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Below are the 20 most recent journal entries recorded in
CJ Smith's LiveJournal:
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|Saturday, March 1st, 2014|
|Examined is one 1900-gram specimen of loss
Word to the wise: do not drink a glass of port before writing up a presentation on necropsy findings. With a little alcohol on board, it's much harder to forget that all those crisp descriptive words are wrapped around one family's heartache. "Examined is a 9 month old, 1.9kg female spayed Bengal cat..." ...someone's beloved pet, a kitten on the edge of adulthood, one they had snuggled and played with and petted, one they came for a second and third opinion to try to save. But it was already hopeless: the disease was fatal. And now we're going to tell you exactly what each of her internal organs looked like when we pulled it out.
I think I'm going to be a teetotaler for the duration of my anatomic pathology rotation.
"That is made of unicorn hair." -- A third-year student taking a written exam
"Propofol. Vitamin P. Milk of amnesia." -- A criticalist
"Every day there's a new blaaaaah-fib drug coming out. I don't switch them, because there's a washout period and all that drama." -- An oncologist
"But you know what? I'm mean." -- Course leader for business
"I just stood at the front door, grabbed my keys, pressed the car's unlock button multiple times, and wondered confusedly why the door was still closed. I'm starting to crack..." -- A third-year student
"This is the best cat ever, just chilling on the table here, no sedation ... sorry, no, this is a cadaver." -- Surgery instructor
Later addition: "How I know I'm tired: after 7 years of living in Davis, I got lost for the first time. Like needed Siri to direct me home kind of lost. What??" -- A third-year student
|Saturday, February 15th, 2014|
|Mind control by polysaccharides
I am CRAVING white-flour foods right now. Waffles, toast, cupcakes, an English muffin, ANYTHING. Most intense I've felt since the yeast control diet. I'd forgotten how this kind of thing could just take over my brain! It's not hunger -- well, okay, I was also hungry, but I had this omelet sitting right there, and it just wasn't what I wanted. It feels like I am, in this one small way, completely insane
I guess I should have known I was swinging into this phase when, last night, I wanted pizza more than I wanted palak paneer. Fine, pizza's tasty, but more than palak paneer? That's just wrong! (For me, anyway.)
I just might be fortunate that there's very little of that stuff in the house. I could imagine chomping down ten pancakes at a sitting, or a whole baguette with Brie all over it, or goodness knows what. Then I'd feel awful for ages. Right now, I'd do it even knowing
I'd feel awful afterward. See? Insane!
So I'm sitting here eating my omelet and drinking my tea, and I'm telling my body it will get loads of perfectly serviceable carbohydrates from other sources, for example this evening when I have wine. It isn't listening.
|Tuesday, February 4th, 2014|
|More quotes from vet school
E-mail subject: "Equine acupuncture demo--need a horse!" (Horse has to be willing to walk calmly into a lecture hall. I am not making this up.)
On Facebook: "Are you in the market for a cerebellar hypoplasia kitten?"
In lecture: "All of you are dogs."
Professor about to begin five hours of endocrine lectures: "If I was going to spend a day doing something, I'd talk about hormones, so there ya go."
"I'm not going to bore you with this stuff. I don't know it."
"They don't usually put people to sleep for peeing frequently."
|Saturday, January 11th, 2014|
|Made a difference to THAT one
Even though it looks like the first cat I spayed didn't survive the next 24 hours
, the first dog I spayed DID.
I was sufficiently rattled (by the fact I had misidentified a particular tissue) that I was not thinking clearly by the time I was searching for the reproductive tract. But I still had the presence of mind to realize that hundreds of small firm dark lumps throughout her tissues were probably a good reason to call for a grownup.
We waited a good 45 minutes to see whether we were going to bother waking this dog up. Couldn't reach the shelter. Senior surgeon busy helping other teams stop bleeders. No budget for biopsies. Anesthetist, who had fallen in love with this sweet pittie girl with a horrific abuse history, dissolved in tears.
This dog was one of a dozen or more who'd been liberated from a bust of a dog-fighting ring. It was abundantly clear from her behavior and from her physical exam that she had been used as "bait" for the dogs trained to attack. She was terrified any time she saw any dog, her legs and face were covered with scars, and at least once in her past, each of her left paws had been crushed and the bones had healed poorly. As with many fighting dogs, she was sweet and friendly with humans. She never stopped wagging (as long as no other dogs were nearby) and I got my face washed more than once. A shelter trainer had been working with her for weeks to see if her behavior could be good enough for a safe adoption out to a family. She'd been deemed adoptable and sent to us for spay... and now this.
Eventually we took biopsies (Davis will eat the cost), spayed her, and woke her up. No one on our team was feeling good about it, but at least we were going to pass the buck to histopathology and let THEM tell the shelter to bury this poor girl.
Report came back today. Ectopic spleen tissue. Not carcinomatosis. Not hemangiosarcoma. NOT CANCER.
Two of three members of my surgery team (that is to say, everyone who's not me) are now down with high fever and Tamiflu, but I can happily report that three out of three have received the good news and have shed another few tears over the fact that this dog will have a chance at a better life.
|Saturday, January 4th, 2014|
|Decluttering a file drawer
Rob: This folder has papers for renewing your passport, including your birth certificate.
CJ: Oh, cool! I wondered where those were.
Rob: "M" is not a good name for the folder.
Rob: Oh look. Frequent flyer miles for airlines that don't exist any more.
Rob: In this folder there are tips on gun cleaning, a receipt from Nordstrom's for a padded bra, and two sheets of Forever stamps. What do you think you called it?
Rob: That would be too easy.
CJ: I bought a PADDED BRA?
Rob: Either that or someone else bought it and you kept the receipt. So what's the folder's name?
CJ: ... Guns?
Rob: Phoenix. You called it Phoenix.
|Tuesday, December 10th, 2013|
|Only in vet school
A note from a fourth-year student on clinics:
"Small win of the day: The top button of my shirt will not stay closed, and I can't find a safety pin, so I use Monocryl suture to close it. The suture material is the perfect shade of purple to match my shirt."
|Thursday, December 5th, 2013|
On October 16 I spayed a cat.
She was more a kitten than a cat, really. A beautiful black short-haired girl, friendly and a bit wriggly, purring up a storm. During her pre-surgery physical exam we had to go through all kinds of contortions and tricks to try to hear her heart over the purrs. She was kneading invisible biscuits wherever we went.
She was also sneezing a bit.
By the next morning, as often happens right after anesthesia and surgery, the evident signs of her illness were more noticeable, more pronounced. She sneezed some blood and goop. We wiped off the inside of her "cone of shame" before turning her back over to the shelter.
Her energy was great, though, and her temperature was within the normal range. She obviously wasn't heavily debilitated. And her personality was wonderful! What a darling. A black cat in October, okay, not the luckiest combination... but maybe she'd be available for adoption in November. Somebody would adore this girl.
We dutifully wrote up all our medical findings in the notes that accompany the patient back to the shelter. Pre-anesthesia blood work results, pain assessment post-surgery, the sneezing, a note that she should be kept separate from clinically healthy shelter animals.
She never showed up for adoption.
For days, weeks, I looked for her shelter number. I told the automated web site I wanted a female black cat and ONLY from that shelter. Nothing. I searched for her number. Nothing. Into November and early December. Nothing.
It sure would be nice to know that the first cat I ever spayed survived more than 24 hours after the surgery. But I don't think she did.
|Moments in vet school
Pet food ingredients lab. Here are fifteen substances, mostly powders. (Three are labeled DO NOT EAT. A fourth one should have been, too. Ask me how I know.)
Which one is poultry by-product meal? Can you tell it apart from chicken meal? Which is purified powdered cellulose? Which is corn starch? Which is soybean mill run? Google Images helped somewhat.
Two fine white powders were nearly indistinguishable. The one we definitively identified as cornstarch was, of course, the one that made oobleck.
|Friday, October 18th, 2013|
|Yeah, derm professors are funny sometimes too
"This is a Shar-Pei, the breed that God forgot to inflate."
"My dog found a goat carcass on the beach, so instead of stopping her from eating it, I took a picture." (From a lecture on food allergy dermatitis.)
"This dog was a Chihuahua at one point in its life."
"Clients come in with these ugly -- excuse me, very special looking dogs..."
"I saw this case when I was a resident, back in nineteen mm m mmmh."
Oh, a few more:
"Cephalexin-infused rice is not pharmacologically active."
"This is a dog formerly known as a West Highland white terrier, now an armadillo terrier."
"This case was over 20 years ago, so this cat has long since gone to the eternal care unit."
|Wednesday, October 9th, 2013|
|Overheard in vet school
"Eating dark chocolate chip gelato out of urine cup with tongue depressor = awesome!!!" - 4th year student on clinical rotation
"I think blood tests should work like this. My cholesterol level will be determined by the jury to be whatever is usual and customary for a person of my age and sex." - 3rd year student in veterinary law class
The rest of these are from various ophthalmology professors.
"Put the fun back into the fundus."
"Throughout the course of your career, if you choose to remain competent… well, it is a choice…"
"Yeah, this slide doesn't really have a lot to do with what we’re talking about."
On nasal puncta and the lacrimal drainage system: "That's why, if you cry – I personally don’t cry, being a man – I cry sometimes on the inside, not on the outside – but for those of you who do cry, that’s why you get a sniffly nose."
"If you can examine the fundus, the fundus can examine YOU."
There's a gorgeous tiger on the PowerPoint slide. "Can anyone guess why I have this picture here? … There’s really no reason. I just liked the picture."
"What percentage of [corneal] ulcers do veterinarians get to see? I lie awake at night thinking about this."
"Rub with a soaked cotton tipped applicator for 45 minutes -- this is why you have residents."
(Don't think too hard about the word "ophthalmology" with that one. Oh, too late?)
"Herpes: It's not just for cats any more."
|Conversations in my house
...or, in this case, on Facebook between members of my house (one of whom is traveling).Rob:
[...sleep... daylight... food...]me:
You crazy boy. Astronomers don't need sleep OR daylight! You should really have food, though.Rob:
7 11 to the rescueme:
They sold you daylight? No, wait! They sold you sleep! I need to go find one of those.Rob:
You can buy anything on the street here. Uhhhh...me:
Oh good. I would like one acrobatic aircraft, three weeks of extra time usable between now and June 2015, and new feet. Thanks!Rob:
I didn't say it was cheap...me:
Yeah, and I didn't say I could pay for it. But I'd like it.Rob:
He's willing to put up with -- nay, even respond to -- complete silliness and nonsense from me. May I state here for the record that I adore this man?
|Friday, September 27th, 2013|
|Quotes from my life at vet school
About dysconjugate nystagmus: "This is not something we see very often, but when we do, we make a movie."
A neurologist talking about one of our internal medicine specialists during lecture: "Dr. Marks, of rectum fame... oh, you're recording this aren't you?"
Lecturer known for being a hard-nose: "I'm wrong sometimes." [Facebook lights up with students recording the momentous occasion.]
On narcolepsy/cataplexy: "It's congenital in this one colony of Dobermans. The way they grade them is they have a corridor of meatballs and they see how far the dog can get down the corridor. Is he a one-meatball, a two-meatball..."
On epilepsy: "Dogs are genetic disasters. There's a reason you don't breed with your brother. ... Apart from the fact he's obnoxious."
The video about "does your dog bite? ... that is not my dog" didn't work during lecture, so the lecturer acted it out, to applause from the class. His response: "Aren't you glad that the one of the dog having a seizure and defecating worked?"
"There are obvious downsides to putting your child on a tiger."
"She's a Dachshund, and she's walking, which is always good."
"Humans are just a different mammal, but they're different." (Glad we got that cleared up.)
"I didn't post a picture in this lecture because when I do tendon ultrasound by myself I cannot tell what is what."
"I think I'm a temperature sensitive mutant."
On neuromuscular disease: An image of a phone message pad, with the message "Hunting dog. Died - stiff & cold, next morning up & running around. Pulled 2 ticks from back leg while dead. Please call." Lecturer: "If only it were always this easy!"
And, of course, one from a student. "There isn't time to do everything they assign you. It's physically not possible, not if you're also showering and sleeping."
|Wednesday, September 18th, 2013|
|Even BIGGER day today
First anesthesia. As surgeon for a neuter, it's kind of hard to kill a patient by accident. As anesthetist, it's always far too easy.
He lived. He's curled up on his fleece and wearing his lampshade (and boy is he not too happy about the lampshade).
Deep breath. I did okay, but there was a lot of fumbling and questioning. I would not say I did this one with flying colors. I hope to be better next time.
|Tuesday, September 17th, 2013|
|Conversations in my house
I need names for the kittens
! We should make them a little nerdy.Rob:
Car, cdr, and lambda.me:
Cadr. Cadadr. Set bang. Plus zero, minus zero, and NAN.
We already have a Joule. We could do units of energy. Erg. What's the English unit of energy?me:
Well, there's BTU, for heat energy. Let's see... [clicky clicky] Foot pound.Rob:
Not a great name for a kitten...
|Monday, August 26th, 2013|
Big day today. I was the surgeon for an uncomplicated dog neuter. With all the things I've done before, assisting and practicing and whatnot, I've never truly been "the surgeon" before.
Our patient recovered quickly, with no signs of post-op pain, and he's now curled up on a fleece towel and wearing his lampshade. Everything went smoothly. I took only about three times as long as a professional would take to do the same thing. :)
It must be crazy to be the teacher for these things. You've got to take people who have never done this before and you've got to set up their education thus far in such a way that they'll do okay. Here, kid, here's your scalpel -- have at it.
|Sunday, August 18th, 2013|
"Could there have been a weird protein reaction that may have set up a type three hypersensitivity that started chewing up the dog’s kidneys and caused a protein losing nephropathy to cause part of the reason for hypoalbuminemia that led to hypooncotic leakage into body cavities? Maybe, but the story just isn’t always that simple."
|Saturday, August 17th, 2013|
|Quotes from various professors this past week
"I don't know what's going on except that we're here."
An oral potassium supplement that dogs and cats would actually eat: "Maybe you could make it liver flavored... or paintball flavored."
"He was the best cat I ever had after that brain damage."
"You always get partial credit if you say cytokines."
On heat stroke: "We should just have a sign at the Vacaville outlet malls. VET HOSPITAL THIS WAY."
"There's no sucking and pulling in physiology."
|Thursday, August 1st, 2013|
|Behind the scenes
"What kind of box should I put him in?"
[pause - I couldn't hear the other person]
"No, the LIVE one! I KNOW what kind of box to put the other ones in."
"This kitten is an alien."
"Ha. She said I got a REALLY GOOD sample."
[next person's turn with the instrument]
"That's nothing. THIS one has its own SPINAL CORD."
"What part of..." shakes an animal's foot at me
"...don't you understand?"Me:
"Er, I'm better with English, but train me and I'll learn."Clinic owner:
"My brain gets consumed with other stuff it's working on. I can't give you words."Me:
"Ahhhh, you have a higher-priority interrupt running. I get it."Clinic owner:
"Whatever you say."
Cardboard box on the table, taped shut with a piece of cloth bandaging tape reading "LIVE FINCH Do not throw away". This makes more sense when the box starts to wiggle and make little scratching noises.
|Friday, May 24th, 2013|
|Overheard in vet school
Stories from the career of a veterinary emergency/critical care specialist:
- In the emergency room
- Senior faculty, residents, staff techs, four fourth-year students, and at least half a dozen first-year students are present
- Patient has arrested on the table and open chest CPR is in progress
- After the requisite time doing compressions, the doctor pauses for a moment to look at the ECG
- The head tech announces loudly, "YOU DUMBASS. YOU'VE GOT THE HEART IN YOUR HAND."
Direct quote. In front of maybe 20 people.
(She was right, though. You don't need an ECG to evaluate heart activity when the organ is lying in your palm.)
I think I'll stick with general practice. I know I'll get embarrassed, probably in front of witnesses, but I am pretty sure I will never get called a dumbass when I've got a heart in my hand.