4 Years in Reflection

Clearly, I like lists I am a type A vet student. As the week of graduation quickly approaches, I wanted to reflect on the top 10 things that have happened to me over the past 4 years.

1. Traveled to China, Jackson Hole, Wyoming, Scotland and England, and Spokane, Washington.
   
2. Attended many veterinary conferences: North American Veterinary Conference, Merck Summer Scholars Conference at Michigan State, VBMA National Meeting, SAVMA Symposium at Ohio State, VVMA conference in Roanoke, VA.
3. Rescued my dog on a Humane Society RAVS trip.
4. Learned how to handle wild raptors, songbirds, and mammals.
5. Lived alone.
6. Lived in Blacksburg, VA, a special place indeed.
7. Became a crossfit junkie.
8. Discovered rock climbing and kayaking.
9. Created and developed lifelong friendships.
   
10. Became a Doctor of Veterinary Medicine.

There are countless other moments that occurred over the past 4 years that have changed my life and shaped who I am. I have become stronger and wiser, while remaining humble and ignorant of many things left to learn. I left a lifeless career to enter a bright, challenging career with the bills to prove it.

Thanks vet school. Thanks to all my friends for their endless support. Thanks to my amazing 3 cats and wonderful dog. Thanks to all my teachers. Thanks to myself for persevering and finding the strength to get through the 4 years. Lastly and most importantly, thanks to my husband. He never wavered when I wanted to quit and drive 500+ miles a week to support me. I cannot wait to support you on your journey of higher education.

This blog entry marks the end of life of a veterinary student. I hope to create a new blog entitled "Life of a Veterinary Intern." Thank you followers for making me a part of your journeys. You can always email me with questions or for inspiration. 7+ years in the making and I can tell you, anythign is possible if you are passionate and work hard enough.

Wildlife Center of VA

This rotation presented challenges and amazing learning opportunities, much like my last few blocks of vet school. I realized how much I have committed to memory about small animals and how little I know about birds, other mammals and wildlife management. After 3 weeks, however, I can collect blood from turtles, vultures, foxes, owls, raptors and songbirds. Today I collected blood from a painted turtle (super hard because you can’t see a vein) and a Turkey vulture both on the first attempt. I am now familiar with radiographs of these species as well. I learned how to identify baby birds, how to bandage broken wings, and when to try and when to euthanize wildlife based on injury. I absolutely loved the cultivated learning environment. Every single case was made into a learning experience by the staff in a hands-on fashion. Kudos to an excellent wildlife teaching hospital.

The first 10 days were extremely challenging, but I persevered and the reward has been invaluable. I am equipped to answer wildlife and exotics questions from my clients. I am no longer afraid of handling birds; in fact I love birds. This block in many ways was similar to my equine block. I went in fearful and apprehensive and left loving it. However, wildlife medicine has its downsides. Many animals cannot be released and are euthanized and many days it feels like you kill more than treat. On the upside to that, for many animals you stop their suffering and there is no client or financial decisions to interfere with the medicine.

The past 3 weeks have again confirmed that I love emergency and critical care; it's where my passion lies. I watched a blockmate who truly is passionate about wildlife and realized that is exactly how I feel about emergency. I am so thankful I had the chance to explore different areas of vet med over the past 4 years: Research, government work, lab animal medicine, wildlife medicine, organized veterinary medicine and many others. It is ironic that all of my exploration led me back to emergency medicine. We'll see how much I still love it after the next year of hard hours. I am ready...bring it on!

Block 16 into Block 17

Spring fever has arrived and graduation fever arrived with it. My locker is cleaned out. My coveralls, surgical gowns, extra scrubs, old stethoscope sold to other students. Received my internship schedule today for the next 12+ months. Only 1 more rotation left between Class of 2011 and graduation day. That day we thought was impossible, that now is going to happen. I have been reflecting on how much I have grown through this process and how excited about my new career I am.

My last rotation at the teaching hospital has been more fun than I ever expected. My week on equine field services included going to Mill Mountain Zoo to help work on a 15 year old snow leopard with chronic vomiting. I jumped in and drew blood, ultrasounded his abdomen and learned once again that a regular vet can do zoo work on the side. The vet was humble, nice and applied his small animal knowledge to the leopard. I felt comfortable ultrasounding him and with his work up and thought to myself, "I could do this." It was a great trip and I learned they make portable endoscopes...so fun.

I have truly enjoyed working with horses. WHile I still don't know the lingo or how to lunge a horse, I do know a nice horse when I meet one and totally understand why they are deemed amazing creatures. I hope to have some trail/pleasure horses one day and definitely want to learn how to basic ride.

Meanwhile, I can count my days left in the Burg on 1 hand, but they are fun days. Saturday is 3.2 mile for 32 run in remembrance, a run I have done every year while I was here. Saturday is also Spokane's last agility lesson. Then it is off to Northern VA for a day to unpack the house and transport the cats for the final time. When I return to Blacksburg it will be graduation week, time to celebrate, canoe and camp with friends and get ready for a new chapter.

37 Days

I am currently on the last senior rotation I will have at the veterinary teaching hospital at VT and I cannot believe it. In some ways I feel ready, in some ways I don't want to leave. It has been one busy block on large animal services, but I absolutely love horses. They are amazing, and I am no longer afraid. I have been blessed with some really great patients to work with, including a baby camel and her mom, who was thankfully nice as far as camel mom's go. I barely had a weekend last week, but as for my last few weeks in Blacksburg I cannot complain. The cases have been rewarding and I have learned a lot. I am more comfortable than I ever imagined I would be and I hope to learn more about horses as a hobby in the future. Lameness is so much more exciting when it is happening in a horse and not in a lecture.

Today I got to experience some alternative medicine therapies applied to chronic back pain; tomorrow I will massage my horse with a human electric massager! While I am nervous that I have been out of the small animal realm for a while before starting my internship, it will be a long time before I get to do this again and it's fun. I realize more each day that life really is the journey and not the destination, although reaching your destination is extremely fulfilling it's the journey that makes it that way.

9 more days of horses than off to work with wildlife. I cannot believe that my life as a veterinary student is coming to a close.

Only 2 Rotations Left!

I have mentioned it before in recent postings, but I cannot tell you how odd it is to be happy and sad at the same time with a dash of disbelief on top. I can vividly remember second year feeling as if becoming a veterinarian was a path with an unattainable destination. Well the destination is heading toward me very quickly.

Recently on lab services, I have had time to do some activites with my 2 year old dog, Spokane. We are in the midst of grasping the sport of fly ball, starting the trail running season, and this weekend started agility lessons, with an amazing trainer in a beautiful Blacksburg setting. Of course as these activities start becoming rewarding for myself and my dog, they will need to wind down soon. While they can be continued when I return to Northern VA/Washington DC area, they will be more expensive, hectic to travel to, and impersonal. I am so grateful to everything this town has given me these 4 years, so here is a list for those Type-A's out there:

Blacksburg Greats:

1. Blue Ridge Parkway proximity- a vista, mountain, trail, friendly face at every mile
   
2. Pandapas Pond- best place on earth for biking and trail running
3. Virginia Tech's spirit- 3.2 for 32, VT football, VT vs Duke basketball, etc
4. Crossfit Blacksburg
5. Akke's Yoga Place & In-balance Yoga- Akke you kept me level-headed years 2&3
   
6. Blacksburg Farmer's Market-always seeing a friendly face and acquiring local goods
   
7. Nellie's Cave Park and all my neighbors- the unofficial offleash dog area
   
8. The lack of chain restaurants and quality of the independent restaurants-Gillie's, Souvlaki, Cellar, Cabo, Easy Chair, Bogens, Sal's, Sake House, Bangkok Bistro, Lefty's, Daily Bread
   
9. Roanoke Non-Ultra Trail Series & Roanoke's charm
   
10. The mountains all around at the end of hard day.

When I think of vet school, I think of the fun and my lifelong friendships that have developed and the sense of community I have never experienced before. I have tuned out the bad because at the end of this experience what remains is an appreciative, stronger (mentally and physically thx X-Fit), smarter, more confident, person, with a sense of self and better friends than I could have ever imagined. I will search the rest of my life to find those friends and community again; I wouldn't be at all surprised if in the end I return to Blacksburg.

There is a tension that develops inside all of us when facing a transitional period between what you are leaving behind and what lies ahead. I have chosen to embrace and feel that tension and it has helped face the reality that this crazy chapter of my life that has been so hard and so rewarding is coming to a close. I decided this week that I wanted to commemorate this time with a class ring, something I never thought or wanted to purchase before.

On a completely separate note, I enjoyed necropsy much better this week. I diagnosed Yew toxicity in a dog that died a sudden death and saw some other cool cases. I love histopathology (the microscopic aspect) and I may be coming around to gross pathology; however, I know for sure I do not want to be a pathologist when I grow up.

This week will involve more free time than I know what to do with. Time to pack, get organized and play wtih SPokane. Next block is primary care land of no life and horses, horses, horses.

Only 3 rotations left...Lab Services Finally Arrives

Anesthesia was an absolutely busy and amazing block. One of my favorites and 3 weeks where I learned an exponential amount of material and gained amazing clinical experience. It was also my last small animal clinical block.

So here I am 2 days into laboratory services, the "vacation rotation." It has been exhausting due to an extremely high caseload of large animal necropsies. The last 2 days I have left after 5 PM, smelly, dirty and tired with homework to do and a dog to play with. I truly hope the caseload lightens up, I feel beaten down and too tired to be a good mom to Spokane and make time for exercise.

In the morning it is crash review of previous material from bacteriology, virology, toxicology, parasitology and clinical pathology. The -ologies coming back from the dead. What I remember amazes me, what I forgot depresses me. But reviewing the material is helpful and so far the instructors have made it fun.

In the afternoon, it's time to play Dexter. Each day we have had 1 horse and 1 cow, and because we do not have an incinerator cutting up the animals for disposal along with the odor are the worst parts. You get pretty messy (#1 dirtiest job ever) and it is physically taxing. I, for one, need knife use 101. I truly hope that Spokane's energy level decreases slightly and that we don't have this level of cases for the rest of the block. In the past few months, I have heard my classmates complain about no necropsy cases today; well I want that complaint.

While I enjoyed pathology classes in years 1 & 2, this rotation made it clear to me that becoming a pathologist is not my gig. Even clinical pathology, which I do love, is not something I would want to do exclusively. Slides are fun, but patients and critical care is much more fun. I keep reflecting on how open my mind was 3 years ago. While I feel a tad guilty to not be as open-minded as I once was, I feel good that I know where my strongest interests lie. It took a long time and a lot of exploration to get to this point. For that reason I beg, please no more horses to cut into pieces please.

Will the Real Vet School Please Stand Up?

Before the start of 4th year, the clinical year of vet school at Virginia-Maryland, I heard horror stories of never sleeping, the pager going off in the middle of the night, etc. While I have had a few days or a week here and there of being stuck at the hospital and away from my bed and family, in reality it hasn't been too bad. There were maybe 3-4 nights where I was at school dealing with critical patients or emergency duty until the wee hours of the morning, 1-2 AM at worst. However, this week, the true vet school "horror story" reared its ugly head.

I was on call for anesthesia and due to an 8-hour shunt surgery case earlier in the day, the rest of the surgical cases were late into the OR for the rest of the day. My assigned case rolled into the operating room around 4PM, and for reasons that will go unmentioned, finished at 8:45 PM. The recovery went well, and I headed home for a bowl of cereal and some zzz's. Around 1:36 AM my cell phone rang. A colic (the second of my anesthesia rotation) needs to go to surgery. Luckily, or not, I was sent home around 4 AM to sleep for 2 hours until morning rounds, with the hope I would compete my case for the next day and be released home to finish my sleep.

Murphy's law continued to be in effect that day. We rolled the kitty into the MRI only to find the special MRI-compatible, recently serviced anesthesia machine was leaking some Isoflourane gas. Awesome. 2 hours later the MRI scan began. I was sent home promptly after the case was completed, however, I never got a lunch break and actually got home at 4PM, not very early after all.

On the bright side, I survived and performed better than I thought possible on only two 2 hour sessions of sleep. In fact, I was proud of myself for making it through, despite feeling like a cloud of bad luck was over my head for 36 hours. In addition, I still absolutely love my anesthesia rotation. I am extremely excited to be off the entire weekend. I have found it amazing that while the hospital has seen 4 colics in the past year, 2 have occurred when I am on call in the past 2 weeks. Dropping a horse is exciting, it's just not where I see my career headed, especially when I know first-hand now that colics really do occur in the middle of the night. But if life has taught me anything, it is that you never know where it will take you.

Special Guest Post by Veterinary Technician Tina Marconi

3 Reasons Why Veterinarians Should Honor Thy Veterinarian Technician

Anyone with even the minimal knowledge of the medical field knows that saving lives and curing illnesses is a team effort – no one doctor or other health care professional is able to handle everything by themselves. It’s the same in a veterinary practice – no one can operate a one-man show unless they want to end up becoming overworked and unable to handle their cases with the required care and efficiency. This is why assistants and technicians are hired – to help out with a veterinarian’s practice, and just as nurses are important to the scheme of things in a people hospital, so too are veterinarian techs extremely important in the world of animal care.

Veterinarian’s who think they know it all and so abuse their techs and assistants or treat them badly should remember that unless they respect those who work for them:

· Their practice could go downhill: Veterinarians who don’t respect their assistants and techs could end up losing their services; no one wants to work for employers who don’t treat them well. And when the word gets around that the veterinarian in question can’t hold on to an assistant or technician, his/her practice begins to go downhill because no one wants to work with them. Overworked veterinarians are not effective, they soon start making mistakes, and they end up losing their clients because they are perceived as not being proficient at their job.

· They could lose regular customers: Veterinarian techs are not just responsible for assisting the veterinarian in all his/her tasks; they’re also the ones who liaise with clients, set up appointments and follow-up visits, and provide aftercare for animals that have undergone surgeries or which require hospitalization. So when a veterinarian does not respect his/her veterinarian tech, their unhappiness and dissatisfaction spills over to the client and patients, and soon enough, the regular ones too start looking for other veterinary practices to handle their pets.

· They tend to show the same attitude toward the animals they care for: Veterinarians are perceived to be kind and gentle people, simply because they’ve chosen to work with animals, creatures that cannot talk and must be handled with love and kindness. But if a veterinarian is abusive towards or does not respect the people who work for him/her, it stands to reason that they’re not going to adopt the right attitude when providing care for animals. They could be skilled and well-trained, but the clinical approach does not work well on animals that can sense hostility from a mile away. Veterinarians who are warm human beings make the best kind of animal doctors, and those who fail to respect their veterinarian techs and assistants may as well shut down their practice and find another occupation.

This guest post is contributed by Tina Marconi, she writes on the topic of online veterinarian tech programs . She welcomes your comments at her email id: tinamarconi85[@]gmail[.]com.

Let the Bittersweet Feelings Begin

My anesthesia rotation has started off great! It has been really fun and an excellent learning experience. It is one block I felt adequately prepared for from the previous years and rounds are pertinent and helpful. We receive a lot of hands-on experience too, no resident in our way. For each patient we devise anesthetic drug protocols and as long as we can justify why, we can experiment (safely) with new drugs and ways to use them.

I performed my first successful epidural on a live patient Friday and it was very rewarding. I used multimodal pain management for a jaw fracture and the patient's plane of anesthesia was very stable. It was amazing to see how effective multimodal pain control can be. Many people think anesthetic gas=pain control, but it doesn't. Better pain management before, after and during surgery decreases anesthetic complications, the amount of gas needed to keep the patient in a good surgical anesthetic plane, and aids in recovery. Anyway, I have been learning a tremendous amount and loving it. The aspects I like are very applicable to critical care medicine and are making me more curious about a residency in critical care. I feel like I am starting a new career exploration journey in that respect.

As I sat in the small animal OR monitoring anesthesia last week, however, I had a moment when I realized I only had 2 more weeks in the small animal hospital. A wave of sentimental feeling and sadness came over me. In fact, as I spend some of my last days with good friends, I find that this feeling of sentiment for Blacksburg, vet school, vet school relationships and all the nuances of the teaching hospital is very strong. I am doing my best to savor the great things I have experienced the past 4 years. It will be hard to leave. I really have despite the long distance marriage and all the obstacles of vet school, loved my four years. I would not want to repeat it, but it was an amazing life changing experience. I cannot imagine having to go through all that I endured in any other town than Blacksburg.

At the same time, when I think of graduation weekend, I become giddy like a school girl. It is hard not to be proud and happy at the accomplishment of a DVM. Transitions are difficult for me, even with a strong plan in place. I hope that taking the time to savour the next 82 days will help make the transition back to life in Washington, DC a little bit easier.

Murmurs and Protocols

My Cardiology/Dermatology rotation quickly became one of my favorites. My ECG reading ability improved, skin allergy understanding and diagnostic skills developed, andcardiac auscultation aural memory expanded. I was sad for the rotation to end.

Luckily, the first few days of anesthesia have been amazing. I really needed a refresher of the drugs, practice making my own sedation and pain management protocols, and clinically watching these drugs in action. The department personnel is amazing, with great energy, advice, and patience. No ICU duty is an added bonus to my enjoyment. I am assured I will learn an exponential amount this rotation and I am pretty excited about it in a nerdy way. Brand new protocols abound with Fentanyl CRI's with lidocaine, combining propofol with ketamine for induction, learning about new opioids, it's all fun and games!

Having anesthesia directly after cardiology and medicine rotations has made me realize why I love critical care and emergency medicine so much. It has made me question whether I will do a residency or not after my internship. I still stand by my position to practice for a few years before re-entering academia, but I am beginning to wonder whether further specialization is inevitable for me. One of the anesthesiologists believes it is. She told me to email her in 1-2 years letting her know I am pursuing a residency and she said it with such conviction I believed her.

Let the anesthesia fun continue. Life is good.

96 days Left and Life Post-Vet School is coming together.

Today is February 7, 2011. A long awaited day in the veterinary profession for those awaiting placement in the internship and residency match program; for those in the know, today is "Match Day."

It is hard to believe I started as a kennel assistant at the Hope Center, a state of the art referral center and will be returning as a veterinarian. I could not be more excited to spend my first year as a doctor learning from some of the best doctors and working with amazing technicians!

Only 96 days remain before graduation. My remaining rotations include: anesthesia, equine services, and lab services and an external block at the Wildlife Center of VA. I feel I have made many strides as a senior student when I look back on the first few rotations, but I still have a lot to learn. Because transition periods can be hard for me, I am trying to reminisce as well as think of the future. It is easy to like vet school in retrospect, but it is also hard to forget the sheer exhaustion and stress that came with the ride.

I am only beginning to comprehend the reality that I set out 7 years ago to become a veterinarian and with boards and match day behind me that journey was a success. In addition, that journey was only the beginning of a long career of learning, helping animals, helping people, being frustrated and exhausted, fulfilled, and longing for boredom. Veterinary medicine is an amazing career, but it comes with a price. Balancing that price will be a challenge next year,but as I have learned the past 7 years, each difficult step forward prepares you for the next difficult step left to take.

I am so thankful to the clinicians that wrote my recommendations, were patient enough to teach me, and everyone who has believed in me. The experience came at the cost of a modest home, but truly has been priceless.

96 days left...

Small Animal Med Take 2: Better and more tiring than ever!

Confession: I love small animal medicine. Despite the intense work that a critical patient requires, so far every case I have seen continues improving. This is quite a change from the usual depressing outcomes I have experienced this year. It has also made this a very rewarding and exhausting 2 weeks.

Confession: I need a work-life balance; I need to exercise, I need to get 8 hours of sleep, and I need to have some time with my family and friends. All of these things make me a much better vet student and person. What is amazing to me is that I have found the right career. In finance, I couldn't wait to leave to have "a life." Now despite being tired, run down and wanting "a life" I willingly sacrifice these things to my detriment for the benefit of my patient and I don't mind. It does make me cranky without the other aspects of life trickled in.

I have learned a lot this block. I have learned new material, more about patient care and decision making for critical patients. I have continued to confirm that I heart critical care, the challenges, the heartache and the reward. The cherry on top was passing the NAVLE!

Becoming a vet has never felt more real. It will become more real in a few weeks when I find out if I got into a match internship program that will confirm where I will be working as a doctor. While I am looking forward to some less intense blocks, I couldn't have asked for more out of my second small animal medicine block. 1 week left then onto cardiology!