Last summer, we had a rising third year vet student work at the clinic for a couple of months. She decided to enter clinics early and chose to schedule an externship for two weeks at our hospital during this time. Those two weeks ended on Friday. As she was leaving, I wished her well with the rest of clinics, and we got to talking about what it’s like just starting them, how you have no idea what you’re doing, no familiarity with the software, no clue what to write in discharges for an owner and maybe half a sense of how to write a SOAP. The whole first couple of rotations in the small animal hospital can be entirely overwhelming. I definitely felt it on my second rotation, soft tissue surgery.
I did not choose to do early entry into clinics. I guess I felt like, even though I had no intention of ever working with large or food animals or going into equine medicine, I still wanted to learn more about them, if only for boards. (OK, I also love New Bolton Center and Kennett Square much more than I even like Philadelphia, so I welcomed the change of scenery for large animal block.) I figured small animal block could only give me more information to use in clinics/real life with some of the electives offered. (I don’t know that it proved true, but I hoped it would at the time.) I started clinics in early May, with the majority of my class. My first rotation was small animal pathology. At the time, I felt like it was a good way to ease into things: the patients were already dead, so there was really no way for me to royally screw up. It did absolutely nothing to prepare me for the mental hell that small animal soft tissue surgery would be.
Soft tissue surgery was my first rotation with live patients, patients requiring treatments, SOAPs and discharges. I took on my first patient on day 2. She was a Miniature Schnauzer that one of our interns spayed. The intern very much wanted control of the case, so I actually got very little practice with my aforementioned potential stressors. My second patient was admitted from clinics for a procedure the following day: a Shih tzu, I think, with a ureteral stone. The doctor in charge was one of the residents. I was on call that night, unfortunately for me.
I got called in less than an hour after I got to my friend’s apartment in the city. (I was staying there, since it was closer to the hospital than my home.) It was for a Cockapoo with a linear foreign body. As that procedure was finishing somewhere between 1 and 2 a.m., the ER called and had a cat with another possible foreign body that turned out to be an intestinal mass requiring resection. When pets go to surgery overnight, they recover in the ICU and need to be transferred to the regular fluid wards first thing in the morning. Surgery on the second patient finished around 5 a.m. I went back to my friend’s place to change and brush my teeth. I took a 10 minute power nap as well and ate some Pop Tarts while walking back to the hospital before 6 a.m.
I had about one hour to transfer two patients from the ICU, get treatments done for 4 patients and SOAPs written for all of them before meeting for rounds and transfers to the service from the ER at 7 a.m. I had no idea how to transfer a patient. There was no one to help me figure it out. This was my first morning of clinics having any patients at all, and suddenly, I was responsible for four of them. I failed miserably at getting everything done on time.
The patient with the ureteral stone was scheduled for a later in the day procedure. I remember, at lunch, sitting alone in a hallway, just wanting to cry because I was so tired. I think I called Justin at some point, and he tried his best to reassure me. During the surgery in the afternoon, the resident was using the surgical microscope, so I couldn’t actually see anything. At one point, she asked me to hold a hemostat that was clamped somewhere in the dog’s abdomen. All I remember is swaying slightly back and forth on my feet while holding that hemostat and telling myself that if I fell asleep right then and fell over, the resident would literally kill me. I left the hospital that evening sometime after 7 p.m.
I don’t remember what day it was, but after continuing to struggle to get everything finished by 7 a.m. for rounds and transfers, I went to drop off samples on the 4th floor to the clinical pathology lab. The resident associated with the ureteral stone dog followed me upstairs and without any introduction beforehand or suggestions for ways to improve afterwards, informed me that if I didn’t get better immediately, I would fail the rotation. Back downstairs and probably running behind again after that exchange, a nurse helping me with one of my patients stated that although she didn’t mind helping me this time, I really should be doing whatever task myself. I just started bawling right there in the patient’s kennel. Her expression immediately turned to, “Oh my God! What did I just do?!”
Somehow, I did end up passing the rotation, but I was beaten down, lacking all confidence and seriously wondering why I ever wanted to go to vet school in the first place because it could not possibly be worth it if I still had almost an entire year of rotations like soft tissue surgery ahead of me. Thankfully, my next rotation would be an externship at Cape Wildlife Center in Barnstable, MA, and it would give me back everything I had lost of myself during the preceding two weeks.
I called and asked the veterinarian at Cape Wildlife if I could possibly come a day later than I was scheduled to arrive, as I was on call my last night of soft tissue surgery. (I did indeed get called in that night.) I had no time to pack and needed to get an oil change for my car before driving to Massachusetts. He had no problem with that. When I got there, he was kind, patient, caring and laid back- everything that the soft tissue residents (one in particular) weren’t. The other students, a mix of pre-vet and vet students, were all wonderful. On our days off, we were free to explore Cape Cod, on our own or with whoever also happened to be off that day. (Also, it was June in New England, so the weather was perfect, which is always helpful for a wounded soul.) I felt mentored, heard, appreciated and learned how to treat and care for so many different species that I otherwise might never work with. It was everything I needed at that moment in my education.
I never had a repeat horrible rotation like soft tissue surgery. It was definitely my low point during 4th year. My misery-inducing resident graduated, and I believe, moved to the UK. Wherever she ended up, I hope for vet students everywhere that she’s no longer involved in training them, and I hope that every vet student has their Cape Wildlife-like experience to boost them up and confirm that they are definitely in the right field. I will always shudder a little, when recalling my two weeks on soft tissue surgery, and I will forever be grateful for the three and a half weeks I spend at Cape Wildlife.
“Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest act of caring, all of which have the potential to turn a life around.” ~Leo Buscaglia
