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.

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

Motorcycles

Maybe he had turkey rhinotracheitis virus?

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?"

"No."

"Are you too warm?"

"No."

"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.

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.

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.

I go to the barn because I like the horses

Blue sky. Green Hay. Chestnut horses. Red berries. It is the colors of summer Mondays that leave the lasting impression.

We trot the first edge of the property. I squeeze with my calves, and feel my mount move infinitesimally faster. I squeeze again, and he pushes off with his hind quarters. He is not a hot horse, but I know how he can move when given the right encouragement. I post slightly faster, rising and falling in my stirrups just out of time with the beat of his trot. He gets the message, and falls into rhythm with me.

As we round the first corner our ride really begins. A mile stretches in front of us, with green hayfield to the left and white fence to the right. My horse sees this and picks up his front feet, showing me his big, bold trot that can keep up with the canter of some of his companions. It is a hot day, and I am glad of the breeze that our increased speed creates. We coast along. I lay my head along his neck as we go under the low hanging branches of the walnut trees across the fence, smelling his sweet, dusty mane.

Past the trees I straighten up. I touch my horse's flank with my right calf, and kiss at him with my lips. In a single beat his gait changes, from the up-and-down of a carousel horse to the back-and-forth of a rocking horse. I settle into his canter, reminding myself to sit up straight, point my toes up, and breathe. Now we really fly. I let a laugh escape my mouth. I am no adrenaline junkie, nor do I have any kind of need for speed. Horseback riding is the one exception. Little snorts escape my mount's nose in time to his canter, and I use these to keep time, keeping my position in the saddle.

We near the end of the long straightaway. I tighten the fingers of my left hand into a fist, and apply pressure with my right leg. My horse's velvet nose bends to the left, becoming visible to the side of the curve of his chestnut neck. I coax him into a circle, then a smaller one, then a smaller one; soon we are moving no faster than a trot, but at a beautiful, smooth canter. Collection, or something like it. My abs protest as I force myself to work on these precision exercises; it's so much easier just to loosen his reins and fly.

We halt in the middle of our former circle. Despite all of the kinesthetic sensations I am experiencing, it is the colors of the day that threaten to overwhelm me. The sky is so blue. The hay is so green, a green that I never would have believed existed in my former life in which I did not frequent hay fields. My horse, my wonderful mount, is such a shiny gold-red in the sun that I can't resist leaning down to hug his neck. His chestnut-tufted ears swivel back at me quizically.

The third edge of the property is uphill; ideal for going fast. This is my favorite part of the ride, but I can't let my horse know that. We trot toward the hill, then canter a bit, and then trot again. I know he wants to run, but it needs to be me who tells his when to begin. As the incline increases, I take my reins in my left hand. With my right hand, I grab the red saddle pad that is peeking out over his withers. I give him the smallest kiss, and he picks up a lovely left lead. We climb, and we fly.

When our ride is over, and my horse is brushed and picked and kissed and put back out to pasture, where he plunges his nose into the water trough, I clean the barn at a leisurely pace. Catching sight of a plastic bowl, I rinse it out and tote it to the property line. There, in patches between the trees, are the largest red raspberries I have ever seen. I hum to myself as I pick,eating one berry for every three that go into the bowl. It is quiet here. I move slowly, and listen to my own breathing. I can smell horses and sweat on my person, but there is nobody here to smell me. I pick for hours, until the 'plunk' of a berry into my bowl disappears into silence as the bottom of the bowl becomes obscured, and finally, disappears.

Sore muscles. Sunburnt skin. Juice-stained fingers. Relaxation. These are the impressions that summer Mondays leave me with, long after my memories of what I said or read or did have faded.