in the icu:

Student: "Why is this dog's fentanyl patch so weirdly located?"

Alacrity: "Dr. [Surgeon] specifically wanted the fentanyl patch placed in this dog's inguinal region."

Student: "Is it okay that it's touching his schvantzer?"

Alacrity: "I don't know, but Dr. [Surgeon] wants it there and she's an awful lot more board-certified than I am."

overheard at 7:30 am on a Sunday:

Surgery resident: "I'm a grown-ass man! I will get a damn betta fish if I want one!"

pudgy cats are the best cats:

Surgeon: "I'm bringing my cat in on Tuesday."

Alacrity: "YES EXCELLENT! I can't wait to squeeze his fat face!"

Surgeon: "Make sure you squeeze his jungle pouch!"

orthopedic surgeon, reviewing some radiographs:

surgeon: "Ah, I see the problem. His penis is in his knee."

on changing:

Surgeon: "Yeah, I just change right in my office. I don't cover the window. I figure if someone happens to look in and sees my frighteningly pale ass, they won't look again."

calling for help is fun, redux:

I just finished another set of overnights, and on one of these overnights, I had a 75 kg dog come in with a gastric dilatation and volvulus (GDV). He was huge, he was adorable, and he needed to go to surgery immediately. So I consulted the on-call schedule, and called the resident on call:

Resident: "Hello?"

Alacrity: "Hey dude, I have a GDV."

Resident: "Okay...I'm in Texas."

(Note: our hospital is nowhere near Texas. It's approximately half the country away from Texas.)

Alacrity: "How are you on call if you're in Texas?"

Resident: "...I don't know."

Alacrity: "Okay, I'll call the other resident."

Now the other resident was not on call (duh), and was at a bar singing karaoke (like you do when you're not on call). So I called the surgeon who was working the OR today, and the guy who is technically on back-up call for the resident:

Surgeon: "Hello?"

Alacrity: "Hey, sorry to wake you up. I have a GDV, and James is in Texas. Would you mind coming in?"

Surgeon: (pause) "Well, who's the primary on-call?"

Alacrity: "James."

Surgeon: "How did this happen? How can James possibly be on call when he's in Texas?"

Alacrity: "I don't know."

Surgeon: "Well, this is just ridiculous! Why wasn't this taken care of ahead of time?"

Alacrity: "Look, man, I don't know. I just have this GDV that needs to go to surgery. Are you in, or do you want me to call someone else?"

Surgeon: (sigh) "Fine. I'll come in."

what should we call Alacrity on surgery rotation?

Watching a TECABO:

thanks srslycute.com

"Hey Alacrity, can you set up the minidriver?":

thanks funny-pictures.picphotos.net

Watching the surgeon cut through the tibia:

thanks brendongreen.wordpress.com

many cooks, small kitchen:

Hiiii Everyone!

So I'm just finishing up with one of my surgery rotations. My internship is a rotating internship, which means I spend different weeks working in different parts of the hospital. I'm mostly on ER, occasionally on surgery, occasionally on medicine, and occasionally on elective time (which includes things like radiology, oncology, and ophthalmology).

Surgery is the scarier for me than ER. Actually, surgery is scarier for me than overnights. I think it's because there are SO MANY THINGS that can go wrong in surgery, and although this is also true on ER, it's far more frightening for me when I'm in the operating room. Dog with pericardial effusion? Okay, I'll tap that. Heart failure cat? Heeeeeey lasix, ghett-echo, and oxygen (and some other stuff later)! But if I'm holding the scalpel? Better not fuck up...

 Also, I pass out sometimes. On my very first day of my very first surgical rotation of my internship, I passed out in a surgery on a dog with carpal valgus. The anesthetist's hands were full as I started to fall, so he caught me by lodging his foot between my ass cheeks, then guided my head to the ground once he freed his hands. Then I crawled out of the room so I wouldn't vomit in the orthopedic OR.

Anyway! The other day, I was draining this dog's abscess. This happened:

Surgeon #1: "Okay, I think you should lance the abscess like this, and then place the drain with the exit hole here, then tack it to the other side like this." [walks away]

Surgeon #2 strolls by, says: "Hey, why are you placing that drain like that? That's not how I do it. I would place the drain like this [shows me a different way], and tack it here like this."

Resident comes over, says: "Dude, why are you placing a drain? I would have just removed this whole abscess en bloc."

Resident #2 comes over, looks, says: "Ooooh. Oh, why are you doing that?"

Surgeon #1 returns: "Alacrity, why are you placing the drain that way? I would have used a much shorter piece, and placed it like this."

Alacrity: "AAAAAAAHHHHHHHHHHH!!!!"

Surgical technician, running anesthesia: "Baaaaaahahahaha that was awesome!"

Balls.

intern adventure day:

Our boss gave the interns all the same day off one day in January, at approximately the midpoint of the internship. The other doctors in the hospital (kindly) chipped in to ensure that we all got to leave a little early the day before.

This was so we could drive to a local resort casino, where we had rented rooms for the night.

The surgeon instructed the surgery intern to leave early after all the surgeries were done. This happened:

Surgeon: "Okay, get on your way. I'll finish up here. Thanks for your help today."

Intern: "Thanks! I SOAPed everyone and hung the treatment sheets for tomorrow. All that has to be done is rounding the overnight doctor when she gets here."

Surgeon: "Rounding the overnight doctor?"

Intern: "...yes?"

Surgeon: "Okay...wait, who's in the hospital?"

overheard in the surgical wing:

Resident: "So I've been wondering..."

Surgeon: "Hmmm?"

Resident: "You know how you can have a 'hummer' with a blow job? What would the equivalent modifier be for the same action with a rim job?"

Surgeon: "Huh. I don't know."

Resident: "Right?"

Surgeon: "What about a 'rummer'?"

Adrian:

have you heard hope whisper through this hospital?

i have.

it ghosts along corridors and seeps under doors

one clear morning, it swirled around four grey fetlocks

trembling in the stocks of the treatment room.

would you go to surgery, doctor? if he were yours?

well, i wouldn’t have the money.

say you did?

if i had fifteen thousand dollars to light on fire?

i guess i’d try.

twenty percent.

the thing about hope is,

it has no regard for odds.

six pairs of eyes lowered as we rolled to surgery

heads shook

and hope stayed.

it curled up next to a plush grey muzzle

and went to sleep.

the operating room hummed quietly

as the anesthesiologist’s nimble fingers

dosed out sleep

pressors, pain control, postive inotropes,

a careful finger on a pulse point, a grave expression.

i held his intestines as surgeons measured, cut and sutured.

and watched the dark coils brighten to pink.

it is surprising how slow the surgeons’ swift hands can seem

when each breath is a victory.

we left bloody footprints down the hall

spots and drizzles to recovery

the big grey horse soaked with red

stood up

swayed

and stayed standing

and the surgeon’s eyes danced.

fifty percent, maybe.

hope crept along as he stumbled to the ICU

dizzy with discomfort and residual drugs.

it melted into the warm bags of plasma

and brightened each golden and expensive drop

but he shivered in his ice boots

and his guts stayed sick and slow.

i watched the lazy loops on the ultrasound screen

and poured buckets of reflux away.

we weren’t sleeping.

i asked my stethoscope for anything but silence

a quiet query for the warm rumble of digestion

then i sat on the textured rubber floor

and watched him breathe.

i was filling a bucket of ice, maybe

when the resident came to his stall.

he said my big grey horse was dying

and i told him he was wrong.

see, though his bloodwork’s in the toilet

and you’d think he’s getting worse

hope is twirled through his forelock

and humming in his heart.

and he will be better tomorrow.

i said the words like ice chips

crisp and cold and tingly

just like that, they felt true.

and they were.

he dragged me across the pavement

two days later, or maybe it was three

so eager for the succulent grass

that he forgot his manners

you know, once –

in a dizzy day after a night in the OR

I heard an exasperated resident ask the air:

why do we even do colic surgery?

some days the horse dies on the trailer

or exsanguinates on the table

or expires after a septic stint in the ICU

but sometimes hope catches up

and hope is powerful.

it can carry a horse over and nudge him forward

get him on the trailer and send him home.

have you seen a grey horse gallop joyfully

with just a shadow of a surgical clip on his belly?

i have.

and love rained down from the surgery lights:

The couple of days right after vet school graduation were kind of insane. I was simultaneously trying to pack everything, turning in various important forms, getting the utilities turned on/off in the correct apartments, and meeting up with my buddies before we all left town.

One afternoon, I stopped by the vet school on an errand and tarried a while to use the free wifi (fun fact! I never set up wifi in my last apartment. Mostly because it was expensive and I spent most of my not-at-home hours in spaces with free internet). I settled on a couch at the end of a long hallway connecting the small animal hospital with the large animal one. It's a cheerful space, with a steady but not distracting stream of passers-by.

The door next to me opened and Dr. Quin emerged. Dr. Quin is a large animal surgeon. He is a suave, sarcastic man who constantly carries a mug of coffee. His ego is larger than the condom supply at a gay bath house.

He has a habit of looking up at his student in the middle of surgery and saying,

"So! Do you have a boyfriend? Or a girlfriend?"

He will then proceed to dispense romantic advice to said student.

Now, this never happened to me. I scrubbed in on one surgery with Dr. Quin during that rotation, and we somehow missed the topic. We've talked maybe eight or ten times in total, and always about veterinary subjects.

Also, I'm quite femme in manner and dress. Many a new friend or classmate has been surprised to discover that I'm into the ladies.

So, Dr. Quin, through the door. I glanced up at him. He paused next to me, fist-pumped, and said,

"Twelve states now!"

Oh my goodness. You guys, I cried. And holy shit, the Quinster's ninja gaydar skills blew my mind.

written on a drawer in the nurses' station:

actual email I just received:

from: surgeon
subject: <no subject>

I have colons - will send.

the prepuce is not the umbilicus:

 student, after another student hurriedly clamped the wrong dangly structure on the newborn bull calf (wooo, he woke up fast):

"Yeah, I guess if you put a pair of Ochsners across my penis, I'd wake up fast, too."

surgeons are weird, redux:

We're in the middle of a colic surgery. The surgeon and the resident are on opposite sides of the horse, who has a 360 degree large colon volvulus.

This conversation happens:

resident: "I wish I had paddles for arms!"

surgeon: "AUGGHHH! The cecum is my nemesis!"

anesthesia is not fucking around today:

Anesthetizing a horse can be somewhat exciting, mainly because it involves a horse going to sleep suddenly and laying down.  There's a way to do it so it mostly happens without incident:

1. Sedate the horse, rinse out his mouth.

2. Position the horse against a padded wall.

3. Rope on the head, rope on the tail. These ropes go through rings in the wall.

4. Anesthesia injects the valium and the ketamine.

5. Someone raises the horse's head.

6. Person on the head rope sits on the rope, holds the tension as the horse gently slides down the wall into a "sitting" position.

7. Person on the tail rope pulls as the horse sits.

8. Flop the horse over, anesthesia intubates, etc.

So we're anesthetizing a horse for colic surgery, and I'm on the head rope. The anesthesia resident turns to me, and we have this conversation:

Resident: "Do you know what you're doing on the head rope?"

Me: "Yes."

Resident: "Well, you have to tell me exactly what you're going to do. You know, students will tell you that they know what they're doing when they actually have no idea."

Me: "You're going to induce him and raise his head. I'm going to sit on this rope and hold the tension while he slides down the wall."

Resident: "Oh...okay, you DO know."

multidisciplinary knowledge at work:

surgeon:  "Do you have a linear probe that has a sort of pseudo-curve-like aspect to it? Or whatever you call those things?

radiologist: "Uh...no."

seriously this happened:

Friends, today I got the most ridiculous page.

The zenith (nadir?) of inane has been reached. It was better than "80085" on the purely numeric pagers, and much more hilarious than "8==D" on the alpha-numerics.

(for those of you who don't dick around with the pager system, these are "boobs" and "cockandballs", respectively.)

But first - the necessary back story:

I've been taking care of this horse for about a week now who we'll call Adrian. Adrian colicked very badly and had surgery that mostly fixed his problem, but his surgeons only gave him about a 20% chance of making it. He is so far doing very well (knock wood). Adrian and I, we've spent hours and hours together. It is fairly accurate to say that I have spent this entire week nursing him in the ICU. I have drawn his blood, given him his drugs, walked him, stood him in ice, caught his urine for testing, and generally fussed over his every need.  At this point, I know the horse well.

So! I get a page to the front desk, which I answer.  I then have the following conversation with Sandy, the front desk person:

Alacrity: "Hey, it's me. What do you need?"

Sandy: "Alacrity, I need you to go check Adrian to see if he has testicles."

A: "...he doesn't."

S "No, I need you to actually go look at him."

A: "I promise he doesn't have testicles."

S: "Well, someone looked in his stall, thought he had testicles, and changed his file to show that he's a stallion in the computer system. But I'm confused, since he came in to be gelded (castrated) three years ago."

A: "He does not have testicles."

S: "Please just go look at him."

A: "You're seriously making me do this."

S: "Yes."

I checked. He's a gelding, doy. Surgery report from the castration is right there in the computer system.

WOW.

post-op commentary on a colic surgery:

"I guess we should take the 4x4s out of his asshole as well."