Have a seat, this may take awhile.

I worry a lot about how my clients feel about the service at the hospital. One of the things that really bothers me is how long we make them wait. If I know my pet's mom or dad has been sitting in the waiting room for 30 minutes, I start to lose focus on what I should be doing and fixate on how impatient they must be getting. My first week of vet school, I even made what could have been a serious medical mistake out in the real world because I felt like I had been taking too long and I rushed to dose and administer a medication.

One of the residents picked up on this recently, and took me aside to give me some advice. She told me when she starts worrying about that, she thinks about the level of service we are offering, and compares it to how long the same service would take in the human world.

I was really glad for her advice yesterday. We told an owner to be back by 4 (I always throw in "although there are often delays and of course you may have to wait a little longer," ), but she showed up at 2:30. She is one of those people who is really, really nice, and cannot stop worrying about her pet when he's out of her hands. As 2:30 turned into 3, and 3 melted into 4, I felt my pulse quickening and my thoughts wandering; I could no longer focus on the ultrasound we were doing, as every 30 seconds that ticked away felt like another eternity for the client.

But that's when my resident's advice began sounding in my ears. What had we done for her pet today? She dropped him off at 11:30. In that time, he was examined by internal medicine specialists, and got a number of blood tests run, and a plan was made to approach his problems. He then had a consultation with dentistry, and an appointment for oral surgery was made for the following Monday (in other words, the next business day.) He had an abdominal ultrasound and chest x-rays. Then he went to see our cardiac specialists and got a cardiac ultrasound, which was reviewed by another specialist within the hour. We got urine and ran additional tests on it. All of the bloodwork and urine results were back before the client even came back to the hospital, and were discussed again by internal medicine specialists. Oh, and did I mention that while he was here, we gave him a pedicure and some grooming?

As we finished up examining the last organ at 4:30, and drew out some urine to run to the lab downstairs, I was somehow completely relaxed. In just a few more minutes, I would get to explain to the owner what we had done for her pet today. Of course she won't be thinking about how much we've done for her in such a short time-- just as I would in her shoes, she'll be listening for what we found wrong with her cat and how we're going to approach making him better. When she brushed off my apology for the delay, as owners always do, I didn't even flinch. Usually I feel the urge to say "No, don't say "it's fine"! I really am sorry and I wish I could make it up to you! I'd give you a discount but of course I don't run things here... I'm just SO sorry!!!" Yesterday, all that was on my mind was how to best communicate the results of the incredible evaluation we'd performed on her beloved pet.

Ambitions of a Vet Student

I was talking with another fourth year student today, and she described the evolution of her career goals:

She came in wanting to specialize in medicine. By second year, she decided she wanted to work at a general practice hospital. By third year, her goal was to get a job. Now, halfway through her fourth year, she dreams of one day getting a full night's sleep.

Walking in circles

Students visit the radiology reading room from all over the hospital, and sometimes it's not hard to guess what service rotation they're on. Today as I watched my friend unwind the leash of a compulsively circling dog for the fourth time, I cleverly deduced that this was a neuro patient.

Circling behavior comes from damage to the brain. A dog can circle simply because it lacks the coordination, balance, or wherewithal to walk in a straight line. Other times, a dog is driven to continue walking in circles until they simply fall over from exhaustion and sleep, only to wake up and do it again. This dog was unusual in that, on top of all of that, he would snarl or bite at anyone who tried to stop him.

At first this seemed really strange to me. It's more than an involuntary compulsion, then, if he is making intentional/voluntary movements to defend his ability to circle, right? It seemed really strange that he would violently defend a behavior that was unrewarding and really just a subconscious compulsion...

But then I started thinking about human behavior, and suddenly the pooch's behavior didn't seem so strange at all. We strive to have more, to make more, to grow a business or a bank account, to get a bigger TV and a better car... and all the way we never stop to think about who might be harmed in our quest. We see this kind of behavior every day, and there's lots of evidence to show that the results of it all don't make us any happier or more satisfied with the life we've lived. Most of the time it would make us happier just to sit back with a smaller piece of the pie and savor every bite. But I think there's something deep down that drives us to acquire, to work, and to compete, and we're so used to doing it that if someone tells us to slow down, even if they're doing it for our own good, we have a tendency to snap at them.

When the doctor says "Huh...."

It's common knowledge that when a doctor looks at your results and then says "Hmmm"... you're in big trouble. I guess there's some truth to this, but I realized something today while reviewing radiographs: it's not necessarily as bad as it sounds. It's not "hmmm, we knew you had a problem but we weren't expecting this" or "hmmm, I don't know how to interpret this strange result..." It's more likely that the doctor has looked at 60 test results today, and has been straining at all of them to find the slightest abnormality. The "huh!" is just surprise at actually having something there to look at.

I'd still rather have the doctor squinting quizzically at my radiographs without finding anything to comment on, of course. From the outside, I always felt like "normal" was something you looked at and confirmed. In fact, in many cases, "normal" just means "well, I don't see anything yet, but maybe if I kept looking..."