Microcosm

Back in November, I posted about how harmony in the practice is what gets us through one-doctor Saturdays at the hospital. The staff — techs, receptionists, boarding employees — make or break those days. Without them, we’d be sunk.

Saturdays are almost always a bit crazier than usual days, but yesterday was insanely busy. From 9:01am, the phones were ringing off the hook and we had between 2 and 4 exam rooms loaded for the entire time we were there. That’s a busy day for us.

The staff working yesterday was in perfect harmony. We had a double-booked schedule for the entire shift plus a few triple-booked stretches. They did a marvelous job. “Just think about how much you will have accomplished” rang true yet again. We took care of everyone and finished the shift almost precisely on time.

Yesterday reminded me that the wide variety of things we took care of is exactly why I enjoy my profession. As a general practitioner, I have the pleasure and responsibility to see everything from nose to tail. Pets and owners with diverse backgrounds, illnesses, and challenges all need my attention. Sure, giving the umpteen thousandth rabies vaccination isn’t a challenge, so that’s where it’s important to capitalize on an opportunity.

During an appointment I have a chance to talk with an owner as I perform the physical exam. Showing them what I see or telling them what I hear helps make them a part of the process. We almost always find something to talk about during a physical. Patients that are generally healthy even present opportunities to educate owners about how to better care for them. Sick patients’ bodies “speak” to me. I translate for the owner.

Puppy and kitten visits are almost always a joy. They’ve got the market cornered on cute. We also get to work with owners that are extremely attentive. I can’t think of a time when the owner of a new pet didn’t engage in a big way. We work together to plan a pet’s start in life: medical concerns, vaccines, food, preventive products, upcoming spay/neuter. These visits are generally very positive, which helps us get to know the pets and owners better without the stress of illness or problems making things more difficult. Puppies do offer a few challenges, too, but it’s rare that they sour the appointment.

Healthy adults are also fun visits. We know these patients and owners better, so while I work I can ask about how a family is doing. I try to engage with the kids that come in, too. It seems to me like an opportunity that shouldn’t be missed. Offering to let a young child hear a pet’s heartbeat through the stethoscope is a sure way to strengthen the bond between that pet and the child. Sometimes we give tours of the hospital. Yesterday, I saw a year-old dog that was just acquired from a neglectful owner. We planned out a way to catch the dog up on health care that fit the new owner’s budget and schedule. It was time well-spent.

We had a run of sick animals to help: vomiting, diarrhea, limping, ruptured skin cyst, constipation, toxin exposure. The gamut was the gauntlet. We pulled blood to send out lab work. We took some radiographs. We ran stool checks. Medications were filled. Enemas were given. On a side note, it may seem utterly bizarre to be excited when an animal defecates. In this case, though, it meant we could send a cat home feeling MUCH better without having to anesthetize her. That’s a win-win-win!

Being able to juggle the random order of events is part of the transition that we all make as we enter the profession of vet med. In school, all of your knowledge is loaded into your head in an orderly, steady format. It’s like filing books on library shelves. Each has an assigned place. Even when you work in the university vet hospital as part of your training, your time is divided into specialty services. You’ll work in orthopedics for 3 weeks, then internal medicine, then ophthalmology, and so on. There’s not much cross-over. When you graduate, however, it’s a whole other story. You have to throw all of your brain-stored books into the air, then pluck out the pages and facts you need as patients randomly present themselves for assessment.

This randomness is daunting to a new grad. Frightening doesn’t begin to describe the situation in which one must go from puppy visit to major trauma to vomiting to euthanasia. A mind that’s not supple enough to change gears like this will snap. All of us do at some point have that little meltdown, just like I did in Hollywood when that tech told me the sun was going to come up no matter what. We learn, though, and we handle it. It has to be handled or you’re not cut out for the work.

As time goes on, I’ve learned to embrace the chaos. It’s what makes professional life interesting. It keeps me engaged. Daily challenges push me — and most all vets — to steadily increase our skills. Each experience benefits the next patient. I figure that each gray hair I get is a case I’ve learned something from. (Darned if I’m not learning a lot!) I’ve spoken often about the intricacies of working with owners. These challenges are as unique as the people who present them. I’ve learned to love that, too.

On any given day at the hospital, we see a slice of all walks of life. We see an assortment of cases and make an assortment of diagnoses. Saturdays are a microcosm within the realm of general practice. I don’t think I’d trade it for anything, even when we feel like we’re tending a three-alarm fire. The best of who we are comes through on days like that. Yesterday our staff made sure that everyone was cared for, and at the end of the day, that’s what matters most of all.

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2 responses to “Microcosm

  1. Fallon

    I loved reading this post and the one you posted in November. It makes me miss you all and the working at the hospital!!