Thursday, December 26, 2019

Being A Team Player

My closest colleague at work is a Chinese guy. He has a BSVM from a Chinese university, which is educationally equivalent to a DVM. He has not completed the (difficult and expensive) program that would certify him to practice as a DVM in the U.S. But he has the same job title as me, and in the 18-month gap when they were looking to fill my position that also included the 6 or so months that they had to wait for me to finish vet school, he conducted nearly all of the non-poultry necropsies that came through the lab. And for the last three months of that period, he had to do the poultry necropsies too. (For the record, he doesn't like working with birds, which is fine by me as I really like doing avian necropsies.)

Since I started working in July, I have completed over 150 necropsies in multiple species. I split each week's cases with my colleague. Using those numbers, by my back-of-the-envelope-calculation, he likely handled over 500 necropsies during the period that he was on his own. This gave him an incredible breadth and depth of experience, and a deep understanding of pathology of disease.

I find working with him to be quite enjoyable. He's got a dry sense of humor and a keen eye for detail. He and I have different styles on the necropsy floor (one time he put the entire head of a cat in formalin for reasons I still haven't been able to discern), but our styles are compatible so we work very well together. We discuss our active cases every day. We trade cases. We ask each other to look over necropsy reports before they get sent out. We argue about differentials (the director is particularly amused by this as we can get rather excited and loud). We cite papers at each other. We call the other one down to necropsy if we have a particularly interesting finding. I was able to ramp up my own performance very quickly by relying on him for advice, which he shared freely. He is professional, courteous, smart, thinks outside the box, and is happy to indulge in black humor when we need to blow off steam. What's not to like about having a colleague like that?

All of this is an introduction to what I really wanted to rant about. I have learned that my predecessors did not regard my colleague in the same way that I do. When one of the pathologists took him on the necropsy floor to teach him the basics, the other two pathologists ran to the director clutching their pearls, aghast and appalled, complaining that he was transgressing a sacred space. It's of a piece with those two refusing to share any details of their cases with anyone else. I also suspect microaggressive racism lurking around the edges of their behavior, but that is only my opinion. In short, my colleague was dismissed, overlooked, and treated quite unprofessionally.

In contrast, I have come to rely on my colleague. And the feeling is mutual! He tells me often how much he enjoys working with me, that he and I make a great team, that he has my back as I take over as supervisor of our section of the lab. He has no interest in being a visible leader himself, but without a doubt he leads by his actions.

The director has told me several times about a police K9 case from a few years ago that was handled quite poorly by one of the aforementioned pearl-clutchers. I don't have all the details but the necropsy wasn't done promptly, the necropsied body was kept for months instead of being released, and the report was treated like it contained state secrets. The mishandling and delays resulted in bad publicity for the lab.

Yesterday, on Christmas Eve, around noon, I got a call from the police chief of a small Arkansas town about 75 miles from Little Rock. A police K9 had been found dead and they wanted to bring him in for a necropsy. I don't typically have to work nights or weekends or holidays, but there are a few rare exceptions, and police K9s are one. The chief and I worked out details of timing. And the very next person that I called was my colleague. "I know you are on vacation, and it's a holiday on top of that, but I need your help," I told him. He said, "Absolutely, we are a team. When do I need to be there?" My second call was to the director to assure him that we had this case well in hand.

I ran the necropsy and my colleague acted as my tech, fetching things, taking pictures, managing my necropsy table. The gross findings were definitive, and we were able to determine a cause of death, document it properly, and get the two police officers back on their way home in about an hour. The director will be over the moon. As I drove home, I reflected on how much I have learned from my colleague in the past few months. Our job is unusual and can be physically and emotionally difficult at times. We are going to be more successful if we work together.

I am ashamed that my colleague was treated so poorly in the past, and even though I know that it wasn't my fault or my doing, and that I can't make up for years of poor treatment, I am reaping the benefits of choosing to treat him with the respect and professionalism that he is due.

Wednesday, December 25, 2019

Orange Basil Lentil Salad

I haven't posted a recipe in quite a while. This is a salad that I've now made twice, with good repeatability. The first time I came up with it, I took it to a party where it was complimented by all. No leftovers either. Yes, it was a bit risky to take a dish I literally created on the spot to a party, but I'm pretty confident in my cooking skills. I made it again last night for my Xmas Eve dinner. Total prep time is about an hour if you take time to drink a glass or two of pinot gris while you are puttering about in the kitchen.

Lentils, 1 to 2 cups dried
Fresh basil, lots
Red onion
Feta cheese crumbles, 6 oz or so (one small container)
Navel orange (one or two depending on size)
Dried cranberries, about 1/2 to 2/3 cup
Fresh greens (arugula, spinach, mixed greens, etc)
Olive oil
Honey
Apple cider vinegar (optional)
Black pepper, fresh ground

Rinse the lentils in a strainer. Cook 1 to 2 cups of lentils on low to medium heat (simmer, don't boil). Don't worry about having extra water as you can drain that off. Use French green lentils if you want to be fancy. Set the lentils aside to cool. When cool, put 1 to 2 cups cooked lentils, drained, in a large salad bowl. The lentils don't take long at all to cook. You can make them ahead of time if you want.

Finely slice a red onion and caramelize with some olive oil. This will take about 20 minutes on low to medium heat. Stir often. Set aside to cool. When cool to the touch, add to the large salad bowl.

Put the feta cheese into the large salad bowl.

Add a large handful of dried cranberries to the large salad bowl.

Finely dice a very large handful of fresh basil leaves. Put 1/3 of the leaves in a measuring cup and put the rest in the large salad bowl.

Note that the order in which you add things to the salad bowl is not actually all that important. Don't add the lentils and onions until they are cool though.

I like feta cheese and used an entire small container. Feel free to exercise more restraint. 

I find this recipe only needs 1 large navel orange but you could use two if you wanted. You might want to increase honey and basil if you use two oranges. Cut the navel orange into quarters and peel two of the quarters and divide into sections. Slice the sections into 1 cm-long pieces and add to the large salad bowl. Squeeze the juice out of the other two quarters into the measuring cup.

To the measuring cup, add some olive oil, a tablespoon of honey, and lots of fresh ground black pepper. If you want the dressing to have more of a bite, add 1/2 tablespoon of apple cider vinegar. Otherwise, it will be fairly sweet. Stir very well to dissolve the honey and mix the oil and orange juice.



Add your greens to the salad bowl. Fill that bowl up! Give the dressing another good stir and pour over the top. Gently mix everything well. Enjoy!

Sunday, December 22, 2019

"You mean they are calling to talk to you about patients that are still living?"

Even though I'm a brand new veterinarian and shiny new gross pathologist, I've got more than two decades of experience as a scientific professional behind me. As a result, I just assumed that I should be doing certain things in my own workflows. For example, I always call the referring veterinarian when I finish a necropsy, usually even before I write my report, and let them know my preliminary findings. Sometimes I don't have a veterinarian contact, so I talk to the poultry house manager or the owner of the beef cow. But the important point is that within a few hours of submitting animal remains for necropsy, our stakeholders get a brief report directly from me. I also started calling vets who submit biopsies, mostly to let them know they sent us an alien baby tissue sample in a woefully inadequate amount of formalin and it would take us a few more days to properly fix the tissue before we could cut it in.

Since making these phone calls seemed to be reasonable and minimally professional, and really didn't take much time at all, you can imagine how astonished I was to learn that the previous holders of my particular job never did these things. Never. Necropsy cases might be open for weeks, and the results never discussed with anyone. One previous pathologist put a sign on his closed office door (the office that I occupy now) stating that he was not to be disturbed for any reason. He never answered his phone either.

My office door is always open. The super nice but very large microscope that I use was deliberately positioned on the desk so that it formed an imposing physical barrier facing the door. I moved it to a small desk on the other side of the room. The light from the windows can be a bit bright sometimes, but I felt that was a small price to pay for getting rid of the physical wall that was between me and everyone else.

I'd been happily rolling along for several months, picking up the phone just about every day to talk to our referring vets, who are located all over the state (I had to put up some maps of counties and cities in Arkansas so I could figure out where these folks were located). Since I assumed this was basic professional courtesy, I was unprepared when one of those vets, who works in a three-vet, mixed animal practice that sends us a ton of necropsy cases, told me that I was a "breath of fresh air" and that I couldn't ever leave the lab. She called me a "treasure." Not much can leave me speechless but I found myself stammering out a reply. And in fact, this happened more than once. Nobody else called me a treasure, but several vets told me that they were extremely appreciative of my efforts to reach out to them about their cases.

Shortly after that, I noticed that vets were calling me. And they were calling to... chat. They would describe some puzzling case they were working on in their clinic then ask my opinion on this or that diagnosis or treatment, often prompting me to look at the phone handset and think, wow, they think I know what I'm doing here. But my geological science background made me very comfortable with exploring a problem with multiple hypotheses that may be overlapping or even mutually exclusive. I can do that with vet med problems too. I am not a naturally glib person, but I love to gab about science, and I always learn new things when I talk to fellow scientists. It seems that my veterinarian colleagues out there in clinics across the state like to gab too, and have decided that I'm either a resource with decent suggestions, or at least a good listener.

I relayed this to the lab director, and he paused then somewhat incredulously said, "You mean to tell me that the vets are calling to talk to you about patients that are still living?" I paused, surprised, and said, "Yes, I think that's exactly what I'm telling you." And he said, "Nobody in your role in this lab has ever accomplished this."

Accomplished simply because I chose to be an engaged professional.

Sunday, December 15, 2019

For Now, I Have To Pass On That

Cooking has been a hobby of mine for years. Combined with all the travel that I've done, I consider myself a fairly adventurous eater. I pay attention to what I eat, and if I like a dish, I try to recreate it at home. I consider myself reasonably experienced in the kitchen to the point that, with the exception of pastries, I consider recipes to be more suggestive than prescriptive. (Why pastries? That shit has tighter engineering tolerances than manufacturing medical equipment.)

I've also been interested in vegetarian cooking for a very long time. I first learned of this way of cooking when I lived in a strict vegetarian, clothing-optional, coed co-op during my first pass through college almost 4 decades ago. I kept my clothes on but paid close attention when I was on kitchen duty with my housemates. Some of their ideas had a pretty big influence on me. For example, I rarely eat packaged food. I prefer to cook using good quality raw ingredients. It takes longer because all those raw ingredients have to be prepped in various ways, but I refer you back to my first point--cooking is a hobby. It's something in which I invest time and emotional energy. And my diet has always included a decent proportion of vegetables and grains. One of my go-to comfort meals, tofu sauteed with onion and spinach then sprinkled with fresh lime juice, is all the way onto the vegan side of the scale.

A sample of the things I cooked this weekend for the upcoming week: cornbread muffins; white beans with roasted garlic, carrots, and fresh basil; white rice; and roast cauliflower and mushrooms with black pepper.

Fast forward to now. About a month ago, I realized that I hadn't purchased any meat in the previous couple of months. Somehow, in a shift that was subtle enough that I didn't consciously recognize it for months, I've become vegetarian.

I realized it had a lot to do with my new job. I handle dead animals regularly. Well, that's a flat-out euphemism. I cut them up. I cut up dead animals of all species. I surgically take them apart. After I remove entire organ systems, I cut those up too to make sure no lesions are overlooked. That was all soaking into my head too, just like those early cooking lessons, so that when I was at the grocery store doing my shopping on the weekends, I'd walk past the meat section and just...keep walking.

It's not a moral issue. I'm not a smug vegan judging you for your choices. You will have to pry the half-and-half in my morning coffee and yogurt and eggs from my cold, dead hands. Grated parmesan is a perfect garnish for just about anything.

For now, I still eat meat if someone makes it and serves it to me. It seems to be the handling of it that bothers me the most. And I've finally found the perfect agility training reward for Archie--boiled beef. Low fat, low sodium, freezes well, and he just goes nuts for it. I buy the pre-cut stir-fry strips and I don't even have to handle them when raw, just dump them in a saucepan and add water.

Is it just a phase? Does it matter if it isn't? It's sure a lot cheaper. Maybe I'll lose some weight too.

Saturday, December 07, 2019

Polishing That Resume

I was busy this week buffing up the resume credentials.

I am now certified to operate our forklift. I'm sure you are asking why I would ever need this skill. Well, we generate a fair bit of biological waste in the Necropsy unit, and we've got to dispose of it somehow. And "somehow" has to conform to an array of laws and regulations. We have a brand-new incinerator in a maintenance yard across the street from the lab, and we use the forklift to lift a specialized bag containing said biological waste out of a container and up into the incinerator. We typically burn between 1000 and 1500 lb of material at a time. That's not really a lot, since an average horse or cow weighs 1000 lb. Nobody at the lab was certified to run the forklift, so I arranged for the training and now 8 of us are certified. Plenty of hands to help whenever we need to burn a load of waste.

This week I also attended a day-long continuing education event on Arkansas aquaculture. I learned about the species that are cultivated in the state, and about important commercial fish diseases and parasites. After lunch, we had hands-on activities doing necropsies and looking over some lab testing procedures. I successfully pulled 3 mL of blood from my little catfish.
















The necropsy part was great. I knew absolutely nothing about fish anatomy before the class, and boy, are fish weird. There are only two chambers in their hearts, although they kind of cheat on the chamber count and add a third structure that acts as a pressure regulator out of the ventricle. They have two long kidneys tucked up near their spine like mammals. In some fish, the function of the cranial part of the kidney can be different than the posterior part. Their kidneys have an excretory function but freshwater fish lack the structures to create concentrated urine, for example. And of course they don't have lungs or a diaphragm. They have very simple guts, basically a stomach and intestine. I was surprised to learn that they do not have cloacas like birds but have two separate outlets, one for urogenital things and one for poop. Comparative anatomy for the win!