Well, okay, it was yesterday really, but since I work 13 hour shifts and couldn’t even conceive of what a computer was let alone how to work one when I got home from work yesterday I’m writing this today. Give me a break for the sake of literary artistry. This is ranting, not reality.
Anastasia has a common malady of young girls, one I am happy to encourage and nurture, called “Iwannabeavetitis”. This leads her to have some, at times disconcerting, hero worship of me, and makes her absolutely passionate about her computer game where she gets to run her own veterinary clinic. I have to give my props to whoever wrote the game since I’m convinced they’re in the field or closely connected to someone who is. Anastasia deals on a daily basis with some of the same weird shit at her computer clinic that I deal with at my everyday clinic. Things like having lunatic staff, a weird homeless guy that comes in a mooches coffee and blankets (although unlike my hospital, Anastasia eventually ended up employing her weird homeless guy), and clients that complain and whine a lot. Anastasia LOVES this game.
But the watered down computer version isn’t anywhere near the lunacy of the real thing and there are days that I want to tell her that, for her own sake, she should just forget it and go and develop her artistic skills so che can be a graphic designer or something where she doesn’t have to interact with the general public.
I’ll set the stage for yesterday. I either didn’t set my alarm on Saturday night or didn’t hear it on Sunday morning so I woke up 40 minutes later than I should have and ended up doing my morning routine in fast forward (which led to me trying to slice the tip off of my left thumb with a bread knife).
I actually ended up at work only a few minutes late and swung into the routine of getting patient rounds from the night doctor, checking all the ICU patients and seeing incoming patients. A routine, if busy, morning.
I had spent almost 3 hours on Saturday mucking around inside a Golden Retriever’s abdomen. It started as a fairly routine foreign body removal. She chewed up and ate, God knows why, lava rock from her back yard and her stomach was impacted with this semi-pulverized gravel. I opened her abdomen, knowing what it was that I was looking for and happened, just in passing, to find that she also had a biggish mass on her spleen. Crap, crap, and double crap.
I had someone call the owners for permission to remove her spleen while I was removing her rocks. Permission granted, spleen, God help me, removed. I HATE splenectomies.
I spent another (ergh!) HOUR digging around inside her stomach pulling out bits of lava rock, plastic, grass, and other unidentifiable goo. I flushed a couple of liters of saline through her stomach, took one last feel and was confident that I had removed everything, then I closed her the hell up and went home.
Sunday morning she wasn’t looking as well as I would have liked. Still a little dumpy, not eating yet, just not recovering as fast as I would hope. This isn’t unusual, I always want my patients to be up and bouncing the next day and they only infrequently are. So I wasn’t terribly concerned except that she was also having some discharge from her incision. Also completely explainable, probably not something to worry about, but since I wasn’t convinced that I’d not dropped a few fragments of lava rock out of her stomach and into her abdomen I was worried. Welcome to the paranoia of the surgeon. Convinced that she was developing peritonitis from having pebbles roaming around amongst her intestines, I had my assistant take an x-ray of her abdomen. The dog wasn’t developing peritonitis, I’d left some of the bloody rocks in her stomach.
Well the owners came to visit and I showed them the x-rays and discussed the next options. We decided that we’d wait to see if these relatively small pieces would pass and then if they didn’t we’d pursue endoscopic retrieval. They were completely cool about it, I was amazed. And pleased, and relieved. And I started feeding the dog large volumes of cat hairball lubricant in the hopes that we could slip the rocks through.
Then crazy IRS lady showed up. Crazy IRS lady is a sometime client that we haven’t seen since about 2003. She was coming in with her cat who she insisted had been attacked by a raccoon. I don’t usually bother arguing with people about why their cat is much more likely to have been fighting with another cat or have been hit by a car than been attacked by a raccoon. I know that when cats and raccoons get into it there’s usually not much cat left at the end, but if the owners want to believe that it’s marauding wildlife rather than their neighbor’s 16 year old behind the wheel of his new SUV, I don’t really want to take the time correcting their impressions.
Sensitive readers may want to skip the next bits.
The cat was basically intact except for his left rear leg. A large degloving (peeled the skin and soft tissue off of the bone) wound over the top of his foot had not only torn tendons and muscles, but had dislocated all of his toes. The bones of the foot were pulverized, his ankle was fractured, the tibia was fractured and I can’t prove that the femur wasn’t fractured. Dirt, grit, and plant material were ground into the open wounds, it was gruesome. And it was beyond repair.
I started my spiel about how the leg should be amputated to save the cat’s life and crazy IRS lady came unglued. “I do NOT want to amputate this cat’s leg!” I spoke soothingly about how well most three legged cats do, explained again about the severity of the injuries, discussed the fact that not only were there fractures the wounds were hideously contaminated, the soft tissue was unsalvagable etc. etc. etc.
“Well I want to have his leg fixed!” she replied. I told her that the leg most likely could not be fixed, that the best surgeon in the world wasn’t going to be able to put everything back together without the cat losing his foot at the very least. That at a conservative estimate, attempting to repair the leg would cost in the range of $5000 and he’d probably end up losing the leg even if they did spend all that money.
This is where things started to get surreal.
“Well can’t he just live with four legs?”
Um, didn’t I just finish telling you that he can’t?
“I want a second opinion!”
I offered to have the other on duty doctor step in and evaluate the cat.
“I want Dr. Regular DVM to see him! Call Dr. Regular DVM!”
I explained that it was Sunday and that Dr. Regular wouldn’t answer the phone.
“Well just call her! Can’t you just (emphasis on the next word) call her?”
I explained that Dr. Regular’s office was closed and that I didn’t have Dr. Regular’s home phone number.
“I’ll just take him home then!”
And that was that. I can’t force treatment when an owner refuses, so we gave the cat a whopping slug of morphine, flushed his wounds as much as was possible, pulled some of the bigger pieces of grit out from between the bones of his foot, bandaged his leg up and sent him home with antibiotics. Crazy IRS lady claimed she’d take the cat to Dr. Regular this morning.
Now the (only) nice thing about this is that our local Animal Control Officer, Pam, is a wonderful woman. I called Pam once crazy IRS lady left, gave her the details of the case and the owner’s contact information. Usually when I report abuse/neglect cases like this Pam, ever diplomatic, will contact the owner with the excuse that “a concerned neighbor” has reported their pet’s condition. I told Pam that in this case I’d be happy if she told crazy IRS lady that I was the one who had reported her.
My technician, who was livid at the idea of this cat going home in that condition, is calling Dr. Regular’s office this morning to see if crazy IRS lady has an appointment to have the cat seen. If she doesn’t, Pam will be contacted and will go over to her house to open a can of whoopass. I love Pam. She is first and foremost an advocate for the animals and she isn’t shy about expressing her opinions when animals are being mistreated. You do NOT want Pam mad at you.
Cans of whoopass notwithstanding, the whole experience, dog, rocks, cat, crazy IRS lady and all, is enough to make me want to go and become a nun. Although considering my verbal response to the bread knife in my thumb, I’m not sure the Catholics would take me. I wonder if the Church of The Flying Spaghetti Monster has nuns.