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I Never Went To Work
By John A. Blair
AuthorHouseCopyright © 2013 John A. Blair, DVM.
All rights reserved.
The Art of Practice
After receiving my degree in veterinary medicine from Michigan State University, I started to work in midsummer of 1962, returning full-time to the Kokomo, Indiana practice where I had done my summer internship. The two veterinarians, Paul and Carl, had bought out the practice owned by Paul's father several years earlier. Both men were hard workers, efficient and well liked, and they were kind to me. They guided me into the art of practice with great wisdom.
Carl and Paul's communication skills with clients were contagious; their object lessons were handled with kid gloves. I especially admired their diplomacy when dealing with pet owners. Watching them work, I began to love practice—the challenges and the rewards.
One day an elderly gentleman presented me with Pepper, a sweet-natured white toy poodle. Pepper had developed seeping, infected sores on his body. An exam revealed no evidence of fleas, and the man assured me there had been no change in diet or environment. I suspected an allergy and recommended an oral cortisone medication. I told the man to give Pepper one teaspoonful, twice a day with food.
A week later, Pepper and his owner were back. The man was very unhappy because he had very carefully applied the medicine twice a day with a teaspoon to all the sores while Pepper ate breakfast and dinner. It was difficult, messy and it didn't work, he announced. The whole bottle was gone and the sores were no better!
How, I asked myself, would Carl and Paul handle this situation? I was sure they would have a way of getting the medicine into Pepper without embarrassing the man. I assured him that the failure was my fault.
"The treatment I gave you isn't working, Sir. We have a new medicine that has just arrived and I'd like you to try it. Instead of putting it on his skin, we're going to give this one by mouth! I don't think you'll have a problem because dogs like the taste. I think he'll lick it right down. And, tell you what, there'll be no charge this time." (The old-timer really liked that deal!)
I substituted another cortisone product for that first one—I even poured out a dose for Pepper, who lapped it up eagerly. So ended the story with three results:
A. Owner observed the dosing technique and the dog's easy acceptance;
B. I learned to explain things more clearly, give a demonstration when possible; and
C. My bosses saw me sidestep a problem and satisfy a potentially unhappy client.
And—not to forget the main objective—Pepper was on the way to recovery within a few days.
Kyle and Squeaky are special to me. They became my very first regular clients. My first job as a veterinarian was with the Kokomo Animal Hospital where I was the assistant for two established vets in a general practice.
General practice means dogs, cats, horses, cows, pigs and everything else—even monkeys. My employers, Paul and Carl, assigned me to Squeaky because, as they explained to Kyle, "This young doctor is up on all of Squeaky's problems. Graduated first in his class. He'll be able to help you right away."
Real reason: Paul and Carl were tired of Kyle's constant complaining about Squeaky's endless litany of symptoms. But, I didn't care; I was proud to have a client of my own!
I saw Squeaky, a perky, young Chihuahua Toy Terrier mix, and Kyle, a middle-aged, overweight, balding bachelor, every Friday afternoon. One week it was allergies. Pollens, dust, grasses, trees, fleas—the suspect list went on and on, but fleas were most commonly suspected. Flea control methods in the 1960s were not very effective, and often caused problems worse than the fleas themselves. "Wait for a good frost" was usually the best advice.
But the next visit, Squeaky had a new problem. He wasn't eating well; "Didn't touch his sausage snacks all this last week."
The next week, poor Squeaky seemed to have a limp. "I can't tell if it's the front left or the front right. Won't you check him, Doc?" Kyle said hopefully.
A week later, the limp was gone, but his eyes were red, "And he rubs them with his front paws. He wouldn't have something in there, would he?"
"Hold on Kyle, I'll get the ophthalmoscope." A thorough exam showed only slight increase in redness. "Probably another allergy, Kyle."
Each Friday the treatment offered for the previous week's ailment always seemed to have worked well. Kyle was pleased, always. I seemed to be gaining a little insight—the doctor must treat the owner too. Now, though, Squeaky seemed to be gaining weight—his sweater fit more tightly. Squeaky continued to thrive. "I'll be sure to record his weight and we'll check next time," I said as they left the exam room.
The middle of the next week Kyle called to cancel that Friday afternoon's appointment—Squeaky seemed to be okay!
With three doctors the hospital was not as frantic as in earlier summers. Carl and Paul had been able to take a day off here and there. The new guy was busy all the time, and loved it. It was well into October when I realized Kyle and Squeaky had been absent for several Fridays. Suddenly I missed them and their weekly problems. My first clients—had I alienated them?
Between patients, I worried from time to time why my first and most regular clients had stopped needing me. It all became clear one Sunday morning with an announcement in the Kokomo Tribune. Kyle smiled out from a photo of him and his new bride, a lovely lady named Helen. Between the happy couple was Squeaky.
So, Dog Parts
Mrs. Starr was very proud of her new Dalmatian puppy, Lucy. She had gone six months without a pet. Everything was going to be perfect this time. Ever since her visit to me two months ago, Lucy's life had been strictly programmed. Three-way vaccine every two weeks for three doses and a dose of broad-spectrum worm medicine every two weeks—no slip-up this time. A previous puppy had developed distemper, a common virulent, viral infection in dogs. Two scheduled doses had, unfortunately, been postponed due to a minor family problem. The make-up vaccine came too late; the virus attacked quickly and that puppy died within a few days.
The previous pup had been carefully selected many months earlier from a highly respected kennel in the East. That pup was to have replaced the Starr's second Dalmatian from that breeder. Both predecessors had been such wonderful pets nothing would do but to replace them from the same lineage. The kennel people had taken the normal precautions to protect that earlier air-freighted pup on the way from upstate New York to Indiana. They air-shipped pups often, but a "temporary" vaccine had failed. They felt so badly that Lucy was a free replacement.
There would be no mistakes this time. All vaccines were given on time; wormings done by the doctor. No doses missed. Regular fecal re-checks were negative. This cute puppy was going to live a long, happy life! Spay surgery had already been scheduled; obedience training had been started. Everything was under control.
Now this! These things! These worms! All over Lucy's fresh stool! "Doctor, Lucy has worms! I saw them, alive, moving, all over!"
"First thing every morning Lucy goes out the back door and down the flagstone walk to my flower garden and does the 'necessary.' Then she checks the back gate and comes in to eat. Well, then I go out to clean up the mess. Today when I went out, THERE THEY WERE. Big, fat worms crawling all over it! EEEEEW! I just couldn't get a very good look at them. Smelled yucky! It looked like they even had horns!"
"Mrs. Starr, I don't understand even the possibility of these being worms. And besides, what you're describing to me doesn't sound like any possible canine parasite. I think there is another answer to this. Could you capture two or three of these 'things' and bring them to me as soon as possible. I'll call you as soon as I get them identified."
Mrs. Starr seemed satisfied that I would find the answer. "Horns," I said to myself, "Horns. She must pour too much bourbon in her morning coffee!"
The next morning Mrs. Starr appeared at 8 o'clock with a wax paper covered cup in hand. "They're in here, Doctor!"
"Follow me to the lab," I said.
Wax paper off; there they were—a cup full of SLUGS attracted to the dog's warm, moist stool on a cool spring morning. "Lucy is just fine, Mrs. Starr," I said. "Better stop by the garden shop on your way home. They'll have some chemicals to take care of those ugly slugs. We science guys call them, GASTROPODS."
Some Bum Thumb & My Right Hand Man
In the spring of 1963, I was finishing my year of "externship" in Kokomo when my right thumb began to hurt for no apparent reason. Not a dog bite, just an all-over minor pain. After a week, it felt no better and was a little red and swollen. Soon there was a faint reddish streak up my right forearm. Then my thumb appeared to be swollen and was definitely more painful.
My bosses, Paul and Carl, began to worry. They sent me out one morning to see a physician friend of theirs. He sent me back with a supply of a new antibiotic. A week later, the thumb was really angry looking—I was using my left hand more and more.
"John, this new medicine isn't working," Paul said. "It looks like you're going to loose your right arm if that infection doesn't start to improve—and soon."
Paul's dad who had started that practice years ago had an old M.D. buddy he swore by. "That old doc still keeps office hours two days a week just to see his old patients. John, you're going to see him tomorrow at 10:00 A.M.," Paul said.
The old gentleman was almost jovial. "You veterinarians get the strangest problems," he said. "Now let me see that thumb."
He grasped my hand firmly, inspected my thumbnail, palpated my arm, then asked, "Young man, is your hobby gardening?"
"Why, no Doctor. I'm busy trying to learn all I can from Paul and Carl before I go off on my own."
"I haven't seen a thumb and arm like yours for years," he said, "you've got 'rose-gardeners' thumb."
"Gosh, Doctor, there are no roses in my life."
"The scientific name is sporotrichosis—a fungal infection that left untreated can be very serious. However, there is an excellent treatment. It is potassium iodide—very effective, but very bitter. It's a solution taken by mouth until symptoms of iodism occur. You'll take one drop a day for three days, then two drops a day for three days, then three drops a day for three days and so on until symptoms of iodism appear, then you continue at that level until the skin lesions disappear. It's not expensive, only bad tasting. I'll send a prescription with you. Good Luck! I understand you're going to start a practice of your own! Again, good luck. Say hello to Paul for me."
I dropped off the prescription on my way back to work, glad to have a diagnosis. That night I took my first dose—one drop—it was awful. As the days and drops increased I tried many different "chasers,"—beer, various fruit juices, milk, bourbon, coffee, diluted vinegar. Water was the best. Symptoms of iodism are a copious increase in secretions, tearing, nasal discharges and saliva.
The medicine did cure my thumb. After four drops a day for what seemed to be half of forever, my thumb looked nearly normal. This regimen continued until my first week or so into my move to Lafayette. I was so glad when that was over. But my right hand continued to have problems that very spring.
I took pride in my ability to "read" dogs behavior. I could pick up on a patient's attitude. Normally I would be able to recognize a nervous or unfriendly new patient. But, shortly after I opened my clinic an aggressive type caught me off guard. He managed to bite me hard, of course, on my right hand. There was only a small break in the skin but severe internal damage. An ice pack after he left helped to control the swelling, but the next day my right hand was badly swollen. I feared I had a cracked metacarpal IV.
I left-handed my only morning appointment and went to see my new radiologist friend at the vet school right after lunch. No, not to be x-rayed, but to see if I could borrow a senior student for the next three afternoons. I needed a "right-hand" man. Bob loaned me his best student for every remaining afternoon that week.
Bob said, "A few days in a regular practice will do this student a lot of good. He needs to see a few days in a private clinic."
I had that young man follow me in his car to my clinic to do my right-handed stuff—my left hand wasn't as smart as my right. I vowed to start doing more procedures with my left hand. Even a little bit of ambidextrousness might come in handy later on. I slipped him a 20 when he left Friday evening—he came back in on Saturday morning too. For the life of me, I cannot remember his name.
A Good Death
"Doc, this is a special dog. Once my dad was working the back 40 and fell off the tractor and broke his leg. Old Trey here ran back to the house and barked until we went up to help."
"He's part of the family. My kids think he's their brother. But all of a sudden it seems like he drinks a lot of water—and he's got this dry cough. We want to take care of him. Make his life easier, spoil him a little now that he's old." The young farmer's eyes pleaded with me to give his faithful old friend a few more good years.
As our pets get old we face difficult decisions. A beloved animal's decline hurts because we care, but also because it is a reminder of our own mortality. As a veterinarian, I sat with many people like Trey's owner and heard stories of the bond they had formed with their pets. Even tough old farmers sometimes wept with the realization that a working animal that had served patiently was reaching the end of its life.
When a healthy puppy or kitten joins your family, you rightfully expect it to bring energy, joy and love into your home. But it is wise to accept that its old age and ultimately its death also will be part of the experience. When man attained dominion over lower animals he also, perhaps unknowingly, accepted the duty of euthanasia.
The word comes from the Greek 'EU' meaning good or well; and 'thanos' meaning death. It is a powerful word—"awful" or full of awe in the Biblical sense.
Many a grizzled, old farmer has hurriedly come into my clinic carrying in his arms old "Duke." "Hasn't eaten for two days now, Doc. He can hardly walk, kinda hides in the yard; stays in the shade; doesn't respond to anyone nor anything. I think it's time—maybe past time. You'll take care of him for me. Please? I'm running late for—something. Just send me the bill." He gently places Duke on the exam table.
He quickly turns and walks out, not wanting me to see the tears welling in his eyes.
Euthanasia prompts a variety of situations like this—with or without running late for a fictitious commitment. Some pet owners ask the vet to come to the home to perform the procedure with family members present, allowing for a "last pat." As pet cemeteries become popular the option of cremation, with or without return of ashes, has become available. Often to assure that the correct ashes were being returned, the well-worn last collar accompanied the urn.
Simple observations will tell the caring animal owner when the time is near. Loss of coordination, stumbling, needing help to arise and incontinence may all be signs of severe aging problems. Vomiting after eating or drinking also is an early senility problem. Even a change in temperament may be a clue to a systemic condition or generalized body pain.
Any of these or similar warnings should alert you to prepare yourself for the euthanasia decision. As heart wrenching as it is, at some point, it is your responsibility to do what is in the best interest of an animal that depends on you. In one sense, it is a final act of love.
One euthanasia was a kind of family affair, but I was the only one there! Tuesday morning after Memorial Day weekend, at the first crack out of the box, in came a desperate call from a retired farmer.
Excerpted from I Never Went To Work by John A. Blair. Copyright © 2013 John A. Blair, DVM.. Excerpted by permission of AuthorHouse.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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Table of Contents
The Art of Practice.................... 1
Excused Absence.................... 3
So, Dog Parts.................... 5
Some Bum Thumb & My Right Hand Man.................... 7
A Good Death.................... 10
Sally Forth.................... 19
Fluffy—A Story About a Boy and a Dog.................... 23
Too Full, Too Deep.................... 38
"Li'l White Truck".................... 41
Sword Horse.................... 46
Milk Fever.................... 48
Calf's in the Cab.................... 52
The Chicken Project.................... 54
Barn Wall Stories.................... 60
My Dog has Something in His Eye.................... 63
The Rose Tattoo.................... 65
The Trouble with Bones.................... 68
Expect the Unexpected.................... 72
My Last Solo.................... 80
Furry Fury.................... 84
Mother Nature.................... 87
Stormy Weather.................... 94
Fascination with Urination.................... 98
Hot Dog.................... 105
Variations on the Cinderella Theme.................... 108
Snips and Snails and Puppy Dog Tails.................... 111
Hooves, Horns and Nails—Don't Forget Scutes & Scales.................... 112
Cauliflower Ear—And Grandma's Buttons.................... 115
Foreign Bodies.................... 118
Stuck Stick.................... 123
Obsessing with Abscesses.................... 126
For the Birds.................... 132
One Can Only Imagine.................... 138