Someone once said, "Los Angeles is 72 suburbs in search of a city." That couldn't be more true.
L.A. is a horrible city filled with poverty, tourist attractions, pollution, and people with so much wealth it's sickening. Can you tell how much I liked it?
If I had only gone to visit and see the city I would probably say that I will never go back. But the truth is, I loved my externship. It's hard to describe but I seemed to fit in so perfectly at the practice. From the moment I started I had already made friends and found teachers. One of the cardiology residents took me under his wing for the two weeks I was there and taught me so much. Of course that was between all his sarcastic comments, anti-semitic jokes, and chauvinism (which was all a complete act, he really was a sweetheart!).
I got to see some amazing cases. There was a dog with severe immune-mediated thrombocytopenia, some blocked cats, a ridiculous number of dogs with mitral valve disease, a kitten with pulmonary stenosis, and even a cat with multiple myeloma. All of the clinicians, residents and interns tried to teach me as much as they could about each case. I even got comfortable with some of the cardiac drugs and how we use them (I am terrible at cardiology). It really was an all around amazing experience.
Probably the best thing came at the end though. One of the clinicians sat down with me to talk about my experience. I told her that I had a great time and really enjoyed the practice. She then told me that they were very impressed with me and would like to see me back for an internship. That blew me away. I am used to my teachers liking me but to hear that I was impressive to "real" people out in the "real" world was something else.
So what am I going to do? I'm not entirely sure. I still have the rest of the summer and two more externships until I have to start seriously thinking about post-graduation stuff. I'm sure I'll be thinking this out on my blog at a later date. Right now I'm exhausted. I flew in to Dallas yesterday and left for my parent's place today to help take care of Murry (the jackass had to have surgery again today . . . I'll explain later). I made it to Eutaw, Alabama. Yeah, long day of driving. Now it's off to bed for me . . . *yawn* . . .
Monday, June 30, 2008
Sunday, June 15, 2008
Scared
I don't want to leave Dallas today.
These past two weeks I've learned a lot about about myself. Verdict on a surgical residency: not for me. I love surgery but I don't think I have the drive to pursue it as a specialty. I don't think I could handle doing what these interns did and going through 2 internships just to spend another 3 years in a residency. Some of them didn't even match so they are back where they started trying to find a job as a general practicioner.
I have also learned that I miss being in a city. I love the activities and culture of being in a metropolitan area. Dallas is too far from my family, which is its only downside.
I'm terrified to go to L.A. Not only am I afraid of the city (for no real apparent reason) but I also have a sick feeling in my stomach because I'm staying at a hostel that I know very little about. I think it's in a decent area (the south end of Westwood) but I have no idea. I've read mixed reviews, some raves and some telling people to stay away. I hope it's okay. Maybe that sick feeling is just because I'm hungry.
I have to believe everything is going to be okay.
These past two weeks I've learned a lot about about myself. Verdict on a surgical residency: not for me. I love surgery but I don't think I have the drive to pursue it as a specialty. I don't think I could handle doing what these interns did and going through 2 internships just to spend another 3 years in a residency. Some of them didn't even match so they are back where they started trying to find a job as a general practicioner.
I have also learned that I miss being in a city. I love the activities and culture of being in a metropolitan area. Dallas is too far from my family, which is its only downside.
I'm terrified to go to L.A. Not only am I afraid of the city (for no real apparent reason) but I also have a sick feeling in my stomach because I'm staying at a hostel that I know very little about. I think it's in a decent area (the south end of Westwood) but I have no idea. I've read mixed reviews, some raves and some telling people to stay away. I hope it's okay. Maybe that sick feeling is just because I'm hungry.
I have to believe everything is going to be okay.
Saturday, June 14, 2008
Plastic surgery for pets?
Tonight is my last night in Dallas. I realize I have not posted much from this city but that is because I have just been so busy having an amazing time. I explored the Uptown district, saw "You Don't Mess With the Zohan" (hilarious by the way), went to a sculpture garden, listened to live jazz at the art museum, saw a production of "Othello" in a park, and learned all about the Kennedy assassination at The Sixth Floor Museum (according to the local gurus on the Grassy Knoll Lee Harvey Oswald was not the gunman and there were multiple shooters).
This past week was more enjoyable at my externship since there was a different group of interns (they all rotate through 4 clinics over the year) who were easier to get along with. We also had some interesting cases. For example, a very small and frail dog that was attacked by a much larger dog came in with spinal fractures. The surgeon placed an awesome external fixator on that made the dog look bionic. We somehow managed to not pierce the spinal cord or aorta, woohoo! When I left the dog was doing great and will be sent home for a while on Monday. I also got to see a total hip replacement and the removal of an abscessed kidney (which exploded and was super awesome . . . the dog did awesome too).
There was also a very interesting case that brought up a lot of issues for discussion. An owner wanted her dog to have perky ears so one of the surgeons placed implants to help them stand up. The dog is not a show dog and has no history of ear problems. This was a pure cosmetic procedure. Unsurprisingly, she was still not happy with the results and flipped out at the surgeon (who really brought this on himself, he knew she was nuts).
This brings up a very interesting question though. Is it ethical to perform an unnecessary cosmetic procedure on an animal? And what is considered unnecessary? We have been ear cropping and tail docking for ages, does that make it right? I don't know too much about either of those to make a comment (although I think these have to do with breed standards?). As far as fixing the ears I do have a few thoughts.
First, death is a possible risk of anesthesia, even in healthy patients. I do not think that any animal (or human) should be put under anesthesia unless it is absolutely necessary. If an animal were to die from anesthetic complications while undergoing a frivolous procedure it would be a great tragedy.
Second, the animal is not consenting to having its body changed. Humans must get cosmetic surgery of their own accord. No one ever performs a boob job on someone without asking. I realize that animals cannot give consent for any surgery but not all humans do either. Patients come into human ERs all the time and go to surgery whether they're conscious or not. This argument of no consent is why some people are against kidney transplants in cats (but that is another topic . . .).
Lastly, in this particular situation it was clear that the owner was not rational about this topic. She admitted that she was willing to risk the dog's life to have his ears the way she wanted them. This is a person who needs medical help, not veterinary.
After a bit of thought I decided that if someone asked me to perform this surgery I would decline. I do not think it is ethical. So where do I stand on declaws, neuticles, tail docking, and the rest? I don't know yet. Perhaps it depends on the situation and why the owner wants these things done. I may be less likely to declaw a kitten with no scratching post than an older cat that the owner's may get rid of because it keeps scratching their children. It is an interesting topic and one I think we all as veterinarians need to figure out for ourselves.
This past week was more enjoyable at my externship since there was a different group of interns (they all rotate through 4 clinics over the year) who were easier to get along with. We also had some interesting cases. For example, a very small and frail dog that was attacked by a much larger dog came in with spinal fractures. The surgeon placed an awesome external fixator on that made the dog look bionic. We somehow managed to not pierce the spinal cord or aorta, woohoo! When I left the dog was doing great and will be sent home for a while on Monday. I also got to see a total hip replacement and the removal of an abscessed kidney (which exploded and was super awesome . . . the dog did awesome too).
There was also a very interesting case that brought up a lot of issues for discussion. An owner wanted her dog to have perky ears so one of the surgeons placed implants to help them stand up. The dog is not a show dog and has no history of ear problems. This was a pure cosmetic procedure. Unsurprisingly, she was still not happy with the results and flipped out at the surgeon (who really brought this on himself, he knew she was nuts).
This brings up a very interesting question though. Is it ethical to perform an unnecessary cosmetic procedure on an animal? And what is considered unnecessary? We have been ear cropping and tail docking for ages, does that make it right? I don't know too much about either of those to make a comment (although I think these have to do with breed standards?). As far as fixing the ears I do have a few thoughts.
First, death is a possible risk of anesthesia, even in healthy patients. I do not think that any animal (or human) should be put under anesthesia unless it is absolutely necessary. If an animal were to die from anesthetic complications while undergoing a frivolous procedure it would be a great tragedy.
Second, the animal is not consenting to having its body changed. Humans must get cosmetic surgery of their own accord. No one ever performs a boob job on someone without asking. I realize that animals cannot give consent for any surgery but not all humans do either. Patients come into human ERs all the time and go to surgery whether they're conscious or not. This argument of no consent is why some people are against kidney transplants in cats (but that is another topic . . .).
Lastly, in this particular situation it was clear that the owner was not rational about this topic. She admitted that she was willing to risk the dog's life to have his ears the way she wanted them. This is a person who needs medical help, not veterinary.
After a bit of thought I decided that if someone asked me to perform this surgery I would decline. I do not think it is ethical. So where do I stand on declaws, neuticles, tail docking, and the rest? I don't know yet. Perhaps it depends on the situation and why the owner wants these things done. I may be less likely to declaw a kitten with no scratching post than an older cat that the owner's may get rid of because it keeps scratching their children. It is an interesting topic and one I think we all as veterinarians need to figure out for ourselves.
Sunday, June 8, 2008
Finally, some quiet time
So I haven't posted since I got to Dallas. I know. There is a good reason for that. Within five minutes of arriving I was decorating cupcakes with my host's grandchildren. That was a sign of things to come.
Barbara is this fabulous woman that has two kids who live about a mile from her. Her daughter has triplets that are 12, and her son has two daughters, 6 and 1. It was the end of the school year for them so things were a little crazy. They trew a little welcome party for me on Sunday (which was so sweet), we went to the symphony in the park on Tuesday, and Wednesday they had their big end of the year party for the entire 5th grade class. Plus every other night we were doing something with the kids or, on one night, we went to eat in the Uptown area. Yesterday there was another party so today is the first day I've gotten to just relax a bit. I've actually had a lot of fun with the kids, they all love me and think I walk on water . . . although, I'm not completely sure why.
But, more importantly, I started my externship. I have just been scrubbing into surgery after surgery all day, every day. It's been awesome. I've gotten to see some really cool stuff. The other day we had a cat come in that had been hit by a truck. At first we thought there were just pelvic fractures but then one of the clinicians suspected there was a tear in the bladder. After confirming that she was correct we opened the cat up. Turns out there was no bladder tear but the pelvic urethra was completely avulsed. We managed to find each end and somehow fixed it. The cat, however, didn't get the memo and wouldn't produce any urine so he eventually was euthanized. We also saw a dog which presented for a stump pyometra which was actually an adhesion between the uterine stump and the jejunum. It looked like something neoplastic was going on but we'll let histo figure that one out.
I've also gotten to see a lot of orthopedic surgeries, which is good since I haven't had my ortho rotation yet. They do a ridiculous number of TPLO's so at this point I am pretty comfortable with the procedure (although I don't think I'm ready to handle a bone saw just yet). Some of the dogs have been pretty huge so I've gotten to see a lot of the joint anatomy (which is super sweet).
The externship hasn't been all great though. For one, everytime they ask me a question I blank and get the answer wrong, so I pretty much look like a moron. Also, the interns have been less than welcoming. They're nice enough but they're so tired from their year of interning that they are just ready to be done with it all. Maybe next week will be better since the group of interns at this location (there are 4) will be changing.
I'm pretty sure after this week that doing a surgical residency isn't going to be for me. I love surgery and all but it seems like the doctors are so focused on the procedure that they don't really pay much attention to the patient. Most of the interns can't even answer me when I ask how old the animal is. But still, I'm learning a lot and emjoying myself which is the important part.
Barbara is this fabulous woman that has two kids who live about a mile from her. Her daughter has triplets that are 12, and her son has two daughters, 6 and 1. It was the end of the school year for them so things were a little crazy. They trew a little welcome party for me on Sunday (which was so sweet), we went to the symphony in the park on Tuesday, and Wednesday they had their big end of the year party for the entire 5th grade class. Plus every other night we were doing something with the kids or, on one night, we went to eat in the Uptown area. Yesterday there was another party so today is the first day I've gotten to just relax a bit. I've actually had a lot of fun with the kids, they all love me and think I walk on water . . . although, I'm not completely sure why.
But, more importantly, I started my externship. I have just been scrubbing into surgery after surgery all day, every day. It's been awesome. I've gotten to see some really cool stuff. The other day we had a cat come in that had been hit by a truck. At first we thought there were just pelvic fractures but then one of the clinicians suspected there was a tear in the bladder. After confirming that she was correct we opened the cat up. Turns out there was no bladder tear but the pelvic urethra was completely avulsed. We managed to find each end and somehow fixed it. The cat, however, didn't get the memo and wouldn't produce any urine so he eventually was euthanized. We also saw a dog which presented for a stump pyometra which was actually an adhesion between the uterine stump and the jejunum. It looked like something neoplastic was going on but we'll let histo figure that one out.
I've also gotten to see a lot of orthopedic surgeries, which is good since I haven't had my ortho rotation yet. They do a ridiculous number of TPLO's so at this point I am pretty comfortable with the procedure (although I don't think I'm ready to handle a bone saw just yet). Some of the dogs have been pretty huge so I've gotten to see a lot of the joint anatomy (which is super sweet).
The externship hasn't been all great though. For one, everytime they ask me a question I blank and get the answer wrong, so I pretty much look like a moron. Also, the interns have been less than welcoming. They're nice enough but they're so tired from their year of interning that they are just ready to be done with it all. Maybe next week will be better since the group of interns at this location (there are 4) will be changing.
I'm pretty sure after this week that doing a surgical residency isn't going to be for me. I love surgery and all but it seems like the doctors are so focused on the procedure that they don't really pay much attention to the patient. Most of the interns can't even answer me when I ask how old the animal is. But still, I'm learning a lot and emjoying myself which is the important part.
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