and to some degree I feel like I'm letting down myself by giving up on my dream just because I'm tired. But in spite of my worries, everyone has been amazingly supportive of my decision.  Family, friends, and clients alike have said they understand and many are surprised that it has taken this long for me to change careers.

I don't expect my new job to be perfect because none of them are (which is something you don't find out until you graduate.)  I know that there will still be crazy/needy clients that have to be handled with kid gloves.  I know that I won't like all the management decisions.  I know there are days where I will be tired and frustrated.  I know there will be battles I won't win.  But I also know that when I leave at night, my time will always be my own.  I know that my days off will truly be days off.  I know that I will spend my days working side by side with people as passionate about veterinary medicine as I am instead of alone. I know that I will have more opportunities to be with the people I care about, that I will not miss any more Thanksgiving or Christmas dinners.

So that's what's been going on with me.  I'm very nervous and anxious and excited.  I have a lot to remember from vet school and a lot more to learn.  I have to figure out how to dress for an inside job where I wear a white coat instead of coveralls.  I have to figure out what shoes I can wear for a full day on my feet running between exam rooms and not feel like my feet are exploding...

And I can't wait to tell you all about it  :-)

The Things They Don't Teach You

Vet school is a 4-year information blitz at 100 mph from all directions.  A lot of it just sticks long enough to pass the test, some of it sticks forever (although that usually applies to useless knowledge), and the rest of it you remember it as you need to.  Unfortunately none of those things are as important as the things they don't teach you.  Such as:  

• How to explain that all the money in the world can't fix a horse's broken leg if the horse can't walk to the trailer
• How to explain there isn't going to be anything wrong with a 12 year old goat that can be easily fixed
• How to convince someone that the horse that has been itching for 2 weeks can wait until morning
• How to tell someone that you have absolutely no idea why their favorite steer kicks at their daughter
• How to restrain yourself from cursing like an R-rated movie when an animal causes you bodily harm
• How necessary an FM transmitter for your iPod is, because if you hear Carrie Underwood make that screeching sound at the end of a song one more time...
• How important it is to keep your GPS maps up-to-date
• How useful traffic reports can be
• How to fill out federal forms that haven't changed in 50 years to the satisfaction of a veterinarian that wouldn't know a cow if it ran over them carrying a sign saying, "Hey, I'm a cow."

There are others, but now you have an idea of what I'm up against everyday.

Little Victories

Finding a gas station that doesn't have an "authorization limit" on credit card purchase.

Freddie 4-Her with the crazy steers obtaining a head chute.

Finding a granola bar hidden under some coveralls on the day you forgot your lunch.

Going to see a mare with a retained placenta and watching it release(intact) as you park the truck.

Truck trolls releasing all the pens they have stolen before you go buy a new pack.

Not having to trim alpaca nails because the shearer will be there next week.

Sick exotic that you couldn't even identify, much less successfully treat, dying before you get there.

Manicure holding up through at least one day of work.

DA surgery patients being pregnant at the next herd check.

Not having to work on my day off.

A Vision in Slime

No doubt about it: being a vet attracts attention.  For the newly initiated you might assume it has something to do with the truck.  Or the coveralls/scrubs.  Or people reliving their childhood dream of being a vet and being jealous that you actually are one.  And those reason are just adorable.  Feel free to keep thinking them, but stop reading now. 

Here are some examples of why people at the gas station are actually staring at you.

• Shirt on inside out or backwards (Because you ran out the door at 5 a.m.)
• Ripped clothing (Hey, at least you didn't get hurt!)
• Stink bug crawling on your shoulder (Sneaky bastards...)
• Large mystery bruise (That you probably don't even know is there yet.)
• Jeans soaked with various dried bodily fluids (Don't worry, most of those stains wash out.)
• Trying to locate the weird smell (It's you - own it!)
• Placenta stuck to your boot (You'll figure that one out when it migrates down to the sole and makes you fall.)
• Alpaca or llama spit on the back of your neck (Looks like dried grass... but with the smell.)
• Blood spatter on your face (Probably from dehorning calves.)
• Dingle-berry in part of your ponytail (Someone's been doing a herd check!)
• Manure in your ear (Palpating... calvings... just being awake and on a farm...)

In the Hands of Babes

A large portion of my practice is dealing with 4-H kids and their project animals.  The kids are great, the parents are always a bit of a.... challenge.  In a world of helicopter parents, it was nice to experience something different today. 


On my way to another emergency call, I got a call from a client about a sow in labor and not making any progress.  This particular client has a daughter somewhere in the middle of grade school age who has seen more than her fair share of on-farm deliveries.  The little girl has always said she wants to be  vet.

Client: "Well a it's been nearly an hour since she had the last piglet. She's pushing but nothing is happening."

Dr. D: "Have you put a hand in to figure out if there is a piglet, because..."

Client: "Well no, I wouldn't know what to do.  Oh my gosh, honey, don't do that!  What?  Ok... my daughter just stuck her hand in and says she feels feet.  And a tail."

Dr. D: "Ok, well does she think she can..."

Client: "Oh!  Doc, she just delivered the piglet!  All by herself.  She just pulled it right out of there!  If you could see this, you would be so proud of her!"


I am proud of her.  Even better, her mother is proud of her and just realized that her daughter is a very capable person. But what I really, really hope is that that little girl is proud of herself.

Welcome to the Neighborhood

Ugh, new neighbors.  Let's see... No sign of a barking dog, no toys, no mattresses stacked in the front yard...


Hi! I'm your new neighbor!

Hello.

We just moved here from... is that.... blood on your pants?

Yep.

Oh...

Among other things.

Um...

None of it is mine.

Ok... bye.

Bye!

Hoof Beats, Volume 1

In veterinary medicine, our version of the K.I.S.S. Rule is the Hoof Beats Rule.  The principle is simple: common things happen commonly.  So if you hear hoof beats, think horses; not zebras.

I have a special knack for finding zebras though, or maybe they find me.  Hard to say which.  It started in vet school with a pit bull named Peanut who had urinary stones.  That isn't an incredibly unusual thing, except that Peanut had the type of stones that show up primarily in dalmatians.  And so goes my career. www.soaysheepbreeders.com

Greta was my most recent zebra.  Her owner, who is a very astute shepherd, called me late one evening telling me that Greta came in from the pasture breathing very hard and not interested in eating.  Sheep, off-feed, breathing hard - it doesn't take a genius diagnostician to figure that this is likely pneumonia.  I instructed her owner to take her temperature, start her on a broad spectrum antibiotic, and give her a pain/fever reducer.  If she wasn't improved in the morning, I would come out and see her the next day.

The next morning, the update was that Greta had not had a fever last night, and this morning her temperature had actually gone down, to a sub-normal range.  The breathing had not changed.  When I saw her, she was quite calm but obviously struggling to breathe.  My first concern was that this was severe pneumonia that she hid from us until it was too late. (Sheep love to hide illnesses and then just fall over dead.)

Stethoscope to her chest and my first thought was: wow.  Those hoof beats I had heard earlier were not a horse.  They were a herd of zebras.   The lungs were not the problem, her heart was.  Further exam revealed distended jugular veins, free fluid collecting in the abdomen, and edema in the legs.

Greta, at 4 years old with no history of illness, was in congestive heart failure. There isn't an easy way to tell  someone that their animal is dying.  Zebras causing the problem are more difficult because it leaves you without a complete explanation about how and why.  It's one of those completely helpless moments where all you can do talk about the components of the problem and why I cannot fix them.

I will remember Greta as one of my very own zebras.  I'm sure they will continue to run me down when I get a little too comfortable diagnosing those hoof beats. 

When the Boss is Away...

... the Associate Will:

• Wake up early
• Stay up late
• See all appointments
• Respond to all emergencies
• Return all phone calls
• Answer any and all questions
• Keep up with the paperwork
• Be polite to everyone
• Show kindness to animals and people alike
• Guide those that are clueless
• Acknowledge jobs well done 
• And last but not least, remember why she has never had a desire to have her own practice

A Saturday Night Scene

Saturday, February 23, 2013, 10:15pm
Thurmont, MD
Sheetz

I'm wearing mud-caked coveralls and muddy snow boots.  The clothes underneath my coveralls have been saturated and subsequently dried with at least 6 different types of bodily fluids today.  My nose stopped smelling myself hours ago in self-defense.

I'm standing at the computer screen contemplating dinner.  It needs to be something relatively healthy that isn't going to keep me up all night with heartburn.  No matter how badly I want a massive plate of nachos with all the toppings, it would just be a bad life decision.

In walks a large group of college-aged girls and they are all slutted up.  Short skirts, high-heels, and pounds of makeup. 

I'm so jealous.  I remember makeup.  And fun shoes.  And cute clothes.  And crazy nights with friends.

I trudge out towards the truck with my turkey and cheese sandwich.  The highlight of my evening is going to be making it to bed before midnight. 

I need a good night's sleep.  There is an antelope with a broken leg arriving tomorrow morning. 

Cash and Kinklings

Throughout the day my boss leaves me voicemails with additions or changes to the schedule and I call her when I finish appointments so that she can keep track of me geographically as I move throughout the practice area.  Thus, if an emergency is called in during the day she can decide which of us is closer to go handle it.  Despite Verizon's maps and claims there are black holes, and sometimes messages are a little garbled.

Friday's message went something like this: "Julie, Mrs.Client's horse is colicking and I need you to go.  He is uncomfortable and laying down, but not rolling.  Apparently her kid didn't lock a gate last night and the horse ate a whole box if kink...*static static static* ...be pretty aggressive in your treatment. Call her when you are on the way."

The horse ate a box of WHAT???  As luck would have it, my boss wasn't available to clarify the message and the owner's phone went straight to voicemail where I left my ETA.  Which was almost an hour.  An hour to do nothing but drive and think about what the heck a box of "kink" could be and why a horse would eat it.  I refrained from Googling the words "kink" and "horse food" together.  I don't even want to imagine the results.

 

That, my friends, is a kinkling.  If you Google the word "kinkling," all the results are about Frederick County, Maryland.  Seems they are a Shrove Tuesday tradition in this very narrow section of the world.  Basically it's a big-ass, deep-fried doughnut.  Seriously, this thing was 2 inches thick, bigger around than my hand, and heavy enough to be used as a blunt weapon.  The local volunteer fire department made 320 DOZEN of these things and my client brought some of the extras home to feed the ducks.

Cash is a well known medical trouble maker.  He's one of those horses you wish you could bubble wrap, just to slow down the injuries.  Cash pushed open an unlatched gate and ignored 200 pounds of horse feed to eat a banana box full of kinklings.  I kept calling them kinkles (and the owner kept laughing and correcting me).  The picture is of one surviving kinkling that she had inside so that I could remember the day I thought the horse ate a box something kinky. 

Fortunately with some pain medication and a heavy dose of mineral oil, Cash made a full recovery.  Maybe he learned his lesson, but I'm sure I'll be seeing him again soon.  Hopefully not for a case of the kinklings though. 

Flock Ewe!

 It's sheep season.  I'm not a huge fan of sheep, because a sick sheep is a dead sheep, which does not leave a vet feeling good at the end of the day.  In addition to general maladies of sheep, they are reproductive nightmares.  Seriously, I feel as though I've done almost nothing for 3 weeks other than treat pregnancy toxemia and put sheep lady bits back where they belong. 

Toxemia happens in late pregnancy when the ewe decides to stop eating, sending her body into a super negative energy balance.  Treatment involves IV dextrose/fluids, calcium supplementation, and force feeding.  Oh, and lots of cursing (under your breath while working on the sheep, in the truck as you drive away, after the owner calls late at night with another question, ect ect) because none of those things are easily/quickly accomplished.

As if that wasn't enough, the ewes also have a fun little trick where they push the walls of their vagina outside their body.  Like this: 

 www.vetnex.com

To fix that, I have to put on a prolapse harness that puts pressure on their rear end to keep all the lady bits inside the ewe, where they are supposed to be.  Like this: 

www.valleyvet.com

Assuming all these hurdles have been successfully navigated, the ewe will eventually deliver lambs.  Maybe on her own.  Maybe with a bit of help. Or maybe she's one of those delightful genetic disasters that require a C-section. But I digress.  After delivery, there is one more thing she can do to ruin someone's day/night.  She can prolapse her whole uterus. Just like this:

www.corriedhu.co.uk

 After she does that, someone has to put it back into the sheep.  Turns out that I'm someone. Then her lambs grow up, become sheep, and make more sheep.  It's a freakin' circle of hell... I mean, life.  Circle of life. 


*I'm aware that not everyone may find the title as funny as I do, but I've been giggling since I thought it up 3 days ago

Vets Are People Too

When I see clients out in the real world lots of time they don't even recognize me until I say hello. When they do they are very awkward, like they don't know how to process me out of context.  I have no idea why.  It's not like I'm going to yell at them for going to the movies instead of staying home and cleaning the barn.

Anyway, Zoo Man saw me at the grocery store today.  I was shopping, he was having lunch in the deli.  He called me over and we exchanged some pleasantries.  Then he proceded to tell me that he almost didn't say anything because he wasn't sure it was me.  In his words, "I was thinking, that girl looks kind of like Julie would if she ever had her hair down, but she's a lot smaller than Julie... holy shit, that IS her."  I decided to interpret that as I look better (or at least slimmer) when I'm not wearing three layers of work clothes.

So for any clients past, present, or future who may read this, here is a little bit about me when I'm not being your vet.

•  I read a lot.  Keeping with family tradition, I'm a total sucker for romance novels (but no, I have not and do not intended to read the 50 Shades books).  I also read popular fiction and am working slowly through a book about wine.  I hardly ever read veterinary stuff other than skimming some magazines; I got enough of that kind of reading during vet school, thank you very much.
• I had a bad bout of insomnia once so I taught myself how to knit.  When friends make babies, I make them baby blankets.  Then I use the extra supplies to make baby hats/booties/clothes that I donate to charity.
• I hate reality television.  I love syndicated sitcoms. 
• I like to cook, but I wish more recipes were written for 1 or 2 servings so that I didn't have eat the same thing for a week.
• I like yoga.  I hate running.

So, if you see your veterinarian out in the world, remember that they have lives completely separate from the exam room or pickup truck.  They don't live in lab coats and coveralls.  So get rid of the shocked/guilty look and say hello.  We know you are people.  Remember that we are people too.

 

The Man With Three Cows

The first time I met the man with three cows, it was to get them ready to breed.
Trying synchronization and insemination instead of borrowing a bull was the plan.
He was skeptical when I told him that this was not a guaranteed procedure.
He told me that his daughter wanted to be a veterinarian.

The next time I went to the man with three cows, it was because only one calf had been born.
That day he learned that he cannot diagnose pregnancy just by looking.
He also learned that bulls are the best at impregnating cows.
He told me that he was fighting Lyme disease.

The third time I saw the man with three cows, I told him that he was expecting two calves in the fall.
That visit, he decided that I was right about obese cows not getting pregnant.
He decided to keep her one more year because she was a nice cow.
He told me that he had torn his left rotator cuff.

Today, I went to see the man with three cows to steer two little calves.
The nice (fat) cow is still not pregnant; he said he was going to sell her.
He eventually decided maybe he would give her one more chance.
He invited me to see a wolf picture he took on his vacation this summer.

Some clients are memorable.
I will remember the man with three cows.