Drinking from the Trough Page 10

  I grinned and sang back, “Get a little drunk, and you land in jaaaaiil!” A nice bit of humor and humanity for a sweaty, smelly job on a hot summer day.

  I’d see Superbear again at the end of the trimester, during my required equine medicine block, but this time, he wouldn’t be my patient. Dr. Bennett thought I’d become too attached to him. He was right.

  Soon after my first equine rotation, I began the food animal block rotation, initially assigned to Dr. Ball’s ambulatory truck for dairy herd medicine. Ambulatory trucks bring veterinary care out to the country to treat animals, since ranchers and farmers can’t bring an entire herd to the hospital. The truck seated three in the front and three in the back; as the smallest person in the group, I got stuck in the “death seat,” front seat center.

  Dr. Ball was tall and lanky, with arms long enough to reach a cow’s tonsils by going in through the rectum. That was an important talent; pregnancy testing is a significant part of herd medicine, and Dr. Ball’s skills were legendary. Golden Arm Ball could tell by feel practically the exact date and time when a cow had gotten pregnant and when she would deliver her calf.

  The procedure sounds (and is) messy, but it’s necessary. First, you must remember to remove your wedding ring; many rings have gone missing up a cow’s rectum. Next, you pull a plastic rectal sleeve over your nondominant arm. Then you reach into the rectum and palpate, feeling for the cervix, uterus, ovaries, and uterine arteries through the rectal wall.

  We students were supposed to learn that skill too, but I never did. The business end of those large, roomy black-and-white Holsteins was literally out of my reach; I can reach only as far as the cervix. My arms are simply too short for bovine practice. Not that Dr. Ball didn’t try to persuade me otherwise. He offered to lift my five-foot-nothing body up and hold me parallel to the ground so I could stick my arm up the cow’s rectum to feel for a pregnant uterus. Thanks, but no thanks!

  Before our rotation had begun, I’d seen Dr. Ball’s classic prank that he played on students learning the preg-testing procedure. Before actually feeling for a fetus, the examiner has to empty the rectum. Dr. Ball was as gifted at cleaning out a cow as he was in determining its pregnancy status and progress.

  Cow feces have the consistency of foul-smelling pudding; they’re not like the fragrant “road apples” horses leave behind. With his arm still in the cow’s rectum, Dr. Ball would aim a shot of bovine feces at an unwary student, covering the entire front of the student’s cover-alls with a sticky slurry of pungent cow shit. Other students put up with this malodorous trick, believing a clinician could do whatever he wanted to.

  Not me; I had no intention of playing this game. The first day of the rotation, in my best “nontraditional student who used to teach K through 12” voice, I quietly told Dr. Ball that if he ever pulled that stunt on me, we were going to have a little go ’round.

  Perhaps he remembered how tough teachers have to be; perhaps it was simply because I was assertive enough to talk to him straight-on about it. Whatever the reason, he honored my request and never took aim at me.

  Dr. Johnson was another food animal clinician I worked with during the food animal rotations. I knew him from my physical education teaching days, because his daughter had been one of my students. I’d known he was a veterinarian before I’d met him because Jeruesha had come to school one day nursing a sprained ankle, which he’d wrapped in the veterinary medicine version of an Ace bandage: Vet Wrap, a sticky, brightly colored wraparound bandage material.

  One morning, Dr. Johnson and our group headed out in the ambulatory truck to a sheep feedlot on the high plains east of Fort Collins.

  I like sheep. They’re easy patients to work with when they need vet care or shearing. They are definitely not the rocket scientists of the animal kingdom. All you have to do is prop the sheep up on its bottom, with its forelimbs up—the same posture as a dog begging—and the sheep sits stock-still. It doesn’t even try to move.

  We reached the feedlot, but instead of meeting a kindly rancher who needed us to work on his Suffolk or Hampshire sheep, Dr. Johnson drove us to the far back of the lot.

  We got out of the truck and stared at a four-foot-high, ten-foot-wide pile of dead, flyblown sheep that lay reeking in the hot sun.

  “Go find out how they died,” Dr. Johnson said.

  We had learned through word of mouth the “four S’s of ovine medicine”: Sick Sheep Seldom Survive. The usual diagnosis is shipping fever, which happens when the sheep are so stressed by transport that they get sick and die.

  I walked off a little to the side, away from my classmates, looked into the bright blue heavens, and said, “Mom, do you see what your nice little Jewish girl is doing now?”

  It was a gross, grisly, and, yes, disgusting task, one of the worst things I had to do that summer. My classmates probably thought I was nuts, because I kept smiling as we opened up carcass after rotting carcass. But all I could think about was my late mother, wherever she was, equal parts chagrined and amused, shaking her head at what I was up to.

  Later that week, Dr. Johnson and our crew of students visited an SPF pig farm. SPF stands for specific pathogen free, which means that the herd is free from disease and must be carefully protected.

  As part of that protection, we had to “shower in” and pick clean clothes from the farmer’s supply to wear before seeing the pigs. After finishing our work, we “showered out” and returned to the truck wearing our own clothes.

  The shower-in, shower-out requirement was one of the reasons I chose section B, with its large animal rotation in the summer. The day we visited the SPF farm, it was ninety-five degrees Fahrenheit, and a couple of showers felt pretty good. I had no desire to be naked on a pig farm outside in February, when temperatures would be in the thirties, if we were lucky.

  Of course, none of the clothes in the farmer’s stash fit me. Everything was huge. I had to use both hands just to hold up my borrowed pants, as if I were wearing a denim barrel with no shoulder straps.

  Without asking, Dr. Johnson grabbed the front of my borrowed jeans at the waist, pulled the belt loops (and me with them) close to him, and secured the loops with adhesive tape from the truck. He spun me around, grinning.

  After I’d gotten over the initial surprise, I grinned back. Cover Carlson with tape, and she’s good to go! And hats off to a creative clinician for finding a solution to my farm fashion problem.

  We also visited an indoor swine facility with Dr. Johnson. It wasn’t an SPF facility, so we kept our own coveralls on, although we did have to sanitize our rubber boots going in and out. That’s an easier process; just step in and out of the tub of sanitizing solution.

  Sows and boars are vicious, and they’re one of the worst-smelling animals in creation. We spent a long time examining the sows and their adorable youngsters. By the time we were finished, we smelled almost as bad as the pigs.

  When we returned to the VTH, the other students bolted to the locker room showers, but I headed straight home. I doffed my clothes and left them in a smelly heap beside the washing machine to deal with later, crept up the stairs in my birthday suit—Pruney and Keli must have thought I was nuts, not to mention foul smelling—and stood under the hot shower for a long time. I scrubbed, I washed, I scrubbed again, but no matter how long I washed, I could still smell the swine aroma wafting off me and up to the ceiling in the steam. I didn’t care how lucrative swine herd management could be; a porcine practice was not going to be in my future!

  My final rotation of the summer was the equine medicine block. It included two weeks of equine medicine, followed by two weeks of equine surgery.

  Just the thought of equine surgery rotation put knots of anxiety in every student’s stomach. Equine surgeons were considered Masters of the Universe. It’s incredibly difficult to land postgraduate residencies in this field. You have to be at the top of your class, with superior recommendations. Most of us believed equine surgeons were obnoxious prima donnas, and the students whose
goal it was to become equine surgeons were up-and-coming obnoxious prima donnas.

  My attitude right from the start was “No one is that good to be that obnoxious, no matter how brilliant or famous they are.” I was willing to challenge it or ignore it, if need be. But I never had to; I got along well with the surgeons and had a great two weeks.

  My first week, I lucked out and was on Dr. Stashak’s service. Dr. Stashak was a nice person, as well as a good teacher and surgeon. He knew that I owned horses, and thus he considered me to be a “horse person.”

  I just shrugged and got on with the work, but to be honest, I objected to that label. The people I knew who referred to themselves as “horse people” were self-aggrandizing, and I didn’t want to be lumped in with them. My classmates certainly didn’t think of me as a “horse person,” even though many of them had been to my house, seen my horses, and had even practiced palpating them back during freshman year.

  One morning, Dr. Stashak operated on Wrangler’s Rocket, a young paint gelding. Rocket was a “wobbler,” a horse with a neurological problem in its neck vertebrae and nerves that prevents normal movement. Riding a wobbler can be dangerous, and they are never used for breeding stock. Surgery is difficult and performed only when the neurologist thinks there’s a better than decent chance that it will help. The surgery went well but had a poor prognosis. Dr. Stashak and I hand-recovered Rocket after the operation.

  The darkened, closed recovery stall had mats on all sides and a large, soft mat covering the entire floor. Dr. Stashak and I sat together beside Rocket, waiting for him to regain consciousness. When he began to stir, Dr. Stashak gave him a small dose of sedative so he wouldn’t thrash around and stand up too quickly, which would disturb the site of the delicate neck surgery.

  The time alone with Dr. Stashak, sitting on the cushioned stall floor together, helping Rocket recover, gave me a chance to talk with him about equine practice. I fretted that my small size meant I couldn’t be successful in equine medicine.

  He reassured me, telling me gently, “Mary, the clients are paying for your knowledge, not your size.” He nodded toward Rocket and said, “And there’s little difference to the horse between a hundred-pound person and a two-hundred-pound person.”

  My second week of the equine surgery rotation was with the most feared professor on the staff.

  Dr. McIlwraith was world-famous in the field of equine orthopedic surgery. He’d pioneered the technique of arthroscopic surgery in horses, a technique similar to the procedure used in human medicine.

  Veterinary-to-human and human-to-veterinary medical breakthroughs happen more often than many people realize. My father-in-law, Dr. William D. Carlson, CSU vet school class of ’52, transposed human radiology into veterinary practice, launching the field of veterinary radiology. CSU vet school’s own Dr. Harry Gorman designed the first artificial hip joint for dogs; later, it was adapted for human use. As the happy owner of my own hip replacement, I owe the late Dr. Gorman an extra dose of gratitude.

  Dr. McIlwraith had traveled the world to operate on the horses of the rich and famous. He’d pioneered arthroscopic surgery and performed it on the racehorse Spend A Buck in 1985, in time for Spend A Buck to win the Kentucky Derby that year. The Sultan of the United Arab Emirates had flown Dr. McIlwraith to Dubai to operate on the Sultan’s prize racehorses.

  My experience with Dr. McIlwraith so far had been a positive one in junior year classes. I found both his lectures and his course notes clear and easy to understand, but I’d heard through the grapevine that he was mean and nasty to students and staff during clinics.

  I’d also heard from someone—I no longer remember whom—that Dr. McIlwraith held a PhD in anatomy too, and if we had a slow week, on Friday, I should ask him to take us to necropsy and show us the surgical anatomy of a horse’s leg. I asked him, and he agreed. He went through the entire forelimb, pointing out which injuries occurred at various locations and dissecting out the anatomy, showing us where the procedures were done. It was a wonderful end to a marvelous week.

  Block tests, the big exams that follow the four-week large animal block rotations, are notoriously difficult; more than one student has gone down in flames. I always struggled, always worried that this time I’d fail the big test big time.

  I worried this time too, but much to my relief, I aced the equine block test—a great ending to an enjoyable summer.

  I spent the fall trimester working as Dr. Kainer’s anatomy teaching assistant, and when spring trimester rolled around, I was on Dr. Ingram’s neurology rotation, the same Dr. Ingram of duck patrol fame. He and my father-in-law had been classmates in the class of ’52, and Earl had been his student, so Dr. Ingram and I were on pretty friendly terms from the beginning. I even knew where he hid when he wanted to escape the duck patrol.

  It’s a tradition for the seniors to make a video for the junior–senior banquet held near the end of the year, and Dr. Ingram agreed to star in our vignette that poked fun at him and his duck patrol.

  In the video, he slipped away from his trailing line of students (including myself) and entered an empty room. He uttered the immortal words, “Beam me up, Scotty!” and disappeared in a shower of flashing sprinkles. I still have a copy of the video; if the Academy of Motion Picture Arts and Sciences awarded Oscars to vet school films, our masterpiece would have been a shoo-in.

  Senior clinical rotations were graded weekly on a 0 to 12 ranking system. Each Friday afternoon, we would pick up that week’s grade sheet from the clinical sciences office.

  Since we shifted to different practitioners each week, we usually didn’t follow the same patient beyond the end of that particular week. As luck would have it, I had the opportunity to follow one patient over two weeks, from diagnosis and surgery through recovery and dismissal.

  The week before I served with Dr. Ingram, I’d been on an elective neurology rotation with a different neurologist, Dr. LeCouteur. One of our patients had been a twelve-year-old golden retriever named Boo-Boo. Boo-Boo’s owners had brought him in because he was weak and was walking on his whole feet instead of just the paws.

  Dr. LeCouteur had taken one look at the critically low glucose level in Boo-Boo’s blood work and sent him directly to surgery to remove the tumor he knew was there. No ifs, ands, or buts: it was an insulinoma, a fairly uncommon cancerous, insulin-secreting tumor of the pancreas.

  Yes, an endocrine disease. At least I knew how to care for Boo-Boo without giving myself night terrors.

  During my regular week on neurology, this time with Dr. Ingram, I continued to treat Boo-Boo, who was recovering from surgery. When it was time for Boo-Boo to be released, I met with his owners.

  When clients come to the vet hospital to pick up their animals, we leave the patients in the wards so their owners can focus on what we tell them, without the distraction of greeting their beloved pets. The student, who in this case was me, explains to the owners what the illness is all about, what the treatment involved, what medications are going home with the patient, and how to administer medications and other at-home care. The student also gives the prognosis, which in Boo-Boo’s case was not a good one.

  Boo-Boo didn’t have a lot of time left, but he would go home to be comfortable with those he loved.

  It’s always hard to deliver that kind of news, but it’s important. It’s crucial to allow enough time for the clients to understand everything and to ask questions.

  Dr. Ingram listened to me chat with the clients and answer their questions. Later, he complimented me on my discussion with Boo-Boo’s owners.

  When I received my grade for my week with Dr. Ingram, my score was 11.96 out of 12. I knew that many of my classmates would have raced to the professor to demand where they’d gone wrong or to argue about the missing 0.04 points, but I smiled; 11.96 was so like Dr. Ingram.

  I wasn’t worried about my grades—I had a 4.0 GPA that trimester—but I couldn’t resist the temptation to pester him. I marched into his office, trying not to gr
in too much, and asked him to tell me just where, exactly, I had missed 0.04 points.

  He leaned back in his chair with his hands behind his head and laughed.

  To this day, that’s the only weekly grade score I remember.

  My last patient as a vet student and my all-time favorite canine patient was a Dalmatian coach hound named Bullet, who belonged to a beer company. He’d fallen off the company’s horse-drawn beer wagon and gotten hung up with his leash on, which left him dangling by his neck. I assisted in the delicate, dangerous surgery to remove the dens (the piece of his second cervical vertebra) that had snapped off in the accident.

  The surgery went through lunch; I was so hypoglycemic that I bumped into the surgeon, who promptly snarled at me. After the surgery, I spied a classmate eating an orange in the hallway and begged for a few segments. I sank down to the floor and reveled in the delicious sweetness, temporarily revived.

  Bullet survived, despite having a major bout of bleeding during the surgery. He had to be treated very gently. I couldn’t put a leash around his neck, so I wrapped it under one shoulder. I took him everywhere I went around the small animal side of the VTH as physical therapy.

  As he improved, I would say to him, “Bullet, hug!” He would rise up on his hind limbs and rest his front paws and head on my shoulders, giving me a full-body hug while I wrapped my arms around him. We looked like odd lovers, a Dalmatian and his married girlfriend. Other classmates tried to get a hug from him, but Bullet was a faithful dog and would hug only me.

  After graduation and before the state board exam, there wasn’t much to do except prepare for the exam. I relaxed, worked in the garden, and (of course) watched my soap opera, which is what I was doing when Dr. Ingram called to tell me that Bullet was coming in for a follow-up exam. Would I like to come to the hospital to see him again? I said yes, absolutely.