Veterinary Assistant Externship: Day 2

Also titled: A Hard Lesson

I was a little less excited for my second day of the externship - not for any real professional reason - simply because I had a friend over from out-of-town and was fairly tired from a strenuous week. I wasn't really looking forward to coming home mid-afternoon, neck and head achy, back sore, feet throbbing. But, because I'm stoic like that, I pulled on my scrubs and got my tush down to the clinic like a good little student.

The morning was different, mostly because it was me and D, the front-desk/vet-tech guy. I got to stocking syringes and wiping down counters, taking down the chairs and setting out the trash bins... and then felt promptly useless. As I cleaned in the back, George the Bulldog (one of our boarders for the day) started barking incessantly. D came in the back and said, "that's it, you're going to iso." Promptly the barking quieted after George was placed in isolation. His companion, Gracie, was unfazed, and looked plainly bored. Much of the morning was spend hosing dog poo off the kennel mats, and sanitizing them for the next occupants.

Eventually folks came in, and I started real hands on work with restraint. First was a little puppy who had really thick skin, and it took a couple of us a few tries to finally get him the fluids he needed. He was a tough little guy, but it was a painful process, and it took a fair bit to keep him still when he couldn't take it anymore. Lesson learned: tiny dogs are difficult to restrain - their heads are really small and will slip right through your headlock if they squirm too much.

A couple of cats needed restraint too. Bloodwork, vaccines... mostly bloodwork. One poor kitty was on chemo. She was thin as a rake and fragile... but she was friendly and very patient with us. Given that she was dehydrated, it was hard to find her veins. But of all the poking from the techs, she didn't fight me. She protested in kind of a quiet, displeased "murrrr!", but no claws, no biting. Can't say the same for all the cats who came in that day. Fortunately nobody got hurt.

I ran my first UA on my own, although I got a second opinion from one of the other techs because... no way could the test be THAT positive for blood in the urine. Sure enough, um, yes there was. Hey, doc!

Got my first look as a UA under the slide. Normally T does that, he knows what he's looking for. But I asked if I could take a peek and he let me. I kept things clean, cleaned things that needed it, tossed used paper towels and soiled linens in the proper recepticle.

And then he came in.

He had an appointment, but he came in early. Apparently this patient - a large German Shepard - had bit his owner four days prior because he wasn't feeling well. Sent the man to the hospital with stitches. Looked like a badly-done ear-piercing. He "just ran out of gas", according to his owner, who brought him in with a few family members, all large and imposing men who had trouble fitting through our narrow hallway.

The owner was an unkempt fellow, and the dog wasn't exactly groomed. I imagined this was a yard dog that was never properly trained out of his aggression, probably in a less affluent area, and given that he was obviously unneutered and had several skin conditions, well... I can't judge people for how they choose to care for their animals, I suppose. It's not my place, unless it's cruelty or abuse or true neglect. But there's a part of me that pities the animal for having been taken up by someone who probably never thought to bathe them, much less take them in for a teeth cleaning or proper vaccination. But right then, as we brought the dog in on a stretcher - to weak to move at all - all the focus was on helping the dog, no matter how he got there.

A number of patients came in during that time. We tried to deal with them speedily, to get them taken care of without a terrible wait, but inevitably some people had to wait longer than they should have. One poor kitty was an "unsociable" lass who'd never been to the vet before. You'd never have guessed: she was as placid and well-behaved as any vet could ask for. Lots of teeth problems came in. Tartar, calculus, infections.

Hey - go get your pet's teeth cleaned. WORTH IT. Those little "dental snacks"? Yeah, not gonna cut it.

We finally managed to get through the majority of the other patients so we could focus everyone on the emergency. Muzzled for safety, he was ferried into the x-ray room by T and I. Not that a muzzle was really necessary... the dog couldn't even manage his bodily functions. T then took the opportunity to teach me even as he utilized my free pair of hands: we took two x-rays, one of the lateral recumbancy, one of dorsal-ventral. We needed to see what was wrong in that dog's abdomen. So, T - who is slightly smaller than I - and myself... we were tasked with wrangling this obviously-suffering dog who was about our own individual weights into a position for the x-rays. We did so as best we could, wearing our latex gloves... there was so much bile, and there were traces of vomit on the front foreleg. As we attempted to x-ray him, he started losing control of his bowels. Poor T nearly retched, but I didn't have the heart in me to react. I couldn't. How cruel would I be if I reacted to this animal's plight with revulsion? I didn't fault anyone else for avoiding contact and commenting on the smell. But I couldn't bring myself to do anything other than help as best I could.

T went back and forth, developing the film, getting a second opinion, taking more x-rays because the last ones weren't clear enough, getting cleanser, throwing away soiled towels, reading the chart, leaving, coming back, leaving, coming back. He was busy on his feet, and quick in knowing what needed doing next. I, however, was tasked with staying with the dog. Lesson learned: never leave an animal unattended on the exam table, as it may flail or fall and hurt itself.

Hours went by. I had to have spent two hours with my hand on the dog's head, stroking him gently, talking to him as soothingly as I could. At one point I knelt down to be eye-level, and looked into the big liquid-brown eyes. They were filled with pain. It was like looking into a cup or a jar that was filled to the brim with suffering. It was terrible. "Live," I told him quietly, "if you can. But if you need to, let go."

After about two and a half hours of me working with this terribly sick dog, the vet came into the x-ray room. He palpated and probed the abdomen. The dog barely moved. The vet's face was a mask of concentration. I just just begin to hold the front paws on one hand, an exposed ear in the other, trying to warm them. I told the vet his ears and paws were going cold, and his already labored breathing had gotten faster. The vet looked grim, and walked out, saying nothing. I was alone again. Ten minutes later, T came in again. "Did he say anything?" he asked. No, I told him. T nodded, said he'd be right back, and left again.

I'd felt it when the animal had come in. I didn't think he was going to make it. I'd hoped otherwise. But now...? Now I was pretty sure. There wasn't anymore time for this dog.

T came back, we gently hoisted him back onto the stretcher, and took him into the exam room to be with his owner. Just two of them now, the owner and another man, both big imposing fellows. The owner welcomed the dog back in, and murmured something about getting him help. A part of me sank. He believed he was going to make it. But I dare not say ANYTHING.

Time passed. I cleaned up as much as I could, sterilizing the holy bajeezus out of the x-ray table with bleach and isopropyl. I was a little dazed. Cleaning helped. As I was starting to feel better, I was helping B in the kennel... the companion of the dog's owner opened the door to the kennel area. You know, that back door in a veterinary exam room you're not supposed to go into. He poked his head in. "Excuse me," he said, disoriented, "we need help. The dog..." He stepped aside as B went in. I caught a glimpse of the owner, his face contorted in agony. In a voice I've had nightmares about, he said, "he's dying!" I looked at the dog, still on the stretcher on the floor, his muzzle off... and his jaw almost feverishly gulping at the air, his lungs fighting to breathe.

The dog did die. I did not witness it. But it could not have been any more ugly than it already had been. The suffering and agony hat animal suffered would finally be over, but from our side of the veil, it would look only like the suffering had frozen in place, transfixed upon the creature's body.

Animal Control was notified. They wanted the animal for rabies testing and incineration, since he'd bitten a human recently. Normally, said B, they go into the freezer right away for disposal. But we couldn't freeze it: Animal Control neede the brain intact and unfrozen.

And so, for the next two hours, the dog lay dead in the exam room.

At cleanup time, I swept around him. His sad form lay limp on the stretcher. His eyes were open, glazed. Why didn't they close his eyes? I will never know.

At closing Animal Control finally came. Unceremoniously he was bagged in two large black trash bags, and carried out to the Animal Control Vehicle. I didn't go with them. I stayed behind to mop the blood and urine and feces and bile from the floor with heavy amounts of bleach. It's not glorious work, and it occasionally thankless. It's dirty work. It has to be. Someone has to do it.

I washed my hands and arms (I'd gotten a fair amount of bodily fluids on myself as I held the dying dog), walked Gracie and George, gathered up the trash full of soiled paper towels and used latex gloves, washed down the counters, sanitized everything, and mopped all the floors. Sweating and achy, but not as bad as the prior week, I went home. A hot shower, a bottle of cold water, and hugs, followed by an afternoon of friends and Warcraft... I was feeling a little better. I could still smell him on occasion. Fiancé told me it was a hallucinated scent. I don't know.

Hard day, but a good one.

Hard lesson learned: I can't save all of them. But I can make it easier on them. And just because I can't save all of them, doesn't mean I can't save any.