Janel's Place

No, I don't REALLY have time to write a blog. There are two more tests next week and reading dermatology notes is similar to shoving pencils into ones eyes. Learning about bizarre cow surgeries... kept me wide awake. Learning the different names for skin flakes and warts on cats and dogs... wow.

But the word on the street is that I'm going to appreciate this knowledge one day. And it is true. Deep in my heart I really don't want animals to be itchy. In fact I looked in my own dog's ear and saw some crap and the ear notes got a little more interesting.

So anyway, I'm writing a quick blog because I watched Julie/Julia a couple weeks ago and felt very sad that I'm traveling through a wild veterinary school adventure with little to no record on what it's really like. I don't think it's too late to start keeping track. Vet school took a dive into reality approximately 3 weeks ago. Seriously. That's when it hit me that all of the books and notes had some connection to a very real career and responsibility. The name of this dive into reality? The anesthesia rotation.

The Anesthesia Rotation: a short epistle

I know. I like to hype things up only to disappoint my massive audience with a punchline about a toad or something. But heck. It's my blog. And I'm not going to even pretend than any of the other 135 students in my class wouldn't laugh their little tushes (word change to keep mom happy) off to think I could take this all so dramatically. But I'm a little different from them. I've spent the last year of my life thinking about life and relationships, cramming vet school in in my spare time. My friends dream about school and I dream about screwball versions of my relationship. It's not that I need to be rescued from the Grinch that stole Christmas. It's just that I've always thought I might marry him, my first real boyfriend ever, and that just scares the s$@* out of me. For a lot of reasons. Some good reasons, and a lot of not so good reasons. But wait, this was supposed to be a blog about vet school.

So anyway, I guess I'm trying to make a point that things really turned a corner after day 2 of that anesthesia rotation. I have to blog about it before it wears off. In fact my last rotation in small animal nutrition taught by the genius from planet intelligence (I've only met two people from that planet by the way -- this guy and my PhD advisor) has replaced much of my anesthesia rotation feelings of awe with an overwhelming stupid complex. Darn it I digress again. What I mean to say is that since day 2 of that rotation I've had 6-7 dreams about anesthesia. 5 of them happened in rapid succession that week and into the next -- on the nights I slept for a couple of hours.

What was it about this rotation? I don't know. Maybe the concurrent beating of regular exams the first week and final exams the second week of the rotation. Maybe the realization that I can pass exams for years and still seem to know NOTHING under pressure. Maybe because without a tech looking over my shoulder I could really have killed that dog. And I fell in love with that dog the night before when I did his pre-surgery physical exam. Maybe because I've never actually cared that much about what I've been doing in any area up to that point. Maybe it really just was how much I loved that little dog from the pound who sat on my lap the night before and had a history of just being a stray. Crap now I'm getting teary.

So yes, the rotation gave us the presumed power to do harm. And it scared me to absolute death. I monitored charts like a little maniac, wanting to beat the casually chattering surgeons and other students. FOCUS you morons! Animal under anesthesia here! I guess I wasn't as bad with my first patient. I was scared and scattered and needed help doing everything, but everything went smoothly. It was my second patient that had apnea right after induction. YES I realize now that that is a normal side effect of thiopentol. I realize that you can breathe for the patient and things will start up again with some nice drugs. I realize that I had even written it down as a potential side effect of drug administration. But dear Lord I did not expect the dog to stop breathing. I did not expect it. Brain blank. That particular dog was pretty much a challenge the whole time with hypotension and low heart rate and whatnot. And I was surrounded by techs and surgeons who knew exactly what to do and did it themselves if I wasn't fast enough. They had calm voices and it couldn't have been a better teaching experience. The dog was fine. And I was fine. Till I got out to the car on lunchbreak and had a meltdown. Wowza. So this is real. So anyway, it was my third patient that I really bonded with. He was a smelly pitbull, so cute and calm and adorable when I sat with him the night before. I didn't sleep that night, rehearsing in my brain what to do if ANYTHING happened. Even when I had time to sleep, still rehearsing and couldn't sleep. Even with a middle of the night visit from my "Grinch" (not really a Grinch) I couldn't calm down. Showed up, had to borrow a stethoscope and timer (after all that I walked out the door in the morning without it), and day 4 of anesthesia had begun. Things were working out. I learned more about delegating responsibilities and keeping patient breathing a first priority. But I was still a little maniac. That dog had a high CO2 the entire time, and as I continued to somewhat calmly give him breaths, I heard some "too light! too light!" exclamations from back on the surgery table ( I was up by his head and didn't even look at the surgeons the whole time), and in mid-breath I zipped my attention over to the gas to turn it up a little, and I left the popoff valve closed! To those who don't know about this valve, it relieves gas pressure and sends expired air to the scavenger system. You close it briefly to direct air back to the patient to give a breath, then you OPEN it so pressure cannot build up and blow out the patient's lungs. I had no idea I had left it closed, and was staring at monitors and watching with panic as his CO2 and respiratory rate started climbing, climbing, climbing. Everything happened so freaking fast, and the anesthetist overseeing everyone came over and went straight to that valve before my brain could even turn on with a plan of action. Doggie fine, Janel completely hyperventilated and bug-eyed but still keeping charts like a maniac because it turns out I can choke out tears if I really feel I have to.

So that's what happened that week. The second week of the rotation I was second in command (the clinical part of the rotation has a senior student keeping charts and the junior just there to help out), but it wasn't until patient number three/day 4 of the second week that my stomach quit hurting. The dreams continued, but my need to clobber the chatterers slowly ebbed as the patients continued to live and wake up at the end of each surgery, and my final patient was a fluffy alpaca baby and I even took some time to wander to the back of the table and see how a carpal arthrodesis is done. With drills and plates and screws and holy heck. But everyone seemed to be enjoying themselves.

Okay that was a decent catch up. I will try to keep this more current because I think veterinary school is going to be getting interesting. I've been watching some seniors in the hospital, and it looks like my stress levels might be cake compared to theirs. But they all seem to be enjoying it. Living the dream I guess. Just need to keep passing those darn exams so I can get there too. And try to hold it together with my Grinch. The day when I can rest in that area of my life will be a seriously good day.