A New Baby Boy and a Little Sleep Deprivation

At the time my second son was born my partners and I were on a pretty tough work schedule. We manned our hospital through the night to be there for emergencies and to look after the growing number of patients under our care.

When I look back, I would never design the work schedule we kept. In the rotation we had one weekend where one of us would leave home on Friday morning, work Friday, Saturday and Sunday until five o’clock without going home. If it was quiet at night we got to sleep. If not, oh well. Debbie was pregnant with Adam and her due date happened to be that Friday. I went to work and it was agreed that if she went into labor I would leave and Tom or Ken would take over. The weekend was extremely busy as July tends to be in our business. By the time I left the hospital Sunday evening I had only slept a couple of hours since Thursday night.

I got home exhausted and Debbie was still patiently waiting for labor to start. I went to sleep at 9 pm only to be awakened an hour later to go to the hospital for our new baby to be born. The labor lasted until the next morning and we were both thrilled to say the least.

I finally left the hospital that afternoon and headed home to get some sleep. I was amazed at how awake I was considering the lack of sleep. It was only when I noticed that I had missed my exit by about five miles that I realized that the adrenaline of a new baby only carries you so far.

I reflect on this and wonder if the model of using interns in human medicine and working them up to 100 hours per week is the safest way to train our next crop of doctors. I can only hope this type of work ethic is not expected to be a right of passage and we can allow some common sense to prevail. In any case, I learned a lesson about going without sleep and vowed to both enjoy my rest as well as my family and career.

Seniors and Their Pets

There is nothing more rewarding than seeing the tremendous benefit of a pet for a senior citizen. I have seen this personally in my own family as well as countless times in my hospital.

My Mom passed away a few years ago. During the latter stage of her life the bond she had for her dogs was heartwarming. She had been an animal lover all her life and had always doted on her pets. As she entered her senior years and spent more of her time alone the relationship with her dogs grew. The emotional benefit of pets is incredible. The petting and cuddling that was a ritual lowered her blood pressure and even helped to ease some of her chronic pain issues. Science has shown that this contact causes the release of several wonderful chemicals in the body to create this effect. The nice thing is that her dog was releasing the same chemicals in his body when they were cuddling.

I think the most important benefit was that her dog got her up and moving. The responsibility and love she felt had made it a priority in her life. Multiple walks daily were a part of their life. The act of feeding and caring for a pet also engaged her mentally as well.

It always concerns me when older clients state they will not get another pet because they don’t want to leave them orphaned. It is possible to make arrangements so the pet gets a new wonderful home if something happens. When I look at the trade off and the benefit to both the owner and pet it is so important to share in that love as long as possible.

When my Mom finally had to move into assisted living and could no longer walk I saw the incredible benefit of therapy dogs. I was present when dogs were brought in and the entire place lit up.

I would recommend “The Healing Power of Pets” by Dr. Marty Becker. It is a great book that talks of the huge benefit of our pets. Enjoy.

Catching Up with a Classmate

I recently had the pleasure of reconnecting with a classmate from Veterinary school. Mike Petersen is a veterinarian in Madison Wisconsin. I can tell from the time we spent together that he is a great doctor with very diverse interests. I can also tell you that he is a great runner.

We met in Santa Barbara to run the inaugural Santa Barbara marathon. Over the previous several months we exchanged emails about our training. It was apparent that he was training to run very fast and I had no hope of keeping up with him. He ran a great time at the race and it inspires me to do better.

Mike has a small animal veterinary practice and also serves as the veterinarian for the zoo in Madison. When I connect with classmates it is nice to catch up and learn that the years have been good for most of us. Talking about running and how we train is educational. It also serves as a reminder that you never stop improving. During the heavy travel of my AAHA presidency I started to feel like I would never run marathons for speed again. Running with Mike and doing research on running has given me new focus and hope. The other nice thing is when I spend time with classmates it serves the same purpose for my veterinary hospital. I have never stopped trying to make it better and am very thankful for our talented staff that does the same.

Mike and I have been out of school for thirty years now and it is always a pleasure to see the vigor with which we approach our lives, jobs and the profession. Thanks Mike, it was great to see you again.

Please Pick up Your Toys

A number of years ago I saw a distraught owner with her Golden Retriever. Every family with young children needs a dog but there are some issues that arise with youngsters and their faithful companion. The Golden Retriever named Sadie was as gentle as the day was long. Unfortunately, Sadie had a bad habit of picking up items that were left on the floor. Sadie came to me early one evening after vomiting up a toy soldier. She looked great on a physical exam but after discussing the situation with her owner we decided to X-ray the abdomen. The film showed a number of other small objects. I gave her an injection to induce vomiting and several more toys were brought up. A follow up X-ray showed a very small item that would possibly pass. I suggested to the owner that we could send her home and fast her overnight. The next morning she returned for a follow up X-ray. This time there were at least seven more items in the stomach. We repeated the process of the night before and several more toys were vomited up. I still didn’t see the small item from the night before. After clarifying that we needed to be sure Sadie didn’t pick up any other toys, we sent her home.
The next morning Sadie had vomited up another couple of toys and she requested another X-ray to be sure that was it. Once again it looked like Toys R Us had set up shop in her belly. We went about our routine and sent her home with an empty stomach.
I called the owner after a week to be sure Sadie was doing OK. The owner informed me that she had brought up a few more toys but was acting fine.
Sadie eventually stopped eating toys, the kids got older or they just ran out of toys but she did great. I have seen dogs eat just about anything over the years but Sadie holds the record for the number of consecutive days on the “bad dog” list.

Who is this?

One Sunday afternoon I received a call from a distraught owner. Her cat Trixie had been missing for 2 days and showed up in a horrible state. I asked her to meet me at the hospital.

When I showed her in, Trixie was indeed on death’s doorstep. It was immediately apparent that this poor cat was suffering and that the humane thing for me to do was to put her to sleep. As I was doing the examination the owner told me she last saw her two days earlier and she looked fine. I reflected on this as I stroked the emaciated black haired body. Trixie had obviously been sick for a long time. Unable to raise her head, she was seemingly unaware of any of the physical exam as I moved from her nose to the back end and prepared to take her temperature. As I lifted the tail I was surprised to find that Trixie was a boy cat. I pointed this out to the owner and she immediately cried out in relief. “That’s not my cat!”

I was left alone with a very sick stray cat and chose to end his life in quiet dignity to avoid the inevitable suffering that was ahead.

Trixie did show up a few days later. She came to see me just to be sure everything was OK. We will never know where she went but she returned the picture of good health.

Odd Jobs in Undergrad

While I was in college I was never without a job. I lived frugally but still had a great time. Because I was in school for eight years I held a number of jobs. Sometimes I changed jobs for more money but most of the time it was just trying to find something that worked with my school schedule. I had some real unusual jobs and to this day when I am hiring a veterinarian I am very curious about their work experience unrelated to veterinary medicine. I think it tells a lot about their work ethic.

Some of my jobs were extremely unrelated to veterinary medicine. I was a night time janitor at Target so if you need advice on waxing floors I am your man. Profiling is a common concern in today’s world. I can tell you that it was alive in the 70’s as well. After working as a janitor in a large department store I can tell a little story that gives a picture of what it was like. I had been one of the janitors for over a year. Most of my interaction with the other employees was limited to clean ups and hauling their garbage away. One evening I was called to clean up a mess at the jewelry counter. The saleswoman was in a talkative mood and she asked me if I had any plans besides Target. When I told her I had just completed my fourth year of undergrad and was entering Veterinary School the following fall she was shocked. She wasn’t even aware that I finished high school.

I also moonlighted as a Fuller Brush salesman for a very brief period to try to make some money during a winter recess. I had already applied for admission to veterinary school and had been interviewed by the admissions committee. The head of the committee was Dr. Magilton. Selling anything door to door in the middle of an Iowa winter was no fun. Fuller Brush wasn’t exactly a hot item so I spent most of my free days walking the streets of Ames carrying a bag full of brushes with doors slamming in my face. Some of the people were really nice and they let me inside to warm up and proceeded to buy a brush to get rid of me. One particularly cold Saturday I was setting the world record for consecutive no responses when I walked up to a very nicely maintained house. I rang the bell and was already backing up as I prepared for the next no. The door opened and there stood Dr. Magilton. He didn’t buy a brush but he was very nice and I kept my hat pulled down tight in hopes he wouldn’t recognize me from the interview. After I was enrolled in veterinary school I considered Dr. Magilton one of the truly nice people you meet in the profession. I told him the story and we had a good laugh about it. I came close to setting the bag down and running away when he opened the door.

The final job to describe here is one of my favorites. I was the dough boy in a Pizza restaurant named Happy Joes. Happy Joes was just opening and I was one of the first employees. The owner was a man named Hank Kohler and he was just a few years older than me. We became great friends and played all kinds of sports together.

As the dough boy, I had my own room down in the basement to make the dough and role them into skins for the Pizza. One afternoon Hank came running down and told me to take a look at the girl he was interviewing. He said, “She’s the one for you Carp.” Well, I took a look and that was the first time I saw my wife Debbie. We have been married for over thirty years so Hank had a pretty good eye.

Some of my jobs were great, some not so great but they all shaped my views on work in general and I met a ton of nice people. My favorite will always be Hank and Happy Joes.
Hank, thanks for the pizza and my wife.

Dr. Nani Ghoshal

Dr. Nani Ghoshal was my anatomy professor during my freshman year of veterinary school. I bring his name up because he retired recently from Iowa State University. We are taught by all of our professors and inspired by some as well. Dr. Ghoshal’s inspiration for me involved his incredible dedication to the students in our profession. It would be hard to talk to a graduate of Iowa State’s veterinary school over the last 45 years and not have them tell a Nani Ghoshal story.

Mine is pretty simple. He was probably the smartest man with the most photographic memory I have ever met. As a native of India, he was a little hard to understand. Many of us who were just beginning our tenure at Iowa State were already intimidated by Dr. Ghoshal. None of us wanted to repeat a question if we didn’t understand him. The fortunate thing was that his memory was remarkable. At the time he was the editor of a two volume textbook of veterinary anatomy. These two volumes encompassed over two thousand pages. Dr. Ghoshal knew he was hard to understand so in answer each question he would give you a page number. On that page (out of 2,000) you would find the answer to your question. Thousands of questions were asked that year and he was never wrong on the page number.

When he retired he told the current Dean of the veterinary school that he would be happy to come back and help if needed. He would request no pay, just a key to the building.
We are a clinical teaching site for the College of Veterinary Medicine at Western University. As such, we have students in our hospital much of the year. I often think of Dr. Ghoshal and how he influenced all of us at the beginning of our career. I hope I can offer some of the same positive influence to our students in memory of a truly gifted professor.

A Night at the Creek

Many years ago when I began my career I was in a rural area and spent many a night on emergency calls. Typically when an owner called, I would meet them at the hospital to see their pet. Early one evening I received a call from a client who had a great heart and always went the extra mile for her critters. She lived way out in a remote area and had discovered a dog that was hit by a car and fell down an embankment into a stream. They had a number of neighbors out there but the dog was very aggressive and they couldn’t get him out. After several minutes of directions I left my home with a stop at the hospital for some supplies before joining them.

It was dusk by the time I found them. The poor dog had been hit and fell down a steep slope into a stream. The stream was shallow and he sat in the water snapping and growling at anyone brave enough to approach. I knew he had to be hurt pretty badly to be in that position and hoped to get some pain medication into him as quickly as possible. The banks of the stream were also steep and dropped the final 3 feet into relatively calm water. I was glad it was a warm evening because it soon became apparent that I was going to join him in the water. I approached him slowly and was able to gain a little trust but he wasn’t about to let me handle him. It was dark now and as the folks on the bank held flashlights on him I was able to slip a muzzle on him. I calmed and reassured him and gave him an injection of morphine as we sat in the water.

He relaxed and I was able to hand him up the steep bank to the waiting arms of the folks who found him. They set him down and I started doing a cursory exam under the dim light they provided. As I worked I could hear a faint buzzing sound. When I asked, nobody else heard it and they looked at me like I had spent a little too much time in the water. I kept hearing it and finally moved the little fellow over only to find that they had laid him on a bumble bee nest. He wasn’t stung but we all moved pretty quickly after that.

I put a temporary splint on a broken leg and with everyone helping we managed to get him up to my car. We went down to the hospital and started him on his long road to recovery. He turned out to be a great dog and I never saw him try to bite again. It is the only time I ever started an exam in water and I am happy to report that we both survived the evening just fine.

AAHA Accreditation

We are an AAHA accredited hospital. AAHA is the American Animal Hospital Association. Why is accreditation important?

Everything I have done in my life has moved forward by comparing my personal and professional performance to benchmarks and standards. If you don’t measure yourself against something great, you will never push yourself enough. It starts when we are in school and get constant feedback on our progress. As we move away from school it is a time when this feedback comes less frequently. When I became a long distance runner my first benchmark was finishing a marathon. I accomplished this and moved on to more pertinent benchmarks. Qualifying for the Boston Marathon came next. After qualifying for and running Boston I had to search for something else to push me. I looked to people who run further in more beautiful and challenging places. This allowed me to become an avid trail runner and ultra-marathoner.

So, what pushes us as an animal hospital? AAHA is the only organization in North America that accredits animal hospitals. This accreditation is based on roughly 900 standards. These standards cover a variety of areas that affect the client, the pet and our staff. Let’s face it; we all think we do a good job. The question is how good are we? We find this out by inviting AAHA in every three years to do a thorough evaluation of our hospital and how we meet their standards. This is a process that allows us to undergo constant improvement. Roughly 14% of the animal hospitals in North America accept and meet this challenge. The nice thing is that these hospitals become an extended family which is AAHA. These hospitals share best practices and all learn from each other. As the standards are enhanced by leading experts in each area, we push ourselves further.

The rewarding part of AAHA accreditation for me is what it does for our entire staff. It gives them a sense of direction but more importantly, a sense of how good we are at what we do.

My First Job in Veterinary Medicine

By the time I had my first job in this wonderful profession I already knew it would be my life’s work. I began working as a kennel attendant at a hospital in upstate New York. I couldn’t believe that I finally had a foot in the door. It also made me realize how little I knew but that was only a challenge, not a disappointment. Some of my current behaviors with animals are very natural now but as I reflect, many were learned at The Aqueduct Animal Hospital. The occasional bite or scratch is your badge of courage in veterinary medicine. I endured my share. Most of course were preventable with a bit of common sense and training. Sadly, as I started out I had precious little of either.

If my parents were alive today they would recall a list of many doctor visits during the early part of my tenure at Aqueduct. I think one of the most unusual came at the expense of my eagerness to please the owner and again a total lack of common sense. I was paid to clean and Dr. Rapp was pretty darn picky when it came to the cleanliness of his hospital. We often joked that he would step over a three foot pile of garbage to point out a spot on the wall. I didn’t mind the cleaning but was eager to assist with a patient whenever he would ask. I was told by other staff members that the best way to get the chance was to come running if you ever heard him call. I took this quite literally. One afternoon I heard a call on the intercom for an assistant to surgery prep. I took off like a rocket. As I ran around the corner I had the misfortune of running into a technician. To make matters worse, she was carrying a handful of used syringes with their needles out. Most people will never experience this and I can not possibly do justice to the pain of having seven needles inserted into the palm of your hand. After the pain subsided I am not sure which was worse, my embarrassment or the horror of the technician holding the syringes. I can say for sure that the doctor who treated me had a first that day.

During the afternoons at that time, Dr. Rapp would schedule a series of short patient visits to draw blood for heartworm testing. This meant having an assistant with him for a couple of hours to hold the dogs while he drew the blood. I always wanted to do this. It would be good experience but mostly it would allow me to wear a white coat for the first time. I finally got my chance. Dr. Rapp asked me to go get a white coat and bring the first patient into the exam room. I called a young lady in with a huge white German Shepherd. I was pretty sure she thought I was a doctor due to the white coat. When she asked what I was going to do when I got out of high school it was a bit deflating. Dr. Rapp came in and prepared to draw the blood. I took hold of our patient and he had another vision for the afternoon. My training that day would have benefited me more for a rodeo career than becoming a veterinarian. In my strain to please Dr. Rapp, the back of my coat ripped out and I was covered in sweat by the time we had seen one patient. He asked me to send someone else up with a jacket that fit and I returned to cleaning spots on walls. If you see me today, you will notice the lack of a white coat. I just can’t handle the memory.