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.