fast pace Lindsey

Note: I changed names of vets here for privacy reasons...this is on the web after all! Hopefully I didn't miss one of the names and forget to replace it with its fake name!

Week 1: small animal medicine...you learn a lot in clinics. I thought I was much more of a medicine person before this week, but a lot has changed I guess. Overall it has been good, just REALLY SLOW. You spend so much time analyzing every inch of history on medicine. There is no quick answer at Tufts since the cases are so complicated. And you hardly have more then 3 patients in the hospital since each one is on 5+ drugs and has 24 hour treatments you need to manage. Before clinics I thought I would love medicine and hate surgery. Now that I have had a taste of both I wish I was still on surgery! Sure the on call hours and case load was intense, but I like managing that much as opposed to one patient a day.

Dawn, the lab tech from Dr. Warren's lab that I used to work with, was walking by today while i read a chart I was about to go in to a room with...she stopped by to ask how I was liking clinics and if I had survived surgery. I whispered to her how surprised I was that I think I liked surgery t=more then medicine. She laughed and said the two were very different paces and the "fast pace Lindsey" she knew to always be managing twenty million things so efficiently would like surgery more, she was not surprised. She told me she couldn't wait for me to do my emergency and critical care rotation since she thinks that will suit my fast paced personality best.

I was bitching to Mark that we see the most complicated, rare, weird disorders at Tufts since all the local vets refer their weird cases they can't solve to us...it is cool, but annoying sometimes since it is not realistic, I will rarely see these cases in practice. Well, today was one of those days where I couldn't stop giggling and wanted to tell Mark about those cases...we saw a german short haired pointer with "caudal vena cava aplasia" today. It is basically a weird and wrong arrangement of blood vessels in the caudal half of the dog...there have only been about 6 cases reported EVER in the history of the world, and of course only one case ever treated successfully, so we will hopefully have number two....if the dog throws a clot we will try to be the second institution ever to fix a dog with this weird disorder. Here's the one case before: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=339271

One of my other patients today was a recheck patient with SLE, or Systemic Lupus Erythematosus, a VERY rare autoimmune disorder in all species (humans get it too). The dog was doing great. It was this really nice couple in their late 50's who were convinced their dog was going to die a month ago, but we figured out it had this disorder and brought it back, she is doing great now. Still not 100%, but 20x better then when she left the hospital a week ago.

The other weird/nice thing that happened today was involving the resident....right now Jaime, me and Jess (three senior students) are on with Dr. Wells, a board certifiied internal medicine clinician, and Dr. Harris, the second year medicine resident (it is a three year program for her to get her internal medicine certificate). Both are great. Dr. Wells is brilliant. Well, Dr. Harris has been working on this intense bile peritonitis, renal agenisis and failure, etc. problem dog...the dog is nasty to us, but has every problem in the book. However, the dog has the most incredible owner, and the dog and the owner are bonded beyond belief. A lot of owners claim "Oh, my dog wont bite if I am here" which is BS, and the dog lashes out of fear and hurts someone. This owner does not claim that, but it is TRUE. When the dog is with the owner she is in heaven and does ANYTHING for him, we can put catheters in or do an ultrasound, I honestly think the dog would let us cut her open and do surgery if the owner was there to tell her to stand still, she is that fucking loyal, but once he is gone she needs a muzzle since she tries to eat us. This dog has been in and out of the hospital every week for the last three months, and the owner talks to Dr. Harris every day. Dr. Harris told us today the owner has spent over $18,000 on the dog in surgeries and diagnostics...

Well she is back now, and her one kidney (renal agenesis means she was only born with one) is failing...we did tons more tests today, the one kidney has tons of infarcts, her chest is filling with fluid, etc. Not good. We were rounding on her this afternoon in front of her cage, and even though the dog would growl and show her lips Dr. Hilling insisted on sitting in the cage with her. Dr. Harris told us the story of everything that she has done medically with the dog in the last 3 months, and Dr. Harris has had a cold so to me she seemed out of it, but I assumed cause she was sick...when suddenly Dr. Wells said to her "Karrie, you need to realize you did nothing wrong. Everything you did in this dog was right and it is not your fault that she has so many medical problems." I had not even realized that Dr. Harris was stressed about that, but I was so impressed with Dr. Wells's incredible intuition and picking up on Dr. Harris's body language. Suddenly Dr. Harris burst in to tears, and I felt really bad....Dr. Wells comforted her and told her that she had done all the right things, and it was ok to cry, cause if she didn't maybe she should be looking for a different career. She told us all that we should all be proud when a case makes us cry cause we try so hard in vain to save them and it was ok. It was a really weird and happy and sad moment all at once.

On a good side note, progressive car insurance started providing in Massachusetts today..I got my quote, and I can't believe it is actually $600 less then it was in NY annually. So I am all set on car insurance, and should have Mass plates by late May!