Wednesday, November 20, 2013

Tattoo.

Ever since I learned that I could cover old tattoos with new ones that I like more when I got my leopard gecko over an old, faded rose on my foot back in May, I've been obsessed with covering the other old, faded rose on my back. It's a tiny little lower back tattoo, about the size of a silver dollar. It used to be very pretty, but now the colors are dull and the detail is blurry and I just really dislike it.

So I've been designing a rat to go over it. I used Shutterstock free images as my base, and then took bits and pieces from different ones to create the final image. I'd steal the whiskers from one, the hind leg from another, the tail from another, and then use Paint to piece them together and the drawing tool to fill in or erase parts. I'm very happy with the results!

The text will be more flowy and script-like. This is the closest font I could find to one I liked. And it will curve around the tail instead of being straight like that. The saying is the one that my closest friends and I chose to have on our necklaces that we made in 7th semester. It means, "I'll find a way or I'll make one." Not only does it have special meaning to me because of those girls, but also because I really identify with it. What Rossie wouldn't? We couldn't get into the state schools, so we went on an adventure instead and did what it took to become vets.

Now just to find a tattoo parlor in Chicago or Indy so I can get it done while I'm on externships. I think I'll email Nic, the guy who did my gecko in San Francisco and see if he knows anyone he trusts in those areas.

Tuesday, November 19, 2013

Horsies!!!

I'm on large animal emergency right now. I love it so far. The hours are a little annoying (7pm-midnight or later, usually). But I love the one-on-one time with the animals. It's quiet, the lights are dimmed, they're sleepy and cuddly. We do walk-bys every hour and any treatments that need done throughout the night. Last night I spent 10 minutes holding a hot pack against a sweet little Arabian mare's shoulder, and feeding her treats and scratching her neck.

While I was in Nashville camping with Don a few weeks ago, I picked up some apple molasses horse treats at a dog treat bakery there. I used to buy treats from them all the time for my rats. They were crazy for the peanut butter blueberry cookies and the cheese sticks. But these apple molasses treats smell *heavenly*. The other brands I've ever given to horses, although the horses love them, smell like Milk Bones. Just bland and uninteresting. These smell like oatmeal cookies fresh from grandma's kitchen. Every horse I've ever given one to has started nickering and bobbing their head enthusiastically.

I just love horses. The sweet, musky smell of a horse barn is one of my strongest olfactory triggers for a feeling of calm and well being. When I was working at Purdue, one of my responsibilities was husbandry for the horses. I'd clean out anywhere from 6-23 stalls every day. I got really comfortable shoving horses around in a cramped stall without fear. I had those horses trained well, too. They didn't get hay until they backed into the far corner of their stall. Anyone trying to crowd me or bump the hay out of my hands got the stall door closed in their face. I don't tolerate bratty behavior from an animal that can kill me with one kick. Most of them would move to the back corner if they saw me coming with hay. The rest would usually only take one, firm "Back!" and they'd move. Occasionally I got a butthead or two who needed work. Then, after I was done cleaning, everyone got a quick scratch and a cuddle before I moved to the next stall. And afterward, if there was time, I'd brush them out, pick their hooves, feed them treats and love on them. Those were my babies. They were research horses, usually a terminal study, so they were euthanized at the end of their time. But I did my best to make sure their remaining days were happy, and all of my coworkers did, too.

And I swear, if I'd had the money or the ability to board him, I'd have adopted Bo. He was undoubtedly *my* horse. Bit a few other people, because he was a stall sour jerk. But we had one day where he tried to bite me, and I yanked his head down by his halter and made it very clear that I was not afraid of him, and from that moment on that horse loved me. He'd poke his head out and follow my every move in the barn, and lean against me for cuddles while I cleaned his stall. I still miss him.

But I don't want to go into equine practice. I've seen enough of my classmates who started out with a strong equine focus and switched to small animal to know that I'd burn out fast if I even considered it. They all say the same thing; they love to ride, have loved horses all their lives, but equine medicine made them hate horses because all you ever see is horses close to death, in pain, aggressive or scared. So I'll stick to cuddles and kisses and treats.

Saturday, November 9, 2013

Compassion fatigue.

It's something every vet student hears about, has lectures on, awareness raising on social media about it... Compassion fatigue is, if anything, overly-emphasized in vet med. And for good reason. Our profession has an alarmingly high burn out rate, and suicide rate. My own professor, when lecturing on the topic, brought up a vet who she went to Ross with who had committed suicide with Fatal Plus euthanasia solution and an injection pump machine from her own clinic.

Today, Dr. Wallace, my beloved large animal medicine professor, linked to this article on Facebook. I'll quote the portion that made my heart clench in empathy:
"Veterinarians are determined, driven, type A people. We as a species hate to give up, we loathe defeat, and we give until the bank is empty. Our ability to maintain a level of empathy for every client, every incident and every patient is unrealistic. How does a normal rational empathetic person put a pet that they have watched grow from infancy to geriatric to sleep in one room and then walk ten feet away to another patient who you are expected to be jubilant and clear headed to examine, diagnose, and treat? Somewhere along the way we learn to mask, shelter, or disregard our emotions. Somewhere it became expected, and we learned to push feelings aside and press on. It is a recipe for a psychopath and a schizophrenic. And we do it every single day."
She goes on to say that we need to take better care of ourselves. Pay attention, stay clued in to what our bodies and our minds are telling us. Look for patterns of substance abuse or coping mechanisms in our own behavior that are red flags. And set boundaries. Learn to say no to clients.

It reminds me of a conversation I had with a clinician when my septic, failure of passive transfer calf was dying. I was watching him lying on his die, struggling to breathe, groaning with every breath, and just clearly in abject misery. He was receiving excellent care. He was on pain medication. But he was still suffering, because he was just continuing to get worse with no hope of cure. We were playing catch-up with his suffering as he continued to plummet.

I asked the clinician, "Have you ever reached a point where you fired a client because they wanted to keep going, but for your own sake of mind and your personal, ethical considerations you felt it was wrong to do so?"

He said no. He said we can control suffering with pain medication, or even induced comas if necessary. He said the owner had to reach the conclusion to end life on their own.

I agree, to an extent. I understand his position. But I disagree on one basis, and that is the sake of my own mental health. Yes, ideally the owner should decide to euthanize without you pressuring them to do so. Saying, "Euthanize or find another vet." definitely falls under the realm of pressuring a client. But if I am treating a patient past my comfort level, and I am upset, and do not want to continue, and feel it is wrong to keep going, and I do this often enough, I feel that I will burn out.

I had this exact conversation again with the anesthesia technicians when we had a particularly nasty case come in and everyone in the room felt that elective surgery in an animal that old and that ill was probably not in the animal's best interest. The technicians agreed with me, and said that they would be more apt to work with a veterinarian who set firm personal boundaries regarding quality of life than one who kept going in the face of suffering.

It helped re-establish my gut feeling that I am not being selfish, or a bad person, or a bad doctor, if I establish boundaries with my clients regarding end of life decisions. I'm pretty confident in my decision now that I will reserve the right to gently, but firmly, show them the door if need be.