Week One: The Learning Curve

I've come up to the clinic tonight to take advantage of free wifi and check on a couple of our in-house patients.  Both patients are female dogs.  One is middle-aged with a broken pelvis and nasty gash from being hit by a car, the other is a 6-month old who is trying her best to tough out the cursed parvovirus.

It's been a little over a week since I checked in last, and looking back over the past 8 days all I can say is: phew!!  I've seen and learned a lot over this past week!  The mission team was here rocking socks Monday-Thursday.  We tackled the surgeries and attended to walk-in appointments Monday, Tuesday, and Wednesday.  The cases ranged from standard vaccinations to severe corneal ulcers (yep, that's the eyeball) to abscesses, arthritis, gastrointestinal upset, ringworm, etc.  We were clipping right along and getting into the groove of the clinic.  I woke up on Thursday in a great mood!  It was one of those productive, hyper, smiley moods that makes you appreciate the little things in life and work efficiently.  It was perfect for the day that Thursday would become.  The entire week's schedule was full before we even made it to Window Rock, but as rez time would have it, many people weren't able to bring their pets to the clinic throughout the week for one reason or another (too far, too expensive, dog ran away for a few days...).  Until Thursday.  EVERYONE showed up on Thursday.  After 8 spays, 6 neuters, random walk-ins, and 14 hours of non-stop action, my energetic mood deteriorated and the mission team went through several states of delirium. After leaving the clinic we had grand plans of eating dinner, drinking a beer, and going to bed promptly so we could wake up the next morning and watch the sunrise with the rest of the mission team.  Instead, we ate dinner, drank a couple beers, and played grade school card games until 3:00am.  It's funny how second winds hit.  Lauren was the only one committed enough to go on the sunrise hike.  The rest of us enjoyed staring at the backside of our eyelids until mid-morning.

Once we all finally rolled out of bed on Friday we drove up to Chinle to visit Canyon de Chelly (pronounced "shay").  It was a beautiful afternoon hike complete with spectacular views, ruins, caves, and climbing.  It was a rewarding end to a productive week! :)


Spider Rock in Canyon de Chelly.



White House ruins on the floor of Canyon de Chelly (1000 ft. below rim).



  By Saturday morning the entire mission group, aside from Lauren, had left for their 14 hour drive back to College Station, TX.  Lauren and I enjoyed a leisurely breakfast and decided to make our way down to Arizona's Apache-Sitgreaves National Forest.  We stopped for lunch at a local restaurant in Eager, AZ and received a "Gig 'em Aggies!" greeting from a man in the parking lot.  My "Texas A&M Veterinary Medicine" decal gave us away.  Both of our sandwiches were delicious, and they seemed even better when we learned that our lunch ticket had been covered by our new Aggie-loving friend!  We never caught his name, but he said he was originally from San Angelo, Texas and had 2 daughters who just graduated from college.  He said they were dirt poor and agreed that we probably were too.  He was right.  His generosity was uplifting and very much appreciated!  After lunch, Lauren, the dogs, and I arrived at Big Lake where we spent the weekend camping, hiking, and generally chillaxin'.  We popped my hot pink tent at a campsite with a waterfront view.  It was perfect!  The weather was great, the dogs were happy to run and swim, and the views were stellar!

Cheyenne & Seu awaiting the commencement of the "retrieve the stick out of the frigid mountain lake" game.

Saturday night's sunset over Big Lake in Apache-Sitgreaves National Forest.

Sunday's hike: Lauren, Seu, Cheyenne, and I at the top of Big Lake's ranger lookout station.

The four of us returned to Window Rock on Sunday afternoon feeling refreshed from our outdoorsy weekend.  Lauren and I cleaned up and headed into Gallup, NM (the closest sizeable town) for dinner and a movie before she left for her summer road trip adventure.  More perfection.  :)  We saw Disney's "Brave" and I had to restrain myself from calling my mother at midnight to apologize for being like Merida.  It's a good thing I didn't call; otherwise she would have undoubtedly been very bear-like.  You'll have to see the movie to understand those sentences.  Sorry.

And so here we are, partially into a new week!  So far, so good.  I feel incredibly lucky to be surrounded by an amazing clinic staff who laughs at my jokes and not at the stupid things I do every-now-and-again.  I am starting to respond to "Dr. Mills" and enjoying breaking my title in like a new pair of shoes (though I still prefer being on a first name basis).  I have my own corner in the vet's office and am beginning to establish a sense of professionalism in my mind.  As long as I have a coffee cup in-hand I feel legit.

One down...

We survived the first day!!!  Our day started at 7:30am and ended at 5:30pm.  It was 10 slam-packed full hours of doing, minus the 15 minute break to sit for lunch.  I knew we were in for a fast learning curve when, upon our arrival, 2 families were already waiting at the clinic door this morning.

The first half of the day was peppered with walk-in appointments while the last half was full of surgeries and straggler walk-ins.  There were dogs with open wounds, a cat with a questionable alopecic area which looked like a burn, a kitten with a possible wrist (carpometacarpal) luxation, and several vaccinations.  One lady was impressed we took the time to ask about and examine her dogs when she brought them in for booster shots.  Apparently to her a vaccination appointment is usually a wham-bam-thank-you-ma'am ordeal with very little conversation or eye contact.  To me, routine appointments provide a great opportunity to connect with the owner and discover some of the intricacies of their daily animal care.  I was happy to know she was appreciative of the dialogue!

Today's surgery list included: 2 dog spays, 3 dog neuters, 2 horse castrations, and 2 extensive wound cleanings.  I was supposed to be in charge of performing/overseeing the spays, neuters, and wound cleanings.  In reality, I had time for the spays.  Only.  (I'm extremely thankful for the awesome support of the other mission team-members who gladly shouldered the responsibilities!)

In my defense, both spay patients were in heat.  This means their uterine and vascular tissues were all engorged, very bloody, and highly friable (aka, the tissue would rather morph into a bloody mess than be handled at all).  The first one went off without a hitch, though it took me a few tries to find the bifurcating tube of tissue the size of Texas.  I double ligated both pedicles (the blood supply to the ovaries) and the uterus and cleaned up.  It was over in less than an hour.  The second one, however, was a learning experience.  I was in the teacher role rather than the surgeon role and the student performing the surgery was doing a terrific job!  He was able to get better tissue exposure and ligature placement than me!  We noticed a small pooling in the abdomen as he was going to close but I assured him that some seepage is normal.  He still seemed nervous though, and to appease him I decided to dig around for any evidence of a faulty ligation.  I couldn't find anything horribly offensive but threw a transfixing ligation through the left pedicle just in case.  We drove on.  He stepped out in faith that I was leading him in the right direction.  It was when he was closing the body wall and seepage was still present that I decided my level of comfort was being imposed upon.  We opened the abdomen again and still couldn't find an obvious bleeder.  After much rigamarro and tenacity we stopped the seepage though!  It seems that we were dealing with a very obstinate pedicle. It took a grand total of 2 1/2 hours.  The dog recovered well and even awarded us with a tail wag when I went back to check on her this evening.  This little patient taught me a lesson in staying calm under fire and being extra cautious when another person's self-assurance might be compromised due to my instruction.

Here's a snapshot of live action in the surgery suite:

Left-to-right: Stephen, Becky, me, Melissa, Dr. Crouch.  Photo taken by Lauren.

And here's my clinic for the next 5 weeks!:



You can think of it as an old condemned building or an old very loved building.  My opinion is still undecided.

I'm looking forward to tomorrow and hoping the experiences from today lead to even smoother sailing.  It's time for brain re-charge now though.  Here's to the first day down!

Off We Go!!

Cheyenne and I left Dallas to head West, well, South first, technically, on Wednesday, 6/13/12, at a later time than was originally scheduled. For those who don't know my packing habits: I hate packing. A lot. I tend to procrastinate and end up packing too much due to feeling overwhelmed--which leads to delayed trip embarkations and heavy baggage. I tried to tailor my urge to pack everything I own for this trip though, and I'm proud! The 5-week packing list was narrowed to this:

...we'll see if it ends up being too much or too little.  Either way, the first two pictures packed down into this!:

Cheyenne and I spent 2 nights in Austin with Kayley, my former roommate, who is settling into her new apartment and new job.  It was a great 2 nights/1 day, filled with Home Depot runs, painting, touring Kayley's new clinic, and eating at wonderful restaurants!  I can't wait to pass back through!

On Friday, 6/15, Cheyenne and I loaded up at 6:45am and made the 10 hour trek out to Las Cruces, NM.  We were able to break-up the monotony of I-10 by taking a breather in Ozona, TX to visit family over the lunch hour though, phew!  In Las Cruces we stayed with a dear family friend, Judy, who treated us to frozen custard after dinner; Cheyenne thoroughly enjoyed hers and was jonesing for mine afterwards:

We arrived in Window Rock, AZ, capitol of the Navajo nation, at 5:00pm on Saturday, 6/16, and met up with the rest of the mission team.  I should take this moment to explain why I was inclined to spend the first part of this traveling internship experience on the Navajo reservation.  I was a member of an organization called the Christian Veterinary Fellowship (CVF) throughout vet school.  In early 2012 I was approached by CVF's mission coordinator with an opportunity to serve on a veterinary team with a local church's mission trip to the Navajo reservation.  There are many things I want to learn over this next year, how to be a better advocate for Christ through my occupation is one of them.  It was perfect!  I signed up almost immediately and managed to persuade my roommate, Lauren, into coming too. :)  So now, here I am--one of two veterinarians on this mission with a team of 4 vet students.

Here's the catch though: the mission only lasts for a week, then everybody else goes home.  I'm planning to stay here until mid-July.  And I just found out, today, that the veterinarian who usually runs the Navajo vet clinic gave birth to a beautiful healthy little girl yesterday and will be out on maternity leave for the next few months.

I guess we got here at the right time for the animal patients of Navajo!  I guess I'll be spending these first few weeks learning trial-by-fire.

Any first job is nerve-racking, but I'm especially anxious over the fact that I'll be the primary active veterinarian at a clinic I was just introduced to yesterday.  It's going to be tough.  It's going to be humbling.  Ultimately though, it's going to be an unforgettable experience which will test my character, bring great amounts of joy, and provide a stepping stone in the right direction.  We (myself and the mission team) start tomorrow.  Wish us luck!