Monday, July 16, 2012

On excuses

Sometime in my past I learned not to make excuses. I can't remember who taught me this lesson, or in what context, but it stuck. I learned, and learned well, that the bottom line is that nobody cares why something happened, so I should skip talking about it and fix it. I get it. Don't deflect responsibility; it is tiresome. Done. I am a champion tongue biter and a first-class apologizer.

But lately, I feel that I learned this lesson too well. At some point, not making excuses turned into accepting responsibility for things that are not my fault. Or, if they are my fault, they are equally the fault of someone else being unclear in communication or expectations.

I am spending this summer doing an independent research project as a sort of door-propping measure in case the academic career track still appeals to me after my clinical year. Two insane bosses in my scientific research past were not enough to teach me to stay well enough away, so here I am. I don't hate it. My project is interesting. I actually understand it. I like that it is my own project, and that I have the responsibility to troubleshoot it and see it through. I love opening the document containing my research proposal and reading the impressive-sounding title. Most of the other people in the lab are lots of fun. I get to work with cats.

I work for a PI who manages her time as if it were literal money, and woe betide the fool who wastes it. She is small and intense and free with profanity; a characteristic I enjoy, because it is humanizing. Next to her, I am a dim-witted, tongue-tied Amazon. Or so I feel. Which brings me back to excuse-making.

I would like to think that by not making excuses for why something happened, it comes through that I am an upstanding person, a hard worker, and not a snitch. But sometimes, especially when people are looking to vent their own frustrations, a person who is prone to accepting responsibility ends up becoming a scapegoat. By not deflecting blame from myself, ever, I have learned to internalize it. I feel bad about not doing something, even when I would have no way of knowing that I should have done that thing. Nobody told me. It is not intuitively obvious. And yet I torture myself with guilt over not having done it.

My project involves two big sampling time points. One of them was this morning, a Monday. I spent the better part of last week getting ready for today; my reagents ordered, my tubes labeled, my protocol memorized. I spend Friday rehearsing what reagents would go in which tubes at which times. I was determined not to make any blunders. My project involves running an ELISA on samples collected fairly non-invasively from cats. It's not important to understand the details; only that it is complicated to set up, that it takes several hours to complete, and that before I could even start the ELISA, we needed to collect samples.

I was all ready for my 8:00 AM Monday morning start time. As I struggled to fall asleep the night before, I kept rehearsing the protocol, tossing and turning in defiance of my 5:30 AM alarm. 6:30 found me in the lab, adding diluent to my tubes, and wondering why nobody else was around. I needed at least one other person to help me transport the cats from where they are housed to where we would perform the procedure. 7:00 came, and then 7:30. I got panicky. I paced the halls. I swore a lot, since it seemed to work for my PI. I rode the elevator downstairs once, determined to get set up myself, before I realized that I could not transport ten cats all alone. Finally, after 8:00, I ran into one of the undergraduates, a new hire in the lab. I hustled him into the elevator before he could even drop his backpack, encouraging him to keep up with my Amazonian strides. Poor kid.

We arrived at the research facility, scanning our pass cards at door after door. I burst into the women's locker room to change into the generic navy scrubs required by the facility. My PI was already there, stepping out of her small, sensible shoes. This was bad. The usual routine in the lab is that the students get set up and she arrives later, in time to start the procedure. She looked up at me, and I saw that she was wondering what in the world I was doing there. "I couldn't find anyone to help me set up!" I blurted out. "I couldn't do it myself. I was calling everybody, but I didn't know what-"

"You needed to put it on the calendar," she interrupted me. I felt my eyes widen. When chastised, I have two faces I make. One is sulky face. The other is innocent contrite face. In this situation, my subconscious chose the latter. She yanked her green top over her head.

"I . . . guess it didn't occur to me. I-"

"I couldn't do anything while I was out of town," she said, shooting me a look through the neck of the blue scrub top she had halfway on.  "That's why I was sending emails late last night. If you didn't do it, nobody did, and nothing is going to be set up." I felt myself engage stage two of innocent contrite face. My cheeks flushed, my lips parted, and my eyebrows knit together.

"I'm sorry. It's my fault." Numb, I started to change my clothes. I turned my back and replaced my own shirt with the rough cotton one. But she continued, accented words aimed at my back.

"Nobody will probably be in until 9:00 and then we won't even get started until 9:30," she said, cinching the drawstring of the shapeless scrub pants. "It's going to be a long day for you." Her phrases were starting to follow one another less and less. Even in my embarrassment, I recognized somebody who was continuing to talk out of temper. A last-word battle. I recognized it because in other situations, I am a champion in this category.

"I'm sorry. It didn't occur to me," I whispered, laboring over my own drawstring now because I didn't know what else to do. I wished she would stop talking.

"You needed to take care of that. I couldn't do anything while I was out of town," she repeated. She walked toward the door. I struggled to make my fingers turn the combination lock so I could put my street clothes away. I swore out loud at my own stupidity. How could that not have occurred to me? Out loud, but in a whisper. Probably not a quiet-enough whisper though, as I heard my PI pause midway through pulling the door open. Great, now I am incompetent and profane. When I heard the door swing shut, I swore again.

Innocent contrite face has a history of leading to tearful face. But I was not going to let that happen today. I channeled the burning sensation into another string of profanity. In for a penny, in for a pound.

I met my hapless undergrad in matching navy scrubs, and together we schlepped ten cats from one building to the next. When we got the the procedure room, a battalion of people was assembled there. They had the air of people who needed to do something really fast, but had nobody to tell them what that thing was. They looked at me. This was my experiment after all. I had nothing to say.

"Which cats are those?" asked the assistant to my PI.

"Umm, let me check." I fumbled with a list of ear tag numbers cross-referenced to names. Clever that I had thought to stash that in my scrub pocket, I thought.

"You should have labeled the cages," she sighed. "Do that now." She handed me a sharpie and a roll of tape, and turned around to bark orders at the rest of the battalion.

"I'm sorry. It didn't occur to me," I mumbled to my roll of tape.

Before long, a sort of order materialized out of the chaos, but the harried tenor remained, for which I felt responsible. The string of profanities continued in my head. I was so dim.

My PI strode in, shoving a stray hair back under her surgical cap. She gave me a terse string of instructions that sounded even harsher in her her normally ebbing and flowing accent, as though I'd even ruined that by my incompetence. I was glad that I was wearing a surgical mask, because I was pretty sure that I had transitioned into sulky face.

The sampling went fine. Each member of the battalion did his or her job. I did not mix up any tubes. All the cats woke up from anesthesia. I double-triple checked that none of my sample tubes would pop open and spill out my precious sample, before changing back into my street clothes and riding the elevator back to the lab where I would perform the ELISA.

I sat on the high stool at the laboratory bench and started the process of setting up my assay. As I settled into the methodical, repetitive work of pipetting, my blood pressure dropped and my breathing slowed. My mind began to unwind. The string of profanity faded out and was replaced by the more rational monologue that I like to think is my normal.

This is my third week in the lab. In three weeks, I have assisted with experiments to learn how the lab works, and have designed an experiment of my own. I have learned how personnel in this lab prefer to handle cats, biting my tongue and feigning enlightenment when I am instructed to give a cat an injection in a way that is different, but no better or worse, than what I have learned in previous situations. I have learned to perform an assay that nobody else in my lab performs. Most importantly, nobody explained to me how scheduling works. Maybe I should have assumed that the calendar in the student office every Monday does not appear there by magic, but really, expecting a person to assume something is always a shaky proposition. And now here I was. I took the blame in person when confronted by my superiors, and I was still feeling guilty about it now. I'd made no excuses for my mistake. I'd stayed true to the edict of that hazy person from my past. So why didn't I feel satisfied?

I fell into a rhythm, popping open eppendorf tubes, drawing a tiny amount of sample into my pipet, and squirting it into the crystalline microplate well, over and over. I consulted and double checked the diagram I'd drawn of my plate layout. The only words in my mind were the coordinates of each sample well: A2, A3, A4. I covered my masterpiece with adhesive and set it on the rocker to incubate. I took my first normal breath of the morning.

I was all set to end this story by concluding that not making excuses is not okay after all. That it only leads to me feeling bad, and rather than impressing people with my ability to take responsibility for my actions, actually makes me seem more incompetent by not explaining the circumstances that led me to those actions. But what happened that afternoon made it unclear again.

I was walking back to the lab from the section of the medical school library where I go to work and write when the student workroom is too crowded. I ran into J, who works in the lab.

"Hey, I'm really sorry about this morning. I wasn't sure what was going on with the sampling and I totally neglected to put it on the calendar." I brushed off her apology and said something about miscommunication all around.

"Yeah, but G (PI) said that she yelled at you, and I feel bad about that. It was my fault."

When I got back to the lab, my PI was there. She asked me how the experiment was going. She smiled, and chatted, and looked me in the eye. Every trace of this morning's brusqueness was gone. I could tell that this was her way of apologizing to me.

I explained nothing to anybody. I took blame that was not attributable to me. I spent all day developing a new worldview in which nobody would be allowed to vent their frustrations on me ever again. And yet now in the outright apology of J, and the implicit one of my PI, I knew that everyone understood. It was okay. The situation had worked itself out. Nobody thought I was dim or negligent. Okay. But did anyone think more of me for not making excuses? I don't know. Would they have come to this conclusion sooner if I had spoken up, or would I have angered tempers and wasted time with explanations? I no longer have an answer.

Sampling day #2 has come and gone. This time, with the help of a savvy undergraduate, I was set up and ready to go the night before. The room that morning had more of a carnival atmosphere than the panic of two weeks ago. Everybody did their job. No voices were raised, except  that of one notoriously grumpy calico, who was nonplussed with our efforts to induce general anesthesia. My PI chatted comfortably with me the entire procedure, and both innocent contrite face and sulky face took the day off. I like to think that my experience and preparation made all this happen, but I think I'm better off thanking circumstance. 

Friday, March 2, 2012

A view from the other side: Part 1

Last December, I experienced life as a client. That client. You know the one I mean. The crazy one.

It started with a lump. Last September, I noticed a golf ball-sized lump on my rat's flank. Geraldine, whom we purchased for $12.00 from PetSmart almost two years ago, seemed unaware. Horrified, I picked her up and prodded the thing. It was firm, and movable, and seemed to be encapsulated. And then I did nothing. She was an old rat, I rationalized. She's been lucky to make it this far. I didn't want to think about it. But the thing kept growing, and eventually it was just too pitiful watching this otherwise bright-eyed creature drag around a side car that was probably a quarter again of her body mass. I resolved to at least consult with the exotics service by the end of the week.

One Friday at lunch, I saw one of the exotics clinicians walk by where I was eating my lunch and chatting between labs. Clinicians in any discipline are hard to get a hold of, because they have a way of running around the hospital all day. Without a second thought, I set my sandwich down and jumped over several chairs.

"Dr. X!" He turned to look at me, and I became aware of how he easily had a foot in height on me. "Are you on clinics this week?"
"Yes . . ." he answered. By his glance toward the stair case, I could tell he already knew where this conversation was going. I tried to make it quick, squeaking out my words. "I have a rat. She has a mass. Can you look at her?"

Dr. X did not miss a beat. In one breath, in his thick foreign accent, he ran through his top differentials and options for treatment. "Bring her in next Wednesday," he finished.

I am not sure what I was expecting, but all of a sudden I was committed. By interrupting that doctor's lunch break, I'd stepped off the precipice. I was going to seek veterinary care for my $12.00 pet who was pushing the upper edge of average lifespan. I loved her, but the idea of medical treatment for a pet rat was something I'd struggled with, and not without guilt.

Everybody falls in a different place on the spectrum of how much intervention they would seek for their pet. There are those who elect euthanasia rather than pursuing any type of treatment, and those who cart their animal to the veterinary school every day for weeks so that it can undergo the radiation therapy that will buy it eight more months of life. Barring outright cruelty, I believe there is not a wrong place to fall on that spectrum. Look at it this way; it's easy to look down on the individual who elects convenience euthanasia rather than treating a pet with a manageable condition, but is that judgment so easy to make in the case of a person with limited financial resources who elects not to pursue a kidney transplant for a cat in renal failure? I don't think so. My struggle stemmed from the fact that I felt that I should be one of the individuals who advocates state-of-the-art medical treatment for any animal in my care. But from a pragmatic standpoint, I wondered if surgery was a good use of resources- mine and the hospital's- for a pet that was frankly a pretty minimal investment.

But it seemed my conscience had gotten the better of me, because now I was going to do it, if for no other reason than that I had an appointment with the exotics service.

Wednesday rolled around, and I started the day off parading through the reception area with a tank full of shavings and one nonplussed rat. I had class early that morning, so I deposited Geraldine in the exotics ward and rushed to lecture. I was to return later to speak with Dr. X. I was prepared to coolly discuss the necessity of surgery and to really weigh the costs and benefits before committing. I was even prepared to discuss euthanasia, although the thought made me feel a little nauseated. When I returned later to speak with Dr. X, as I expected, he brought up surgery immediately.

"It's most likely a mammary tumor." I nodded. I knew from my previous life working in research laboratories that rats have mammary tissue over much of the body, making mammary tumors a common affliction in rats lucky enough to live that long.

"We should be able to take it out easily, and we would recommend spaying her at the same time to hopefully prevent recurrence."

This is the point where I knew I should stop and consider my decision. I thought about the small amount of money my husband and I had saved from our summer jobs, and the particular use I had in mind for it. I felt my face flush. I inhaled, ready to ask about other options, but no words came.

"Okay," I squeaked. "When?"

Surgery was scheduled for the following day, and I sheepishly sent my husband a text message about transferring some money from our savings account for rat surgery the following day.

As I walked back upstairs for my afternoon classes, I was of two minds. On the one hand, I knew I had been intimidated into electing surgery. Not by Dr. X; he was doing exactly what he would have done with any patient, which is recommending the treatment with the best chance of a positive outcome. I had intimidated myself out of debating a course of action with someone I perceived as an expert. On the other hand, I realized that maybe I really had made the best choice. Maybe this was no less than my due diligence for an animal for whom I had taken responsibility. In any case, I was even more committed than before.

At home that night, I prodded Geraldine's lump again. I watched her haul it around with her as she performed acrobatics, climbing upside-down on the roof of her cage. I started imagining a life for her without the lump. The next morning, I packed her back into her tank of shavings, and drove her off to meet her fate.

Friday, December 16, 2011

Weird finals dreams #2

This dream was all about food.

I dreamed that I was at a store trying to buy salted caramel gelato. I was really pumped about the salted caramel gelato, just as I would be in waking life. I opened up the freezer case and poked my head inside. I rifled around. There was no salted caramel gelato! I was heartbroken!

Moving my hand a few inches away though, I came upon some bar cookies. They were like fudge, with a layer of green minty stuff, and a layer of crushed nuts. I drowned my sorrows in them, and they were delicious. I also noticed some strawberry ones, but in my opinion the mint ones were much better.

Cut to a scene of me in a lawn chair. I am spooning and eating an enormous coke slushy. I don't even really like coke. Or slushies. But in my dream, the texture was amazing, and I was sad when it melted.

Weird finals dreams #1

I never feel stressed around finals. It's more like a marathon, compared to the sprint that is a regular exam. I have no real obligations other than to study . . . and keep on studying. I'm not usually sleep-deprived because I have all the daylight hours to study without juggling other activities like class and work. The stress must be there somewhere, though, because I frequently am visited by strange, vivid dreams during finals.

Last week I dreamed that one of my classmates had a swollen head, and I had to come up with a list of differential diagnoses as to why. I came up with:
Infectious: viral
Infectious: bacterial

Maybe he had turkey rhinotracheitis virus?

Wednesday, October 12, 2011

Slainte, Universe

Last Friday, a friend and I spent the afternoon working the vet school booth at a large dairy cow expo. We students are required to do a few outreach things in the community to qualify for our educational funds to use for externships and conferences. Neither of us was thrilled that we'd signed up; we'd just finished an exam and would have preferred to spend the afternoon napping. But there we were.

Nobody came to talk to us for an hour. Being two chatty people, we passed the time chatting. I was in the middle of animatedly making a point, when out of my peripheral vision I saw a large figure approach. The table at which I was seated moved three inches into my abdomen as a giant man leaned his bulk on it. This man was actually ruddy-faced. I don't think I have ever had occasion to describe a real person that way. But his round cheeks were so red beneath his close-set blue eyes that I could almost hear the wind whistling over the moors as I puzzled over the fact that this man was bent at the waist with his face five inches from mine.

Now, the Dairy Expo is evidently a big deal, diplomacy-wise. During our uneventful hour, I had noticed people walking by wearing little red ribbons, indicating that they were visitors from abroad. The red ribbon pinned to the ruddy-faced man's cotton plaid shirt read "Ireland."

"I think I'm going to faint," he gasped. Well, actually, he lilted it, adding to the absurdity of the situation.

My friend and I looked at each other. "Do you need water?" she asked. "Do you want to sit down?" I tried.

"No," he gasped as we ran through all the treatment options we could think of.

"Do you need to eat something?"


"Are you too warm?"


"Well, I hope you don't faint!" I cried, letting panic creep into my voice. I imagined him falling, limp, across our spindly table. I pictured my friend and me pinned by the table between a giant Irishman and the concrete wall behind us.

"I hope I do!" he cried. This was not the response I expected, since this man was clearly having a heart attack. I was in the middle of one of those split-second reveries, in which I visualized extricating myself from the twisted tablecloth and trying to remember CPR.

"You do?" I struggled to think of a medical reason why fainting might help his condition.

"Yes, I do, because then a pretty lady might kiss me and wake me up." I swear that, as he said it, his eyes actually twinkled.

I uttered a few incoherent syllables. I blushed. I abandoned my search for the nearest AED. My friend, who is better-adjusted than I am, burst out laughing.

He stayed a few more minutes, chatting about Ireland and and the U.S., until his smaller and less-twinkly traveling companion came to retrieve him. As he left, he took my entire hand in his rough red palm and shook it.

"Come and visit my country any time!"

So for the price of my Friday afternoon nap, I got to encounter a real, live cultural stereotype. One that caused me panic, and then flattered me. Perhaps the universe sent him to our booth, since neither panic nor flattery from giant friendly strangers is compatible with being in a slump. Slainte, Universe.

Tuesday, September 27, 2011

Sophomore Slump

It's here. It seems I am not immune to the downward trend in vet-school opinion ratings following the euphoria of first year. Lately I have been short on patience with people I normally like, stressed about an exam load that is actually much lighter than last semester's, and anxious about social dynamics within my class.

I can attribute my blah-ness to many things. First, I have not figured out my workout routine. Last semester, I was running three times a week. I am a fairly terrible runner, so I was not running far, but boy did it do wonders for my mood. I was on a runners's high all semester; my focus was awesome and my grades rocked. It turns out I'm one of those people, the kind who get a little nutty when they don't get their run in.

Second, as I predicted, school is one big kvetch-fest. My god, people, don't you know we feed off of each other? Every minor inconvenience is the end of the world. And the worst part is, I take part in it, just to connect with people. Being the lone Pollyanna in a group of Eeyores doesn't make you any friends. But it brings me down. The worst is talking about people. Most of what is said is not mean-spirited, but almost all of it could be taken that way out of context. The worst part is, I take part, because it's the way of communicating. I know that to excuse myself from this kind of talk would be to excuse myself from a large part of the social life of the school. But what other choice do I have when I find myself repugnant for joining in, ad stress out about who might have overheard me saying what?

Third, I am entirely overcommitted. I thrive on being productively busy, and the desire to avoid boredom is one of the things that led to me veterinary medicine in the first place. But three officer positions, even though one is in a fairly inconsequential club, is spreading me thin, on top of my weekly overnight on-call shifts in the hospital.

Fourth, my schedule is such this semester that I have no mornings free, which translates to no horse time. I didn't realize how much I relied on it until a resident asked me to hold a horse for him while he discussed it with a group of students. With the lead rope in my hand, giving the horse's ear a good scratch, I put a name to a missing piece.

Fifth, there is a project that I'm working on. It's quite close to my heart, and the possibility of failure is very real. If I am successful, it will be a stressful sort of success; but if I am unsuccessful, I will be heartbroken.

I am feeling that creative pull again. Perhaps that will translate to more writing. I am also going to make a point of running this week, no matter what else I have going on. I've got to shake this funk.

Tuesday, August 30, 2011

My stethoscope

I will start second year this week. I am ready to go back. I am excited to learn about bacteria, viruses, toxins, and all the other abnormal stuff that this year will introduce. And yet, lately I have been contemplating my stethoscope.

My stethoscope is a Littmann Cardio III with the double bells, in color navy. Fairly standard for a vet student to buy during his or her first year. So standard, in fact, that I have a little name tag attached to distinguish it from the other navy Littmann Cardio III stethoscopes that various of my classmates own. The reason this piece of medical equipment has been in my thoughts, I imagine, is that when I hold it, I re-experience the excitement of starting first year.

Our stethoscopes arrived during the first week of school. Along with my classmates, I opened the boxes like I was opening the Ark of the Covenant. Inside, nestled into its foam padding, was the physical metaphor for the profession I was undertaking. I took it home with me that night because I wanted to explore it, and did not want to seem too excited in front of classmates who were still strangers to me. I bicycled to the library that sunny late-summer afternoon, feeling the corner of the box digging into my back through my bookbag, and feeling the more important for it. "I have a stethoscope!" I texted to one of my friends. What I meant was, "I am really going to become a doctor!"

Other sensations can evoke in me, to a lesser extent, the fresh excitement that my stethoscope conjures. Going to the library in the medical school on Friday afternoons, secretly loving that I was studying instead of hanging out or napping. The smell of the teaching hospital, which morphs from antiseptic, to hay, and back again as you walk through the wards. Two rounds of finals have worn some of the polish off my memories of sunny afternoons by the windows in the library, and a summer of working on-call shifts in the teaching hospital has tinged that smell with top notes of exhaustion and annoyance. But my stethoscope remains pure.

So when I go back to school this week, I will tune out the complaints of my classmates. I don't want to hear about how not ready they are to be back at school, or how they wish it was still summer. Because, a year in, I am still lucky to be there. What's more, I am excited to start something new. When the readings pile up, and the on-call schedule becomes ridiculous, and the days seem too short to accommodate the work I need to accomplish, I will think about my stethoscope, and I will be excited.