Diary of a Third-Year Vet Student: Up Close and Personal

My junior clinical rotation in Rural Veterinary Practice ended today. But the entire week amazed, astounded, and challenged me.

Yesterday, I rode with the vet, technician, and fourth-year student to a farm call for a horse euthanasia. Turns out those three had been to that particular farm just the day before. Their diagnostic work had led to a very poor prognosis for the horse, and the owners called the vet even before she and the team had returned to campus to request the euthanasia.

Veterinarians confront death on a near daily basis. It is a significant element in compassion fatigue, and contributes to the high suicide rate in our profession. I think that this link should be sufficient to highlight what a real problem this is, and how AVMA is trying to address it.

But we can't stick our heads in a hole and pretend that euthanasia doesn't exist. With that awful power comes an even larger responsibility. Now, when we are students, is the time for us to learn what we can about euthanasia. On the way to the farm, the vet lectured me and the fourth-year about how the euthanasia should go, what variations in procedure were reasonable, what could go wrong, and what contingency plans we might need.

To the credit of the team, the euthanasia went very well. Some contingency plans had to be activated but because the vet had prepared us well, the clients were not aware that we had to shift to plans B and even C. For me, the bar for this procedure has been set very high. It is so important that we learn how to perform euthanasias respectfully and humanely. Every member of the team was wiping their eyes, so I know that we were all grieving for the loss of this beautiful animal along with the owners, but the vet med team was professional and respectful--and I got to see first-hand that that doesn't mean they were cold or distant. It was a good lesson.

Today, I spent the morning at another dairy. I didn't admit this in my earlier post, but two days ago, my success rate at diagnosing pregnancies was 50%. Today, I palpated six cows and I was 100% successful. I predicted pregnancy AND in which horn the fetus was lodged (left or right). After I had palpated her, a very tall, lanky Holstein farted in my face, speckling poop all over my hair and goggles (that $10 investment to protect $400 eyeglasses was incredibly smart), to the great amusement of the vet. But I didn't let that stop me. I am becoming much more confident in recognizing physical indicators of pregnancy in cows. A little poop won't slow me down.

I also got to perform a field castration of a young male calf. I won't go into the details of the specific procedure, since I don't think that is appropriate here. But I will say that when a university vet does one of these castrations, the procedure includes sedation of the animal sufficient to drop them to the ground, a focused nerve block to the spermatic cord, a quick rough scrub of the scrotum using chlorhexidine then alcohol, and tetanus toxoid, long-acting antibiotics, and analgesics afterwards. Not one of those things are used in the real world. Why not? It's all about cost and time (since time = money, it is just another cost).

I was describing the procedure to a classmate who is only interested in small animal medicine, and she was shuddering and shaking her head, saying, no, no, not for me. What factors make her say, my god, castrating a calf like that in a pen in a barn is my worst nightmare, and make me say, wow, that's really cool, can I do the next one?

I am positive that my horrible experience in small animal surgery at the hands of a very poor instructor has colored my perspective for a long time to come. He made me cry during my dog spay surgery, and fucked with my head enough to make my classmates worry about my state of mind for several days afterwards. I will not name him, but I will shame him: to make all of the women in that lab cry, but to openly encourage the men, is to be a fucking misogynistic asshole. I promise you, here, now, that if I have a clinical rotation with him in the next 12 months, I will call him out.

What has changed? How do I have mojo now when I apparently lacked it in fall term? My experiences in the large animal side of vet med are responsible. To date, all of my experiences with large animals have been positive and successful, supported in full by the clinicians in charge of my learning. Sure, those learning events aren't always taking place in a nice, clean clinic or a sterile surgical suite. But I see that as part of the challenge: how to deliver humane, thoughtful, cost-effective medical treatment in a herd/flock setting.

Sometimes we learn by good examples of bad examples. And sometimes we are challenged to do our best by supportive and thoughtful teachers. I choose the latter path.