All My Patients Have Tales
Favorite Stories from a Vet's Practice
By Jeff Wells
St. Martin's Press Copyright © 2009 Jeff Wells
All rights reserved.
Mrs. Perkins was methodically explaining the symptoms that her new cat, Henry, was experiencing. Although she hadn't had him long enough to know him well, she said it was obvious he wasn't feeling up to par. Mrs. Perkins was a vibrant blonde in her early thirties, with the typical Norwegian Dakota accent. Her husband traveled a lot for his job, and she was elated to have a fuzzy new companion.
She looked me up and down skeptically, clearly evaluating the new guy on the block. I had been out of veterinary school for only a few months. I'm sure it was more apparent than I would have wanted to admit that I was still a little nervous about every case that walked through the door, afraid that I might not be able to handle the situation or that I might misdiagnose the ailment of a beloved pet.
"I just picked him up from the Humane Society two days ago and he was fine then, don'tcha know," Mrs. Perkins began. "Then last night, he began to howl when he went to use the litter box. It was the most horrible noise I have ever heard a kitty make. You've just got to help him."
Even though I was a novice, I had a pretty good idea what was afflicting the recently adopted feline. "Do you know why he ended up at the Humane Society, Mrs. Perkins?"
She pondered for a moment before responding. "You betcha, I remember now — they said he was urinating on the owners' carpet the last couple weeks."
These were the classic signs of a urinary infection, and the howling indicated that a bladder stone was now blocking Henry's urethra, making it nearly impossible for him to empty his bladder. I would need to palpate the bladder to see how full it was and take an X ray to determine the exact location of the blockage. Henry was still in the blue plastic carrier that Mrs. Perkins brought him in. I set it on the Formica exam table between us.
I opened the metal-grate door and began to ease my hand in to get hold of the patient. My hand was almost to the cat's head when his new owner remembered an important piece of information. "Oh, Doctor, I almost forgot — Henry is practically feral. You can't pet him or pick him up. I had to coax him into the carrier with food and slam the door." This was definitely information I could have used earlier! Now I stood frozen, with my arm elbow-deep in the cage of an uncivil feline. On instinct, my hand began to pull back, but it was too late. A sharp pain shot up my arm, and the familiar sensation of warm blood washed over my palm. Henry had sunk his teeth into my index finger.
A white furry tornado then spun out the door of the carrier, tearing at my forearm as it made an escape. Henry hit the floor at a dead run and slid on the linoleum tile as he rounded the corner, disappearing through the doorway of the exam room. Still in shock from my own injuries, I bent over, holding my damaged limb against my abdomen, and held back words that would be unacceptable in rural South Dakota. Mrs. Perkins began to tear up. "Oh, Henry! Please don't let him get hurt or escape outdoors," she pleaded. "He's so fragile."
This statement brought me back to my senses and I began to imagine how upset Mrs. Perkins would be if Henry did manage to make it outside or got hurt trying. I took off after the frightened feline, temporarily forgetting my shredded hand.
Henry had made it into the reception area and immediately started climbing the curtains. Determined to bolt, he seemed to have reached a maximum level of hysteria, spewing excrement randomly as he scurried from drape to drape. The question I frantically pondered was how to get hold of the frightened cat without exciting him even more or losing a limb in the process. While I stood in the middle of the room, wondering why this situation had never been described to me in veterinary school, he made a full circle by using the curtain rods as a trapeze set, then disappeared into the next room.
Mrs. Perkins yelped as Henry streaked by her in the hallway and made for the laboratory, the one room with the most potential for damage by an overstimulated kitty. Following the trail of rancid diarrhea and wondering how the intestinal tract of just one ten-pound cat could possibly produce so much, I followed him into the lab. By this point, I felt sure that Henry was displaying some as-yet-undiscovered biologic mechanism that generated an infinite amount of fecal material, because it now blanketed the once-pristine countertops and sterile instruments in the room. The only good news was that he had decided to take a hiatus behind the autoclave and was now peering out at me from behind it. His pupils were wide open with fear, and the backs of his eyes reflected the fluorescent lighting, giving them a greenish yellow glow. He sat still as a statue, like young deer or rabbits when approached in the deep grass, seeming to believe, If I don't move, the human won't see me.
Now I had to decide how I could get hold of Henry without making the room even more of a disaster zone. For lack of a more brilliant plan, I turned to the basics. "Kitty, kitty, kitty," I called, trying to sound as loving as possible under the circumstances. It didn't work. These words only seemed to alert the frozen feline that I could actually see him, jolting him back into action across the countertop. "Oh, no, not those!" I hollered, but it was too late. The thirty-plus blood tubes that we had worked so hard to get from the unwilling two-hundred-pound pigs the previous afternoon crashed to the floor with just a little shove from Henry. It had taken hours to extract the blood for viral testing. My inexperience, combined with the determination of the hefty swine, had provided a year's worth of entertainment for the farmer and his neighbors. Now I would have to call him, explain the situation, and endure the ridicule of another trip to the farm. I could already picture the scene: Even more locals would be invited this time. Chairs would probably be set up and maybe even tickets sold. But first, I still had to retrieve this cat.
I decided then that I had had enough. Henry made for the door to exit the lab, but I stood my ground. This time, he hesitated, giving me that crucial split second. I dived and scooped him up, keeping his glistening white teeth at bay. He wiggled and clawed at me, making his way up my shoulder. Then he abruptly stopped moving and appeared to relax. He was hanging by one paw from my earlobe. The razor-sharp claws had punctured the fleshy portion of my ear deeply enough to support his weight. I don't know if he had finally given up from exhaustion or had just decided to claim victory, but it seemed that someone had turned off his switch.
When Mrs. Perkins found us, her reaction was not what I might have wished. Instead of saying, "I'm so sorry. Are you okay, Doctor?" she said, "Oh, you haven't injured my Henry, have you?"
With the feline still attached to my ear, blood running down my neck, and Mrs. Perkins scolding me about proper pet restraint, I began to reflect on what exactly had brought me to this point. Eight years of strenuous college curriculum, national board exams, and a huge student-loan debt all added up to this glamorous title of veterinarian, which I had coveted for most of my life.
I wondered what my friends from college were doing now. Probably sitting in plush offices, making big bucks, and working with clients who didn't regularly bite them, I guessed. Yet I really do enjoy this sometimes crazy career choice of mine, and I can't imagine not having chosen it, even though I'm not always appreciated by owner or patient.
Removing Henry from my ear, I carried him back into the exam room, where the whole fiasco had begun. Once he was on the table, he continued to appear relaxed and fairly normal. Mrs. Perkins held on to him while I slipped a sedative into his rear leg. I don't know if he felt better or was just out of fight, but he put up with me. The sedative took over in a few minutes, allowing me to pass a urinary catheter to relieve any blockage. He went home with antibiotics and a change of diet to help prevent any recurrence.
So why did I decide to become a veterinarian? It isn't an easy path; it requires years of hard work just to get that D.V.M. degree and the diploma to hang on a wall, followed by long hours for moderate compensation once you've got a wall to hang it on. To explain myself, I think I'd better start from the beginning.
How You Get There
At least once a week, I am presented with a young boy or girl who wishes to become a veterinarian. These kids' parents are often standing proudly behind them, faces beaming. These future vets always have a great love for animals and a deep sense of dedication. But I have to choke back the urge to awaken them to the long, arduous training and all-nighters that lie ahead of them before they will actually be able to heal an animal. Usually, I just summon a smile and pat them on the head, wishing them the best of luck. I always visualize a little of myself in these eager faces, which reminds me of why I longed to become a veterinarian and what got me through those eight years of college.
To understand what led me down this wild road, we have to flash back to my childhood. I grew up in a small farming community in southeastern Iowa. On the edge of the Bible Belt, it was not a big tourist destination, but it sure was a great place to be a kid. It's still the kind of place where most everyone knows everybody else and people really do take care of one another. Retail shops surrounded a picturesque town square with a bandstand in the center. Weekly instrumental concerts filled steamy summer evenings, and townspeople enjoyed the music from the comfort of strategically placed lawn chairs. It was a town that might have inspired Norman Rockwell, and it hasn't changed all that much in the last forty years.
We lived on a small "hobby farm" just outside of town, where I kept almost every type of pet at one time or another. Cats, dogs, horses, cows, sheep, and even pigs sometimes ended up on our little acreage. Active in the local 4-H club, my sisters and I proudly showed off our menagerie at the county and state fairs in late summer. Fortunately, my father made a living teaching agriculture at the high school, so we didn't have to count on our animals for income like the real farmers.
My favorites in our collection were a Saint Bernard named Heidi and a white Welsh pony named Midge. Heidi and I logged many hours of roughhousing, which usually ended in her pinning my shoulders onto the lush lawn with her front paws, then bathing me in saliva with her immense tongue. This was before canine oral care had gained popularity, a fact that sent me straight for the shower before sitting down for dinner.
Midge spent most days grazing in belly-deep grass pastures, but she always rose to the occasion when she was asked. She could be ridden without a saddle or bridle. You could just jump on her back and take off for a ride across the property, no tack required. Midge was also a big draw on grade-school field trips. Our class would fill up a school bus and head for the petting zoo we called home. Everyone got a ride on Midge, and she was more than happy to oblige. Kids would fall off and even end up underneath her, but she would just stop and wait for them to get back on. These days, of course, insurance companies would never allow such activities for schoolkids.
Growing up around all these animals made it easy for me to answer the age-old question of "What do you want to be when you grow up?" with "A veterinarian, of course." Conveniently, the local veterinary clinic was less than a quarter of a mile from our house. I got a job cleaning kennels at the clinic after school and spent available weekends riding along on farm calls. Soon I was hooked, and there seemed to be no other logical career path.
I'm sure my teachers felt there was no way that I would ever be able to make the grades required to get into veterinary school, but sometimes being told you can't do something makes you even more determined to accomplish it. When it came time to graduate from high school and head for college, I was filled with anticipation. I arrived at Iowa State University determined that, with a little hard work, I could make the cut, but I was in for a big surprise. Reality hit when I opened the new campus phone book soon after I arrived and was completely taken aback by what I saw.
It seemed that almost every other freshman in the university phone book was a prevet student, too. There must have been four thousand of them, and Iowa State's veterinary college accepted only about eighty in-state students every year. My heart fell as I turned the pages and began to wonder what my second choice for a career might be. After a couple hours of couch time spent staring blankly at the television in utter dejection, I mustered the energy to crawl into bed. With the covers pulled over my face, I came to the realization that I had already purchased all the books for my classes, and I'd spent years telling everyone that I wanted to be a veterinarian. So for now, I decided, I at least had to give it a try.
The first couple of years involved lots of chemistry, physics, and many other assorted "weed-out" classes. Many of my fellow students had what seemed to me a truly amazing ability to act like they had everything under control. These people did such a great job of putting on a front that I was certain I was the only one who was struggling, even when using every available minute to study.
Once, after a big physics test during my sophomore year, I noticed a girl standing at the bulletin board, pondering the test scores. I had been looking for an excuse to talk to her for over a year and now took this opportunity to do so. She was very attractive and exuded confidence, making it extra hard to initiate a conversation. "Tough exam. How did you do?" I managed to say while safely staring at the computerized spreadsheet taped to the wall.
There was an uncomfortable silence. I began to assume she had no interest in talking to me, when she breathed a deep sigh and turned toward me. Her eyes were misty, and tears began to spill down her face. In a matter-of-fact tone, she declared, "Well, that's it for me. I've gotten D's on all the exams in this class, and my grade point average can't take it. No veterinary school for me." I was shocked. She had always appeared to be a confident shoo-in, but all was not as it appeared. Concluding that this probably wasn't the best time to ask her out, I walked away, and I never saw her again.
Toward the end of junior year, it was finally time to send in my application for veterinary school. This meant taking the Medical College Admittance Test, the same exam taken by medical school hopefuls. It was one of those exams that actually shorten your lifespan — at least I think it did mine, for the next two days proved to be the longest of my life. Put a few hundred extremely nervous preprofessional students in one lecture hall and you can practically smell the tension. I felt nauseated for most of the forty-eight hours, especially when I realized there were entire pages of questions about which I was completely clueless. This accounted for areas on my answer sheet where the filled-in dots formed an assortment of geometric patterns that I'm fairly sure had nothing to do with the correct answers.
A few months later, the letter from the Iowa State College of Veterinary Medicine appeared in my mail slot. I stood staring at it, wondering if not knowing was better than knowing and being disappointed. Realizing that someday it would have to be opened, I tore into the envelope. "This letter is to inform you that you have ... not been accepted for next year's freshman class."
I wanted to put it back in the mailbox and ignore the fact that I knew. But it was too late — the genie was out of the bottle, and now I had the terrible task of telling my parents and friends. Everyone else took it better than I did, and even though I wanted to run away and become a ski bum, I decided to give it another try.
I learned later that without a bachelor's degree, getting accepted on the first try was almost impossible for anyone. In fact, several applicants already had master's degrees. A year later, after completing my degree in animal science, the envelope contained a much better answer. It was a day of celebration, and I remained blissfully ignorant of what lay ahead the following fall.
Four years of undergraduate work, during which I was constantly stressed about keeping a high-enough grade point average to be accepted, culminated in my finally arriving at that mythical first day of veterinary school. I sat in the last and top row of the stark freshman lecture hall. The chairs were early-modern plastic, attached to imitation wooden desks barely large enough to hold a piece of notebook paper. The dean was explaining the rules and regulations of the school while the front-row crowd frantically took notes. They were at it already, the same students who had raised the curve in my prevet classes back on the main campus. Which of the dean's general remarks could possibly need to be written down? I wondered. These front-row students were working hard to impress the "right people" early on. As it turned out, these attitudes and seating arrangements would remain the same for the next four years. (Continues...)
Excerpted from All My Patients Have Tales by Jeff Wells. Copyright © 2009 Jeff Wells. Excerpted by permission of St. Martin's Press.
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