From Chattanooga, it's back home to Maryland.
Even after three years of living here, it still doesn't seem like we've been here all
that long. But, as of Mimosa 11, we've now published more issues of this fanzine
from Maryland than we managed to do in Tennessee. The following article is from Sheryl
Birkhead, who besides being the first friend we made after moving north, is also a fan
artist, fan writer, and... veterinarian.
Seeing Sharon Farber's account of the patient who managed to undo every therapeutic avenue known to man brought back memories of a patient I met while in fourth year veterinary school (small animal rotation.
Before I get to that, I think I ought to fill you in on some information. The veterinarian is a general specialist -- we are expected to be a surgeon, dermatologist, neurologist, and ***** (you name it). The specialties exist, just as in human medicine, but the 'normal' veterinary office does not employ specialists and many owners do not want to pay the specialist's fee. There are several other differences between veterinarians and RDs (real doctors), but education cost is not one of them. Also, our patients don't talk (which is a mixed blessing -- at least they can't talk back to us, either) and we are expected to deal with multiple species. The closest human physician to a veterinarian is probably the pediatrician, until you talk about equine practitioners -- the babies they deal with are just a bit larger than the human counterpart!
But back to Wolf...
On rotation, a group of seniors in veterinary school works through a specialty together. Each has his or her own cases, but they work as a group between rounds, treatments, and so on. In this respect, Wolf was not "my" case, but all seven of us on Small Animal Surgery together came to view him as a group project.
Big dogs are subject to a variety of hip problems and, depending on the size and age of the dog, may be treated in a variety of ways. Wolf was (as you may have already guessed) a wolf cross, the other parts being German Shepherd (or Alsatian, depending on your upbringing) and Husky. He weighed in at about 200 pounds. Luckily, he was truly a sweetie of the canine world, otherwise he'd have eaten most of us for lunch.
Wolf, at a mature 4½ years, had been diagnosed as having progressive degenerative disease in both hips. The veterinarian had referred him to our teaching hospital, realizing the treatment of choice (if the owners would go for it and the cost involved) would be to re-do hips by some method -- one at a time. Unfortunately, it turned out that his maturity and other factors dictated that one hip socket be destroyed (letting the body create a "false joint") and maybe the other one could undergo a replacement. Obviously we would only work with one hip at as time, trying to leave him with at least one good leg to stand on (no, don't blame me for that one -- the surgeon involved loved using it).
So, Wolf's right hip was, essentially, removed and he started long term physical therapy. Now, that sounds simple on paper -- but think about it. You have a BIG dog who can't walk, can't talk, and is in a lot of pain --- what do you do? The student who was assigned to Wolf's case, Elizabeth, had to work longer hours than the rest of us simply to stay even -- it meant cleaning up a lot of messes (remember, Wolf was a BIG dog!) and asking for a lot of help. Wolf had to be "walked" twice a day, which meant having the help of two or more students to roll towels under his rump and lift him -- helping with the rear, while he tried his best on the front end. Remember, I said we were lucky he had a good temperament; think how it must have felt to get all this rolling around -- without benefit of painkillers!
This went on for several weeks. Each of us helped in turn, depending on how heavy our own case loads were. The rotation was drawing to an end and Wolf was still with us. By now, he was developing pressure sores, despite turning (and we tried to rest his bad hip as much as possible). He was also really getting bored. He had learned how to drag himself around the cage area but he was so big that he would not fit into any of the cages, so he had a corner of the patient area marked off for his own -- which meant that as he learned how to get around, we all had to learn how to dodge portions of his anatomy as we worked with our own patients.
Elizabeth was at her wits end (luckily it was almost the end of the rotation and then Wolf would be someone else's worry...) because Wolf had begun chewing up anything not nailed down -- he was really bored! Anything -- blankets, foam pads, papers -- was fair game if it was within tooth/paw reach.
We'd go in and sit with him while writing cases, just to keep him company. We'd leave a radio on, have the ICU students drop over to see him on the hour; we'd do any and everything we could thing of to keep him mind off the hip and his teeth away from it so we didn't have to listen to him howl.
Eventually we came up with a better idea. I willingly admit that I was not the one to come up with it, but I have to say I helped. The large animal service was particularly proud of their equine neo-natal unit and they about popped a gasket when they came in to find a 'small' animal lounging happily on their brand new foal water bed. We though this was great -- Wolf had people bustling around, loads of new smells to think over, and (best of all) it was relatively easy to turn him. Perhaps his sores would heal now. Except for the large animal surgeons (who hit the ceiling, but we figured by the time the paperwork was done and Wolf was somehow gotten back to the small animal ward, we would be off the rotation), everyone seemed pleased by the whole thing.
How blissfully unaware the uninformed can be. This one's for you Sharon -- on our last day of rotation a screaming, foaming at the mouth large animal surgeon descended upon us during rounds -- but no one cracked and admitted being the perpetrator. (I didn't know there were so many colorful epithets for one poor(?) dog.) Wolf had chewed a hole in their environmentally controlled, thermostatically regulated... water bed. Where there's a will, there's a way -- and ingenuity doesn't lie solely with the human species!
All illustrations by Diana Harlan Stein