Showing posts with label open. Show all posts
Showing posts with label open. Show all posts

14.7.10

1.05: Questions

Vets have a huge array of tools at our disposal, to hunt down a diagnosis or to form a treatment plan. We have various scopes to look down every orifice or cavity, big or small. Stethoscopes to amplify minute sounds. There are a vast array of blood tests we can run, from general profiles down to specific enzymes. We have microscopes to look at urine samples, fine needle aspirates, scrapes, smears, and biopsies - examining things right down to the cellular level.

We can use x-radiology to see through a patient and add barium to see how something will move through the gut or blood vessels. Create x-rays in real time and you have fluoroscopy to see swallowing or coughing. We can use ultrasonography to rapidly build a mental 3d image of a patient's insides. And then there is advanced imaging like CT or MRIs – taking detailed cross sections through the patient.

We can even use medications as a diagnostic tool, by analysing the response to a certain medication. Surgery can be used in the same way, as well as to directly visualise things you can't pick up on imaging. And of course we have our eyes and ears, noses and fingers, as we examine a patient in the consult room.

But the most important instrument, the one all vets rely on, is often undervalued or overlooked - yet it is always the first one we reach for. It is used long before we even lay our hands on an animal. It appears simple to operate at first, and yet at the same time it is a complex artform which requires practice and skill to perfect, to use and interpret. It drives us, on a personal level as well as a professional one.

It is the vet’s first, last, and most powerful tool: The humble, and mighty, Question.

15.6.10

1.04: Serendipity

On a dreary afternoon, a client saunters into the waiting room with their boxer leaping about their legs like a dervish, brandishing his bright crimson bandage like his namesake in a championship prizefight.

With a sharp intake of breath, the bandage is cut away- the Owner looks in shocked silence before exclaiming, "Wow! It's all healed so well! Thank you sooo much."

I can't help but grin as I wave off the praise, "Ah, no- don't mention it, I'm just glad it all turned out so well."
"I'm sure you are just being modest," they retort, and I shoot them a knowing look, like there's a secret only the two of us will share. And as they leave the clinic, a grin from ear to ear, I'm left wondering when things actually started going right...

10-14 days earlier:
"CRAP CRAP CRAP CRAP CRAP... Please stop bleeding! Please stop bleeding! CRAP... Goddamn suture material, blunt needle- I swear, if you don't stay straight in my needle holders, I'm going to kill you and all of your needle-children... Can I please get more swabs? *squirt* Can I please get A LOT more swabs? uhhh, Oh... shivers, this isn't good... Um, cautery? Is there cautery? Please tell me there's cautery! Great... now... how does this work again?!"

Since graduation, I've held one vet's words in my mind constantly:
"It doesn't matter how well or poorly you do a surgery, you're only ever judged on the skin sutures."

10.5.10

1.03: Words

My pen hovers above the card. I don’t know what to say. There are so many things I want to tell you. But these emotions just refuse to be translated into words. I want to tell you how deeply sorry I am that your dearest companion is now deceased, and that I know just how painful it is to lose one so beloved. How it leaves a silence, an absence, an emptiness inside you. That the following days will be filled with sorrow, how time seems to drag on endlessly, and all ordinary things just seem so difficult. How the rest of the world just keeps moving on, even though a huge part of yours has just ended.

I want you to know that I tried my hardest, and how I wish so much that I could have saved your dear one. Even though you wanted to throw all the money you had at it, it was just one of those things that nothing would fix. How I wish tragedy would never befall people so loving, so kind and caring. Of all the people in the world, how could this happen to you? I don’t know, I just don’t.

I want to thank you for taking this little soul into your hands, into your family, and giving it a wonderful home, a wonderful life. And though it ended so suddenly, that life was full and rich. That you gave your beloved one a final gift: to go quietly, painlessly, and in peace.

I want you to know that you’re not alone.

I set the pen down. Sigh. I have no idea what to write. How can I write a little letter like this, an insignificant cluster of words, when your world has been torn apart? How pointless it is to send you a letter. Useless words. I’m just sorry. I’m so sorry.

21.4.10

1.02: Roles

I step into the consult room for a routine vaccination, smile and pat the dog, make small talk with the owners, send them on their way, and expect not to see them again for another year.
I step into the room with a dying cat, the adrenaline rushing through me, urgent and straight to the point (and very quickly I step right out again and run very fast with the animal to the treatment room.)
I step into the room with the rabbit I’ve been treating for months for the same problem, the owner I know very well now, and just wish I had a quick and simple answer for the nice people who have spent hundreds on their beloved little rabbit.
I step into the room to tell the owner his dog has cancer.
I step into the room to announce that the budgie survived overnight and is going really well now.
I step into the room with the owner sobbing uncontrollably as I gently end his cat’s life.
I step into the room with a new puppy, with a huge smile and radiating positive energy that echoes off the walls.
I step into the room with the demanding owners who've left their cat with an open fracture for five days and try to explain politely why I can't treat it for free.

A consult room contains a million worlds. Every time I walk into that room I have to completely drop whatever ordeal I’ve just been through and be who I need to be. In a single hour I take four consults. In just one hour (and I work a minimum nine hours a day) I am four different people with little or no time to recover or get over what I’ve just done. It’s at the end of the day, at night, when I’m exhausted, that I take it all in. Then, I'm just me.

2.4.10

1.01: Beginnings

It hit me, in a moment of sheer terror, that first day when I walked into the consult room with my named printed on a drug label and stuck on a badge over where SAMPLE ONLY was engraved, and there was a puppy urinating on my hand and an owner asking me if desexing was reversible that Holy crap, I’m not a student anymore, I’m a fully qualified veterinarian.

After having my hand held, constant supervision, unlimited access to all the textbooks and journals I could want and bumming around with my friends at Hogwarts School of Vetness, I was now in the Big Wide World. I had Responsibilities. I had a You Can Vet Now certificate. I had Keys to the Restricted Drug Drawer. I had to make my own decisions, I had to figure out what was wrong with the animal and fix it, and I had to take life and death into my own hands. Oh crap, am I really ready for this? How am I going to make it through my first day alive?

And how on earth am I going to survive out here on my own?