Friday, January 12, 2018

Diary of a Third-Year Vet Student: Worms, Eyeballs, and Feral Ponies

Last term was all about the small animal surgery lab: dog and cat spays and neuters. This term will be all about the large animal surgery lab.

For this lab course, we are again working in teams of three or four. Different teams, though. This time we were teamed up based on our relative experience with horses. Each team has been assigned a miniature horse. Over the next 7 weeks, we will perform a variety of diagnostic procedures on the ponies (after labs in which we practice first on cadavers), and we will castrate the ponies in a couple of weeks.

The ponies are feral. Entirely feral, never been handled. Some are quite young (my team's pony is at most six months old), some are several years old. Feral mini ponies are little ninjas, and can strike you with front or rear hooves as they choose. They can also bite. However, we've been pretty lucky this year. Most of the ponies are so shocked at being yanked from a cold, muddy pasture somewhere in Oregon and placed in dry, warm pens with abundant food that they only put up token resistance to being haltered for the first time and being handled and dragged about for the first lab.

The ponies are owned by one individual who is making them available to the vet school for the use of the junior surgery lab. So far, they have been weighed, dewormed, vaccinated for tetanus, and had a physical exam and basic blood work done. Some arrived with conditions that required immediate treatment. About half of them are underweight and the students have to come in twice a day and give them additional rations. Because they are technically patients of the vet hospital, I can't post any pictures of them as that would violate client and patient privacy. But I can post this cool picture of a worm that we found on the floor of our pony's pen this afternoon (horses are social animals so the ponies are penned in groups of four; no telling which one passed it). Better living through deworming, right?

Strongylus vulgaris, a common intestinal worm in horses.

One of my classmates spotted the worm so I made her collect it in an exam glove that I had in my pocket. Everyone was excited and wanted to look at it. I eventually set it up on a paper towel in the female student's locker room so people could get pictures.

In case you hadn't noticed, by this point in our education, vet students are completely unacceptable to be let out into the general population.

Another example. We had an ophthomology lab today. We did some basic procedures on mares from the vet school's teaching herd but we practiced the more invasive procedures on heads from horse cadavers. Just the heads, sitting out on lab tables. The heads were used first by half of the class yesterday so by the time of our lab today, the eyeballs were not in great condition. So the first thing we did was pump a bunch of saline in to them to practice a particular type of injection, which had the beneficial effect of plumping them back up again.

We all openly acknowledge that we have crossed a sort of Rubicon. When non-vet people ask us what we are studying in class, we shrug and say, oh, you know, dogs and cats and horses and things. What we really want to say is, worms, eyeballs, and how to find barely descended testicles in young feral ponies.

Wednesday, January 03, 2018

Archie and His Tennis Balls, Continued

It's hard not to compare Archie to Harry: male, black and white smooth fox terriers, sweet and loving and astonishingly stubborn. And both utterly obsessed with tennis balls. That's not particularly fair to Archie--he is very much his own personality. But the overlap between them is surprising.

I had to keep all tennis balls picked up when Harry was around because he would guard them rather fiercely. Mine! All mine! I was able to channel his energy into a great career in flyball, but that only fed his obsession with tennis balls. I have no doubt that Archie would also do well in flyball, sailing over the start/finish line shaking his head and growling with the ball in his mouth as he passed the dog coming in, just as Harry did. Mine! But I prefer to keep Archie focused on agility for now.

Even though Archie is not particularly guardy for a fox terrier, I still have to keep tennis balls picked up. Otherwise, he would either bury me in a mound of them while I was studying (he picks the balls up and drops them inches from me, letting them bounce a few times, then repeats this...endlessly) or he would chew on one constantly like a large yellow cud. That's not great for his teeth.

I can't even say "ball" around him--he starts flinging himself around the house with the same energy as if I had said "agility" or "walk". His pupils dilate, his ears come forward. He drools a little. He runs to one of the spots where I store the balls, looking back at me expectantly.

I think there are around 20 or 25 tennis balls in the house. I'm not actually sure of the total count because even though I am vigilant about looking under furniture for them when I clean and picking them up after we play, Archie somehow manages to produce 1 or 2 a week. I have absolutely no idea where he stores them. In fact, I have decided that he makes them. I think Archie has a laboratory somewhere in the house where he conducts his alchemy: turning lead into tennis balls. Retorts bubbling away, flasks of stinky, gem-colored liquids, mortars filled with ashes of newt. 

I have a dog bed in the bathroom because I gave up years ago on peeing and showering alone. Mimi sticks to me like a burr and 99 times out of 100 she will curl up in that bed long before Archie shows up to see what's going on. The other morning, I got out of the shower to find Mimi standing there glaring at Archie who was tightly curled up in the dog bed. Hmm, that's odd, I thought. It wasn't until I finished my routine and was leaving that I found out why he was in the bed--he was curled up on top of TWO tennis balls. Two. Did he lay them like eggs? Did he bring them in from his secret laboratory in anticipation of napping on them during my shower? It is a complete mystery.

Saturday, December 23, 2017

Diary of a Third-Year Vet Student: Whew

It was a difficult term for my cohort. Five people failed Large Animal Medicine and at least one person (perhaps some of the five, perhaps different people) failed Small Animal Medicine. That is a dismal attrition rate, at least 8% of the class.

One of my classmates pointed out, quite correctly, that nobody should be failing out in the third year. The ranks should have been thinned in the first year, not this late in the game when people have accrued significant debt and invested years of their life. There is no consolation prize, no interim degree that we can be given then sent on our way. We did in fact lose four or five in the first year and more in the second year. And here we are, in the third year, still losing far too many people.

Failing in vet school is defined as getting a grade of D or worse. What happens to someone who fails a course in vet school? They begin the process of remediation. I don't really understand remediation. My friend M says our ignorance is a good sign. There are lots of "if this, then that" qualifiers, but sometimes people can take another exam; if they pass, they will be allowed to continue. Sometimes people are not allowed to advance and have to wait for an entire year to repeat one or more classes. If that happens, their graduation is delayed by a year. This happened to a woman from the class ahead of us. She just appeared in our Large Animal Medicine lecture this term. She failed it last year and had to repeat only that course. I suspect that she is one of the five I mentioned above. If she failed it a second time, what happens? Honestly, I don't know.

It was a difficult term for me too. I felt like I was on the wrong foot for the entire term. Some good things happened, like the publication of our laying hen ovary paper on the Monday of finals week. Some very bad things related to the still-unresolved issue of the predator happened too. I felt like I spent nearly all my free time doing nothing but studying. But I barely passed Large Animal Medicine myself. That is not like me.

I also found out towards the end of the term that one of the surgery instructors made every single female student cry during surgery. I thought it was just me. I was struck nearly speechless when I found out that he treated all of us that way. Only the women students, not the men. Yeah, that's a problem. I don't go to school with precious snowflakes. My female classmates kick some serious ass. But he was so cruel to all of us that he made us cry. That was just one more burden added to this already overwhelming term.

I had grand plans for the break. With the successful publication of our first manuscript, I wanted to get the draft of the next one ready for my co-authors. Such grand plans. About all that I managed to do was re-take all of the photomicrographs so that I have high resolution images for the next paper. I have 66 histology slides and ended up with a couple of hundred images. They are very nice, to be sure. But I only have the barest outline of text to go with them and dozens of new references to read. That's not likely to be advanced much in the next couple of weeks.

I'm going to view this dismal term as a wake-up call. I need to change my study methods for some of my courses. I need to get more exercise. I'm still in the game.

I'll leave you with this picture of a pre-cancerous lesion associated with chronic inflammation in the surface epithelium of the ovary of a laying hen. I haven't white-balanced the image yet--I do that by hand in Photoshop. Still, it is impressive. I'm describing this lesion as "exuberant epithelium."

Monday, November 13, 2017

Saturday, November 11, 2017

Diary of a Third-Year Vet Student: The Journey

It's been a busy term with exams and surgeries nearly every week. It feels so much like first year--we are buried in mountains of information, don't have much time to process it before being tested on it, and no time to reflect on it afterwards because we are looking up at the next mountain of lecture notes that we need to go through. Even so, I've had a post queued up for over a week, but after thinking it over, I decided to ditch it and go in another direction. 

Vet school is incredibly stressful. Part of it is learning minutiae of the physiology, anatomy, diseases, parasites, and reproductive habits of 8 to 10 species (at a minimum), and how to alter or repair those things with drugs, nutrition, surgery, husbandry. Part of it becomes so much more real in the junior year when we do the dog and cat neuter/spays in our surgery lab. Cutting into a living, breathing animal is amazing and terrifying by turns. 

This fall term has not gone well for many of us. People who make it this far in vet school are typically not the kinds of people who react calmly when things don't go well. In other words, when someone who is used to performing at a high level in all things encounters failure, it's not pretty. Oh, of course, let's be rational: nobody can be good at everything. But that is not good enough. We vet students reject that almost to a person. The result is lots of stress, lots of tears. I don't want to give the impression that every day at at school is filled with day-care toddler meltdowns. Not at all. The stress and tears fill the interstitial spaces. 

Sadly, veterinarians are more likely than other adults in the general population, even adults in other medical fields, to experience depression and have suicidal thoughts

There is increased awareness of this situation among vet students. It helps that professional organizations like AVMA are publishing results of studies like the one linked above. However, there is still reluctance to talk openly about our stress and anxiety. It is as if, by saying, I did not do this thing well, we are saying, I failed at this thing. I hope you can see that there is a universe of difference between those ideas. The problem is that vet students (and ultimately, veterinarians) are a tiny subset of the population that were selected by a vet school precisely for a particular combination of traits. I think that one of those traits is that we can't admit failure. When you combine that with the fact that death is a daily component of a veterinarian's job, it is an explosive and toxic situation. 

 I think that our class is getting better at talking to each other. We all need a bit of prodding to get started. But give one of my classmates a poke, and suddenly she is telling you about fears and anxieties that are exactly yours as well. And you realize, you are not alone in this. We are getting better about looking after each other, even if we don't talk about things openly and easily. Sometimes a hug is needed. Sometimes we need to check in on each other a little more directly. Sometimes we need to give affirmation: I see you, I value you as a person.

None of us had illusions that the journey to becoming a veterinarian would be straightforward or easy. And I don't think we are complaining that it's too hard. Learning how to manage the stress properly is now part of our routine just as much as learning about the medicine. 

Tuesday, October 24, 2017

Diary of a Third-Year Vet Student: Kitty!

I completed my first cat spay yesterday. It was a long, grueling afternoon. The surgery is difficult--the tissues are tiny and delicate (our cat was at most 8 months old), and it was the first time most of us had ever opened up an abdomen, so the cutting and the closure procedures were much more complicated than what is required for a dog neuter. But unlike my first surgery, I didn't stumble out of the building afterwords wondering what the heck just happened. I felt like I owned this surgery. What made it so much more powerful was going in this morning at 6am to check on kitty and seeing that her incision was not red or bruised or oozing, watching her gobble the jar of chicken baby food and a good third of a can of the wet food that Beast eats, both of which I brought in from home, and having her purr and knead her paws so much that I could hardly conduct her physical exam. Even cleaning up urine-soaked pellets from her litter box made me happy--it meant that I didn't damage her delicate ureters which are located quite close to her uterus. Or what's left of her uterus. I took most of that out along with her ovaries.  

It wasn't perfect. We are still learning, and mistakes are inevitable. The key is to catch them, get help, and correct them right away. 

The surgeries take far longer than they would in a clinical setting. This means that your teammate who has anesthesiology duties for that surgery has a really important job: keeping the patient alive. But as hectic as this surgery was, my teammate managed to snap some pictures of me and my assistant, and I'm really grateful to her for that. 

I've written quite a few more paragraphs for this post then deleted them. What we vet students are doing is not a secret, but as we advance in the program, I'm finding few laypeople are as into the details as we are. I'm finding that the details can be distressing to some people. With the current anti-science and anti-fact climate in our country, descriptions of how doctors and veterinarians learn and perform our trade can be twisted and turned around to suggest that we are being immoral or cruel or used to support arguments that we are not to be trusted. I don't want the blog to become a source for that kind of misinformation. So I will leave the details of the surgery for another day.

Friday, October 13, 2017

Not Today, Satan. Not Tomorrow Either.

You might have noticed that the volume of public/media conversations about sexual predators has been increasing in the past couple of weeks. I have some comments to make about this.

As a woman working in a conservative, male-dominated field for nearly two decades, I experienced sexual harassment in all of its overt as well as subtle forms. I fended off most harassers with the direct approach: touch me again or speak to me like that again and I’ll hand your balls back to you on a platter. I had no problems speaking up and went to supervisors and mentors on several occasions when the direct approach was not effective. I was never dismissed or ignored. I had no idea how lucky I was.

I never encountered the more destructive and insidious “Weinstein” style of harassment until last year. Not surprisingly, it was within an academic setting. The academy is as notorious as the entertainment industry for its poor treatment of women. I could single out STEM fields but there are predators in every discipline, not just the sciences.

I first encountered this particular predator via the “whisper network.” Third- and fourth-year vet students would quietly tell the freshman and sophomore students to keep an eye on this guy. He would stand too close. He would say inappropriate things. He would try to touch you. It wasn’t possible to avoid him entirely since he taught a required course for second-year vet students. He’d been doing these things, and much worse, for decades, but few students were willing to jeopardize their grades and degrees by speaking up. While they certainly knew about this, deans and university administrators can’t act on rumors. And although I think one of the charms of the academy is that tenure can shelter eccentricity, the very dark flip side is that tenure can protect predators.  

I was on high alert whenever this predator was in my vicinity, but I was not expecting any interaction with him. I was not his type at all. He is taller than average and I watched him repeatedly use his height to physically dominate smaller female students. That’s what his kind of predation is all about: exploitation of power differentials and domination.

However, to my surprise, he did actually say something to me that was so inappropriate, so shocking, that I went straight to the dean’s office and reported it. I don't view myself as a hero or a warrior. I reported it because I was mad as hell that this kind of gross behavior occurred in my vicinity. I was mad as hell that this fucker had been getting away with this for years. I was mad as hell to think that he could target other classmates, some of whom I’m rather fond of.

The dean did not ignore me or dismiss me. Phone calls were made. Additional meetings were held with other university administrators. I felt like I had been listened to.

As it turned out, I was not only listened to but things begin to happen. At the end of the summer, I was asked to testify before a faculty panel convened by the university president to evaluate the many accusations that had been accumulating around this predator for years and to determine whether he should have his tenure revoked. I was a witness for the outside counsel hired by the university to represent their interests in the matter. Not everyone involved was willing to appear in person, because there was questioning and cross-examination. I totally understand that. First you are afraid that, if you speak up, you will not get approved for a grant, will not pass a class, will not be able to advance in your academic career. Then you are told, we want you to face this fucker and his rude lawyer in a small, stuffy room crammed with people you don’t know and tell your story. That is just too much for most people. However, I am not so easily intimidated. This is not always a good character trait to have, believe me. 

The final outcome is still pending. But I know that I did the right thing by speaking up. The predator has been removed from all duties involving teaching and supervision of students. It’s just a matter of time.