I never thought I'd be so happy to be back

I am finally back home. It only took me about week to get here.

I had to spend some time with my parents and cats because the little devil, Murray, decided to eat my mom's bathrobe and needed surgery again. Yup, that's right, that would be foreign body removal #3 now. He is a horrible cat. He's lucky he's so damn cute. My dad, who is allergic, is totally in love with my cats now. He wants no expense spared when it comes to their health. This is a complete change from before they were taking care of them. I'm glad he understands why I love them so much.

I'm glad to be back to my apartment. As much as I love living out of suitcases, it's nice to have a real bed, my own washer and dryer and a kitchen again. My car is happy to. The little road warrior can rest for a week or so before I take her on any more major trips. So how many miles have I gone over the past month?

Total miles driven: 2767
Total miles flown: 2648

Total miles traveled: 5415

That's a lot of miles. And the summer ain't over yet!

Soon enough I'll be having to make some big decisions and I really don't want to. Being offered this internship has kind of thrown me for a loop. If it wasn't at such a respectable place that I know will open doors for me it wouldn't be as big of a deal. But now I really have to think hard about whether or not I want to get a job or do an internship. And if I do want to do an internship do I really want to do it there? I've been avoiding thinking about this by telling myself I still have 2 more externships to do.

I think I'm just going to continue to live in my own little world of avoidance for a few days more. Right now the only thing I'm concerned with is finishing my laundry and finding some food . . .

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.

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.

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.

Good-bye barns!

Its over! I made it through large animal surgery! Alright, I'll be honest, it wasn't that bad. This past week was actually okay. We had a couple of interesting surgeries and we worked well together as a team. This rotation was not nearly as bad as my large animal medicine rotation. I had a laryngeal tie-back surgery which was pretty interesting. However, I did spend most of my time as a retractor and my arms were killing me by the end of it. But on the plus side I did get to stand on a stool and be the tallest person in the room for once, and I got to work with Dr. Freds who is so nice and has a great sense of humor. Then today we had to make sure that the tie-back was still in place so we scoped the horse. Dr. Gray actually let me drive the scope! It was so cool! Earlier in the week we had a horse go to surgery to have a tooth taken out. I got the lucky job of sticking my arm in the horse's mouth to show the surgeons where to repel. Then I had to catch the tooth. My hands smelled like horse breath for the rest of the day!

The three of us really bonded over this rotation. I feel like I have two new friends that I wish I had known about over the past two years. We have similar senses of humor, similar outlooks on life and none of us took ourselves too seriously. One of the girls and I sat up in one of the viewing rooms to watch a colic surgery one day and ended up talking for two hours just about life and school and everything else. Turns out she's super cool and I'm sad I didn't get to know her sooner. But after being in clinics and the changes in dynamics between my friends I'm definitely glad to have some new people to call friends.

We did have a little bit of excitement on the last day. A horse came in who was sired by Storm Cat (yes, THE Storm Cat). This horse was worth $500,000 before he was even born. He was colicking so badly he looked like he was just going to lay down and die. Another classmate tried to tell me he didn't look so painful because he wasn't rolling or biting at his sides. I tried to explain to her that he was WAY past that point. I can't adequately describe how he looked, it was so bad. They finally took him to surgery at 8 at night and instead of finding some crazy intussusseption it turns out he had proximal enteritis. Well, now he's got significant ventral edema since he can't hold fluid in his vessels and he has his feet constantly iced. The sad thing is that he was already slotted to run in the Kentucky Derby this year. Unfortunately its not looking like thats going to happen for him. I don't know how the case turned out but it was very sad.

I go onto dermatology next. Then after that pathology. Thank goodness, I'm starting to wind down, my brain is done with this whole clinics thing.

Slowest rotation ever.

Large animal surgery has officially started and it is slow. Painfully slow. We found out on the first day that our attending clinician just decided to not come in for the first two days. That means we can't do surgery this week. Not much of a point to being on a surgery rotation and not be able to do surgery. At least my team is great. I'm on a team with two girls who are are really chill and drama free. The other team is a compilation of the most annoying students from my class. Ugh. I would have shot myself if I was on that team. I'm friends with Heather but her know-it-all attitude really drives me nuts. After my LA medicine experience with her I don't think I'll be able to work with her again. So my team and I have spent the first couple of days just trying to keep ourselves from going crazy with boredom. Our resident, Dr. Gray, is nice enough. She moves a lot slower than the other residents so it takes forever to get anything done. But all in all we have a good team.

We do have a couple of inpatients. I have a mare named Stop Whining who had a failed laryngeoplasty and now has a draining tract. They had to remove the sutures and now she is useless as a racehorse. Poor girl, she's just going to be a broodmare now. Now that her tracheostomy tube is out she's going to go home to heal up and then thrown out in a field to have babies for the rest of her life. I also had an emergency come in today, a horse named Cracker. We were told that Cracker ran into a car but after talking to the owner it seems she found him in the field with his injury. He had an open wound just distal to his stifle. The middle patellar ligament was torn and flapping in the wind and there was a piece of bone floating around that we discovered was his tibial crest. Kind of an important insertion point for some muscles, like, oh I don't know, the biceps femoris for one. Yeah, not so good. We took out the dead bone and sewed his leg back up then prayed. The best part of the story was that the owner had another piece of bone that she found on the car (we can only assume there was a car in the field that he ran into . . . go figure) and wanted to know if we needed it. Umm, not so much.

So hopefully we'll get some cooler surgeries and the rotation will pick up. My sister is coming into town for Thanksgiving, should be interesting.

Ahhh, the joys of Movember.

Yes thats right. I said Movember. You see, something strange has taken over the small animal hospital. The sweet aroma of mustaches is in the air. The romantic tingle of facial hair has captured all of us. This year some of the surgery residents and clinicians, along with several students, techs and several people from other departments has taken up Movember. A month long celebration of the mustache in an effort to raise money for prostate cancer awareness. The men started the month of November clean shaven and at the end of the month they need to have a full blown mustache. People are asked to donate money to their favorite Mustache Man and whoever raises the most money is the winner. This has led to some strange facial hair. Dr. Coomes has a nice handlebar mustache, Phil has a moderate Fu Manchu, Dr. Black has . . . well no one can really define his mustache. The creativity some of the guys are showing is amazing. I will have to post pictures at the end of the month. The best part is that all of these guys are seeing clients while looking absolutely ridiculous. It is awesome.

Neuro has come and gone. Lulu finally went home today. Even though I am now on large animal surgery I went up to meet her owners and say good-bye. Her owners were so grateful for all that I had done that they almost cried when they met me. They tried to convince me to stay in Florida and work for their son (who is a vet) when I graduate. They even bought me Angel perfume for being their own angel. Lulu is doing great. I think she'll be up and walking in a month or so. I'll miss her though, she was a great dog and I got really attached to her.

The last week in neuro was interesting. We had Captain Satellite. No really, that's what's printed on his name badge. He's out there. Way out there. Half of what comes out of his mouth makes no sense. This man taught one of our classes freshman year dressed in a pink bunny suit. Sounds like a cool guy to work with, right? Not so much. He was argumentative, rude, and just an all-around annoyance. He called one of my classmates a scum-sucking loser. Not in a serious way but it wasn't funny either. Not that that particular student was on my good side this rotation (he acted like he didn't even want to be in vet school), but still, he's not scum-sucking. I did have my first back dog though. Charlie. Charlie was this fat dachsund with a ruptured disc at T11-T12. The surgery was awesome. We took so much disc material from the spinal canal. It was like pulling out loads of cheese. Then the resident let me close completely, all the layers! It was so cool!

Speaking of cool. I can't forget to mention the heartworm removal I got to see last week. Cardio pulled 27 heartworms out of this dog through the jugular vein. It was quite possibly the best thing I have ever seen.

A cow's life is not for me

So oncology has come and gone. The second week was rather uneventful we had only a few appointments because the clinicians were lecturing that week. I really had a lot of fun on that rotation. The techs were awesome and although being the only student was hard I liked the one-on-one attention. Learning about chemo was pretty cool too. Its amazing what we're doing in veterinary medicine these days. Whats even more amazing is how well the animals tolerate it. Animals do so much better on chemotherapy than humans, its crazy. We can't cure cancer but we sure as hell can make it go away for a while. Some of our patients are going on two years in clinical remission of lymphoma. It'll catch up to them some day but those two years are like an extra 15 for a person. Its amazing.

I've moved onto the food animal and reproductive medicine rotation (FAMS and we lovingly call it). I don't want to kill myself yet but I'm getting there. I was late the first day and it was Dr. Ram that was there to greet me. Dr. Ram has no sense of humor and his first words to me were: "We start on time here." Well crap, there goes that grade. Truth is, they never told us what time we had to be there and my friends all told me we didn't have to get there until 8:30. I tried to get there by 8:00 just in case but traffic was horrible so I didn't get there until 8:05. I felt like an ass. Oh well, no sense in beating myself up over the past right?

The field trips on FAMS have been . . . . interesting. Its hot, there's a lot of cow crap, and the smell of the silage makes me want to vomit. But it could be worse. The residents are all pretty cool. We joke around a lot and have a good time. My first day we did an LDA surgery and I got to scrub in. It was awesome. I had my arm inside the cow and was feeling the abomasum and everything. Although the face I'm making is less than flattering. They even let me close the incision. Unfortunately when we came back today the cow was looking very dehydrated and she had a 'ping' on her left side again. Even though we did a really solid omentopexy she may have displaced again. We'll recheck her in a few days to see what we need to do next.

The calves have been both the best and the worst part. One dairy farm we went to yesterday had this field full of hutches almost as far as you could see. The hutches were small and dirty and the little roofs barely gave the calves enough shade. They all looked small and sick. I almost cried when I saw it. Many of the calves had pneumonia and I know that last month a lot of their calves died from heat stress. We took blood from about 60 calves to test their total protein and 30% of them were at an inadequate level, only 40% were in a good solid range. The calves we saw today were in a better situation. They were in a clean and dry area with sand, a barn to shade them and plenty of fans to keep them cool. They seemed happier (if a calf can be happy). A lot of them were jumping up and down and wanting to play, it was very cute. We had to dehorn some of them. I didn't like that. Not because it was cruel, they couldn't feel it because we blocked them, but because I was terrified of missing and burning part of their face off. We used this tool that gets really hot and burns the cornual epithelium. Not something to mess around with. But all in all today was a better experience than yesterday with the calves.

Today we also got to lance an abscess. Finally, after months of being on clinics I got to see some good 'ol pus!! A cow were were removing sutures on had a big lump on her neck. We stuck a needle in it and pus just started dripping out. Dr. Mendle lanced it and pus just started to pour out of her neck. It was amazing. I got video of the whole thing. Then, when we thought there was nothing more that could possible be in there, Dr. Mendle pulled out this:
Just a gianourmous thing of fibrin. It was amazing. I couldn't believe my eyes. That poor cow must feel so much better now, I can't imagine having that much pus in me just stretching out the skin. It was so satisfying to take it all out of her.

So I have one more week of FAMS and then vacation. I can make it through one more week. I hope.

Oncology . . . cancer is keeping me busy

So I've been the only student on the oncology rotation this past week. Its been crazy. I've been staying mainly with the surgery side of the department for this week, next week I'll focus more on medicine. Its a great rotation, everyone is super nice and the department head, Dr. Miles, is hilarious. I walked in on him dancing to the song 'Gettin' Jiggy Wit It' the other day. I almost died of laughter. The cases are crazy. Some of these clients have been told there is no help for their pet and then they come here and we give them an option. A women came in with her dog, Tabasco, who had just been diagnosed with osteosarcomma. The dog has bad hips and stifles so the owner didn't want to do a limb amputation. We offered her stereotactic radiosurgery to treat the cancer. Turns out we're the only place in the world offering that for animals. How cool is that?

I had another crazy cat lady this week. Well, really, a crazy cat couple. The husband was scary. Dr. Fray likened him to Norman Bates. No really, he might murder us if the cat dies. The cat has a liver mass. Most likely its benign but the owners want us to take it out. Fair enough. Trying to get a history from these people though was like pulling teeth. I somehow managed to get the history of the cat's entire family. Don't even think about asking how many cats they have, they don't even know. The best part was when the wife taught me a song I had to sing to the cat when he got his asthma medicine. The entire oncology department has been trying to get me to sing it. Not going to happen. Later in the week I had to call them with the results of their ultrasound and fine needle aspirate (which the woman tried to tell me was the same thing as a biopsy . . . not so much). That was when I screwed up. She asked if we were going to do a clotting profile and cross matching on the cat prior to surgery. I said that I didn't think so but that we could do it if it would make her more comfortable. Apparently she was really upset by this and told the referring vet that she was losing confidence in us. Turns out, I found out later, that we always do a clotting profile on liver lobectomies. Luckily my clinicians weren't too upset with me because they think she's crazy anyway. I'm dreading when this cat comes in on Wednesday for surgery.

We had another dog come in, Rocky, who is a doberman with an oral sarcomma that takes up the front of his mandible. The other vets they went to see said they couldn't do anything for it. Our surgeons looked at him and told them that we could help them. Granted, he'll have to relearn how to eat but he'll be sarcomma free . . . at least for a little while. Its a very aggressive tumor and will most likely show up again in some form. It should be an awesome surgery, unfortunately I won't get to scrub in on it. Oh well, such is life I guess.

Our surgery day this week was ridiculous. We started off with Bart, who was supposed to have a liver lobectomy. Well, when we got in we realized the mass was too close to the hilus and next to some nasty large vessels. So we opted for not trying to kill the dog and tried to remove as much of the mass as possible without bleeding the dog out. Despite all our efforts he still bled a lot and needed a transfusion, he made it though. We still have him because he decided that peeing on his incision was a good idea and now has an infection. He's still having trouble with the whole peeing outside thing, which makes taking care of him kind of a pain in the ass. Plus, he won't eat for us. I think he needs to go home at this point. He'll eat there and his incision looks 100% better.

So after that surgery, which took longer than expected, and getting Bart settled into ICU, Dr. Cane told me to grab something to eat quick because we had to get started on the next surgery. I grabbed a bag of chips and was halfway through before Dr. Cane and Dr. Fray started moving into the OR. So much for lunch. So we started the next crazy surgery. Poor little Dexter had a peripheral nerve sheath tumor on his sciatic nerve that extended up to nerves L5, L6, L7, and S1. So we had to do a coxofemoral disarticulation, hemipelvectomy, and hemilaminectomy in order to remove the leg and the nerves at their origin on the spinal cord. It was such a cool surgery, they even let me use the cautery to transect the muscles of the hind leg! Dexter actually did really well after surgery. He recovered like a champ and was running around on his three little legs like nothing ever happened. It was awesome.

Not everything is so happy about oncology though. Not surprising. Molly is this sweet cat with these owners that are just the nicest people. She came in to start a new protocol to treat her GI lymphoma and hemangiosarcomma (very rare in kitties). We did an ultrasound before treatment and unfortunately found that her hemangiosarcomma grew despite the treatment we had been doing. Since HSAs are such resistant tumors we decided that it would not be in the best interest of the cat. We had to tell the owners that it was now about end of life care and providing a good quality of life while we can. It was so sad, the wife was crying and the husband was being so supportive. You could tell that he was trying to keep it together for her. It broke my heart.

There wasn't much time to be sad though because I had to wrastle Marmaduke, an ill-behaved Great Dane. It was like trying to wrestle a foal. Litterally. He was huge. We had to give him medetomidine before we could give him his chemo.

Next week should be busy since we have to fit five days of appointments into four. Stupid labor day. I still have to go in on Monday to take care of Bart, the amazing peeing wonder dog.

Some neat pictures of cases

So I realize that I've been very lax in posting pictures with my blogs so I'm making it up for it now with pics of some of the cases I've talked about.

This is Speedy. He's one of the resident gopher tortoises in the zoo med department. He had a broken ulna so we made a makeshift sling for him out of duct tape. He was not very happy about it!





The next few pictures are of Buddy, the dachsund who I wrote about earlier (under the post "Buddy's Story". The most recent news with Buddy is that he's home doing very well with very grateful owners!
This is the chop job that buddy had done by the emergency vet. You can already tell that there is something nasty going on with that skin.






The picture to the left was taken intraoperatively (duh). You can see we're holding back the liver and oh, whats that? Oh yeah, thats a rib in the abdomen. Not good.







Here is Buddy after the surgery. He had so many tubes coming out of him for a few days. He basically just stayed like this for 3 days. It was heartbreaking.








This is after we removed the vacuum bandage. Look at the beautiful granulation tissue!









And then this is Buddy a couple of days after we removed the vacuum bandage. Look at him standing all on his own!!





And now for my favorite picture yet! A pic of me doing CPR on a foal. I was such a rockstar!

I ate a chocolate bar today . . . a big one

It is 9:15 pm on day 3 of SA surgery. I am tired, drained, excited and want to cry all at the same time. We received patients yesterday. I saw a hypercalcemic cat who probably doesn't have a parathyroid tumor. Which sucks. I kinda wanted to see one cut out. We're still not sure what we're going to do with it. Then I saw Checker who has blocked at least 10 times and needed a perineal urethrostomy. The owner of this cat is crazy. She puts regular crazy cat ladies to shame. She has a ziplock back filled with her cat's shaved hair from 3 years ago in the cat's binder. She tape recorded herself talking to be played when the cat is in wards. She feeds a mixture of 6 different natural cat food brands. We did the surgery yesterday (after the random blackout that completely screwed up our day). After which I had ICU duty until midnight.

So today I ran on 4 hours of sleep. But to make up for it I got to scrub in on a coxofemoral disarticulation on a leopard that had chewed its foot off after getting caught in a wire. It was amazing. I was so lucky to get to work on that case. I was on fire too. I was able to identify everything that Dr. Black pointed out to me. I asked intelligent questions. I even made people laugh. Although, apparently my suture cutting technique needs some help. I also got to watch part of a PDA surgery. I saw a live heart beating on the table in front of me. It was amazing. I almost wanted to cry. But I got to do that later.

The crazy cat lady made me cry. She insisted on spending time with her cat in the wards. On her 2nd (yes, second) visit I told her she only had 15 minutes because I had a lot of work to do. After 20 minutes and several warnings she threw a fit and accused me of not caring for her cat properly. It was a scene. Luckily Jim witnessed the whole thing and said I did everything right. The lady even flipped out at Dr. Lemming later. Dr. Black will be doing all of the communication with that case from now on. I cried though. I think it was mostly from exhaustion and hating confrontation. I know she's crazy and its not my fault. I just couldn't deal with it at that moment.

So that explains the chocolate bar. It was necessary. Everyone agreed. Even Checker.

Adventures in surgery day 1

I started small animal surgery today. I thought I was going to cry the entire morning. I was supposed to be on orthopedics but then Dr. Emmett threw me a curve ball and switched me to soft tissue instead. Which meant I had to do a neuter today. And I hadn't reviewed anything. I don't know how I did it but I muddled through. I was even semi-confident. I had no idea where anything was all day, didn't know what to put in the clinicians orders, had no idea how to write an operative report, and was completely afraid that Dr. Lemming was going to eat my face off. And yet, despite all of that, I still managed to kick a little ass in rounds. Or at least kick more ass than those around me. This is going to be a hard one. But I think I'll be able to manage.

Just when I got used to how things worked in zoo med they take it all away and toss me head first into surgery. I just hope I don't kill anything these next two weeks.