Sample Wall of Shame

Under the umbrella of Pathology, the lab section that I supervise has two main functions: necropsy and histopathology.

Histopathology refers to both the study of disease in tissues and the process of preparing tissue samples so they can be examined under a microscope. Tissue samples are systematically collected during necropsies. Histopathology is one of the many tools we use to help determine the cause of death of an animal. Veterinarians (and doctors) also remove tissues during surgical biopsies and submit those for histopathology. In those cases, we are not necessarily looking for the cause of death but examining the tissues to determine if cancer is present, or to identify the cause of a persistent lesion or disease state in the animal.

Tissues slated for histopathological analysis must first be fixed. The most common fixative is formalin, an aqueous solution of formaldehyde. Formalin causes cross-links to form between proteins and makes tissues stiff. Formalin-fixed tissues don’t decay (they can degrade over time, but we will let this oversimplification go). Once the tissues are stiff, they can be cut into very thin slices and placed on microscope slides. The rule of thumb for proper fixation of a tissue sample is a 10:1 ratio of formalin to tissue.

But this post isn’t about what goes on in a histopathology lab. It’s about the containers that veterinarians choose to hold tissue samples and formalin that they then ship to us. I keep pictures of the more creative choices in a folder that I labeled “Sample Wall of Shame.” Here are some of the best. 

 

This container is for food, human food.

 

So is this one. It was sealed with packing tape and formalin leaked out during transport.

 

 

This vet submitted the uterus of a dog in a Gold Peak tea bottle. When collected at the time of surgery, the tissue undoubtedly went into the bottle easily. We had to cut the bottle apart to get the fixed tissue out. And yes, that is a zip tie that was used to close off part of the uterus. We still don’t know why.

 

This vet chose a pill bottle which does not have a liquid-proof seal. They thoughtfully folded the submission form into the same baggie as the pill bottle. Formalin leaked onto the submission form.

 

 

This vet chose a glass mason jar and opted to seal it with packing tape instead of wax film. Glass is an insanely terrible choice. And the submitter still didn’t have enough formalin for the size of the sample.

 

 

This vet used an appropriately sized, commercially prepared jar with sufficient formalin to fix the submitted tissue samples. They had marked one of the samples with a suture, a common way to differentiate multiple samples placed into one jar. Unfortunately, the suture caught in the threads when the jar was closed and most of the formalin leaked out during transport, contaminating other samples in the same shipping box.

 

 

There was not enough formalin in this commercially prepared jar for this large tissue sample. 

 

Why does any of this matter? Formalin can leak out of poorly sealed containers and contaminate submission forms, packing materials, and other samples in the same shipping box. Leaks expose shipping, receiving, and histopathology personnel to formalin, a carcinogen. Tissues that don't get fixed completely can rot, obscuring diagnostic details. Glass containers can break, creating sharps hazards. 

Sure, the commercially prepared jars that I showed in the last two examples cost money and some vets may want to cut costs where they can. But selecting any old container that comes to hand creates unnecessary risks, potentially ruins samples, and shows poor attention to detail and poor understanding of the requested diagnostic test. 

To be sure, this is not a problem unique to our lab. All diagnostic labs have to deal with improperly packaged samples. We wear PPE and use biological safety cabinets and fume hoods to handle samples to mitigate risks on our end. And of course we educate clients who submit samples like this as often as we can. 

Even so, I regularly add photos to my Sample Wall of Shame folder. 

 

 

DNF

 When I was much younger, it bothered me when I was unable to finish a book. It felt like a mixture of disrespect to the author and laziness on my part. And after a certain point, the sunk cost fallacy would kick in and I’d think, I’ve made it this far, might as well finish it. Not anymore! These days, my patience is tissue-thin, and I will drop a book in just the first few pages if I am not enjoying it.

My three biggest reasons for not finishing a book are poor (or absent) editing, YA fantasy that wasn’t marked as YA, and sloppily researched, key plot points, usually involving a subject that I know something about.

Why no YA fantasy? I am an adult woman. I don’t want to read a story targeting hormonal 12-year-olds.

The best example of sloppy technical research is anything churned out by Frieda McFadden. Even the laziest writer can read a Wikipedia article to find out some basic facts about how trains or credit cards or grocery stores work, for example. God help us when she veers into medical-adjacent plot points. Sheer nonsense. Was she trying for fantasy on top of the psychological mystery angle? She, and her readers, apparently don’t care. Count me out.

I recently added a fourth reason for DNF: florid, overblown writing. I don’t encounter this very often because I don’t read genres that tend to the florid.

I had already passed over a new biography about Hedy Lamarr several times. Although “The Only Woman in the Room” seemed to be an intriguing story, I never could get hooked enough to check it out. But I’ve got several holds pending at the library and I decided to fill the gap last week with this book since it was available.

I was horribly disappointed. I couldn’t make it past 20 pages. It seemed to have been written using an algorithm that specified that every noun had to have one or more adjectives and every verb one or more adverbs. It was ponderous. Adding insult to injury, verb choices were always the most complicated possible. No “she said” for this author. It would be “she breathily intoned” or some other tortured word choice. Even more insulting, key points were repeatedly repeated. I don’t want to be hectored when I am trying to escape into a story (looking at you too, Louise Penny).

I can’t believe that people read this and thought, wow, such a good book. The fact that it was on the NYT Best Seller List means nothing since those rankings are easily manipulated. This book was so overdone that I am not sure if humans were involved in its writing or editing. Either way, it was DNF for this human.

Spicy

I’ve been working through some training issues with Frankie in the past few months. If I am honest, these are things I should have been addressing when she was a puppy. I had no idea that she would turn out to be such a spicy little speed demon.

Her performance in the competition ring is quite different from what she does when we are training. The biggest problem, and there are several, is that she won’t come to me at the end of a run.

I’ve done pattern games. I’ve worked on building value for the leash. I’ve dropped leashes all over the training field and interrupted her runs to ask her to run to a leash for a reward. No problem! But in a trial, her brain leaks right out of her ears. I can usually (but not always) get a full run out of her but we rarely finish the course together.  After she clears the last obstacle, she takes off and runs around the ring, refusing all recalls and attempts to catch her. She’s even become wise to people holding out food. She doesn’t take any obstacles, just runs around at top speed. I’ve been complimented many times on how fast she is … while she is running around like a feral beast. Not her finest moments. 

My interpretation of this behavior is that she is so overstimulated that she simply can’t stop at the end of the course. She still has energy to burn.

So what’s the solution? Her drive is off the charts on a normal day. She can ramp up in seconds. I want to use that drive, not squash it. Since I don’t think I can bring her arousal down in any substantial way, I need to try to plane off the spikes. 

On recommendation from friends, I consulted with a local trainer who has a reputation for working with spicy dogs like Frankie. She said, “Look, you aren’t going to wear this dog out by throwing a ball at the trial.” I agreed. Besides, playing with balls and tugs ramps her up even more. Then she dropped this: “But wearing her out shouldn’t be your goal.”

What a revelation! Of course. I need to find ways to shape her drive and help her with impulse control. Trying to make her tired doesn’t address either of those things.

This trainer recommended sniff walks before every run. Those are 10- to 15-minute walks in which I ask nothing of the dog. Frankie sets the pace. If she wants to sniff one spot for 5 minutes, that’s fine. The only requirement is that she not pull on the leash. Sniffing releases endorphins. Walking and sniffing are gentle, steady stimulation, not rapid jerks and spikes like play brings.

I tried this at the last trial in February. It was a challenging task with morning temperatures in the teens, but I managed to pull it off four times each day. The time management was exhausting. But I did see a small difference even though it was the very first time I tried this. Frankie’s focus was better at the start of each run. But she was still running off at the end, especially on the second day. While sniff walks are an important addition to our trial routine, they won’t solve everything. There’s still some training to do!

Since early December, I’ve been training Frankie in contact heeling and its related movements. I will try to remember to film one of our training sessions, but you can check out videos of this online. It’s used to train dogs who do bite and protection work. It’s also used for reactive dogs.

 It’s not just about heeling but about positioning the dog in space. What sets it apart from old-school obedience training is that the dog remains in close physical contact with the handler. Plus, a lot of the contact heeling trainers use positive training methods, even for dogs training for bite work, and I’m all about that. No leash corrections or e-collars for us. Once I learned about contact heeling, I realized it was a missing piece for Frankie! I had already noticed that she likes to be touching me. I realized I could use this training to build more value for being with me, build routines that include movement (Frankie wants to go go go all the time), keep up a high rate of reward, and be able to take all of this on the road, that is, use it at trials, not just at home.

We are by no means experts, and I have no intention of training her up to competition level, but I am seeing a shift in her focus and attention. I’ve added contact heeling moves to our gate and start line routines for agility. Instead of trying to distract her with treats before we go in the ring, which only ramp her up, I ask her to calmly and smoothly move around with me in coordinated, set patterns that she knows and has been rewarded for many, many times.

Frankie will be a life-long project. But I am grateful to be learning so many new things with her.

 

Moving On

I really enjoy my job. I get to see an amazing array of animals and diseases. I am constantly learning new things. The lab’s clients are interesting and entertaining. It’s a work in progress, but I think that the lab section that I supervise is running pretty smoothly. 

But this job doesn't define me entirely. As much as I look forward to coming in to the lab each morning, I don't live to work.  

The stress points of this job have changed over the years I’ve been here. The old incinerator was a huge source of drama and stress. We got a new unit in the fall of 2024 but the hoped-for reduction in drama and stress didn’t show up right away. There were significant operational growing pains and I was still spending entire days and even weeks on the phone with the manufacturer trying to diagnose problems. I performed many of the repairs myself. But things finally settled down with that.

In the past year or so, an entirely new source of stress has popped up. Arkansas currently doesn’t have a school of veterinary medicine, but by this fall, it might have two! Arkansas State University in Jonesboro is nearing the end of the approval process with the AVMA and hopes to start their program this fall. The other school is associated with Lyon College. This private school of vet med is being backed by venture capital. Neither school is building a teaching hospital. They are using a distributed model in which third- and fourth-year students complete required rotations in private clinics and at other vet schools. Both ASU and LC want to send students to my lab for necropsy training.

Our lab is old and small and resources are limited. ASU is being reasonable and has agreed to send no more than 40 students through our lab each year. That is a lot but it should be manageable. Lyon College is not being reasonable. They want us, that is, me, to deliver necropsy training to entire cohorts.

Putting aside the fact that the mission of the lab does not include teaching, the fact that I’m only one person, the fact that we literally don’t have enough space to have that many more people in necropsy, there’s the issue of Lyon College itself.

Lyon College will have few entrance requirements beyond the student’s ability to pay. The VC funding behind the new school is focused on profit, and the losers in that scenario are the students. The dean they hired has a particularly unsavory past. I’ve repeatedly expressed my concerns about the lack of space and resources as well as my reluctance to partner with Lyon College in general. I’ve been told that this partnership will happen no matter what.

The people making that decision are not factoring in one very important variable. I have a choice. And I’m choosing to retire far sooner than I would have if they had not forced Lyon College on me. I will be out before the first students from either ASU or LC come to the lab.

I met with my financial advisor yesterday. He assured me that my portfolio can accommodate this change. We had a great in-depth discussion about my options. He’s good at his job and has really listened to me. I’m already making plans!

 

Ice Storm Hijinks

 It has been a warm, dry winter in central Arkansas this year but January is always full of surprises. Last weekend, we got hit with a thinning edge of the big storm that affected so much of the rest of the country. Arkansas is not prepared for ice and predictions were dire. I stockpiled water and food and staged blankets and crates in the upstairs guest room in case we lost power and I needed to set up a warm room. Since I don't eat much processed food, I cooked for a couple of days and filled all my food containers. 

We didn't lose power or water, thankfully, but we did get hit with three separate deposits of sleet and ice. The dogs are okay with going outside on their own but when it was o'dark thirty and blowing horizontal ice, Frankie had to be pushed. They did a lot of their business directly under the deck.  

The storm had mostly finished by Sunday morning so I opened the garage door to assess the situation. I found a 2 foot tall, 3 foot tall berm of ice snugged up against the length of the garage door. I obviously wasn't getting the car out until that was gone. It took me 3 hours of shoveling to move the berm. 

 

 While I was out there, I did some exploratory chipping and shoveling a little farther out on the driveway to see what I was dealing with. It didn't look good. Since it was mostly ice, the snow shovel wasn't rigid enough. I had to stab down with a regular shovel to break it apart then use the same shovel to move the chunks.

 

The weather on Monday was clear and sunny. I waited until around noon then spent 4 hours clearing the upper half of the driveway. My driveway is long with a slope to the street. This took another 4 hours of work with the regular shovel. The ice was too thick and the chunks were too heavy to move with the snow shovel. It was quite tedious. I finished the job on Tuesday and spread some grit I had left over from my wall projects on the remaining patches of ice. The street was still impassable but that was going to take more than my efforts to resolve.  

 

The fox terriers were running around in the backyard across the top of the ice like Legolas from LOTR, leaving no footprints. We went out every afternoon and played fetch with a tennis ball. It was very cold but sunny and clear. 

With time, the ice compacted down to a glass-smooth surface. So yesterday, when Frankie blasted down the deck stairs and headed out to make her usual perimeter run, she slipped and fell on her side. She had a lot of momentum and started sliding across the sort-of flat middle part of the yard, bounced off the top of a rock wall (I thought for sure she would fall over the edge), and finally slid to a stop against a tree. She easily covered 50-60 feet on her side. She stood up, gave herself a shake then very carefully began to make her way back up to the deck stairs. Since my seat in hell is already reserved with an embossed place card, I was on the deck doubled over with laughter for the entire performance. 

 

Reminder

 Locum work, also called relief work, has always been a thing in both the human and veterinary medicine fields. Oddly, it seems like it's mostly nurses from the human side who do locum work, while it is DVMs who travel around in vet med. When the world turned upside down during COVID-19, locum work really took off to the point where it has become a solid career option for some veterinarians. 

Some assignments can last for months, such as covering maternity leave for a regular employee, while others consist of an occasional overnight or weekend shift. Some practitioners use locum work to travel widely, while others stick closer to home. There are companies who will find locum assignments for you (for a fee usually), or you can arrange them yourself through personal connections. 

Locum work can pay really well. DVMs covering overnights at an emergency clinic can earn over $1500 for a 12-hour shift. That's a car or student loan payment or money saved for a trip. You can be paid as a regular W-2 employee or as a 1099 contractor, which is a bit more complicated for tax reporting. You have to arrange DEA licenses for each location that you work at. And if you travel, you'll need a license to practice in each state. All of that is just bookkeeping. Quite manageable. 

Locum work isn't for everyone. It takes a certain personality and ability to walk into a strange clinic with pre-existing technical protocols and interpersonal drama and get right to work treating patients. To add to the stress, a DVM, locum or otherwise, is expected to be a team leader. It doesn't matter if you don't know where the bathroom is. A relief practitioner needs to both check their ego and take the lead. 

I've started picking up Saturday shifts at a local clinic. I only do one shift per month, and sometimes skip a month. The clinic is corporate, meaning it is owned by a much larger company, so I was hired as an hourly employee with W-2 wage and tax reporting. 

Why would I do this when I have a perfectly good job? There are lots of reasons! For starters, when I pick up a Saturday shift, one of the regular vets gets to spend that day with their family. Burn out is a problem in vet med. I'm helping out my colleagues.

While that sounds terribly noble, there is also a selfish reason that I'm doing it. I get to put my hands on living animals. I get to practice medicine. I absolutely thrive as a veterinary pathologist and am good at it, but working a Saturday in the clinic reminds me why I spent all that time and money getting the DVM degree. 

Because of the many bad habits I've picked up from being a pathologist, I told this clinic that I would absolutely not do surgeries, dentals, or even laceration or wound repair. I would only take wellness clients. I would be okay with giving vaccines, but no other sharp things should be put in my hand, ever. And they are fine with that! 

I see between 14 and 18 clients per shift, which is a lot. Each time I do a relief shift, my hands and brain remember physical exam skills that I learned in school but haven't had a chance to use since I graduated. Sure, we do physical exams before a necropsy but we are evaluating very different things about the animal in front of us.

 The owners I work with are in a different place too. They are bringing their pets in for wellness exams, vaccines, parasite preventatives, nail trims. Simple stuff. Basic health care. For the most part, they are relaxed and calm. It's a different world.  

There's another reason I'm doing this. I've already started to think about retirement from my current job. I'm still a couple of years out but now is the time to start planning. By keeping my skills up and my connections solid, I can step from my current job into part-time relief work without a break. I am grateful that I have that option. 

 

Wall

 My backyard is quite steep, the soil is poor, thin, and rocky, and there are lots of mature oak and walnut trees. Erosion is a problem and I’ve been experimenting with different ways to manage it. I don’t want to put down sod because I don’t want to waste water on it or deal with the tons of chemicals it would need to remain alive on the aforementioned shitty soil. Clover does okay in some spots. It dies back in the summer but the roots remain and they help hold things in place. Throwing clover seed around isn’t going to solve the erosion issue however.

The biggest drainage problems are in the two farthest corners of my yard. After watching dirt pile up against the fence in those corners, I needed to get serious about fixing the problem this year.

I decided to build a retaining wall using those 22 lb paver blocks. Going into the project, I wasn’t sure I could do it. Conceptually, building a retaining wall with pavers isn’t hard. But there were complicating factors for this particular wall.

This was my first attempt at such a project, and of course I chose an area where I had to step up the bottom course FIVE TIMES to accommodate the natural change in elevation. It also took more blocks and paver base than I expected. 

 

 

 

Since I wasn’t ready to commit to an entire pallet of blocks, I got 18 blocks at a time from Home Depot. Because they are heavy, I could only move 4 at a time in the wheelbarrow. And because my yard is so steep and there are other barriers in place, I had to navigate half a dozen switchbacks for each trip. It took me an hour to move 18 blocks from driveway to the job site.

I teach dog classes on Sundays, so I could only work on the wall on Saturdays. Like most normal people, I have other stuff I also need to do on the weekends so I really could only work on the wall for a few hours each Saturday morning. It took 5 weeks to build it, including 6 hours to dig the initial trench. 

 

Is it perfect? Of course not. It’s not even all the same color because Home Depot ran out of grey blocks and I had to finish the wall with tan ones. But it’s reasonably level. I managed to work out the step-up process after a couple of false starts. And I did it all myself.