Rantings of an insane veterinarian...

I'll apologize in advance for this post. It's going to be long. It's going to be involved. It's going to cover veterinary and non-veterinary topics. It's going to have lots of tangents. And most of all, it's going to be one BIG RANT!!!!!

I'm so frustrated right now. Frustrated to the point that I have seriously considered giving up veterinary medicine. It's a combination factor. You know how in life a bunch of things build up then the tiny straw is what pushes you over the edge?? Well, that's where I am right now; teetering on that edge...

First my landlady. She's bipolar, no kidding. One moment she is very nice to me then she does crazy things and makes me so angry I'm boiling inside. Her latest escapade? She went into my apartment again without permission while I was at work at night. Upset the dogs terribly and if anything makes my blood boil it will be when someone upsets any of my fuzzy four-legged children (or my mom, or my really good friends)! She then sends me an e-mail to inform me that I need to neaten up the place as she'll need to be showing it soon as she looks for a new renter. I cannot possibly express how much I am looking forward to shaking the dust of that place off my boots!!!!! (38 days!) I don't feel comfortable leaving my dogs at home anymore (where they are happier) but I can't really bring them to work every day either. What am I supposed to do???

Next it is the talking heads at work. The specialists are the first to receive criticism. There is one particular doctor who cannot be satisfied unless she is being critical. I do not care what you choose to do with a case, it will not be right for her. I've actually experimented (not to the point of putting my patient in danger you understand) by doing opposite things on different cases with the same presentation just to prove my point that it doesn't matter what you do, you'll never make her happy. This morning I threw the file at her. I think she may have realized I was a teensy bit annoyed. Afterwards she had to butt in on another matter then come by and ask if I "was okay? Was it a bad night?" Uuuggghhh!!!!! If you really cared, you wouldn't treat people like crap all the time then out of the blue when you feel inclined (i.e. there's something in it for you) be all nice. I hate that! I can deal with the short-tempered explosive personality better since it's not a manipulative anger. I tell myself that they are the ones that are unhappy which is why they act like such A-holes.

In continuation of the above theme is the really frustrating thing about this particular internship. I feel that I have learned and benefited from the internal medicine, oncology, neurology, and dermatology services but surgery has been a waste of my time. And I LOVE SURGERY!!! That's what I want to do but I've not grown at all from my surgery experience here. I learned more from my friend (who is a surgeon) that I'm always bugging with questions that these idiots are incapable of answering. They are all so busy patting themselves on the back about how smart they are and how stupid the interns are to even realize how little they know. That's why I characterize them as the talking heads and rounds (when we are supposed to discuss cases, learn, and be taught) are fondly referred to as mental masturbation.

Additionally, some of the staff make me want to poke hot needles in my eyeballs. Some of the people I work with I will miss when I leave. Maybe one day they'll face facts and be smart enough to leave this hell-hole. Many of the people, however, are the laziest group of people I've ever worked with and they love to toss blame and criticize. What is so hard about just doing your job??? Why can't anyone be adult enough to claim responsibility for what they do???

Then comes the recent patients. I took in a STAT emergency tonight that was a 7 month old cat just adopted today. His new owners took him home and their Shih Tzu unexpectedly attacked the cat, grabbing his chest and shaking him violently. They rushed him to their regular veterinarian who took an x-ray but didn't place an IV catheter or try to stabilize him. When he reached me he was in cardiac and respiratory arrest. We got IV access then resuscitated him once. I've never seen an animal alive with a blood pH of 6.7 before... Didn't last long even with aggressive attempts to stabilize. We could not resuscitate him the second time around. He obviously had severe internal injuries and it was just a crappy way to start the night.

Much like the case I saw two nights ago where the patient was a 12 year old Boston terrier that was in severe congestive heart failure of both the left and right side. There was not a normal body system on that poor dog. Had to give the owner the lovely "please be prepared for a bad phone call in the middle of the night" routine. Managed to keep her alive until the next day so she could have diagnostics then she died. I'm being critical of the doctor taking care of her by saying that I think he was not aggressive enough with his therapy. Don't get me wrong, I know she didn't have much time but I felt that I had stabilized her to some degree and, speaking as someone who has been there all too often, just a few more days is worth a lot if you are not creating unbearable suffering.

Another recent case was the lady that could not bring herself to euthanize her cat because she couldn't live with it but instead I now have to live with the image of the cat slowly suffering and dying while knowing that I could have eased him away. I resuscitated that cat twice before it could not be brought back because she also would not make it a DNR even though there was nothing humanly possible to do for him. Then I get the angry phone call from her friend who demands to know "if you can put a man on the moon how is it that you could not resuscitate her cat?" I know it stemmed from the pain and frustration they were feeling but I don't hold the power to restore life in my hands. If I did, I would heal everything and our furry (or not so much) companions would live as long as we do....

I was informed last night that I had finally lost it when I suggested that I would get a cape and be "Super Intern!" This thought stemmed from the conversation that the techs were having stating that in Vermont there is apparently a new position being created due to the shortage of large animal veterinarians. They were calling it "Super Tech" meaning the job is a technician who is trained to do some of the things a veterinarian would usually do without having to go to vet school. I do not know details but if I get to wear a cape I could go for it. Really.

So, I made a deal that I will do three extra emergency shifts in order to be allowed to leave one week early. Believe me it's well worth it!! Thirty-eight days and counting; I CAN'T WAIT!!!!! Yes, I know that happiness is not found in a place but this place has been truly frustrating. I hope that one day I find somewhere that I can practice medicine in a way that is satisfying and fulfilling without being asked to compromise my integrity and beliefs. If it doesn't happen soon, though, I may go back to school and teach English literature. Ah, Shakespeare. Brings to mind the "pound of flesh" extracted by this place. I truly hope that my next internship is more rewarding. There is potential since it is at a university and most academic internships are better than private practice in all respects. Then I get to make one more try at a residency. Don't think I'll try again if I don't match this time but who knows what idiocy the pea brain inside my head will come up with next.

With that I will sign off since I'm sure that is plenty rant for now. Maybe next time I'll have something funny to say instead of griping.

I want to scramble some eggs now myself

Sorry for the length of time between posts lately. I've been kinda down because the practice is not very busy due to the economy. Also, sitting at work and playing on the Internet isn't good blog fodder.

I've been enjoying Dr. May B. Insane's posts a lot. I get a lot more detail over the phone, but her writing style is superior to mine and very fluid. I can only write like that when I really get in the mood to write, which isn't often anymore.

Someday I will cease to be amazed at people's stupidity. But not today. My receptionist got a call today from somebody wanting to know if we'd sell him some euthanasia solution to euthanize his own cat with. When we said no he asked if there was anything he could give his cat to euthanize it himself. And this is the second time this month.

Just wanna scream, people suck

I want to scream. Full blown, hair pulling, so loud the neighbors call the police scream.

These people call today. Their daughter gave them a dog a while back. They've been talking with our satellite practice on the phone for a while, but there's nothing in the computer about it. Apparently the dog is 10 years old, went blind a while ago, and they think it may have diabetes mellitus. Oh, and the dad just ran it over in the driveway. They think it's leg is broken. They want to euthanize it. But the daughter (who gave them the dog in the first place) just wants to "let nature run its course."

Really. Please. If you were screaming in pain after YOUR father ran YOU over would YOU want ME to LET NATURE TAKE ITS COURSE!?!?!?!?!

So the call back a few hours later. Apparently the dog is "on it's last legs" and they won't be coming in.

So they call back a few hours later. The dog is still alive and they're bringing him in for euthanasia.

So they show up and tell us the dog died on the way up. But they say, and this is a direct quote, "At least he went peacefully." Really. Like laying in agony for 6 hours is PEACEFUL while you slowly die of shock and blood loss?

I'd love to meet some people in a dark alley someday. Then they could be all peaceful.

More Eggs, Anyone?

Felt that it might be time to expand on a few more of the personalities with whom I work...

First, however, a brief tangent (me, a tangential rabbit trail?? Never!) onto a pet peeve directed at all of you pet owners out there. It never ceases to amaze me how people who work in human health fields seem to think an animal hospital is somehow different. Today, an emergency triage was brought back to ICU and we were beginning to examine it amongst all the other critical patients when we see an unknown lady just walk through the door. One of the assistants went and stopped her saying "I'm sorry but you can't be back here." Her reply? "Oh, it's ok. I'm a registered nurse." !!!!!!!!!!!! You, of all people, should know that you don't just randomly wander back to the ICU; way not cool!! We, as veterinarians and vet techs don't wander into the ICU at the hospital when we go there for an emergency visit. Come on, show the same courtesy please!

Now for the scrambled egg serving of the day.

I fondly call them big lazy, medium lazy, and little lazy. (Medium lazy left, though, thus disturbing my happy trio.) They are the non-boarded, internship trained so-called emergency doctors. They fill shifts that the interns cannot and cover swing to give us "more experienced support." HA! Bull-hockey-doo. They work three days a week (two day shifts and one overnight) and spend the majority of that time sitting on their hineys. When it's crazy-busy the intern is still expected to see all the cases. The excuse for not helping? Well, it's your internship, you're here to learn. Once again, bull-hockey-doo. Basically, they are just really good at getting paid for doing nothing. Maybe I should study their technique... My other most favorite thing about the lazies is the way they get away with certain things that would cause on of us, as interns, to be roasted. A couple of prime examples would be the following: 1) a case staying on ER for discharge later in the day (i.e. not transferring to a specialty service for continued care) for which they leave no discharge instructions translating to mean that someone has to take up the slack and spend time typing those on a case that should be just a baby-sitting affair; 2) they stop even looking at ER cases that walk through the door 30-45 minutes prior to their shift ending or prior to the intern's arrival (when they are on swing). This means that cases that may be critical can just sit in a cage while the distraught owner waits. This makes me very angry and the turn-about is that if one of the interns did this (not that any of us are actually that lax, even my less favorites) we would be screamed at in a sub-human fashion. Oh wait, I forgot, I guess we are less than human since we are interns...

Bowing to the request for more on Gigi the Hooker. Gigi is the top administrative official at this clinic site (it is now owned by a corporation that owns multiple clinics). She wears tall black leather boots with spikey heels to work most of the time. One of her chief jobs is to go out and visit our local referring veterinarians (rDVMs). Some of them have gotten annoyed at the clinic because there were some issues in the past when the rDVMs were left out of the loop about there own patients. Gigi is really good at kissing-up and selling the clinic to them again. Hence my nickname for her as the hooker. I also sometimes refer to her as the Joker because when she smiles her face resembles him a bit.

That's all the eggs for now but I'm saving more for later. The other recent event/comment that I will share because it amused me is this: one of our specialists just started working here while I was away then I came back and was almost immediately working closely with him on his service. He asked where I was headed from here and when I told him I was doing another internship he asked if I had a propensity for leather, whips, and chains... As I usually answer when stating my plans, "thus confirming my insanity." Later y'all.

Public service announement 1,762

So, people, this is a great time of year! The grass is starting to grow, the trees are starting to leaf, the farmers are (trying) to get fieldwork done... the mosquitoes, flies, and ticks are hatching and preparing to make our life miserable for another season. The lawnmower comes out and maims it's first victem of the year- if you're 5, you shouldn't be mowing lawn. And it's that favorite season for veterinarians once again...

Heartworm, intestinal parasites, and Parvo!!!

Now is the time of year when it's important to make sure your four-footed friends are protected against the things that it's easy to protect them against. Make sure your vaccines are up to date. If you get a puppy- vaccinate it! Nothing makes me more mad than somebody who spends $300-$2000 for a puppy than dosen't get it a $22 parvo vaccine. Then they complain about their $800 veterinary bill. Make sure your dogs AND cats are on heartworm preventative. Many, many veterinary clinics will sell single doses of heartworm prevention to people who can't affort to buy 6 or 12 doses at a time. Don't eat at McDonalds one day and spend that $6 to get your pet's heartworm prevention for a month. And don't forget the fleas and ticks! All of that over-the-counter drek they sell at Wal-Mart DOES NOT WORK!!!! Flea collars DO NOT WORK. Flea baths/shampoo DO NOT WORK. You'll save money in the long run to just go ahead and buy that Frontline, Advantage, Advantix, Revolution, Vectra, Promeris, or Comfortis flea prevention from your veterinarian. And it ACTUALLY WORKS, what a concept.

Today I saw a femal pit bull who's gums were WHITE on presentation. Her hematocrit was in the low double digits. She had a horrible case of hoodworm/whipworm anemia, the worms themselves, and had never gotten a vaccine, or a heartworm test. She was covered with fleas. And yet her toenails were painted, so her owner loved her. Her owner was just ignorent. I don't know yet if she'll survive her profound anemia, weakness, and dehydration from diarrhea and vomiting. Owners couldn't afford a transfusion. All this could have been prevented with a dose of a heartworm preventative that got hooks, whips, round, and heartworm. And some flea control that works.

Vet visit including blood work, labratory tests, and treatment: $350

Cost of one month of heartworm prevention and flea control for a 50 pound dog: $22-ish

So $22 x 12 months = $264

Education: Priceless