Ahem.

9 October 2012.

You know what that date represents? That’s right, my last blog post.

I’ve been asked about the blog, prompted by friends and family, nudged here ‘n there with friendly reminders, and I just keep forgetting.

But really, the 10 months between that post and this post are the very best representation of what vet school is like: everything other than school just gets away from you. Especially second year; at least for me.

So here’s a recap. And a promise … no … a commitment … no … a … a … a statement of intent (there, I like that – less commitment) that I’ll try to do better. That’s the most I can say. Before I start, I’ll say this: this post is basically a catch-me-up recap of the last year. If you read this for vet school info, the first bit might be interesting, but that’s it. The rest is just personal life stuff. So spare yourself, unless you’re also here for that, because it will be a lengthy post.

Second year of vet school was hard. (That right there wins the understatement of the year award.)

Like first year, there’s a virtual ton of information to absorb and memorize, and no time to do it. Many, many days consist of nothing other than lecture for 8 hours. My typical Monday actually started at 8am and didn’t end until 7pm because of an evening elective. Try going home and doing homework after that. Worse yet, second year is when you actually need to start thinking rather than just memorizing. Who knew how hard thinking can be?

The positive side is that second year is when you start getting medicine classes, so some of the material becomes more interesting, and much of the material becomes more relevant.

First semester last year consisted of (among other less interesting things), neuropharmacology, parasitology, bacteriology, more pharmacology, dermatology, systemic pathology, epidemiology, reproductive biology, and an entire course focused only on swine. Hopefully it’s clear why that’s a heavy load.

Second semester brought even more pain, with another imaging (radiology) class, toxicology, surgery, cardiopulmonary disorders, nervous system disorders, ophthalmology (eyes), urinary system disorders, clinical pathology, and a core avian course (similar to the earlier core swine course). So finally, this was the semester we really started hitting ‘medicine’ courses, with all those “disorders” courses. In that sense, the semester was a lot of fun – most of us went to med school to learn medicine, and even though we all love science, most of us are here for the nuts ‘n bolts of diagnosing and treating. It’s not that the basic science isn’t fun or interesting, it’s just that it gets frustrating feeling like you’re not making any progress toward actual medicine. So even though nervous system disorders, for instance, is a topic that makes me want to run the other direction, it was still a great class because I felt like it was relevant material that I had better remember. Try to remember, anyway. (I just tried to localize a neural deficit yesterday and didn’t get quite as close as I should have.)

So all in all, second year is an odd mix of overload and “whew, finally something interesting.” It’s very difficult to describe if you haven’t experienced it. I think, though, that those factors explain why some people say they love second year and some people hate it: it all depends on whether you’re talking about the overall workload, or whether you’re talking about the material.

I was surprised at the classes that turned out to be interesting second year. I feared dermatology and ophth… opho… I can’t spell it any more than you can. Eye stuff. But they were both taught excellently, and the hallmark of good teaching is that it captures your interest. Surgery was fun, although a bit anticlimactic because I had already gained a fair amount of experience via extracurricular activities the last two years. Urinary disorders made me wonder why anyone (me included) has cats.

Ok. Enough about school. There were lots of fun stories to relate, but they are all a year old now.

On the home front, one of the biggest challenges that I (foolishly, stupidly, etc.) overlooked when I left the workforce to head toward school was health care. There are a million things to think of, and I just plain forgot this one.

I know, brilliant. Try not to hold it against me when you’re considering where to take your animal for veterinary care.

The company I worked for (CenturyLink) gave me an extremely generous severance package when I left. Among other things they subsidized continued health care for one year for my family. All at once in November 2012 I got mail reminding me that the subsidized coverage was ending. Oh. Shoot. Anyway, that problem is now resolved after going one month without insurance for my kids and six months without insurance for me and my wife. Let me tell ya – for all the people who sit in their big, air-conditioned homes opposing health care for people without; you should try going without your employer-provided health care for a while and see how well you sleep at night. Once you’ve done that, I’ll respect your opinion opposing publicly subsidized health care. Until then, your opinion means absolutely nothing to me. I laid awake nights trying to figure out where to get health care coverage. In this case, our lack of insurance was because of poor planning on my part, so I’m completely open to criticism. But for many people out there, their lack of health care is because some “job creator” doesn’t want to provide them with affordable coverage, and any other avenues are just too expensive. Frankly, it’s reprehensible. Alright, I’ll get off the soap box.

Other family news…. Tirza finished kindergarten this spring. She seems to like school, which isn’t surprising – she’s a social butterfly. Clay finished third grade, and continues to do well. I think he’s hitting the point where school isn’t 100% fun and easy, though, and it’s a bit of an awakening. Ian is just Ian: he smiles, he plays, he throws a fit when it’s time for a nap. What can you do? Word to the wise: the kid has an arm – do not give him something to throw if you aren’t paying attention. He’s clocked me on the head more times than I can count. Usually what happens is I’m sitting somewhere minding my own business when out of nowhere a ball (or plastic toy, or pencil, whatever) smacks me on the side of the head and I hear giggling as he runs away.

We added two new members to the household December. I brought home a couple kittens (two little littermate brothers) from school that had been orphaned. (Yes. Many of us in veterinary medicine are actually big suckers just like you think we are.) They’ve both adapted amazingly well to the household. Really, we couldn’t ask for better cats. They behave themselves, keep each other occupied, are just social enough to be fun without being ‘needy’, and don’t cause problems. Sherman is a tuxedo undersized guy who runs the household. He keeps the other cat in line and, amazingly, while he hasn’t managed to take over leadership from Lucy the dog, he isn’t afraid to walk up and smack her on the nose. Herman is an all black guy who is an utter sweetheart. He’s quieter and keeps a bit more to himself, but has completely adopted my daughter Tirza. While he usually doesn’t sit on anyone else’s lap for too long, she plops him down and he stays right there. She grabs him to go to bed and he just curls up and lays there. Hard to figure out. I guess Tirza is a cat whisperer or something.

The biggest trick with the cats was … Lucy the dog. She had never, to our knowledge, really been around cats much. Twice I had seen her with cats in other homes, and both times she wasn’t quite aggressive but was somewhat more than just curious. So I didn’t really know what to expect in ‘her’ home. Sure enough, she viewed them as intruders. Or lunch. Both, probably. (Can you imagine how a dog’s brain works on that? “Wow! This is awesome! Lunch, and I don’t even have to run outside to hunt it!”)

Kelly politely suggested a few times that we probably should return the cats. I’m stubborn, though. And darn it, I’m supposed to be learning something about how to deal with things like this in vet school. So I threw together a quick and dirty behavior modification plan using some of the core fundamentals of habituation and desensitization. For the first week or so, I kept the cats confined to a small, mostly dark area with their food and litter. (As an aside, this is probably a good practice any time you move new cats into a home; give them time to calm down and relax. Cats just don’t do stress well.) A gate kept the cats in and the dog out, and I didn’t really let the dog spend any time near the gate. The idea is to separate them, while knowing that they can still hear and smell each other. After a week of that I gave them small doses of supervised interaction. I’d take the cats out into the living room, put a basket muzzle on the dog, and let them interact for a bit, and give everyone heaping doses of positive reward (petting for the cats, petting and treats for the dog). After a week or so of that, we did supervised interaction without the muzzle. All in all a pretty simple plan of attack. The problem with most behavior issues that are correctable is really human patience; not the ability of the animal to change. (But, the corollary is that not all behavior issues are correctable.) Even an imperfect treatment will probably work given enough time and patience.

This picture is the result of the ‘program’:

I won’t claim that Lucy is excited about the situation, but she’s at least not eating the cats.

In sad news, we euthanized Ivy in June. We had told ourselves we were going to let her enjoy one last winter since she loved the snow, but she didn’t really go outside much. She deteriorated to the point (mostly mentally) where things just weren’t good, so we finally had to let her go. She was a sweet Husky: a little grumpy with age, but she loved people and had always been a reliably friendly, playful dog to us. We watched old videos of her; she used to race down the stairs at full speed and launch herself across the room to land sideways on the couch (only to leap off, run upstairs, and do it all over again). It was pretty hard on the couch, but it was hysterical to watch. Especially the time she missed the couch altogether and went careening off onto an end table.

I was reminded of her yesterday when the UPS guy dropped off some school supplies for the kids. I went out to meet him (because Lucy really, really hates the UPS guy). I heard her bark behind me, and I laughed and said to him “Dang. I was hoping to get to you before she noticed.” He said, “Don’t you have a Husky?” I told him we had just put her down a few months ago. He said he always looked forward to seeing her (because she laid outside in the front yard every day) and that she had always been sweet when he stopped to drop things off. The guy has a good memory if he can remember all the animals at homes along his route.

By the way, I’d encourage you to click on the picture of her. It looks a bit funny stuck in the blog post, but if you look at it full size I think it’s a very striking picture of a beautiful dog.

This summer (and last) have been a fantastic opportunity for me. Not too many guys my age get to just take two summers off to spend with the family, and I’m disappointed that it’s coming to an end. School starts back up the day after Labor Day, and then there’s no more lazy vacation time: we’ll finish up third year a month or so early and transition immediately into 54 weeks of clinical rotations. And then it will be graduation and (hopefully) transitioning into a job. Which, of course, means all the extra long hours that go with any new job.

Speaking of this summer, in addition to spending time with the family, I took a job working in ICU at the university. I’ve always felt like one of my challenges is lacking a clinical background, and thought that working in ICU might help. There are a lot of important qualities in a good clinician (judgment, knowledge, communication, …), but at the end of the day you also need to have some basic physical skills. Many of my classmates bring a background in clinical care with them to school; they’ve worked as vet techs or assistants or the like. Many of them already have developed those fundamental skills, whereas I hadn’t. I think the job has worked out very, very well. It’s an environment I love working in and I’ve gotten exactly what I hoped for out of it. In addition to the physical skills, being constantly surrounded by cases with interesting histories has given me the opportunity to work through a great variety of diagnostic challenges. One intern a few weeks ago, during a quiet moment in ICU, said “Hey, do you want to talk through these cases?” Obviously, anyone with that attitude is probably a born teacher, and she did a fantastic job of forcing me to think through the cases and verbalize my understanding of them.

I’m grateful to the hospital for giving me the opportunity (especially considering I had no experience going into it). Even better, the hospital has decided to keep the student employees once school starts again. In what turns out to be a best-case scenario (as far as I’m concerned), they will have regular ‘shifts’ but we will be able to take them as much or as little as we want. So if I want to work and get paid, I’ll take shifts. If I’m overloaded in school, I won’t. I can’t see how it could be any nicer than that.

That’s all I’ve got right now. There have been an incredible number of fun, interesting, or otherwise notable moments in the last year, but I don’t think I’m going to recap them all other than to say that vet school and life continue to be a wild adventure, a big risk, and a lot of fun. And, I will do my very best to write more regular, short updates.

Parasitology: Not Your Friend

We have our first parasitology exam tomorrow.

(What am I doing writing this, you ask? It’s called the Ostrich Effect. And no, ostriches don’t actually do that – it’s just a myth, sorry. They’re actually pretty ferocious when necessary.)

Anyway, I just wanted to say that parasitology scientists are among the most sick, perverse sadists ever seen. Imagine, if you will, that you have to name a couple chicken and turkey parasites. They’re similar parasites but cause completely different diseases. One of the upper GI track, one of the lower GI tract. Would you name them a) something similar but distinctive enough to clearly distinguish between them, or b) basically the same thing to create stress for vet students?

Of course you chose B. You’re an evil parasitologist. And so you came up with Trichomonas gallinae and Tetratrichomonas gallinarum. Because you want to make sure nobody understands what you actually do in parasitology – that’s all part of the mystery.

Or take Tritrichomonas foetus, which has the poor cow as its host. Pretty straightforward. Except – what’s this? It shows up in the cat?

Seriously? Cattle and cat? Is that some kind of joke? A small carnivore and a big herbivore, and nothing in between? Granted, this one isn’t the fault of parasitologists – this is more like a great cosmic joke played on veterinarians: “Hey, let’s just create a parasite that lives in cattle … and cats. Ha. That will fool them.”

Bah.

Second year, first semester classes

A number of people have asked me what classes we have this semester. Here’s the list. It makes me wince to read it, much less go to all the lectures. That shouldn’t be taken as a knock on either our teachers or learning in general – it’s just a lot of material. And that’s an understatement. I can’t imagine what it would be like if we didn’t have the teachers we have.

• CVM 6013
• CVM 6025
• CVM 6132
• CVM 6142
• CVM 6202
• CVM 6203
• CVM 6205
• CVM 6220
• CVM 6299
• CVM 6303
• CVM 6400
• CVM 6840

And that’s it! See, not so bad. (Really, the list is more tolerable when I leave the names off.)

Ok, for real this time.

• Professional Development III: Applied Communication. The “professional development” series doesn’t really end at UMN, which is a good thing. We talk about a wide variety of topics, generally centered around the professional life of a vet (things like how to communicate with clients and colleagues, how to approach ethical questions, etc.).
• Large Animal Hospital Practicum: Year 2. This one isn’t a big deal – a day or two in the large animal reviewing some clinical skills. I think I’m in the minority, but I find it fun. I didn’t even realize it was a separate ‘class’ until a few minutes ago.
• Reproductive Biology. Show up for the sex jokes.
• Veterinary Neuropharmacology. This might be confusing to some people, who see ‘neuro’ and think of things like antidepressants for people. “Neuro” refers to anything in the nervous system, not just behavior or the brain or whatnot. So anesthetics (local and systemic), tranquilizers, muscle relaxants, and anticonvulsants fall into this topic (along with behavior-modifying drugs).
• Infectious Agents: Parasitology. This covers some of the simultaneously coolest and grossest stuff you could ever learn about.
• Veterinary Bacteriology and Mycology. This will be a huge memory-intensive course. The first couple lectures have been very basic, but I suspect this one will suddenly run away on me.
• Clinical Epidemiology. I know what epidemiology is, but I have no idea what we’re going to learn. It has all the potential in the world to be awesomely interesting, or a big dud.
• Systemic Veterinary Pathology. It makes me giggle that we tend to have this just after lunch, because it’s really just a semester-long slide show of guts-that-have-things-wrong-with-them.
• Clinical Skills III. This is a continuation in our ‘clinical skills’ series designed to get us the physical/clinical skills we’ll need. This semester we start doing mini-rounds at the hospital. You don’t get into every service at the hospital, but I drew dermatology, surgery, ophthalmology, dentistry, and oncology. I’m bummed I didn’t get emergency care, but pretty excited that I did get five services I would have picked in a heartbeat anyway. Oncology and surgery were top of my list, and the others are just great, too!
• Skin and Adnexa. This is taught by someone with a genuine enthusiasm for the subject who makes a compelling case for its importance. Can’t complain. Even if the pictures are gross. Adnexa, by the way, means ‘appendage’. In this context it refers to thinks like hair, sebaceous glands, sweat glands, hooves, nails, etc. Anything you might associate with skin that isn’t actually skin likely falls into ‘adnexa’.
• Swine Core. I wish I could say I cared about pigs, but I don’t. Yes, it’s critical to have veterinarians caring for them as a way of safeguarding our food supply (and by that I don’t mean keeping the pigs safe, I mean keeping you safe if you eat pigs – that’s the big-picture role of a production animal veterinarian). But all I think about when I see a pig is breakfast. I’m sorry. (Not really.)

All told, 27.5 credits. It’s not so horrible – I think it’s a credit or two shy of last semester, actually. And if there’s one thing I’ve learned (hopefully there’s more, but….) it’s that credits don’t translate into difficulty. I got creamed by a couple insidious classes last year that I would never have guessed would be difficult – but those were the ones bringing my GPA down. A 6-credit semester-long physiology course? No sweat. An easy-peasy ‘behavior’ course? Oops.

Our first two days have been fine. We’re in an old classroom that they normally don’t use anymore, because our classroom is being remodeled. It’s a bummer we’re squished into the (smaller) room, but it’s working just fine. The seats were so horrible in the classroom being remodeled that you won’t hear any complaints about being stuck in a different building for a week or two.

Time to go read about Pasteurella multocida, the bug that makes your hand swell up after a cat bites you. Turns out it’s most likely just part of their natural flora, not something they pick up later in life. It’s like a build-in parasitic toxin/poison cats can inject in you (except that it’s a bacteria). Awesome.