Kim In Vet School

Oncology- tumor biopsy

2011-07-15T14:00:00.000-07:00

Today I got to biopsy a big subcutaneous tumor. It's probably the most hands-on I've been allowed to be in vet school!

"A" is a 12 year old labrador with a golf ball sized mass over her shoulder that seems to be causing her to limp.

We were highly suspicious that it would be a primary bone tumor called osteosarcoma. But, we took radiographs and were delighted to find out that the tumor was not affecting the bone. (Osteosarcoma generally carries a very poor prognosis.)

This leaves us with several other potential causes.

We did a fine needle aspirate of the mass and came away with a lot of blood and some maybe soft tissue tumor cells. Essentially, the fine needle aspirate wasn't diagnostic.

So, today we did a biopsy of the tumor.

We put A under general anesthesia. We then clipped the hair over the mass and did a sterile preparation. Then, Dr. Daly let me do the wedge biopsy. I took a big slice out of the tumor and Dr. Daly commented that I was not a wimpy biopsy-er. After that, the tumor bled and bled and bled. We stopped the bleeding primarily through cautery. Then, I even got to place the sutures!

The biopsy results are still pending.
But, overall a very exciting time!

Oncology- Today was hard

2011-07-13T14:00:00.000-07:00

Today was hard. As much as I love Oncology- and I really do- sometimes it's just hard. Cancer isn't an easy thing. Most patients are not cured. A lot of them can be made to feel better for a while. But, there are some patients who we just really can't do anything for them.

Today was one of those days where it seems like all of the cases we see are those can't-do-anything cases.

My patient, "S", was a 5 year old orange tabby cat. He was so sweet. And his owner loves, loves, loves him. S was dumped by the owner's house as a kitten. One day, while dying of respiratory infection, S jumped up into the owner's lap and declared himself adopted. The receptionist put him in an exam room this morning and told us that she could hear him crying when she left. He cried a couple times while we gathered the history and physical exam. He also cried a little while we talked to him about our diagnostic plan.

The thing is, watching an older man cry just pulls my heart strings. As Kristen (one of my classmates) puts it, I am a co-cryer. His eyes well up and it is just totally reflexive for mine to well up too.

Even starting off in tears, it only got worse from there.

On ultrasound, S had a large mass originating from his pancreas with several other organs involved. On cytology, there was evidence of carcinoma. So, he has a pancreatic carcinoma that has already metastasized.

Even in humans, this is a bad, bad, bad tumor to have. There's no good treatment options.

We broke this news to his owner, who just sobbed. He hung his head, tugged his hair, sobbed and apologized. We told him there was nothing to apologize for.

It was heartbreaking to hear that he hates the month of July because his wife was diagnosed with cancer in July, he was diagnosed with cancer in July, and now his cat was diagnosed with cancer in July. I think we all cried a little.

Soft Tissue Surgery- compliments

2011-07-04T14:00:00.000-07:00

True compliments in vet school are few and far between; but I got a very nice one today.

Dr Bonin, Caroline and I were leaving ICU after doing a final check in on our patients and he said "you two are the hardest workers on this rotation. You do such a good job and have such a good attitude. And you're pretty knowlegable too."

He also told us that we were going to do well this year if we keep up this attitude and work ethic.

(He also mentioned that 2 of our rotation-mates are not doing a very good job. On top of being lazy, one of them makes really stupid mistakes because he doesn't ask questions and doesn't take initiative.)

Overall, a very uplifting moment!

Soft Tissue Surgery- Electrocautery is awesome

2011-07-01T14:00:00.001-07:00

We amputated G's leg today. We did what is called a proximal third amputation, where we left a piece of the femur. Dr. Bonin feels like this is more cosmetically appealing. Right now, that's hard to judge. I'd have to see it when it's healed better.

The amputation process was so interesting! While I'm pretty sure I won't have electrocautery in general practice, it was really awesome to use in surgery today! I even got to control it for most of the procedure. We used it to control bleeding vessels and to cut muscle bellies- simultaneously cutting and cauterizing.

The coolest part of cutting the muscles with the cautery was the way the muscle fasciculated after being cut. It looked like the muscle was boiling.

The primary surgeon found my fascination with that hilarious.

What have you found fascinating lately?

Soft Tissue Surgery- "G"

2011-06-29T14:00:00.000-07:00

"G" came in early this morning on Emergency because she was hit by a car last night. As far as we can tell, she doesn't have any broken bones, but she has really significant soft tissue injuries.

She has a puncture wound over her right eye that made a pocket under her skin that goes back to the level of her ears on the top and all the way over to the left eye. We're managing that wound conservatively with bandages for a while before we really close it up in a few days.

She also had a pretty big abrasion on the front of her right front leg. We're doing the same bandage song and dance on that one.

The big story is her left hind leg which has what we call a "degloving injury." Think about when you're wearing a glove and you peel it off at the end. It's like that, except skin instead of a glove. The skin from her ankle to her toes is missing. There are exposed pieces of muscle and bone. We could manage this with bandages for 3-4 weeks and probably save the leg, but that would cost the owner $6,000-$8,000. Instead, tomorrow we're going to amputate her left hind limb.

I'm really looking forward to the surgery! And I think that she'll feel a lot better once the dead/dying foot is gone.

Soft Tissue Surgery- "J"

2011-06-27T18:58:00.000-07:00

"J" is a 3 year old Bulldog who has had skin infections since his owner rescued him a year and a half ago. He has a severe infection underneath his tail.

The infection under J's tail, which is what he came in for, is so painful that he screams and bites when anyone tries to examine it. He also has a severe ear infection, a deep chin furunculosis (deeply infected hair follicles) and several other patches of pyoderma (skin infection.)

Overall, he is a little ball of greasy skin infection. And he REEKS. A lot. It's honestly nauseating to stand near him for too long.

Tomorrow, we're doing surgery to remove his tail, which will eliminate the fold the infection under his tail has been growing in. It will also remove the skin that is most affected. After he recovers from the pain of surgery, that should help him a lot. We already consulted Dermatology to help set up a lifelong management plan for his skin problems.

This case just re-inforces for me that Bulldogs are a breed I will never, ever own. What dog (or cat!) breeds do you never want to have?

Soft Tissue Surgery- And the surprises keep on coming!

2011-06-23T14:00:00.000-07:00

A's CT scan brought even more surprises to her already complicated case.

The CT scan revealed several very small nodules (in the 1-2 mm range.) Beyond that, the radiologists had a hard time agreeing on what the CT scan showed. Part of the process is using the software that comes with the CT machine to evaluate the density of the masses.

One of the radiologists got values indicating the masses were mineral density, which would likely mean that they are benign mineralizations that happen in old lungs. The other radiologist got values indicating that the masses were soft tissue density, which would likely mean that they are actually malignant. And the fact that different "windows" (ways to look at CT images) and different computers give different values indicate that the CT machine is broken in a way the radiologists can't explain.

Either way, benign or malignant, surgery is not the best option. If the masses are benign, then obviously the risks of removing a lung lobe significantly outweigh the benefits. If the masses are tumors, the fact that there are multiple ones in multiple lung lobes makes surgical resection a poor option.

The owner has a follow up appointment in a month with oncology for a repeat CT scan and further advice.

Interestingly, I'm on oncology in a month so I'll get to see how this case ends!

Soft Tissue Surgery- Sometimes you're in for a surprise

2011-06-22T14:00:00.000-07:00

My first day of Soft Tissue Surgery was a day of surprises- for me, the doctors, my patient and her owner.

I signed up for "A", who was in for a mass removal. We had a long fax from her primary veterinarian with pretty much everything that's ever happened to "A" in her care, including a long string of text messages about hookworms.

As far as I could tell from A's record, she had a mass over her right hip that her owner wanted removed. Talking to her owner, she's had masses for quite some time and they've just been there. She had one that came in more recently and seemed to grow more quickly than the other masses. She also had a murmur that had been noted in her record, but her owner hadn't been informed about (which is an entirely seperate issue! Always tell owners about their pets' medical problems!)

Because of her age and the different kinds of masses she had, we opted to do a 3 view thoracic radiographs (aka, "a met check") to see if any of those skin masses had metastasized because if she had lungs full of tumor, it doesn't make sense to put her under anesthesia for skin tumors. On those radiographs, we found a single very small nodule. We did fluoroscopy and rubbed barium on the masses on her skin at that level to make sure it was really a lung nodule and not just her skin masses projected over her lungs. Sadly, it was a lung mass.

Based on that, we really changed our workup. We ended up doing an abdominal ultrasound, aspirating and looking at all her masses under a microscope, doing bloodwork and a urinalysis and doing an echocardiogram (to evaluate her murmur). All the masses are benign, and she's the picture of health for an 11 year old dog.

Tomorrow, we're going to do a CT scan. We can see smaller masses on a CT than on radiographs. If we see lots of masses she becomes an oncology case (because surgical treatment is no longer a possibility and chemo would be the only viable option.) If not, we're going to do a thoracotomy (cut open the chest) and a partial lung-lobectomy (remove a piece of her lung).

So, surprise! You come in for a mass removal and end up losing a piece of lung instead!

Equine Internal Medicine- Foals

2011-06-20T14:00:00.000-07:00

I got a really great text message last night from Dr. Norton, one of the residents I worked with on Equine Internal Medicine, even though I've been off the rotation for a week and a half. She was letting me know that the owners of one of my first equine patients had finally named the foal.

For some background, it is very common for owners/breeders to not name foals until they're older. I don't really know why that is. But, when foals are born, they're called Mare'sName Year'F (F for foal.) My guess is that you don't get as attached to animals that don't have names and that foals (like puppies or kittens) sometimes take very ill and die. It's easier to let an animal go, or to make hard decisions weighing life and finances, if the life doesn't have a name.

But, anyway, my patient was a little foal with significant diarrhea. She was in the hospital for a little over a week, and cost her owners close to $3,000.

They named her Aggie's Special Country Star. They "had to name her aggie because she wouldn't be alive without all or our hard work." That's so sweat! And it feels really good to have all the hard work I did noticed. (I had to do treatments every 2 hours for the first couple days she was in my care.)

Cardiology- Heartworm Disease

2011-06-17T13:00:00.000-07:00

One of my patients on Cardiology was a 3 year old rescued dog who had been previously diagnosed with Heartworm Disease. While the rescue organization and his new owners have done fabulously by this dog, it makes me sad that so many dogs still get heartworm disease.

Heartworm disease in dogs (and cats!) is preventable by the administration of one little pill a month. Or in the case of cats, a vial of liquid applied to their skin. Most of the time, the dogs even actually like the pill.

Here are some basic facts about heartworm disese that every pet owner should know:
-Heartworm disease is a preventable infection
-Dogs get heartworm disease from being bitten by a mosquito carrying heartworm larvae
-Cats are an atypical host for heartworm, but they can get it. And if you tell me your cat is an indoor cat, I have to ask if you've ever seen an outdor only mosquito. I haven't! I get bitten by mosquitoes inside buildings all the time!
-Heartworm preventative medications are much less expensive than treatment
-Heartworm infection can cause permanent changes to your dog's heart and lungs
-One of the most common signs of heartworm infection in cats is that they just drop dead

In conclusion, make sure your pets get heartworm prevention regularly!

Equine Internal Medicine- "Spitfire"

2011-06-15T13:00:00.000-07:00

I feel so blessed to have been involved in Spitfire's life, as short as it was.

He came in as a 10 day old pony foal who had intermittently had fevers, fast heart rates and fast breathing since he was born. When we asked his owners more, they said that he sometimes dribbles milk out his nose when he's been laying down.

When we were looking at chest radiographs to look for aspiration pneumonia, the radiologist said "Well, if this was a dog, I would say this looks like a persistent right aortic arch (PRAA)." We didn't really do much about it then, but when I brought up the radiologist's comment again in rounds, we decided to pursue it a little further. I got sent over to the small animal hospital to talk to people who might know more about PRAAs, because it isn't something that's really reported in horses (9 times in large animals in general, it turns out.)

It got everyone all twitterpated and very excited. He had a lot of very good prognositic factors. After that, it was a very emotional rollercoaster between doing the surgery or euthanizing him.

In the meantime, Spitfire and I really bonded. I named him Spitfire because he had such a delightful personality. He was full of spunk and silliness. He'd walk right up to people and chew on their pants or lab coat. The emergency/overnight students who did his midnight-2AM treatments called him Chompers. He liked to run and buck around the paddock outside when we turned them out in the morning. He liked to steal stethescopes and carry them around his stall. His mother put up with him with goodnatured grace. Overall, he was just a little spitfire. (His owners ended up naming him something else, but I still like Spitfire better.)

Sadly, the surgical attempt to correct his congenital defect didn't go as planned. It ended up going really poorly and he was euthanized on the table. We all knew it was a real long shot that he'd make it, but that doesn't make it any less sad.

Equine Internal Medicine- Toxicity Horses

2011-06-13T14:00:00.000-07:00

My first day of Equine Internal Medicine was a little overwhelming! We started the day with 4 students and 13 patients! But, 6 of them were from the same ranch and had all come in together with an unusual neurological presentation.

11 of the family's 20 horses were taken on a trail ride and left in a dry lot pen with a bale of crappy hay afterwards while the family dealt with another problem. The horses ended up eating all the way down to the bottom of the bale of hay, including some plants they wouldn't normally eat. They were also given a normal dose of their normal dewormer.

A day or so later, those 11 horses were in some state of neurological distress. They were somewhere between ataxic ("walking drunk") and recumbent (unable to get up.) The owners ended up bringing in the 6 worst off horses. They got supportive care- fluids, nursing care, etc- and they got better!

It felt like such a miracle! We were so glad to see them all turn around and get better.

Orthopedic Surgery- "M"

2011-06-10T14:00:00.000-07:00

Friday, June 10, 2011
Orthopedic Surgery- "M"
M is an 8 year old Golden Retriever who came in morbidly obese (secondary to recently diagnosed hypothyroidism) and completely non-ambulatory in the back because he had ruptured both his cranial cruciate ligaments.

Cranial Cruciate Ligament ruptures are like ACL tears in humans. If you've ever met someone with an ACL tear, they are incredibly painful! Especially if the medial meniscus gets involved.

We performed Tibial Plateau Leveling Osteotomies on both of his legs at the same time. I got to put in 1 bone screw in each leg! While the first 24 hours after surgery were pretty painful, he was way better than when he came in the day after surgery. It was really awesome to see.

The only problem with him was that his owner was away on a business trip and he ended up spending nearly a week longer in the hospital than he needed to. For a while, M went on a hunger strike. I went through almost every food in our dog food kitchen. I tried puppy food of several brands, I tried the high calorie recovery foods, I tried baby food, I tried hot dogs and hamburgers and chicken breast. He'd eat maybe one bite of anything new then refuse to eat more. Finally, while some of my classmates were eating lunch, he looker interested in their food and willingly ate their leftovers. We were ecstatic! I think he ended up with nearly a pound of turkey and brisket that day. Then we fed.him Turkey lunch meat (with progressively more dog food and less turkey until he was on just dog food.)

Orthopedic Surgery- "Z"

2011-06-08T18:46:00.000-07:00

My first patient ever was a 140 pound Saint Bernard puppy. He came in because his referring veterinarian found an Osteochondrosis Dissecans lesion on both his shoulders after he started coming up lame while exercising.

We confirmed the diagnosis and evaluated the rest of his shoulder joints and both his elbow joints using CT. It still blows me away that we use CT on animals! Z's CT scan made quite a first day for me, because even though he was highly sedated, he jumped off the gurney and tried to take off across the parking lot! Luckily, Wendy (the orthopedics technician) caught his leash as he came off the gurney and he didn't get away. He also slept soundly through his CT scan.

He stayed with us for nearly a week before we did arthroscopic surgery on his shoulders. He was such a handful! Young, exuberant, and strong! I had bruises on my wrists from him pulling on the end of the leash.

Technology

2011-02-14T20:12:00.000-08:00

I've been thinking about technology- specifically technology for networking and communication- a lot lately.

I've come to the conclusion that, by and large, veterinary medicine is either uninterested or stuck in the past. For example, love it or hate it, Twitter is continuing to increase in prevalence as a way that businesses and organizations choose to connect with customers, consumers and otherwise interested parties. There are a handful of veterinary related organizations on Twitter (AVMA, AVMA's governmental relations arm, some individual animal hospitals and vets, a few professional organizations- Texas Veterinary Medical Association, American Animal Hospital Association and American Society for Veterinary Journalists are especially active- and a few vet schools with varying degrees of activity.) But overall, vets refuse to take the time to do it.

I, however, really love all of the technology that exists right now. I blog, I tweet, I post. I want more of my peers and colleagues to come do it with me!

Things I’m Tired of Hearing

2011-02-10T07:27:00.001-08:00

There are some things that they tell us a lot during vet school that I’ve gotten really tired of hearing.

1) “Grades don’t matter!”
That is just, quite frankly, not true to me! It may be that nobody’s really going to look at your GPA when you get a job (though, I don’t really believe that), but that doesn’t mean grades don’t matter. What if you want an internship or a residency? Or what if you just don’t not want an internship or a residency? (You just don’t want to close that door yet?) Or, what if you’re just accustomed to getting good grades? What if just the getting of good grades is what matters to you?

2) “You’ll get this later.”
We hear this a lot in lecture. They’ll be talking about something and mention a caveat or a detail (or even sometimes another major concept) then backpedal with “but you’ll get that later.” Uh, guys, we’re nearing the end of third year; there’s not a lot of later left!

3) x% of you will be divorced
That’s not very nice… but they’ve been telling us that throughout vet school. In orientation it was that some percent of you will get divorced by the end of vet school (and some more by the end of vet school.) Later they start telling us that x% of us that have gotten married in school or made it past the relationship killer that was vet school will get divorced once we start in practice because we apparently can’t balance our lives. It feels kind of like the people who tell you that you shouldn’t bother getting married because half of marriages end in divorce (although, I read recently that statistic is changing and fewer marriages are ending in divorce.)

Practice Management

2011-02-08T11:34:00.000-08:00

It's been a long time since I updated; I haven't been very good at keeping this up. But I'll try to do better.

This past weekend was a rough one for the third years.

While it seemed like everyone else in Texas- from Dallas to Houston- was celebrating having Friday (or more) off due to snow, the third years took their lives in their hands and came to school anyway for a seminar about Practice Management. (We did get to start an hour late...)

It was good information- very good information- but with 2 8 hour days, I'm not sure how effectively we absorbed all of it. That's just a really long time to be listening to the same topic.

I enjoyed the information on how to operate a succesful practice. The things clients say they want (a coat hook in the exam room!), the amount of time a client will wait in your lobby before they give up and leave (15 minutes) and how to use financial statements to evaluate the success of your business.

I found the stuff about contract negotiation to be important, but hard to absorb. Most of what I got from that is that you should hire a lawyer to look over your employment contract before you sign it.

Animal Behavior

2011-01-25T12:07:00.000-08:00

While I don't always agree with what Dr. Beaver has to say, I've learned a lot in this class.

For example, there are 10-15 kinds of aggression. All of them need to be dealt with in different ways and some of them are easier to treat than others. For example, dominance aggression is usually easier to deal with than prey aggression. Prey aggression has its own internal reward (getting to chase/catch the animal playing prey item!)

Today, we talked about ADHD, which is over-diagnosed in humans and under-diagnosed in animals.

Week One, in review

2011-01-17T12:52:00.000-08:00

My first week back to school went really well!

I only have one elective this block- Resolving Small Animal Behavior Problems- which should be interesting. It's important information but I find myself presenting arguments in my head when this particular professor lectures. Especially when she starts talking about cat behavior. But, hopefully, I'll get something valuable out of the class!

Small Animal Medicine has been entertaining so far (my favorite vet school professor has been lecturing.) It's a little rough that it meets 8 hours a week, though!

Correlates is, well, correlates. We got our first case last week. I spent something like 6-8 hours on it... but it really reaches this point of diminishing returns where doing more isn't getting you anywhere. You've followed the process as well as you can but you're going to make the wrong judgement call anyway, so why bother?

Practice management is... something. The projects should be fun and worthwhile and assuming we have guest speakers pretty often it should be ok. While I like Dr. Posey very much as a person, I find his lecture style a little disjointed which can be frustrating.

Radiology is rough. It just doesn't seem fair to have it in the 3-5 timeslot on Friday!

However, I have all this free time... I have no idea what to do with all of it! It's crazy!

New Semester

2011-01-10T08:58:00.000-08:00

Classes start today (I'm actually writing this from break in my Resolving Small Animal Behavior Problems class).

I'm both excited and a little nervous. For some reason, I feel the least prepared I've ever been for the start of a semester. I don't feel like I have all my stuff organized very well. I feel just all at odds! (And I would much rather be at home with my fiance and my parents!)

At least there's just one more semester of classroom stuff before clinics!

Hodgins decided to talk to his dad for a while

2010-12-08T15:21:00.000-08:00

kimmiecat: ;/'.............................................................................................................................................\
nate.bishop11: huh?
hodgins!???
its been so long Hodgins!
i miss ya bud!
you behaving?
kimmiecat: IOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOo'[p; buuuu7pppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppppp
nate.bishop11: darn i still don't understand you cat

Funny/Interesting Things Professors Say #6

2010-10-17T17:47:00.000-07:00

Small Animal Medicine
“If you’re high, you don’t die.”
“so nobody’s taking any pig pancreases and squeezing them…”
“and what happened? It took us 15-20 years to find out we’re dumb.”
“I’m just going to lay down on the floor and cry right now.”
“or it could be some by product that’s mostly chicken feathers.”
“I’m not going to get on the floor and seizure…”
“those other glands are sitting there having a picnic. They’re taking a nap.”
“if you just give them oral calcium, you may as well just sprinkle water on their legs.”
“everything gets revved up like a cat on red bull”
“they’re like sick chickens… they all look the same”
“In vet school, I think I highlighted ‘ruffled feathers and pasty vent’ for all the chickens.”
“The fact that you’re all here and relatively alert means that you had your morning cortisol surge”
“Iatrogenic… which means ‘my bad’”
“If I said ‘pop quiz!’… it takes about 4 minutes… but in 4 minutes you’d have doubled your cortisol.”
“the heart doesn’t like being bathed in potassium… if has no sense of humor about that.”
“the best test to see if a gland is dead is to kick it really hard and see if it moves.”
“we are going to come up to it and pharmacologically shout in its ear.”
“The whole point of being a tumor is not obeying the rules!”
“they think old age mandates them to look like that…”
“If you see someone pull up 1 cc of dex SP and put it in a small dog, have a sharp intake of breath”
“and then the tumor thinks ‘I may be small, but I’m not frightened!’”
“If Europeans can do it, surely Americans can too”
“I have like 2 multiple choice questions on your exam… keep that in mind.”
“sometimes foo foo dogs… you throw a ball at them… who cares?”
“can you see the distichia in these dogs? Crank up your imagination”
“Give all your clients a sharpei, boxer or pug for Christmas and keep yourself in business.”
“Animals that live on the couch are less likely to be impaled with a large stick than a hunting dog.”
“syncope and sudden death are the same except you wake up from one of them”
“your eye is not very good at hearing things”

Large Animal Medicine
“The mare doesn’t look sick then next thing you know *pffft* you have a dead fresh fetus on the ground.”
“Baytril is rampantly used in the small ruminant industry… if they’re ugly they’ll treat it with bayrtil.”
“In a pig, it’s an IP injection… intra-pig.”
“it’s not an AVMA recognized method of euthanasia… but if that’s your goal…”
“you can dance in a cow’s belly in muddy boots then hose them out and they’ll do fine. A horse would not tolerate that.”
“I’ll tell you this is a 3 year old thoroughbred racehorse… a good one… a fast one.. and he’s not been running good lately”
“You guys have enough on your plate without bearing weight on your sole.”
“Color is important in treatment!”
“Oprah Winfrey got… no… show some control… oh well, I started it.”
“pennis…pennis… it’s not a game you play with a raquet. It’s a male reproductive organ.”
“you can get out of a lot of things if you fake a seizure”
“the mounter or the mountee… whichever you prefer to be”
“that’s a big teat… or 2 testicles.”
“I kid you not… it’s made out of shark… woven something shark… no really, shark.”
“… well, the people that own them… the sheep and goat… they don’t know.”
“Once you are all the way in there, it’s a pleasurable experience”
“early stage feces… they call it feed”
“why do you guys laugh when I try to teach you things?”
“When you say things, people assume that you mean them”
“All my patient, as a food animal vet, die… and then we eat them”
“a lot, a lot, of dairy men are pinging their own cows… *laughter*… have a little decorum”

Emergency Medicine
“It makes sense that Florida has one…. They’ve been hit by hurricanes forever and 10 days.”
“It’s like tryingto text at a football game…it’s not going to happen.”

Primate Medicine
“monkeys are like Italian family… everything is going fine then WHAM something happens and somebody’s getting smacked.”
“we call them the cheerleaders, the younger breeder groups we have.”
“at some point, all of this gilded cage will end and you’re going to graduate.”
“so you’re starting to play doctor..”
“I can learn so much about you, Will, if I know your weight and look at your stool.”
“Don’t wear white. If you do, they’ll throw and you’ll get campylobacter and shigella.”
“lubrication is something we strive for in all aspects of sex”

Radiology
“it’s like saying they have 2 elbows. I simply don’t care.”
“it’s spondylosis deformans… and it all makes me yawn.”
“does everybody know what golf is? That Tiger Woods guy… just google it.”
“I’m Dr. E as you all know and I love imaging.”
“Or are these inspisated boogers?”

Surgery
“these are not tablets that are sent from heaven.”
“therio potential. *rocker fingers*”
“if surgery was easy, there wouldn’t be so many medicine people.”

SR Medicine
“And I’m sorry, if you walk in with a packed cell volume of 8, you’re getting ready to die, you just may not know it yet.”
“you’re going to have a few animals out there who are problem children.”
“the parasites aren’t going to hurt the horses… so use them as a big vacuum cleaner.”
“We need to DEworm them… they did a fine job of worming themselves.”
“It’s sort of like a plumber… his plumbing always leaks”
“I’m sorry, this is not that… this is a testicle.. I see that now.”
“word got around that there was this guy you could scratch his back and he’d ejaculate… he was the most popular patient in the hospital”
“I’ve seen a lot of Chlamydia problems.”
Professor: “Do you have any experience?” Classmate:“With Chlamydia? yes. … no, I meant the vaccine!”
“you can eat and take care of business all in the same place… very efficient if you’re a cat.”
“once you get 3 or 4 parasites in there, it’s hard to get enough nutrition… I know… I was just talking about my granddaughter and now I’m calling them parasites… but that’s what they are!”
“there for a while, I was kind of a rockstar the goat world”

Baby Goats!

2010-10-13T21:31:00.000-07:00

The best part of large animal skills was definitely NOT being at school at 7AM every weekday for 3 weeks (5PM for 1 week and both times for 1 weekend) to feed and walk a horse. Or, really, several horses. I get it that knowing the husbandry of the animals we treat is important, but if I wanted the responsibility of owning a horse, I would own a horse.

The ACTUAL best part of large animal skills was the labs themselves. We learned how to cast cattle, which is a fancy word for pull them onto the ground using a strategically placed rope and 1 (or maybe 2) person (people.) We anesthetized pigs. We drew cow blood. We trimmed goat feet. Even better, we went and examined the baby research goats! There were babies from a couple days old to a couple months. They were so very cute.

It's things like this that remind me why I'm here.

It's Like Being 14 Again

2010-10-13T20:28:00.000-07:00

One of my professors recently said that being a 3rd year in vet school is like being 15. You're almost grown up, and you want it so bad, but there's nothing you can do to speed it up. It's so close you can taste it, but it's just out of reach.

But, I think that it's like being 14. The dream, the growing up, the independance of it all is so close. The license is close. But 4th year is like being 15. You're almost there. You've got a learners permit. You get to try it in real life. There are real risks and real rewards but there's someone there watching over you, guarding your back.

I can't wait. I want to grow up!

My Own Animals Are a Great Learning Experience

2010-09-28T11:29:00.000-07:00

My kitty, Elli, has a long and sordid medical history (this is my favorite way to start this story! It’s the vet student equivalent of “on a dark and stormy night…”)

The important part of her history is that she has a history of (really severe) reaction to vaccinations. This is really not all that uncommon, though I would argue that the degree of severity she had is out of the ordinary. She also is really freaked out at the vet… she spikes a stress fever and even develops a heart murmur only in the clinic (I can hear it at the clinic and not at home, and she’s even had an echocardiogram).

When we moved back to vet school after a summer at home, I noticed that Elli was coughing. She’d had a coughing spell for a couple minutes a couple times a week. One of those all out cat coughs where they flatten themselves toward the ground and streeeeetch their necks out. I took her home with me to the Banfield I worked at over the summer and we narrowed it down to being feline asthma or potentially an upper respiratory tract infection. We ended up giving her depo-medrol (a long acting steroid) with a presumptive diagnosis of feline asthma.

A week and a half later, I noticed that she has a mass about the size of a pecan right where she got the injection.

I talked to one of the feline internal medicine professors (Dr. Zoran) about her medical history, long term and her more recent. She told me to never ever ever again give Elli depo-medrol, because she’s probably reacting to the substances that make the depo-medrol a long acting steroid. She told me to aspirate the mass and take the stained slides to Dr. Barton (the oncologist/cytologist). I actually went and told Dr. Barton the same story and she told me that she’s never seen/heard of/read about a sarcoma (cancer) associated with depo-medrol (though they are associated with vaccines). She gave me instructions about what kind of sample to take (she wanted a core biopsy.)

My friend Ashley and I pinned Elli down at home and took a core biopsy of the mass. When we pulled the needle out, she oozed out some lemon pudding consistency material. (Don’t you love how pathology uses food descriptions?) So we took an impression smear of that and then decided to try to aspirate the mass.

I stained the slides then looked at them with Dr. Barton. We went over them and found the mass was just full of necrotic tissue, with some degenerating neutrophils and a little bit of the drug.

It’s fun to learn from my own pets! (Though, I hope Elli doesn’t develop any more medical problems for a long time!)

Surgery

2010-09-12T19:43:00.001-07:00

Surgery class is intense. All of the group positions are intimidating in their own way.

The anesthetist is responsible for maintenance and monitoring the patient for the duration of the surgery. This involves taking measurements every 5 minutes for the entire surgery time. That's a lot of measurements. And they're in charge of making sure the animal stays under anesthesia. At the end, they're responsible for euthanzing the animal, which is a weighty and emotionally, if not technically, difficult process.

The surgeon and assistant surgeon are responsible for cutting into the flesh of an animal, maintaining the sterility of the area, and closing the incisions they make. This process is done with various teachers circling around and watching you like a hawk. There's the added problem that you want to ask questions but it often feels like asking questions and having your work evaluated by an already-trained eye (rather than your and your partner's starting-to-be-trained eye) will make you lose points. While we're supposed to be in this to learn to do it right, it's hard for us to stomach earning a 17/25! Most of us are used to much higher grades than that!

Funny/Interesting Things Professors Say #5

2010-09-05T17:55:00.000-07:00

Small animal medicine
“… I have a Bernese Mountain Dog… which is kind of ridiculous.”
“The other thing about cancer cells that’s really dastardly…”
“… well it won’t be available for the dogs that were dead…”
“…cut them off and put it under the mattress with a frog’s leg and it will go away.”
“I’d rather have 6 years with a boxer than 17 years with a Chihuahua”
“3 days later his right atrium ruptured… which is suboptimal”
“he will get revenge… in a multitude of ways… most involving urine and feces.”
“when clients freak out about amputation, I ask ‘how many legs do you have?’ and they say ‘well… 2.’ And I say ‘well, you do pretty well.’”
“and then the reconstruction people will build you a new nose and you and you can go into public.”
“no pet should die without the benefit of steroids.”
“the recurrent laryngeal nerve is something one avoids in surgery if one can.”
“there are lots of important things with long names in there… and some short names too.”
“we’re talking therapeutic radiation, not nuclear destruction…”
“a cure for cancer is to live long enough to die of something else.”
“that’s a surgery for a person really experienced at removing sphincters”
“this is the rectum of a dog… but it’s too close for you to tell that.”
“You can’t just walk up to someone you don’t know and say ‘this is a bad plan!’”
“And no one knew then that cisplatin splats cats…”
“I said ‘I don’t know if this treatment is going to be possible because we need to be able to get the bloodwork faster…’ and he said ‘Oh, ok. I’ll get a plane.’ And he flew in for every chemo treatment the dog needed.”
“perhaps they are smart about some things… but this is not one of them.”

Radiology
“if you think you can slap a cast on any fracture, you’re living in the 1940’s”
“if you’re left with a jaw that doesn’t work… you’re screwed”
“you can use your brain and be right a lot of the time.”
“but my grandma didn’t go to vet school… you did.”
“… I would be correct, and I would be a bad doctor”

Large animal medicine
“no matter what is wrong with a horse, with a heart rate of 120… it’s bad.”
“normal horses are pretty boring”

Animal Models
“Betty White’s writing kind of induces violence.. but she doesn’t do it herself… she’s kind of old..”

Surgery
“He’s young and nice… I’m going to try to fix that… I can’t fix the young…”
“I’m probably not going to bite your head off… almost definitely”

Emergency Response and Management

2010-09-01T21:03:00.001-07:00

So far, my favorite class is my Emergency Response and Management elective. It's essentially about the process of preparing for and responding to crisis events. Those include any size natural disasters (tornadoes, hurricanes, earth quakes, flood, drought, etc.), infrastructure disasters (bridge collapse, fire, etc.), terrorist attacks, etc.

The grade in the class is based on completing 4 of the FEMA training classes for emergency response (and attendance.) Because of this, the students in this class will be in the first group of people that the vet school response team will pull from for students to take to disaster response.

We're also listening to lectures about the process of preparing a community for disasters- either in their area or what they should plan to do to shelter other communities.

I'm kind of hoping that something happens during 4th year that we'll get called to respond to! I think it would be awesome!

Actually, on this topic, September is Emergency Preparedness Month! You should check out this link and make sure that you and your pets are prepared!

http://www.ready.gov/america/

Alcoholic Monkeys!

2010-08-26T19:47:00.000-07:00

Today in Primate Medicine we learned about lots and lots and lots of different kinds of monkeys.

However, my favorite was the African Green Monkeys. They have a very strong dominance hierarchies, which has been interesting in studies using them to study alcoholism. The monkeys really enjoy screwdrivers (orange juice and vodka). The alpha ones, however, don't drink much because they're too busy protecting their social status. The ones in the middle of the social structure drink socially for fun. The ones at the bottom of the social ladder become alcoholics.

That would be a really interesting study to have participated in! Though, perhaps not to clean up after. Drunk people are annoying enough; I can't imagine drunk monkies.

Back to School!

2010-08-24T19:53:00.000-07:00

I am having my (probably? maybe?) last first week of school ever!

I haven't had the first lecture of all my classes yet, but so far things are going really well! However, I am a little nervous about the fact that my schedule changes significantly every 4 weeks! That's kind of scary. I'm pretty sure that a lot of us are going to show up in the wrong places at least a couple times.

Finals!

2010-05-02T19:58:00.000-07:00

I'm not expecting to blog much this week... I'm going to be immersed in finals.

Monday: Pathology
I need an 80% on this one to get an A in the class. Not bad!

Tuesday: Radiology
I need a 91% on this one to get an A in the class. That kind of makes me nervous.

Wednesday: Infectious Disease and Public Health
I need an 83% on Infectious Disease and a 70% on Public Health for A's.

Thursday: Toxicology
I'm riding a 102% in the class right now. Based on the weight of the final, I need an 81% for an A.

Friday: Surgery/Anesthesiology
Since I have no real idea of what I made on the lab practical last week, I don't really know what I need for an A. Probably something beween an 82-87%. Hopefully she'll get the lab test back to us before the end of the week.

“… and then you had an epiphany.”

2010-04-28T19:44:00.000-07:00

Love him or hate him, I find Dr. Willard’s lecture style in our (pre-)correlates class hilarious.

We’re given a case presentation and lab data about a week before class and are expected to generate a list of the most likely diagnoses, a set of tests we’d like to run to narrow it down more, and what we would do to treat the animal right then. In class, he calls on people from the class roster and asks them questions about the case. (He’s always going to ask you why you said what you said, too.)

If you’re wrong, he corrects you by saying, “… and then you had an epiphany…”

I have to try really hard not to crack up every time he says it! It such a hilarious and tactful way to say that you’re wrong and you should try again. (It can get frustrating, though, to watch a classmate flounder while you have an answer you’d like to give.)

Funny/Interesting Things Professors Say #4

2010-04-23T19:40:00.000-07:00

Professor quotes

Path
“and if you’re a human… which everyone in here is…”
“It’s the retching of all retching…”
“If you have proteinuria… let me know!”
“If you’re a person, and we all are…”

Inf. Dz
“If I can’t latch on and I’m in the GI tract, I get washed out.”
“As you’re walking down the alley, the cows are lifting their tails and literally shooting it at you.”
“Veterinarians are the foremost poop-ologists.”
“That’s pretty close to screamin’ high.”

Tox
“Let me tell you what these stupid sheep do.”
“Any questions on LSD?”
“some people swear by fescue, other people swear at fescue.”
“I guess it’s ok to mutilate them as long as you don’t pick them.”
“I figure if they’re edible, I’ll eat them. I’m not picking anything off a cow patty.”
“people really want to get somebody else to pay for their mistakes.”
“We’ve been fighting France’s wars for year.”
“If you have to be bitten by one of these snakes… you want the copperhead.”

Surgery
“there are a lot of voices that go on in my head, but that’s not one of them”
“look at me! I can do hand ties. Breaks the ice with people..”
“It can be a pretty… whole body experience… to do those surgeries.”

Public Health
“What about the cool, new, sexy organisms.”
“I sit in the men’s restroom and hear the commode flush and I listen… then I hear the sink.”
“We need to learn from the blacks. They’re washing their hands.”
“There’s a stranger out there, and he’s got a pig under his coat. He’s probably a bioterrorist.”
“You’re supposed to know it.. but I’m not going to test on it because I can’t remember it either.”
“The kid gets overexcited about the kitten, the kitten gets underexcited about the kid, and voila! The gets scratched.)
“To a cat, the whole world is a litter box.”
“What are you, a laboratorian?”
“Are there any fish people… not fish people… aquarium types in here?”
“When you don’t have enclosed spaces for cats, you have escapees… which is sub-optimal.”
“45% of people have more than 1 pet… especially the cat folks.”
“long haired cats are like dust mops”
“it will turn a cat yellow… if you do it only once, it probably won’t be permanent.”
“I don’t know many dolphins that go hiking in the woods”
“lepto really, really likes Hawaii… can’t really blame it…”
“There’s nothing here that really screams ‘ I have leptospirosis!’”
“If you had to pick a brucella to be infected with… pick canis.”

Schedule!

2010-04-22T10:55:00.000-07:00

They finally posted our elective schedules for next year! I'm pretty exicted about it! Though, there may be some changes later.

Sterile/Aseptic Technique

2010-04-20T07:05:00.001-07:00

As it turns out, maintaining sterile technique for the length of an average teaching hospital surgery is going to be really hard to do! And in some ways incredibly frustrating.

First of all, my New Year's Resolution for 2010 was to stop chewing my fingernails (and cuticles.) So far, this has been a huge success. I had long, pretty fingernails. But, for proper surgical techinque your fingernails have to be 1-2 millimeters long and can't be painted. I cut them before lab last week to shorter than they've been since just after I quit chewing them... and they were still too long. I had to cut them even shorter before I could scrub in! And, I'll probably have to cut them again tomorrow because they've grown quite a bit since last week.

Then, there's scrubbing in which is, quite frankly, painful. It's not so bad on the fingertips and fingers, but when I get down to my palms and arms... ow! We have to use a really bristly brush and scrub at least 20 times per section (and you divide each finger into 4 sections, each hand into 4 sections, and each arm into 8 sections.) Also, we have to keep our arms held above our waist, with our elbows above our wrists. That doesn't sound hard until you try to hold your arms in that unatural position for 10 minutes or more.

The rest of the process is just a little hard to get the hang of. There's drying your hands while bent over a little bit and not touching the towel to yourself, the environment or an area you've already dried. Then there's putting on a gown without touching it to the table or the ground or putting your hands out of the sleeves. Then there's putting on gloves over the sleeves of your gown.

It's a hard set of new skills and habits to develop, but in the long run, it's worth it. If you learn top of the line now, when you slide a little in practice hopefully you'll still be good enough you aren't killing patients with infections.

“Expertise generally consists of doing a lot of small, boring, seemingly insignificant things very, very well”

2010-04-15T19:53:00.000-07:00

Dr. Willard said this to the Internal Medicine club at a lunch meeting at one point and it’s really stuck with me. Because, it’s really true but I’d never thought about it that way before.

On TV, the experts in things have these really cool, sexy jobs where they do awesome stuff all the time. And while veterinarians get to do some really awesome things and save animal lives and such, the process of getting there and the process of doing it are actually rather small, boring and tedious.

As we’re going through the process of learning how to put together our cases for third year correlates, it turns out the process of diagnostic medicine is quite tedious. It’s nothing like House. Granted, we’re generally doing less rare (“zebra”) cases and more routine (“horse”) cases. Also, veterinary medicine is still very closely tied to your clients’ economics, unlike human medicine. We can’t just run hundreds of dollars of tests and hope something sticks, we have to pick the 1 or 2 tests that are most likely to get you the answer you need because that’s all your client is going to pay for.

So, basically, I’m going to keep trying to do these small, seemingly insignificant things very, very well!

Radiology

2010-04-14T08:27:00.000-07:00

Radiology almost always feels like playing "Where's Waldo."

Sometimes it feels like a normal game- where you get the satisfaction of finding him. But most of the time, it feels like somebody gave Waldo an invisibility cloak.

The pointer flashes over an area of grey and wiggles around. You're supposed to be seeing a lung lobe, or a liver lobe, or a lymph node... Mostly, you nod, draw a circle on your notes in that area and hope you'll be able to see it when you sit down to study... Or that, at least, on the exam, you can pick something if they ask you to ID something in that area.

Poinsettias

2010-04-09T07:40:00.000-07:00

I think it's pretty common myth/knowledge/lore that poinsettias are toxic to dogs. I know I had always heard that.

We learned this week in Toxicology that while poinsettias were quite toxic in the 70's, the ones sold commercially aren't anymore. The poinsettia sellers have bred the toxic agent out of the plants.

I think that's really awesome! (especially because it means I can have poinsettias at Christmas now! Sadly, lilies are still out.)

Pedagogy

2010-04-06T05:57:00.001-07:00

One of my biggest problems with vet school is that our professors have little, or no, pedagogical training. So, while they’re by and large brilliant, interesting, nice people… a lot of them are terrible teachers. Either they don’t get how to organize a lecture, or they don’t do a good job of conveying the information they want us to know, or they’ll say things like “just do the clinically relevant stuff!” while as 2nd years we don’t have the experience yet to determine what’s relevant and what’s not, or they’ll not be any good at writing questions that evaluate what we learned.

Recently in our infectious disease class, the professor said “I’m terrible at writing test questions!”He’s known this for quite some time, and received many complaints about, but as far as I can tell, he hasn’t done anything to change it. I know that writing good questions is hard, but a big part of teaching is being able to write evaluations that accurately reflect how well the students learned!

April Fool’s Day

2010-04-02T08:32:00.000-07:00

Overall, I had a very low-key April Fool’s Day. But the one prank I was privy to was hilarious!

In my 8AM surgery class, the professor came in and said that due to historically bad attendance in the second half of the course, the course coordinator had given her permission to administer the points for her section on the exam as a pop quiz. We all kind of nod and pull out some paper to write down our answers.

Then she puts up the first question and it’s really hard. We aren’t sure of the answer and are starting to sweat.

She puts up the second and it’s just mystifying. We have no idea! We didn’t talk about that!

She puts up the third question and it’s impossible. It’s something that might show up on the board exam to become a surgical specialist.

By then, I figure it out but most of my classmates are still panicking.

She puts up the last question and it’s just so impossible it’s hilarious.

Then she asked us what day it was, and you could just see the realization dawn on all of us.

We applauded.

Funny/Interesting Things Professors Say #3

2010-03-31T17:51:00.000-07:00

Professor quotes

Pathology
“I did brush my teeth this morning… so…”
“some student have described it as nuclear spooning.”
“Cats look different anyway… they’re like little horses in miniature. No, really, they have a lot of similarities!”
“transmissible venereal tumors can be present anywhere dogs like to touch their nose or do the nasty.”
“this is in species that love to contract their spleens”
“Platelets are sensitive little guys. You talk to them ugly and they get agitated and aggregate.”

Infectious Diseases
“Good guess! I mean, good answer.”

Toxicology
“I would think if you have an upset stomach, you wouldn’t want to take strychnine.”
“I don’t know how you guys are going to finish a major exam in 50 minutes…”
“those big planes have a glide path about like a rock.”
“obviously children don’t lick it off.”
“He should have been shot between the eyes… or slid down a 40 foot razor blade into a barrel of turpentine.”
“Most people don’t read the damn label, just like most people don’t read the damn instructions.”

Surgery
“The single, lone ranger, advantage…”
“Silk… oh! Bad, bad boy! Wicked! Evil!”
“The angels sing when we start talking about Surgilene”
“If anybody says “I’m going to sew this back together” I’m going to jump them and wrestle them to the ground.”
“placing 45 simple interrupted sutures is a real buzz kill.”
“this is part where I feel like I need to interpret through dance or something”

Public Health
“I’m going to try to make this not boring… this could be hard.”

Surgery!

2010-03-30T08:45:00.000-07:00

I’m really excited to be starting Surgery class. Granted, this semester we won’t actually get to cut anything. (I don’t think.)

But we do start learning the best way to hold our instruments. And the best way to organize and sterilize a surgery pack. And the best kinds of sutures to use. And how to tie sutures. Basically, we learn all the stuff you need to know to be a surgeon!

I have the added issue of being left handed, which is only problematic in that right now, all my tools are right handed. I’m going to be spending this semester deciding which ones I want to sink the money into ordering in left handed. Surgery tools are expensive enough; they’re even more expensive left handed.

I hope I can keep the multitude of similar, but slightly different, scissors straight!

We finally get to pick classes!

2010-03-25T13:27:00.000-07:00

After 2 years of having our schedules completely out of our hands, we finally have some freedom to choose. (Granted, there are 19 hours of required class in the Fall and 16 hours of required class in the Spring.)

Honestly, it's a little overwhelming! There are 63 options, and we have to narrow that done to a minimum of 14 and a maximum of 20 or so.

Then there's fact that we aren't guranteed to get any of the classes that we want. They assign us to classes based on request and then lottery.

So, my current plans are:

Emergency Response and Management (which has 130 slots, so I'll definitely get it)

Primate Medicine (25 slots, but I assume not a lot of interest)

Animal Models of Human Disease (10 slots, but probably not a lot of interest)

Interactive Emergency and Critical Care Small Animal Cases (30 slots)
OR
Contemporary Issues in Animal Welfare (second choice in that time slot, also 30 slots)

Small Animal Endocrinology: Problem Solving (8 slots)
OR
Diagnostic Cytology Topics (second choice, 40 slots)

Small Animal Dentistry (30 slots, who knows if I'll get it! I'm signing up for this one in 2 slots, in hopes one will come through)

Small Animal Cardiology (130 slots)

Food Animal Advanced Elective (130 slots- good for boards)

Clinical Lab Animal Medicine (5 slots, I assume not a lot of other interest)

Resolving Small Animal Behavior Problems (130 slots)

Common Complaints (8 slots, everyone wants it... so, we'll see!)
OR
Physical Medicine, Rehab, Pain Management, Alternative/Complementary Medicine (16 slots)

Small Animal Oncology (100 slots)
OR
Diagnostic Lab (6 slots)
OR
Physical Medicine, etc (16 slots)

Feline Medicine (80 slots, but it fills up every year!)

Regulatory Issues: Update for the Practitioner (80 slots. I'm not excited about this one, but it's important for being accredited/licensed as a vet. It's more important for large animal people for health certificate stuff, but it's important for rabies vaccine administration in some states and I don't know where I'm going to end up.)

Small Animal Gastroenterology (130 slots)

Small Animal Nutrition (65 slots)

Emergency Medicine (130 slots. Everyone can take this one. Dr. Bailey teaches it 6 times a year.)

There is a Ton of Toxicology

2010-03-23T07:44:00.001-07:00

I’m a little overwhelmed with the amount of information we’re expected to know about toxicology. We just started this class halfway through the semester (it started after pharmacology ended.) And, wow! We thought we had to know a lot about pharmacology (drug names, mechanisms of action, significant side effects, contraindications, general category of disease affected) but toxicology seems like so much more!

Both classes do weekly quizzes (I think mostly to force us to keep up with the information.) In pharmacology, each quiz would cover maybe 3-4 pages of the notes that I make from lecture. In toxicology, the first quiz covers 20 pages of condensed information (and 60 of the note set, which is about 600 powerpoint slides of information!)

I’m trying to keep about 15 heavy metals and 10 pesticides straight (for just this quiz!) with respect to names, forms, pathogenesis, organ system most affected, animal most affected, lesions and treatment.

It’s just a lot of information!

Antimicrobial Resistance

2010-03-22T13:52:00.000-07:00

I’ll try not to get too much on a soapbox here, but I feel very strongly about the antimicrobial use in livestock debates that are raging right now.

The gist of the argument from people like the Infectious Disease Society of America and Katie Couric is that livestock producers are using antibiotics willy-nilly in their livestock and that this is contributing to antibiotic resistances that we’re seeing in human medicine.

I have several problems with this assertion. For one, I don’t think that livestock producers are using antibiotics willy-nilly. It isn’t in their economic best interest to do so! They have narrow profit margins on a per animal basis, so they tend to only treat when there’s some kind of economic benefit. The argument they make back here is that “growth promotant” antibiotics are used to treat subclinical protozoal parasite infections. My response to that is that is a subclinical infection and the animals are healthier without the parasites.

For two, why are they so uptight about antibiotic use in animals? Have they looked at the use of antibiotics in human medicine lately? Most doctors throw antibiotics at people when they come in for the sniffles. Also, most people don’t complete their antibiotic courses. So, my general feeling here is that while veterinarians do probably need to clean up their act with regards to prudent use of antibiotics, those human medicine folk need to clean their own house before they complain about our dusting.

Spring Break is Over!

2010-03-21T17:01:00.000-07:00

We went on a cruise and it was awesome!

The vet school blogging will start back up tomorrow!

Spring Break!

2010-03-12T18:58:00.001-08:00

Today marks the beginning of Spring Break!

I'm heading off on a cruise, so the posting will start back up next week.

Club Lectures

2010-03-11T16:04:00.001-08:00

One of the coolest things about vet school is the extra-curricular activities. I really love going to the lunch and dinner meetings hosted by various clubs. Mostly I’m in clubs that apply directly to my interests (AAFP for cats, LAM for lab animals, ACVIM for internal medicine), but I enjoy going to meetings when other clubs host meeting that they invite everyone to.

Tonight’s meeting was hosted by SFT (The Society for Theriogenology) and the speaker was the guy who does artificial insemination for Sea World. The lecture has been awesome.

The procedures they do are so cool. There are neat pictures of dolphins and baby dolphins and orcas and baby orcas. (Baby marine mammals are so cute!) The speaker is hilarious! (Or, maybe, it’s so funny because even vet students aren’t immune to the reflexive giggle when somebody says “penis.”)

My favorite quote of the evening: “The last killer whale I got pregnant…… Never mind. Moving on…”

After a long hiatus

2010-03-10T07:09:00.000-08:00

Hello there, internet-world. I've been away a while! School got very time consuming (no surprises there, I'm sure!)

However, I'm back and intending to post at least 3 times a week from here on out!

Vet school gives me plenty to talk about.

Pathology and Food Words

2009-09-14T09:45:00.000-07:00

My pathology prof enjoys telling stories about Robert Vircow, apparent founder of pathology. One of his favorites is that Virchow was the son of a grocer... And he described lesions in terms he was familiar with.

So, for example, the lesion associated with TB had a center of caseous necrosis. "Caseous" is a fancy word for "cheese-like" and they always describe it as looking like dry cottage cheese.

Ready for lunch?

Veterinarians are NOT Engineers

2009-08-26T20:19:00.001-07:00

Pharmacology today was definitely a demonstration of how differently engineers and other scientists think.

We had to do some pretty basic drug calculations before class this morning. (Things like if you have 50% dexamethasone solution and you want to make 450 mL of 2.5% dexamethasone solution, how many mL of stock solution would you have to add to your saline?) In class, we went over the answers to the questions. First, it took 45 minutes to do 3 simple problems, which was bad enough.

Second, it was just so... haphazard. She just rambled along on the board writing down numbers WITHOUT units. In engineering, that's a HUGE no-no. If you're going to make an error in your calculations (or find it easily once you do), it's often because you flubbed the units somewhere. You either didn't do the conversion factor right (multiplied by pounds/kilograms rather than dividing by kilograms/pounds or something) or you are using the wrong units somewhere (liters instead of milliliters or something) for example.

Even worse to my sensibilities, she kept calculating out intermediate quantities, which is introducing a completely unecessary level of rounding error into your problem. And while that's often not a big deal, it can make anywhere between a couple tenths to a couple orders of magnitude difference! And with some drugs, even a couple tenths of a gram/millilter/whatever can be devastating. Then she was going on and on about how sometimes you need to back correct for volume added affecting your final concentration (which can be a big problem. But if you're worried about that, how are you not worried about rounding error?!) I mean, basically, the more times you enter numbers into your calculator, the more wrong your answer is. That's the whole point of dimensional analysis! (Besides that it's an easy way to track units.)

Just... incredibly frustrating!

And then, we did a clicker question where she gave us all metric values... and wanted the answer in ounces. When we asked for the conversion factor from mL to oz, she refused to give it. Really? I mean, in practice we can google that if the pharmacy really insists on oz. And really, who does that?! Medicine happens in metric, folks. (Besides, if I want to convert units like that, google is an excellent tool. Go ahead, enter "209 mL in ounces" into google... It will tell you "209 mL = 7.06713074 US fluid ounces." Thanks, Google, old pal!)

And so it begins...

2009-08-24T15:35:00.000-07:00

The first day went really well, over all.

The classes, so far, seem like they'll be fine. A lot of out-of-class learning, though. The pharmacology professor even told us she doesn't plan to just teach us the information... we're going to spend the class time learning to apply information to new situations. Or something like that. I'm a little skeptical.

Parasitology should be ineresting in that I'm really interested in parasites. Pathology should be fun because it's a bunch of crazy, gross stuff. Pharmacology/Toxicology I'm not exicted about (though, Toxicology should be better because I like the professor, who was my faculty mentor)... it seems like a lot of busy work. Tomorrow, we'll have our first round of Nutrition, which could go either way.

2VM!

2009-05-08T07:32:00.001-07:00

Today is my first full day as a 2VM!

I'm thrilled!

Anatomy Goats

2009-04-16T21:02:00.000-07:00

My anatomy goat is a girl.

And she's pregnant...

... with twins. (At least we don't cut the uterus open until next week...)

:(

And, the new professor told us that they try to make sure that all goats used in anatomy lab are pregnant. That makes me really sad! So, rather than just 1 life per group that has a female goat, we're taking 2 or 3. That seems wasteful to me.

Neurology

2009-04-15T18:37:00.000-07:00

Neurology can be really interesting. And it's nice when it feels like it finally really clicks!

And everything seems to be coming together now. And the quizzes are going better than the first few went.

Sorry this isn't long! I have a lot to do!

Student-Faculty Liason

2009-04-14T20:36:00.000-07:00

Tomorrow are class officer elections... I'm running for Student-Faculty Liason. I think it sounds like an interesting position, and I wasn't totally thrilled with its handling last semester.

Here's the speech Leslie and I wrote up. I won't recite it word for word (I can't do that) but hopefully get the gist across:

Hey everyone, in case you don't know me I'm Kim. I know that the SFL job is difficult, and demands a lot of patience and tact. I think it also requires the ability to work with the professors and administration without being disrespectful, or too easily discouraged. Despite all that, and even having seen everything Bryan and Kati have dealt with this semester, I really want this position.
I think it's essential for the SFL to address problems using the proper channels and without being dismissive of students' concerns. Perhaps most importantly, I think that following up on issues once they've been presented to a professor or administrator and keeping the class informed of progress being made on those issues cannot be ignored.
Yesterday I dropped by Dr. Rogers' office to pick up a Rice hat (which is a long story), and she asked me about the concerns we presented to her a few weeks ago and where our class is coming from. Dr. Rogers assured me that she and the curriculum committee are equally concerned about the situation, and are working towards a solution.
I hope you'll vote for me, but even if you don't, feel free to come talk to me about any issues later. Thanks!

Cow feet are even weirder than horse feet

2009-04-13T19:34:00.000-07:00

They really are! The blood supply and nerves to the feet of ruminants are insane.

There are names like "proper axial digital nerve II." Really, do we need that many names? Apparently, yes, but like, really? Calm down anatomists.

Study, study, study

2009-04-12T20:06:00.000-07:00

It's amazing how much time I spend studying.

It just hits me sometimes. I spent so long studying today!

I got up at 8:30, studied 'til 10, went to the grocery store, ate lunch, studied with a classmate from noon to 2:45, hosted my study group from 3 to about 5, made dinner, studied more, took a break to read a chapter of a fun book, and then studied some more!

What a boring day... but, hopefully it will pay off and I will ace the phys test Tuesday.

Renal Physiology

2009-04-11T16:43:00.001-07:00

The kidneys are complicated and strange!

So much back and forth and fine regulation. And things that just don't seem to make a lot of sense, intuitively. Why bother to filter things out if you're just going to suck them all back in?

Oh well...

Back to my books!

Vet School v. Med School

2009-04-10T07:32:00.000-07:00

I don't remember who said it to me, but I was talking to someone about vet school a few days ago and about how we do the same things they do in medical school, especially the first 2 years, but about 6-10 species instead of 1. The response was "yeah, but you go into less depth, right?"

My response was something along the lines of "... No. We do the same depth. And more, sometimes."

Because, really, we do. Granted, there are some things that we skip over because they're just not going to happen in the veterinary world (trying to correct an exencephaly, for example. That's when you brain protrudes through your skull at birth because things didn't go right in the womb. Granted, your GP doesn't know how to fix this either.) Though, the gap between human and animal medicine gets slimmer every day (A&M does at least 12 greater than $1000 MRIs a week. That's just unbelievable to me!)

But, really, we know everything about animals that your GP knows about how you work... plus more! Your GP isn't going to be putting you under general anasthesia him/herself. Your GP isn't going to cut you open and move your organs around (either in a spay/neuter, or a gastropexy, or an intestinal anastamoses. All of these are surgeries regular vets do pretty frequently.)

Rumens!

2009-04-09T19:52:00.000-07:00

Today, I stuck my arm in a cow, up to my shoulder! And not even in the super nasty part of the cow! Just the sort of nasty part of a cow.

In Physiology today, we did our rumen phys lab. So, we went over to the large animal clinic and played with the fistulated cow. She has a tunnel that goes from the outside world into the first part of her stomach. It's... really cool! We uncorked it, gloved up and stuck our arms in as far as possible. It feels really neat to touch the inside wall of the rumen. It's all wrinkly!

And I lucked out and she didn't squirt me with rumen fluid like she did Dayna!

Lab Animal Medicine!

2009-04-08T12:07:00.000-07:00

I'm really excited!

I finally got elected for something not-by-default! I'm VP of the Lab Animal Medicine club, which as far as I can tell means I'm in charge of lining up speakers. This seems like an excellent networking opportunity for lining up summer internships next summer!

Also, largely, I'm thrilled to actually win a position. I didn't manage to get elected for anything at the beginning of the school year (granted, those elections were in the first like, 2 weeks of school, so they were pretty meaningless. "Well, I like her shirt best, so I'll vote for her.") And I got elected to the Student Chapter of the AVMA Executive Committee as Governmental Action Committee Chair because nobody ran against me.

Goats

2009-04-07T16:46:00.001-07:00

Goats are strange... or at least, our anatomy goats are strange.

I cannot for the life of me figure out why the fat over their shoulders has approximately the texture of cottage cheese.

Schedule between now and the end of finals

2009-04-06T16:29:00.000-07:00

4/6-4/12
-Palpation Exam (Tuesday)
-Microbiology Exam (Wednesday)
-Neuro Quiz (Wed/Thursday)
-Lab Animal Med Elections (Wednesday) (I'm running for president or VP)
-SCAVMA EC Meeting (Thursday)
-Leslie's Bachelorette party (Friday- in Austin)

4/13-4/19
-Physiology Exam (Monday)
-Correlates exam (Tuesday)
-Neuro Quiz (Wed/Thursday)
-American Association of Feline Practitioners elections (Thursday)
-Public Health Individual Response due (Friday)
-Leslie's Bridal Shower (Friday night-Saturday morning- in Dallas)
-Mentee/Mentor Matching (Sunday)

4/20-4/26
-Microbiology Exam (Wednesday)
-Neuro Quiz (Wed/Thursday)
-Neurological Exam
-Meet with Dr. Cohen's lab (Thursday)
-Open House! (Saturday)

4/27-5/1
-Public Health Group Project due (Tuesday)
-Microbiology Lab Final (Wednesday)
-Neuro Quiz (Wed/Thursday)
-Meet with Dr. Cohen's lab (Thursday)
-Correlates Final?

5/2-5/7
-FINALS!!!!!!!!!

Horse Palpations

2009-04-05T16:44:00.000-07:00

I did another practice round for my horse palpation exam today.

And we got help from Dr. Bratton-- who was a large animal practitioner, was an assistant in my small animal anatomy lab and is assisting in neuro this semester (he used to teach it).

As Stephanie said: "Learning horse palpation from Dr. Bratton is sort of like taking a religion class from God."

And it really is! He's awesome! And so helpful! And I cannot express how grateful I am that he'd give up some of his weekend to come help us!

Small Animal Clinicians v. Large Animal Clinicians

2009-04-04T16:32:00.000-07:00

The difference between small and large animal clinicians never ceases to amaze me. While I am in no way interested in large animal medicine, I like the doctors in the large animal hospital so much better!

They joke with each other, they joke with the students, they give more interesting tours. In general, they are just way less uptight. I really appreciate that. I think it will make the required large animal rotations 3rd and 4th year a lot more bearable. Even if I don't like/care about the information, at least they all try to make learning fun!

White Coat Ceremony

2009-04-03T07:29:00.000-07:00

Today is our White Coat Ceremony. When it was introduced to us, they said it's traditionally a marker of your transition from preclinical to clinical studies. While that sounds like a lovely idea, it seems a bit premature. Second year is completely classroom just like first year (though they apparently spend less time in lab, which will be nice.) Third year starts a combination of clinical and classroom. So, I think maybe the White Coat Ceremony would fit better between second and third years.

Oh well, it should be a nice ceremony and a nice white lab coat. (though I still wish I had a lab coat like the ones on Bones. They manage to have a shape, besides giant solid color rectangle.)

Foal Team False Alarm

2009-04-02T18:43:00.000-07:00

I'm actually a little bummed about it!

My foal team was on call last night from midnight to 8AM. At about 10 I got a call saying a foal was coming in around 12:30 and they'd need us there to help. I was scheduled for the second half of the shift (4AM-8AM... we're split into an A group of 3 people and a B group of 3 people who rotate first and second half of shift on call), so I went to bed pretty much right away.

Then, I got a text at 2:45 that we didn't have to go in. B group got the blood work and radiographs done.. and the foal wasn't down, so they got sent home and we didn't have to go in.

I'm kind of sad. While I'm glad not to have had to leave my apartment at 3:45 AM, it would have been neat to play with a baby foal!

Braaaaaains

2009-04-01T14:27:00.000-07:00

Only in vet school (or, I suppose medical school) would you take a test in which there are a bunch of brains floating in little tubs of water.

There's something surreal about walking into a room full of buckets of brains.

(Nevermind that they were all cut up in totally bizarre ways, which, in fact, can make it very hard to identify structures you're used to seeing from other angles or in reference to structures that were lopped off on the test specimen.)

Oh well, now that the neuro exam is over it's time to catch up in Microbiology!

Blog Every Day April

2009-03-31T13:39:00.000-07:00

I heard about this idea on a message board. It's mostly aimed to help those of us who tend to think "I just blogged!" only to realize it's been 2 weeks.

So, I'm going to try to BEDA this blog! Wish me luck!

Oops.

2009-03-29T17:53:00.001-07:00

Sorry for the long absence. Vet school has been... time consuming.

And given that I try to keep the tone here relatively upbeat, there's been very little of interest to say about school, lately. It's been a rough semester. The best thing about it is that the end is quickly approaching.

Guts are gross (and other sundry Anatomy talk)

2009-02-16T06:09:00.000-08:00

I know it sounds rather self explanatory, but really, I didn't have a good concept of how gross guts are before we opened the abdominal cavity of our anatomy horses last Tuesday and the cut them out and dug around in them on Wednesday.

The smell was overwhelming. Usually in lab, we get used to the smell by the end of lab. Not that time. Not even a little. It didn't help that some of the horses weren't as well preserved as others, so there were some rotting abdominal contents discovered. (At least ours were well preserved. Actually, they were quite nice.)

Overall, ours wasn't terrible. But all of the steps involving draining intestinal contents were not fun. Not fun at all. Someone had the bright idea to drain our horse's left ventral colon (a relatively early part of the large intestines) by cutting a slit in it, shooting water up it, and then upending it over the floor. It was... nasty... to say the least. It also managed to clog the drain twice, so he had to pull out the drain and dump the catch into the tissue collection bucket.

Then, today, we cut the horse in half. Literally. We took a hack saw to the back, right at the end of the rib cage. We're doing all the pelvic cavity dissection sort of head on. I am forced to wonder, however, how useful a view this is. There will never be any time in anybody's future career in which they will hack a horse in half to go about their procedure.

Foal Team

2009-02-03T20:47:00.000-08:00

My friend Caroline convinced me to sign up for Foal Team. It's essentially a class that counts towards credit 3rd year, but mostly it's for experience dealing with horses. We're on call at certain times to go in and help monitor baby foals that need ICU kind of supportive care. It sounds pretty interesting.

However, the coordinators randomly assigned groups and group leaders... and I'm stuck being one. It's a little bit of a raw deal, especially given that I don't really know anyone in my group. However, I now have it divided up so that out of each 8 hour shift we're assigned, each group member is only on call for 4 of those hours (however, the ICU people will only ever call me, and I have to call the rest of the people. Boo!)

So, I'm hoping it will be an interesting experience, but I'm a little worried! My first on call shift is this Friday, from 4-8PM. (The whole shift is 4PM-midnight.)

Vet School Jokes #4

2009-01-29T20:52:00.001-08:00

To the tune of "It's a Small World"

It’s a life of classes; A life of fear.
It’s a life of textbooks, A life of beer.
Eight to five every day,
And for this we must pay.
It’s a vet school after all.

It’s a vet school after all,
It’s a vet school after all.
It’s a vet school after all.
It is our vet school.

There are just four years but it seems a ton,
And there’s lots of pets, some for everyone.
And although we may fret,
We will conquer this yet!

It’s a vet school after all.
It’s a vet school after all,
It’s a vet school after all.
It’s a vet school after all.
It is our vet school.

Horses

2009-01-26T20:27:00.000-08:00

I think this may become a common complaint over the course of this semester, but...

Horses are SO WEIRD.

There are so many things about their anatomy that seem like design flaws. And then, the horse people had to go and give everything weird names.

For an example of a design flaw, their eustacian tube (between the middle ear and the mouth... so, like if a kid has tubes in their ears, it's keeping this open) dilates out and makes this huge pouch along the back of their head. If they get an ear infection, this pouch tends to get infected and fill with pus... and can lead to significant nerve damage, because there are lots of important nerves there. And, nobody has any good reason for this pouch to exist.

As to weird names... They call what amounts to our wrist the knee. And they have fetlocks and pasterns and coffin joints.

Also, they basically walk on the tip of their middle finger.

Crazy beasts!

First Day of Second Semester!

2009-01-12T17:05:00.001-08:00

This semester should be quite an experience. We spend a lot more time in class, therefore we have a lot less time during the day at school to study and a lot sadder schedule (we have physiology at 8AM every day... instead of having it every day but at different times so we had 9AM Monday starts and 10AM Friday starts.)

Overall, the classes seem like they won't be so bad. There's a lot of reproduction, which is not my favorite, but it should be ok. It's just 1 unit of physiology and 6 weeks of embryology.

Schedule:
Monday
8 - 8:50 AM -- VTPP 912 Physiology II
9 - 9:50 AM -- VIBS 913 Microscopic Anatomy II
10 - 10:50 AM – VIBS 912 Gross Anatomy II
11 - 11:50 AM – VTPB 911 Veterinary Microbiology
1 - 2:50 PM – VIBS 913L Microscopic Anatomy II Lab
3 – 4:50 PM – VIBS 912L Gross Anatomy II Lab

Tuesday
8 - 8:50 AM -- VTPP 912 Physiology II
9 - 9:50 AM -- VIBS 912 Gross Anatomy II
12 - 2:50 PM -- VIBS 912L Gross Anatomy II Lab
3 - 4:50 PM – VMID 913 Clinical Correlates II

Wednesday
8 - 8:50 AM -- VTPP 912 Physiology II
11 - 11:50 AM -- VTPB 911 Veterinary Microbiology
1 - 2:50 PM – VTPB 911L Veterinary Microbiology Lab
3 – 4:50 PM – VIBS 913L Microscopic Anatomy II Lab

Thursday
8 - 8:50 AM -- VTPP 912 Physiology II
9 - 9:50 AM -- VIBS 913 Microscopic Anatomy II
10 - 11:50 AM – VTPP 912L Physiology Lab
1 - 2:50 PM – VIBS 913L Microscopic Anatomy II Lab
3 – 4:50 PM – VIBS 912L Gross Anatomy II Lab

Friday
8 - 8:50 AM -- VTPP 912 Physiology II
9 - 9:50 AM – VIBS 926 Public Health
11 - 11:50 AM -- VTPB 911 Veterinary Microbiology

Oh, Dr. Blue-McLendon

2008-12-25T19:44:00.000-08:00

This article quotes my Correlates professor... she really does sound this insane in real life when she talks:

http://news.yahoo.com/s/ap/20081219/ap_on_fe_st/rudolph_s_gender;_ylt=Ark3k5NJxHWlM.h3lwtYkV3tiBIF

There may be a perfectly good reason why Santa doesn't get lost on his annual Christmas globetrot: His flying reindeer just might be female and don't mind stopping for directions.

The gender of Rudolph and his or her sleigh-hauling friends — the subject of goofy Internet chatter every year around this time — is now being pondered by renowned wildlife experts at Texas A&M University.

"Santa's reindeers were really females, most likely," said Alice Blue-McLendon, a veterinary medicine professor specializing in deer who cites the depictions of Santa's helpers with antlers as the primary evidence. It turns out reindeer grow antlers regardless of gender, and most bulls typically shed their fuzzy protrusions before Christmas.

But Santa's sleigh helpers might also be castrated males, known as steers, said Greg Finstad, who manages the Reindeer Research Program at the University of Alaska Fairbanks.

Young steers finish shedding their antlers in February and March, just as non-expecting females do. Bulls generally lose theirs before Christmas, while expectant mothers retain their antlers until calves are birthed in the spring. This allows them to protect food resources through harsh weather and to have enough for developing fetuses, he said.

Sledders most often use steers because they maintain their body condition throughout the winter, he said. Bulls are tuckered out from rutting season when they mate with as many as a dozen females in the months leading up to December. That leaves them depleted and too lean to pull a sleigh or sled through heavy snows, Finstad said.

Many females are pregnant after rutting season, which lasts from summer and into the fall. That would mean long hours of backbreaking work for an expecting Rudolph, as well as Donner, Blitzen, Cupid, Dasher, Dancer, Prancer, Comet and Vixen.

"You don't hook up your pregnant females to a sled," Finstad said. "That is not good animal husbandry."

But other aaspects of the Christmas story support the all-girl sleigh team theory, Blue-McLendon said.

For example, would a boy reindeer really sport a shiny red nose that almost glows?

"Females like accessories," said Blue-McLendon, who in 2003 led the school's cloning of a white-tailed deer. "I think that fits because females like bling. We like shiny stuff."

As for the reindeer games, forget the rough antler-smashing stuff. Blue-McLendon suggests a female Rudolph would be more up for "games of wit."

And as for the name, Rudolph could certainly still work.

"Why not?" Blue-McLendon said. "I know women named Charlie."

Grades

2008-12-11T15:41:00.000-08:00

Grades are mostly in (at least in the unofficial grade display online) and I did pretty darn well, if I do say so myself.

Physiology (6 hours): A
Anatomy (4 hours): B
Histology (4 hours): A
Immunology (2 hours): A
Clinical Correlates (1 hour): A
Professional Development (1 hour): A

Vet School Jokes # 3

2008-12-01T08:39:00.000-08:00

Caroline and I have composed another song, because the first one went over so well! (We sang it to the whole class and won a contest with it for a $50 prize we split between the 2 of us!)

This one takes a little more slurring/creative liberty, and wasn't quite as popular. Oh well, sequels never are.

The 12 Nerves of Cranial

1:
On the first day of classes
Doc Hoffman gave to me
One olfactory.

2:
On the second day of classes
Doc Hoffman gave to me
Optic, to see!
And one olfactory.

3:
On the third day of classes
Doc Hoffman gave to me
Oculomotor
Optic, to see!
And one olfactory

4:
On the fourth day of classes
Doc Hoffman gave to me
Fourth, trochlear
Oculomotor
Optic, to see!
And one olfactory

5:
On the fifth day of classes
Doc Hoffman gave to me
TRI-GEM-IN-AL!
Fourth, trochlear
Oculomotor
Optic, to see!
And one olfactory

6:
On the sixth day of classes
Doc Hoffman gave to me
Abducens abducing!
TRI-GEM-IN-AL!
Fourth, trochlear
Oculomotor
Optic, to see!
And one olfactory

7:
On the seventh day of classes
Doc Hoffman gave to me
Facial nerve as motor!
Abducens abducing!
TRI-GEM-IN-AL!
Fourth, trochlear
Oculomotor
Optic, to see!
And one olfactory

8:
On the eighth day of classes
Doc Hoffman gave to me
Vestibulocochl’r
Facial nerve as motor!
Abducens abducing!
TRI-GEM-IN-AL!
Fourth, trochlear
Oculomotor
Optic, to see!
And one olfactory

9:
On the ninth day of classes
Doc Hoffman gave to me
Glossopharyng’l
Vestibulocochl’r
Facial nerve as motor!
Abducens abducing!
TRI-GEM-IN-AL!
Fourth, trochlear
Oculomotor
Optic, to see!
And one olfactory

10:
On the tenth day of classes
Doc Hoffman gave to me
Vagus a-wandering
Glossopharyng’l
Vestibulocochl’r
Facial nerve as motor!
Abducens abducing!
TRI-GEM-IN-AL!
Fourth, trochlear
Oculomotor
Optic, to see!
And one olfactory

11:
On the eleventh day of classes
Doc Hoffman gave to me
Accessory, who cares?
Vagus a-wandering
Glossopharyng’l
Vestibulocochl’r
Facial nerve as motor!
Abducens abducing!
TRI-GEM-IN-AL!
Fourth, trochlear
Oculomotor
Optic, to see!
And one olfactory

12:
On the twelfth day of classes
Doc Hoffman gave to me
Hypoglossal, tongue
Accessory, who cares?
Vagus a-wandering
Glossopharyng’l
Vestibulocochl’r
Facial nerve as motor!
Abducens abducing!
TRI-GEM-IN-AL!
Fourth, trochlear
Oculomotor
Optic, to see!
And one olfactory!!!!

Long Absence

2008-12-01T08:37:00.001-08:00

Sorry about disappearing off the face of the blog-o-sphere.

The end of the semester rush caught me up. It's been crazy busy with end of semester exams and social activities... and, now, brought to you by people who seem to hate students: FINALS!

I have a final every day this week, except Friday:
Monday: 9 - 11 AM: Physiology
Tuesday: 8 - 10 AM: Immunology
Wednesday: 1 - 5 PM: Anatomy
Thursday: 8 AM - noon: Histology

Anatomy Terms

2008-11-10T20:11:00.000-08:00

Sometimes the words we end up using in Anatomy bother me.

Some of them are not descriptive, which bugs me. For example, the accessory pancreatic duct in the dog is the primary route by which pancreatic secretions reach the jejunum. The pancreatic duct may not even be present. (That varies from dog to dog.)

Some of them are overly descriptive. For example, the perforating branch of metatarsal II. This would make sense if there were other branches that perforated the foot... but, there's only the one artery. Too much information!

Then, we just use some of the same words over and over and over. For example, there are 3 (!) zygomatic processes in the skull. The zygomatic process of the maxillary bone, the zygomatic process of the temporal bone (both of which join the zygomatic bone to form the zygomatic arch) and the zygomatic process of the frontal bone (which points off the frontal bone toward the zygomatic arch... which has a frontal process of the zygomatic bone.)

Anyway, I think the terminology is ridiculous sometimes!

Pathology Club Rounds

2008-11-03T10:36:00.000-08:00

The pathology club that I'm in periodically does what they call "50x rounds" where clinicians present a case seen by the clinics.

Today, one of the cases was a 6 month old Doberman Pinscher show dog who presented this summer with a week long history of lethargy and an insanely high white blood cell count. It turns out he had leukemia.

The most interesting part of this was that dog was refered by the clinic I worked for this summer! I remember this dog! He came in for the appointment that got him referred to A&M while I was working! I think I may have even actually run his initial blood work myself!

What a small world!

Vet School Jokes #2

2008-10-29T16:38:00.000-07:00

So, there is this structure in the abdomen that rhymes with Supercalifragilisticexpialidocius (the celiacomesenteric ganglion and plexus.) Today during our study time, Caroline and I were singing the Mary Poppins song, but with mostly the real lyrics (except replacing the ganglion and plexus.) It was pretty hilarious... but, even better... Caroline and I have composed a better version!

Celiacomesenteric ganglion and plexus

Um diddle diddle diddle um diddle ay
Um diddle diddle diddle um diddle ay
Celiacomesenteric ganglion and plexus!
Found near major arteries and other things that vex us.
You’d better know just where its found
Cuz’ likely they will test us,
Celiacomesenteric ganglion and plexus!

Um diddle diddle diddle um diddle ay
Um diddle diddle diddle um diddle ay
Looking in the abdomen
can make you very sad
The tangle of the vessel s and the nerves can get quite bad
But finding the aorta sure will help you stay on track
And if you find this structure you will surely get the knack!

Oh, Celiacomesenteric ganglion and plexus!
Found near major arteries and other things that vex us.
You’d better know just where its found
Cuz’ likely they will test us,
Celiacomesenteric ganglion and plexus!

Um diddle diddle diddle um diddle ay
Um diddle diddle diddle um diddle ay
So when you’re taking the exam
And you get all confused
Remember all the very weird mnemonics that you used.
Don’t breathe the formaldehyde and try to find the answer,
And don’t forget to wash your hands or else you might get cancer!

Celiacomesenteric ganglion and plexus!

Bobcat!

2008-10-23T19:05:00.000-07:00

Today was pretty much the longest day of school ever. I was at school for more than 12 hours. This 12 hours included a histology exam (with a part at 8AM, a part of 3PM and a part at 4PM), an anatomy lab, and a 3 hour after school session about veterinary ethics. It was a long day.

Then, when we walked out to the parking lot, there were cars surrounded by caution tape... including, mine. In fact, mine was in the center of the caution tape zone.

Because... there was a bobcat in the car under mine. Yes, an honest-to-God bobcat.

After the wildlife people showed up, they ended up poking the bobcat with a syringe on a stick. After the first stick, the bobcat crawled under my car! THERE WAS A BOBCAT UNDER MY CAR! It was super cool!!!

Sadly, I didn't end up with any good pictures. I left my real camera at home and the situation was a little too much for the iPhone. But it was so cool!

You can't really see anything, but the 2 spots of light under my car with the shadow in the middle is the bobcat.

The cool thing about being a first year

2008-10-17T16:07:00.000-07:00

Or at least, one of them.

Some background: This week, I took my parents' dog, Raz, in to the Teaching Hospital to get the mass on his face evaluated then removed.

It's really cool how excited everyone-- older students and clinicians-- is to talk the you, the first year. They like to ask about your classes (and reminisce about how awful anatomy and physiology are.) They like to tell you that it will get better. They like to tell you stories from their own time. They like to offer to let you help out during procedures and show you around. It's really nice to feel like they're all really excited that you're there and that they want to teach you and want you to do well!

Auction Barn

2008-10-07T18:26:00.000-07:00

Well, food animal medicine is definitely out. I have full, 100% eliminated that from my possible career choices! (Not that I was ever seriously considering it. I really am down to lab animal medicine or small animal practice, essentially depending on how much I want to put myself through more school when I finish my DVM.)

Today, I went to the Auction Barn for Correlates class. It was... horrifying, and kind of scary. I mean, I know they're trying to find the best/safest/most humane way to quickly move a lot of animals... but... still.

We were sitting in the back watching the cow/bull auction. And, it was just painful to watch them shock the cow up for bid multiple times. I understand that the buyers need to be able to see all sides of the animal (to look for things like bad eyes/limbs/teats/whatever)... but, it's sad to see an animal run into the chute looking terrified then see it get shocked 4 or 5 times to keep it spinning.

Then, in the back, it was even worse! There was 1 guy that I really couldn't tell what he was shocking the cows for, except maybe for fun. They were trying to get them into the chute kind of single file, but he was paying attention to this set of them that were in the back (pointing the wrong direction) and he'd shock their butts. This does not make them turn around... it just makes them try harder to go straight... The thing about animals is they run AWAY from pain, not towards it.

It was just... really sad.

Vet School Jokes

2008-10-03T08:16:00.000-07:00

You know you're a vet school nerd when...

... you make Histology jokes! And you laugh at them.

In class on Thursday we took the written part of our Histology exam at 8AM. As Caroline and I were walking back into class she was making sure she'd found "her" seat (which is one row forward and to the left from me.) When she sat down she said "Oh, good, my little lacuna!" (A lacuna is the little well that a bone cell sits in inside the bone) and my response was to stick out my arm and say "canaliculi!" (A canalicula is a channel between two lacunae allowing communication between the bone cells.)

We both laughed and laughed and laughed.

Canaliculi!

Anatomy Reaction

2008-10-01T13:31:00.000-07:00

Well, I am continuing to react to Anatomy lab.

Monday I got through without any ill effects. I was super, super careful about not touching anything, though.

Today, I must have been more lax. Near the end of lab, I ended up with the right side of my face, my right ear, and a bit of my neck turning bright, bright red and itchy and a little bumpy/hive-y. I washed it off and used the anti-histamine cream again... but, it's just really embarassing and kind of scary.

I do not want to keep doing this. I need to find out what, exactly, I'm reacting to and if there's any way to avoid coming into contact with it. Because, you know, I have tons of spare time to be spending doing that!

Anatomy Exam, Round 2

2008-09-26T18:36:00.001-07:00

I haven't been posting much lately because we just moved into the second round of exams. This time, we started with Anatomy, rather than ending with it.

I spent the whole week in pretty intense study mode. I think I learned it pretty well, or at least, did the best I could!

The exam went well enough! I don't look at the key posted afterwards, because honestly, it doesn't make much sense to just look at a list of terms disconnected from anything. I don't even remember what I answered for the questions by the time the key gets posted.

The most interesting part of the exam, though, was that I managed to get a skin reaction about halfway through the lab portion. I was sitting there at my questions (we rotate through stations every 70 seconds) scratching my neck like crazy. Eventually, Dr. Herman came over and asked me if I was ok. I told her that my neck REALLY itched and she looked at iy and said I was gettng some hives. She then brought me a damp paper towel and I rubbed it down, which helped a lot but didn't make it better. She then brought me some cortizone creme, which helped a lot. At least, it made it bearable to finish the exam! My head and neck still feel a little weird though!

I guess I am just really reactive to formaldehyde (which I already kind of knew, I just didn't know it was so extreme. It might just be getting worse as I'm exposed more.)

Funny/Interesting Things Professors Say #2

2008-09-18T09:02:00.000-07:00

(I meant to do this weekly, but then I kept getting busy! Also, I will add more once I go home and have all my notes with me. I only carry a select set on any given day at school.)

Anatomy:
"We don't want those 50 skull bones moving around... We want joints of stability there!"
"Gomphosis... kind of a silly word, but a joint nonetheless."
"Do we need to know innervation? Absolutely not... yet."
"When I was in vet school, I was taught, and learned, and believed that somebody made these up. But they do exist! but, functionally, they don't exist."
"We can't use 'knee' in veterinary medicine because of those horse people."

Physiology:
Dr. Cudd
"If you bang your retina with a hammer, you would have a sensation of light."
"They're going to think you're a Turk if you don't."
"If you go out of here and only vaccinate poodles for the rest of your life, you'd be in your own personal hell. At least, I would be."
"I don't know how many of you watch Robot Wars.... yeah, it's a great show."
"Obviously, the [chicken] head is not required for flapping and running."
"We're going to be black and white in here, but it's a grey world out there, folks."
"It's what's going to take care of you if a bengal tiger walks in."
"The nervous system is kind of like a little old lady who drives with both feet."
"The rare horse can kind of flip out on you."
"If you dilated all your blood vessels maximally at once... you'd die."
"I was an exciting horse doc... now, I am a boring professor."
"We don't have to think 'I don't want to urinate right now' all the time."
"There are many reasons dogs could be having accidents in the house. Sometimes, they're 'on purposes.'"
"Most dogs don't drive."
"Skeletal muscle is greedy, liver is generous."
"When you graduate, 50% of you will be poodle punchers. 10% of you will have green arms..."
"They have "Vagaled" out. Their heart rate goes buhbuhbump... bump... .... ... clunk."
"Hopefully, if you're terrified you're running and not crying."
"The important thing about eyes is, you can screw them up."
"Human adaptation to light takes about 30 minutes... animals just aren't saying."
"Usually, that's an acute death."
"Know the classic drug for this? Cocaine."
"Animals are very uncomfortable with cornea problems whihc can lead to veterinarian discomfort."
"Ear infections. Do you know what they smell like? I'm pretty sure you'll find they smell like money."

Dr. Wasser:
"You know which edition you're getting because the number of dolphins on the cover increases. So, even if you can't read, you know which one you've got."
"Bald eagles... not really a good bird. They're fancy vultures."
"As you know from your experience with vision..."
"Owls are... dumb as bricks. They're massively stupid. It may be that they don't have so much brain because they have so much eyeball."
"I was out in the swamp at night... usually for biology reasons..."
"There's your mouse... or rat... it's kind of hard to tell. There's your rodent."
"This is about to be an ex-mouse."
"Your eyes would shrivel up, rendering them useless."
"I don't know why you'd want to have a poisonous fish on your space ship."
"I don't mean me.. I mean 'we'... science..."

Phys lab:
"Just think of the horse as a big, one toed dog."

Histology:
"I don't know if penguins have lymph nodes..."
"I don't eat any kind of viscera. But, Dr. Russel, he'll eat anything. He's British."

Immunology:
"We basically dealt with the enemy last week."
"We don't consider these professional phagocytes. They must be amateurs, I guess."
"A cell gets infected with a virus and gets stressed. You would too."
"Like many diagrams in immunology, there are a lot of boxes and arrows that go all over the place."
"Remember that part of organic chemistry? Oh, I feel sorry for you!"
"...T cells are a hell of a lot more complicated than that."
"They're the kind of cells that live fast and die young."
"Macrophages are sloppy eaters... they drool a little."
"... probably working with whooping cough. That was popular in those days."
"Steroids have a different context if you're an Olympic athlete, but these have different actions!"

Osteosarcoma

2008-09-15T15:25:00.001-07:00

My cadaver in anatomy this week was euthanized probably relatively shortly before dying of cancer.

When we started to open the thoracic cavity today we found a little growth on the bone of the 7th or 8th right rib. As we opened the cavity further, we found another small growth and then an enormous (2-3 inches across, in a 40 or so pound dog) growth on his right 1st rib. We showed it to Dr. Hoffman, who was very impressed, and then told us that this was probably the dog with a tumor on his thoracic limb (it was!)

So, the poor little guy (who was probably only about 8 months old) had a primary tumor on his antebrachium (forearm) that metastisized to several locations in his thoracic cavity... and we think we can feel a tumor or two on his liver through the diaphragm. Too bad we aren't opening the abdominal cavity this week!

Exams

2008-09-08T15:22:00.000-07:00

Today I finished the incredibly grueling first round of exams. Between 2 Mondays, I took Immunology, Histology, Anatomy and Physiology.

So far, I have three of those grades back (including the Physiology exam I took this morning.)

Immunology: 98%
Histology: 94%
Physiology: 92%

Basically, I'm doing really, really well and I feel really, really good about it!

And I'm not going to study tonight. I deserve a break after all that!

AAFP Panther Declaw

2008-09-06T19:48:00.000-07:00

This Friday evening to Saturday evening I went to San Antonio with the American Association of Feline Practitioners to watch a panther declaw then do some practice visual-only medical exams at a wildlife sanctuary.

After a relatively long drive, we went out to dinner together as a group!

Saturday morning, we went to the clinic and posed for a photo-op before doing surgery!

We then weighed him, drew some blood, did a bunch of xrays then did 2 declaws to remove ingrown toenails that were causing him significant pain. This is a picture of me and the black leopard after his surgery.

Then we did some practice medical exams and got to see a lot of animals at the wildlife sanctuary. It was really interesting. Though, it got really hot, and because of some scheduling trouble, we ended up skipping lunch. So, by 3:45 I was hot, hungry, a little dizzy and totally ready to leave.

First round of exams!

2008-08-31T07:28:00.000-07:00

Next week will be my first round of exams. All of them are "minor" exams (meaning they weigh less than "regular" exams, and may be shorter, but have the same level of difficulty as all future exams will have.)

I must admit to a fair bit of nervousness. Though, actually, I'm feeling pretty good right now. I did well on the Histology practice exam. I'm very comfortable with Immunology (thanks to Dr. Hillis at Baylor!) Anatomy I'm a little worried about, but I just need to keep going over and over and over the muscles and I'll be ok. Physiology doesn't actually happen til the 8th, and I have no idea what to expect from it.

Wish me luck!

Lab Animal Medicine

2008-08-27T19:42:00.000-07:00

We had the first meeting of the Lab Animal Medicine club today. And I'm very excited about the prospect of working with lab animals!

There are so many different kinds of things you could end up doing in lab animal medicine-- from governing type work (writing Good Laboratory Practices, GLPs) to taking care of animals used in reasearch to doing your own research projects. Also, it's a field that is in desperate need of new recruits (meaning that there's lots of available positions!) and it's in the top 2 most highly paid veterinary positions (starting salary is somewhere around $100,000!)

The downside? A 2-3 year residency then taking boards. (However, the residency does defer your student loans and pay enough to live on...)

So, this seems like a really great possibility! Now I just need to figure out what it takes to be competetive for lab animal medicine residencies!

Also, next weekend I'm going to an Wildlife Orphanage in San Antonio to watch a panther declaw and tour their facilities with the AAFP (American Association of Feline Practitioners). I'm pretty excited!

Veinipuncture

2008-08-26T19:38:00.000-07:00

Today we did a "blood and plasma" lab in physiology lab.

Our (remarkably patient) lab dog, Winkler, got blood drawn with a syringe in two veins (once each in the right cephalic and right saphenous veins... essentially, the major vein of the front leg and back leg.) And, we tried (about 5 times) to place a catheter.

I got to draw the cephalic vein blood... and, I hit the vein on my first try! I was very proud of myself. Actually drawing the blood was harder, though, because while I have the one handed motion down for a 3cc syringe, the 12cc syringe provides A LOT more tension. I ended up having to use 2 hands.

We never did get the catheter inserted properly. Poor Winkler was really patient with us, though!

Professionalism #1

2008-08-25T17:03:00.000-07:00

One of the things they're really stressing to us is that we're "professionals" now and that means we have different standards of behavior than we did in undergrad.

One (of the many) things about professionalism that our professors are stressing is punctuality. We heard about it at orientation. It is written into every one of our syllabi. DO NOT BE LATE. Don't do it. (With one exception. Dr. Landis is willing to make a few minute allowances on the 8AM histology lecture for unforseen circumstances like car trouble or your cat threw up all over the floor and you had to clean it up before you left.)

Dr. Hoffman, the anatomy professor, takes punctuality so seriously that he says that if you are going to be late, do not come to class. Stay in the hall. Talk to him later and he'll catch you up. If you walk in the door late, the whole class will have to take a pop quiz.

Well, someone decided to test him today. And we had a pop quiz (luckily, it wasn't hard because we haven't learned much.) We were all glaring daggers at the girl who came in late. I'm still peeved about it.

Be professional! Or at least make sure that your problems and your bad planning don't negatively impact the rest of us!

Funny/Interesting Things Professors Say #1

2008-08-24T19:17:00.001-07:00

Anatomy:
"Veterinarians are highly trained, well educated problem solvers."
"Even though it is a dead animal course, we're going to evaluate you on some live animal stuff!"
"I said 'do do,' I'm sorry."
"Some of us are lumpers, some of us are splitters. I'm a lumper."

Physiology:
"The day before you graduate is the smartest day of your life. The day after you graduate is the dumbest year of your life."
"If you're bored with physiology, then study anatomy..."
"Excerise. It's a really good idea. Sleep. You have to. Play. But not too hard or too often."
"Is it a gorilla glue bond?"

Physiology lab:
"So, if you have a 1% dirt solution, you have 1 g dirt per 100 mL solution."

Histology/Clinical Correlates/Professional Development:
Uhm. I didn't write anything down, so it would seem they haven't said anything that struck me at the time as particularly funny!

Anatomy Lab Couldn't Stay Injury Free Forever!

2008-08-21T17:29:00.000-07:00

Dr. Hoffman was so impressed that we got through the first day with sharps without any accidents... but, apparently that was just to lull him into a false sense of security!

One of my classmates went to the hospital today. (Well, really, 2 did... one got hurt and one of his lab partners drove him to the hospital.)

Apparently, he was transecting a muscle and his hand slipped... and he gouged himself in the other hand. Dr. Hoffman said that he "has good tendon function" but he needed to go get sutures. It really freaked the poor kid out. He was fine going over to the sink, but he started throwing up when he actually looked at it. (I probably would too... it's very different when it's your own body.) Hopefully he'll be the only injury this year! (And, hopefully his hand is really ok! They're so delicate! You really don't want to go cutting stuff in your hands... you can do permanent damage really fast.)

What We DON'T Know

2008-08-20T21:28:00.000-07:00

Quite frequently when I read science textbooks I'm struck by what an incredible volume of knowledge we have accumulated about a wide array of topics.

But, almost as frequently, I'm struck by how much we DON'T know. (And also by how much we think we know, but then find out we were wrong about.)

Right now I'm reading pretty general information about bones-- such as how to classify bones by shape (which is more touchy-feely than classifying them by location)-- and I come across this statement:

"The exact constitution of the crystal lattice is still under study, [...]"

And it is just incredible to me that we know so many things about the bones, and their structure and their function and their histology, but we're missing something so fundamental as the constitution of the crystal lattice.

(Also, apparently, if you soak a dog fibula in hydrochloric acid for a day, you can then tie it in a knot.)