I had this patient the other day who needed abdominal radiographs, and since the radiology technician was at lunch, I decided to take them myself.
That was silly. Here is how it went:
First I found a technician assistant (TA) and a visiting student to help me. I asked the TA if she knew how to set up the system (she did), so while that was happening the student and I got the dog on the table and on his back. He was a big fellow, and he wasn't very keen on being on his back.
I tape the dog's hind legs to the table, get dressed in lead, and hold his front end still.
The machine whirrs and makes a funny sound.
Okay, so I start setting up the system again while the student holds the dog. A passing technician sees how this is going (not well), and comes over to help. The dog escapes and starts vomiting. We clean up, regroup, and get the dog back on the table.
I re-tape his hind legs, get dressed in lead, and hold his front end still (again). The dog wriggles. The radiologist (Dr. Nell, who has apparently been watching this whole thing) snickers. This conversation happens:
Dr. Nell: "ALACRITY!"
Alacrity: "WHAT."
Dr. Nell: "USE BONDAGE!"
Alacrity: "I AM using bondage!"
Radiology technician returns from lunch at this point, assesses the situation, and joins in:
Radiology technician: "Did you have to hold the dog in the worst way possible?"
Alacrity: "Come on, man! I'm wearing lead and everything!"
RT: "Yes, but did you have to sprawl across the table so you're spraying your entire body with radiation?"
It was basically awesome. But I got diagnostic films!
things I have consumed today:
1. Banana
2.Vega Sport Performance Protein chocolate shake
3. Carrots and hummus
4. Two mini chocolate bars
5. Three handfuls of oyster crackers
6. One handful of Raisin Bran (without the raisins)
7. Five spearmint breath mints
8. A small handful of Cadbury mini eggs
9. Chia crisps and hummus
10. Seven chocolate covered graham crackers
11. A handful of pretzel crackers
12. Five house-shaped cookies
13. Water
14. Apple cider with whiskey
2.Vega Sport Performance Protein chocolate shake
3. Carrots and hummus
4. Two mini chocolate bars
5. Three handfuls of oyster crackers
6. One handful of Raisin Bran (without the raisins)
7. Five spearmint breath mints
8. A small handful of Cadbury mini eggs
9. Chia crisps and hummus
10. Seven chocolate covered graham crackers
11. A handful of pretzel crackers
12. Five house-shaped cookies
13. Water
14. Apple cider with whiskey
female emergency doctor, to the electronic medical record system:
"I don't have time for this shit. 'Automated Error", you can suck my balls!"
Adrian:
have you heard hope whisper through this hospital?
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.
resourcefulness ftw:
Here are some things you can fix with extra suture:
1. Torn clothing.
2. Torn bedspread (thanks, cat).
3. Broken strap on shoe.
4. Torn scrub pocket.
5. Rip in pocketbook.
6. Worn-out seam on messenger bag.
7. Broken rivet in strap-on harness.
1. Torn clothing.
2. Torn bedspread (thanks, cat).
3. Broken strap on shoe.
4. Torn scrub pocket.
5. Rip in pocketbook.
6. Worn-out seam on messenger bag.
7. Broken rivet in strap-on harness.
internship tips: style edition
Hey there everyone!
So, my phone case is falling apart. It's almost two years old (like my phone), and has been shedding little rubber pieces for about six months. The bottom half is now so shredded that I have taped it back together with catheter tape so it doesn't totally separate from the phone. I've thought about getting a new case, but a) I'm not sure they make my phone case anymore, and b) I'd rather just get a new case when I get a new phone. Which will probably be when my phone stops working. Hooray!
Anyways! Here's some advice for dressing like a champion during your internship.
1) You need more scrubs than you think you do.
I, too, thought five sets of scrubs would be sufficient. I was wrong. Figure out whatever your longest stretch of workdays in a row will be (five days? eight days? eighteen days?), and multiply that number by 1.5. You should go get at least that many sets of scrubs.
2) Your scrubs should be the right kind of scrubs.
Simply put, your scrubs should not suck. If your internship is like my internship, you will spend upwards of 15 hours per day in your scrubs on a regular basis. The best kind of scrubs are:
- Comfortable
- Well-fitting
- Easily washable
- Dark in color
- Constructed with numerous pockets
Your scrubs should not be falling down or intimately hugging your ass cheeks (unless you're into that). You should be able to sprint, squat, and turn a cartwheel in your scrubs without a catastrophic wardrobe failure.
Sometimes you can find the right kind of scrubs inexpensively at thrift stores, or purchase them used from friends who do not need them anymore. Or, if you and your internmates are dramatically gaining and/or losing weight during your internship*, you can swap scrubs with each other.
3) Acquire some super-comfy long-sleeved shirts to wear under your scrubs.
These will keep you warm on chilly days, serve as an extra layer of protection against cat scratches/Shar Pei fur, and (if you are not particularly buxom) potentially allow you to not wear a bra, which on its own is a major win.
4) Your shoes should be amazingly comfortable.
I have this pair of flats that I wear almost every day:
I can chase a loose dog through the hospital, climb up to the top shelf in the pharmacy, and stand all day long in these shoes. Neither my back nor my feet hurt at the end of the day.
Four months in, these shoes are already profoundly scuffed/worn. They are unlikely to survive my internship as anything other than "kicking it with my buddies" shoes, whereas they originally began as "fancyish flats". This is totally okay - they are beyond comfy, and that is what matters.
I advise you to find your pair of amazingly comfortable shoes. It will make a world of difference!
5) Get a watch. An analog watch. With a second hand.
Your phone is not your watch. Okay, I know your phone can act as your watch, but an actual watch is way easier. I challenge you to get out your phone and access the timer app to count the fetal heart rate in the pregnant bitch while one hand is holding the dog and the other is ultrasounding.
6) Get an easy-to-care-for haircut.
Friends, I am of the opinion that your haircut during your internship should be maximally simple. Go for the kind of haircut that allows you to spend 30 seconds or less on your hair in the morning. Why? Because...if you spend 30 minutes each morning straightening/curling/styling your hair before work, that is 30 minutes that you are not sleeping. Sleeping is better**.
My haircut is a short, vaguely androgynous alternative lifestyle haircut that requires exactly zero styling products, complicated maintenance, or extensive fussing. I shower, dress, vigorously rub my head with a towel, and go to work.
You can have low-maintenance long hair as well - I did in vet school. I mostly rocked a ponytail, French braid, or bun.
Good luck, fellow interns! Remember, if you have the right scrubs and all the comfy extras, wearing scrubs every day is kind of like getting to go to work in pajamas. Except...not.
*This happens, apparently - probably because we all have different stress responses re: food and exercise, and internships are really stressful.
**Unless the straightening/curling/styling is comforting to you in some way, or is your daily self-care moment. As Autostraddle would say, you do you.
So, my phone case is falling apart. It's almost two years old (like my phone), and has been shedding little rubber pieces for about six months. The bottom half is now so shredded that I have taped it back together with catheter tape so it doesn't totally separate from the phone. I've thought about getting a new case, but a) I'm not sure they make my phone case anymore, and b) I'd rather just get a new case when I get a new phone. Which will probably be when my phone stops working. Hooray!
Anyways! Here's some advice for dressing like a champion during your internship.
1) You need more scrubs than you think you do.
I, too, thought five sets of scrubs would be sufficient. I was wrong. Figure out whatever your longest stretch of workdays in a row will be (five days? eight days? eighteen days?), and multiply that number by 1.5. You should go get at least that many sets of scrubs.
2) Your scrubs should be the right kind of scrubs.
Simply put, your scrubs should not suck. If your internship is like my internship, you will spend upwards of 15 hours per day in your scrubs on a regular basis. The best kind of scrubs are:
- Comfortable
- Well-fitting
- Easily washable
- Dark in color
- Constructed with numerous pockets
Your scrubs should not be falling down or intimately hugging your ass cheeks (unless you're into that). You should be able to sprint, squat, and turn a cartwheel in your scrubs without a catastrophic wardrobe failure.
Sometimes you can find the right kind of scrubs inexpensively at thrift stores, or purchase them used from friends who do not need them anymore. Or, if you and your internmates are dramatically gaining and/or losing weight during your internship*, you can swap scrubs with each other.
3) Acquire some super-comfy long-sleeved shirts to wear under your scrubs.
These will keep you warm on chilly days, serve as an extra layer of protection against cat scratches/Shar Pei fur, and (if you are not particularly buxom) potentially allow you to not wear a bra, which on its own is a major win.
4) Your shoes should be amazingly comfortable.
I have this pair of flats that I wear almost every day:
Four months in, these shoes are already profoundly scuffed/worn. They are unlikely to survive my internship as anything other than "kicking it with my buddies" shoes, whereas they originally began as "fancyish flats". This is totally okay - they are beyond comfy, and that is what matters.
I advise you to find your pair of amazingly comfortable shoes. It will make a world of difference!
5) Get a watch. An analog watch. With a second hand.
Your phone is not your watch. Okay, I know your phone can act as your watch, but an actual watch is way easier. I challenge you to get out your phone and access the timer app to count the fetal heart rate in the pregnant bitch while one hand is holding the dog and the other is ultrasounding.
6) Get an easy-to-care-for haircut.
Friends, I am of the opinion that your haircut during your internship should be maximally simple. Go for the kind of haircut that allows you to spend 30 seconds or less on your hair in the morning. Why? Because...if you spend 30 minutes each morning straightening/curling/styling your hair before work, that is 30 minutes that you are not sleeping. Sleeping is better**.
My haircut is a short, vaguely androgynous alternative lifestyle haircut that requires exactly zero styling products, complicated maintenance, or extensive fussing. I shower, dress, vigorously rub my head with a towel, and go to work.
You can have low-maintenance long hair as well - I did in vet school. I mostly rocked a ponytail, French braid, or bun.
Good luck, fellow interns! Remember, if you have the right scrubs and all the comfy extras, wearing scrubs every day is kind of like getting to go to work in pajamas. Except...not.
*This happens, apparently - probably because we all have different stress responses re: food and exercise, and internships are really stressful.
**Unless the straightening/curling/styling is comforting to you in some way, or is your daily self-care moment. As Autostraddle would say, you do you.
internship tips: self-care edition
Hi friends!
How is it going with you? I hope you are also sitting in your favorite coffee-shop on your day off. I hope you (like me) are contentedly nestled next to the only outlet amongst a herd of adorable, curly-haired, (probably) lesbians. Perhaps you are sipping a delicious mug of chai, watching the delightfully charming parade of queers go by.
Anyways! It's time for a list of things you can do to make your internship less bad:
1. Cultivate an appreciation of some sort of morning beverage.
Mine is herbal tea. I'm a naturally energetic and weirdly hyper person, so caffeinated drinks upkick that and make me frenetic and/or wacky.
It should be a beverage that is easy to make, and you should make it yourself. Yes - obvs it would be faster to buy it, but if you're an intern you probably don't have money for that nonsense.
Make your coffee/tea/smoothie/whatever and sip it before you begin your day. This sounds quite simple, but having a routine and a comforting beverage will settle your mind - no matter how crazy your day is about to be!
If I don't have time to finish my tea during rounds, I leave it by the front desk - it makes it easy to grab a drink between patients.
2. Be kind to your future self.
You are absolutely, 100% not going to want to listen to your voicemail, check those lab results, or read that blood smear tomorrow morning before rounds. You are going to want to sleep in. I know it's probably 11pm, but just do [whatever it is] before you go home. Your future self will thank you.
3. Make a daily list of your tasks.
This does not have to be extensive or complicated or take a long time. Grab a piece of paper, write down your shit, stick it in your pocket. Mine looks kind of like this:
[Patient 1] - treatment sheet, SOAP, call owner, get biopsy results.
[Patient 2] - treatment sheet, SOAP, call owner, get rDVM records, check bloodwork, mass removal.
[Patient 3] - treatment sheet, SOAP, call owner, neuro exam, get neuro consult, check coags.
Daily list = improved efficiency = go home sooner = sleep more = less suck.
4. If you need to ask a specialist several questions (i.e. get advice on more than one patient), have all of your ducks in a row so you can have one (hopefully short) conversation. This will make your day go faster (this is good, see point #3), and the specialist's day go faster - meaning s/he will probably be more inclined to help you in the future because it wasn't particularly onerous this time.
5. Take cases that scare and/or confuse you.
Okay, so I have a hard time managing patients with diabetes. I don't know why. I think it's because I never know what insulin dose to start with, they often have numerous other problems, and there are approximately a zillion factors that make one more or less insulin-resistant.
So, I signed up to take care of a patient in DKA with Cushing's disease, hypothyroidism, and financially constrained owners. It was an endocrinology adventure, and I learned many things. Now managing patients with diabetes is a bit less frustrating for me.
Look, if you're doing an internship, your colleagues (hopefully) assume that you are trying to learn and are quite willing to teach you. If you somehow manage to avoid all the cases that are uniquely confusing to you during your internship, they will still pop up for you later in veterinary life (still as confusing as ever!) and I'd imagine that's going to suck.
Hooray for internships! By the way, if you are on the conventional US veterinary internship cycle and are reading this at time of posting, you are approximately 1/3 done with your internship. Also, go sign up for the match if you (like me) are doing the match again for residency/specialty internship purposes. The time is now.
How is it going with you? I hope you are also sitting in your favorite coffee-shop on your day off. I hope you (like me) are contentedly nestled next to the only outlet amongst a herd of adorable, curly-haired, (probably) lesbians. Perhaps you are sipping a delicious mug of chai, watching the delightfully charming parade of queers go by.
Anyways! It's time for a list of things you can do to make your internship less bad:
1. Cultivate an appreciation of some sort of morning beverage.
Mine is herbal tea. I'm a naturally energetic and weirdly hyper person, so caffeinated drinks upkick that and make me frenetic and/or wacky.
It should be a beverage that is easy to make, and you should make it yourself. Yes - obvs it would be faster to buy it, but if you're an intern you probably don't have money for that nonsense.
Make your coffee/tea/smoothie/whatever and sip it before you begin your day. This sounds quite simple, but having a routine and a comforting beverage will settle your mind - no matter how crazy your day is about to be!
If I don't have time to finish my tea during rounds, I leave it by the front desk - it makes it easy to grab a drink between patients.
2. Be kind to your future self.
You are absolutely, 100% not going to want to listen to your voicemail, check those lab results, or read that blood smear tomorrow morning before rounds. You are going to want to sleep in. I know it's probably 11pm, but just do [whatever it is] before you go home. Your future self will thank you.
3. Make a daily list of your tasks.
This does not have to be extensive or complicated or take a long time. Grab a piece of paper, write down your shit, stick it in your pocket. Mine looks kind of like this:
[Patient 1] - treatment sheet, SOAP, call owner, get biopsy results.
[Patient 2] - treatment sheet, SOAP, call owner, get rDVM records, check bloodwork, mass removal.
[Patient 3] - treatment sheet, SOAP, call owner, neuro exam, get neuro consult, check coags.
Daily list = improved efficiency = go home sooner = sleep more = less suck.
4. If you need to ask a specialist several questions (i.e. get advice on more than one patient), have all of your ducks in a row so you can have one (hopefully short) conversation. This will make your day go faster (this is good, see point #3), and the specialist's day go faster - meaning s/he will probably be more inclined to help you in the future because it wasn't particularly onerous this time.
5. Take cases that scare and/or confuse you.
Okay, so I have a hard time managing patients with diabetes. I don't know why. I think it's because I never know what insulin dose to start with, they often have numerous other problems, and there are approximately a zillion factors that make one more or less insulin-resistant.
So, I signed up to take care of a patient in DKA with Cushing's disease, hypothyroidism, and financially constrained owners. It was an endocrinology adventure, and I learned many things. Now managing patients with diabetes is a bit less frustrating for me.
Look, if you're doing an internship, your colleagues (hopefully) assume that you are trying to learn and are quite willing to teach you. If you somehow manage to avoid all the cases that are uniquely confusing to you during your internship, they will still pop up for you later in veterinary life (still as confusing as ever!) and I'd imagine that's going to suck.
Hooray for internships! By the way, if you are on the conventional US veterinary internship cycle and are reading this at time of posting, you are approximately 1/3 done with your internship. Also, go sign up for the match if you (like me) are doing the match again for residency/specialty internship purposes. The time is now.
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