Drinking from the Trough Read online

  There’s a significant danger of systemic illness with this type of injury. “Systemic” means any infection that could spread through the body, and the doctor treated the wound aggressively to prevent that. After numbing the area with a local anesthetic, he made a slit in her abdomen and checked for the discharge that would indicate infection. Fortunately, there was none; Marcie’s body had encapsulated the infection (formed a kind of protective bubble around it, like an internal scab), and she never became systemically ill.

  As soon as the immediate crisis was over, I left Marcie at the hospital and drove to the surgeon’s office to see how Keli was doing. The surgeon invited me to take a look. I remember staring at Keli’s exposed liver and thinking, From rusty nail to Keli’s liver . . . what a strange day. The average dog owner never sees her dog’s liver, let alone an engorged remnant of functional ovary destined for the trash.

  We brought Keli home, where she slept on the floor near us while we watched Mary Lou Retton win the Olympic All-Around Gold Medal in women’s gymnastics.

  Marcie stayed in a hospital stall to continue her recovery under the watchful eyes of the fourth-year vet students, who were on duty twenty-four seven to learn equine medicine.

  Although I wasn’t a student at the hospital yet—that part of my training wouldn’t start until my third year—I routinely attended the large animal rounds in the vet school barn in the summer, and I was there the Friday after Marcie was admitted. The senior student who presented Marcie’s case did a fine job.

  Marcie was a good patient, quiet and cooperative, unlike some horses that would just as soon kill you as look at you. Initially, I wasn’t sure of the senior student who cared for Marcie because I didn’t know her, and she wasn’t enamored of horses. But she won me over; she did a first-rate job, with both treating Marcie and communicating with Earl and me. I learned later that Marcie was the favorite of all the students who were on the equine medicine rotation during her stay.

  After Friday’s large animal rounds, I asked one of the equine residents for the nail that had been removed from Marcie’s abdomen. He refused.

  I knew that every vet kept a collection of bizarre objects found in patients, but the nail was my property. He still refused; he wanted it for his personal animal foreign body collection, and it didn’t matter what I wanted or to whom it belonged.

  I eventually asked the clinician who was in charge of this resident to please retrieve the nail and return it to me, which she did. And yes, I still have it; I keep it in my desk drawer, part of my own “bizarre objects” collection and a reminder that my careful plans for the day have to stretch and shift to accommodate the surprises that surface.

  Although I was more than a year from being a student doing clinical rotations at the Veterinary Teaching Hospital, Marcie’s recovery gave me a taste of what it would be like to be available around the clock, caring for a seriously ill equine patient.

  As happens from time to time, there was a bacterial outbreak in the vet hospital’s barn. In this case, it was Salmonella, a species of bacteria commonly associated with food poisoning and spread through contaminated food or water. Its source was a patient’s intestine; the bug was flourishing and making its way around the barn.

  Although Marcie still needed ongoing treatment, we had her discharged and brought her home.

  Since our barn had three stalls and we had only two horses, we’d already set up the larger stall, which had a stone floor, as a “just in case” hospital stall. It was large enough for us to work around a horse, but small enough that the horse didn’t have enough room to lie down. The stone floor would have been uncomfortable to lie on too.

  It was important that Marcie not lie down, because horses can get “cast” in stalls (and other places)—they lie down, get stuck, and can’t get up again. They can injure themselves as they struggle to stand.

  Once home, Marcie was on “stall rest,” the equine equivalent of bed rest. We wouldn’t give her full run of the corral until she’d finished all her treatments and we were sure she was fine. We tucked her into the makeshift hospital stall and fastened the chain across the entryway.

  Her medication was the same as at the vet hospital: twice a day, I crushed the huge antibiotic tablets, mixed them with molasses, and filled a big syringe (the tip cut off, and no needle) with the molasses and medication sludge. Then I reached up (and up; I’m a lot shorter than Marcie), positioning the syringe as far back into her mouth as I could, and pressed the plunger, aiming for the interdental space or as close to the back of the jaw as I could. Marcie swallowed the goop down without complaint.

  I checked on her frequently during the day and evening. Earl took the night shift, since he worked nights and was up in the wee hours.

  Within a day or so, she was feeling fine, so we let her eat a little bit more each day, though she was still restricted to her stall. Finally, after several days of intensive care in the barn, we allowed her to join Franny out on the lawn to eat grass. I was glad to see her in the yard again; she and Franny made great lawnmowers and saved us a bundle on the cost of hay.

  A couple of mornings later, I stepped outside the house and nearly had a heart attack. Marcie was lying flat out on the lawn. From where I stood, she looked dead.

  I ran to her and checked: she was breathing. I ran back to the house and called the student who had taken such good care of her in the vet hospital.

  She was kind enough to not laugh at my panicked description. “Marcie’s fine,” she reassured me. “She’s just decided to take a siesta on the comfy grass in the warm summer sun.”

  When my heart rate finally dropped back to normal, I stretched out beside Marcie on the lawn. Keli gave an approving “Ah-woooo!” from the dog pen. I agreed; plan or no plan, the day was a perfect ten.

  8

  It’s All in How You Talk to ’Em

  The Veterinary Teaching Hospital—VTH—was the temple of veterinary medicine at Colorado State University.

  We had arrived.

  Well, mostly. As juniors in vet school, we shifted from days filled with lectures to mornings filled with fascinating clinical rotations at the hospital, where we got to do medicine and surgery instead of just reading and listening to lectures about them. Classes on more disease systems filled our afternoons.

  The mantra of veterinary procedures is “See one, do one, teach one.” On clinics, each junior student worked with a senior partner; the senior had the responsibility, and the junior watched and learned. Clinicians oversaw everything.

  I admired the “See one, do one, teach one” method. I may not have been number one in my class, but my teaching skills were still razor sharp. I’m the one who taught our class valedictorian how to place a central venous line into a dog in the ICU.

  After clinics and before classes, I still went home for lunch every day, except for the day of the Incredibly Long Cat Spay.

  On that day, I was the anesthesia student for two of my junior surgery lab classmates. My job was to manage anesthesia and monitor the vital signs of the patient while my classmates spayed the cat. Close monitoring is crucial; without it, the patient could die or wake up in midsurgery.

  My record time for a cat spay was eighteen minutes. I doubt I was fastest, but after being Steffan’s partner in junior surgery lab, I had pretty fast skills for a student.

  These guys were at the other end of the spectrum. They achieved our class record for the longest cat spay ever: three and a half hours. We worked over clinic time, through lunch, and showed up late for class, still dressed in scrubs and covered with surgical gowns.

  Most of the topics we practiced were organized into one- or two-week blocks called “rotations.” Dr. James Ingram, nicknamed Grim Jim, was a popular and respected veterinary neurologist who led us, literally, through our neurology rotation. He had a reputation for slipping away, so the students would lose him. Or, more accurately, he would lose the students, on purpose, maybe because he never liked the moniker Grim Jim.

  S
tudents arranged themselves like ducklings following their mother to stick with him. Earl told the story of when he’d been at vet school ten years earlier, the “duck patrol” had actually followed Dr. Ingram as he’d sauntered out of the hospital and across the parking lot, all the way to his parked car. They didn’t break formation until the good professor drove away.

  We had a “gunner” in our class named Dane. Gunners are students who will do anything to gain recognition and prove they’re superior. They show up in every professional school and graduate program, and the game is always the same. The gunners monopolize class time, trying to show how smart they are by arguing with the professor or asking questions they already know the answer to. The other students pass the time playing “Gunner Bingo,” guessing (and sometimes placing bets on) how many questions the gunner will ask, then comparing results later in the day to see who won.

  This particular day, Dane spent ten long minutes asking Dr. Ingram his question. The question was elaborate, exquisitely crafted, and filled with extensive detail.

  Silence filled the room as we waited for what would surely be an equally elaborate and important answer.

  Dr. Ingram slowly pushed his gray hair back, took off his glasses and cleaned them with a plain white handkerchief, wiped his face with the handkerchief, returned the handkerchief to his pocket, settled his glasses back on his nose, and looked Dane intently in the eye.

  “No.”

  No? That was his answer? Yes, that was it—all of it. Dane’s face flushed bright red as the rest of us crumpled into laughter.

  Each spring, four piglets were put in a stall on the food animal side of the barn so we could learn how to handle them and practice doing procedures on them. They weren’t sick; they were there simply for our practice. Their final fate was noted on the stall’s “reason for admission” card, which proclaimed in large, clear letters, “BBQ.”

  Pigs are a particularly obstinate breed of farm animal. Boy, can they bite! In one of his books, James Herriot tells the story of a snooty, first-in-his-class visiting vet student trying to draw blood from pigs for necessary blood tests. By the time the student had finished, he was covered in porcine excrement from the enraged patients. Like that student, I never did learn to draw blood from a pig; I still panic when I think about my screwups and the deafening squeals of angry pigs.

  Although I didn’t much like pigs, I loved the barn. The smell of hay was sweet, as was the fragrance of horses on the equine side of the barn. The smell on the food animal side wasn’t as nice, but it was still a place of comfort for me.

  One morning, my classmate Bullet Bob and I were on barn duty on the food animal side. Robert and I had been cubemates our first year and had become good friends. He was a good ol’ cowboy from the eastern plains of Colorado, a big guy who plodded his way through school as if he were a slowpoke. But he was no dummy; he opened his own practice immediately after he received his license, the first of our class to do so. He set up shop in the eastern plains, a vast, semiarid region not usually considered for Colorado tourism ads. There wasn’t another vet within a hundred miles, so Robert practiced on all species. He was the first among us to earn a six-figure income.

  On that morning, while Robert and I were on barn duty, the energetic piglets escaped their stall.

  Jailbreak!

  We did have the presence of mind to close all the barn doors, but darned if we could catch those little piggies.

  They sprinted up and down the wide aisles of the barn, squealing and grunting. They fell and rolled over and over after trying to negotiate ninety-degree turns. We’d chase; they’d flee up and down the aisles, back and forth across the barn.

  The only thing we got for our efforts was sweaty. Robert was intent on catching the piglets, but I ended up laughing, utterly useless to the task at hand. Nothing in my childhood in the upscale, predominantly Jewish suburb of Highland Park, Illinois, had prepared me for this. All I could do was watch the piglets race around, laughing at their silly-sounding and incredibly loud vocalizations.

  Robert and I were coated in sweat and dirt. The piglets showed no sign of slowing down, let alone returning to their stall.

  Finally, after what seemed like forever, Dr. Smith, the food animal professor in charge of all pigs great and small, came in. He was a short, slight man, not much bigger than I am, and a native of Alabama with an accent to match.

  Oh no, I thought, Robert and I are going to be in big trouble.

  Dr. Smith ignored the thundering Four Porkers of the Apocalypse (who also ignored him) and stepped into their stall. Then he let out an ear crushing, “SOO-EY PIG! SOO-EY PIG!”

  To my utter, open-mouthed amazement, the pigs ran at top speed right into their stall.

  That was enough to put me on my knees, cackling hysterically.

  I thought Dr. Smith would be angry with me for my helpless laughter and for being so useless.

  But he casually closed the stall door and, with a twinkle in his eyes, looked at me and drawled, “It’s all in how you talk to ’em.”

  Senior year began the day after junior year finished. There could be no gap in the care of the patients; the former seniors had graduated two days after their last day on clinics, and we were the new seniors. One day we were junior students; the next, we were in charge of the cases. It was a little daunting.

  At the time I attended veterinary school, seniors were on a trimester program, with fall, spring, and summer trimesters. Each student was in school for two of the three trimesters. Most students spent their “off” trimester working in some capacity in veterinary practice outside the university.

  I chose section B so I could have large animal rotations during the summer trimester (outside in summer was better than outside in winter) and because I already had a job with Dr. Kainer as an anatomy teaching assistant for the fall trimester. My small animal rotation would be during spring trimester.

  Senior year was certainly no less stressful than the first three years, but I enjoyed it—the professors, the patients, and my classmates, even some of the odd things we were required to do—much more. The close relationships that developed between students and professors, made possible because we worked together in small groups of five or so during the weekly rotations, made all the difference.

  The equine and food animal rotations were in four-week blocks, each followed by a huge exam. These block tests were fraught with fear. Other rotations included ophthalmology, radiology, anesthesiology, electives, and more. I continued to make it home for lunch every day, except for the last two weeks of my vet school experience. Those two weeks were my small animal surgery rotation, and there simply wasn’t enough time to make it home and back again. I brown-bagged two slices of Little Caesar’s pizza for a quick and tasty lunch every day—and packed five extra pounds onto my normally 102-pound frame. Twenty pieces of pizza in two weeks will do that.

  My first rotation was an elective I’d chosen, equine medicine. Attending barn rounds on Wednesday and Friday mornings was required for all seniors on large animal rotations. I was already used to them; I’d begun attending them the summer after my first year.

  The clinician on duty that week was Dr. Bennett. My first patient was a marginally sick horse. Because it was such a minor case, I asked Dr. Bennett if I would be presenting during rounds. He said, “No.”

  When we gathered for Wednesday’s barn rounds, Dr. Bennett called on me first to present my patient. Ack! I was totally unprepared and stumbled through my case.

  That was a lesson I never forgot.

  From then on, I carried the information about each case in my head, lab work values and all. I didn’t use a cheat sheet; I presented from memory, whether I was explaining the overall issue with my patient or answering a question about a specific detail. If someone asked me what the blood glucose value was for my equine patient, I could tell them, exactly, what that value was without referring to any notes. I drew from my experience as a teacher too; I had years of practice with public
speaking, and I was comfortable pulling up information I’d prepared whenever I needed that information.

  During that first week, one of the patients was Superbear, a gorgeous American paint horse stallion from Arizona.

  Superbear had been in an exclusive paint horse show in Denver, where about half the horses had come down with colic (belly pain). Colic can lead to laminitis, which is a dangerous inflammation of the hoof wall. Laminitis, in turn, can lead to founder, where the bone that goes into the hoof rotates away from the hoof wall, crippling the horse. (Thank goodness I’d paid attention to Dr. Kainer’s lectures on the structural anatomy of the equine hoof!)

  None of the other horses had been as sick as Superbear; they had been treated successfully at VTH and released the week before my rotation had begun. Dr. Bennett assigned Superbear to me.

  I fell in love.

  Although I look upon stallions with trepidation, Superbear was my all-time favorite equine patient because of his sweetness, his gentle beauty—I have a fondness for paints—and his will to fight his dreadful illness. I think he knew we were trying hard to save him. I even dreamed about him at night.

  Superbear was a well-known stud horse, so his sweet disposition surprised me. Stud horses can be nasty. After all, they have only one thing on their minds: a pretty little mare and Barry White on the stereo.

  Superbear was hospitalized all summer, isolated in his own hallway. No other horses were allowed in his section of the barn due to the possibility of spreading his infection via the diarrhea caused by his disease.

  I cared for this sweet beauty under Dr. Bennett’s supervision, doing everything I could except for feeding, which the barn employees did. When Superbear went down with his illness, unable to stand, I cleaned his stall myself, and I devised a berm of wood-shaving bedding to prevent his mess from getting out of his stall and endangering the other patients.

  One day, I was shoveling out Superbear’s stall, dumping the heavy, soiled wood shavings in the bin outside, when Dr. Ball, the bovine practitioner whose rotation I’d be on soon, drove up in his food animal ambulatory truck. A bunch of my classmates were in the truck, and as they all looked on, Dr. Ball belted out the lyrics from “Old Man River”: “Tote that barge! Lift that bail!”