So for all the mopey feelings I've been having over the last two weeks because I am absolutely exhausted and sort of fed up with this semester, tonight was an amazing reminder of why I am here in school for 3.5 more years and what I really truly love.
Some where along the way I fell in love with emergency and critical care medicine. It's kind of funny because the first few times I experienced emergency medicine I said NO WAY is this for me. Wrong! Turns out I absolutely adore it. I love that you never know what is going to walk in the door. You have to be at the top of your game in all areas because you never know what area of medicine you're going to need to draw upon to help you figure out what the problem(s) is. You meet people at some of the worst moments of their lives and you make an impact, no matter what the out come is. You make moment by moment decisions based on what is happening right in front of you using your skills and knowledge, technology, and a bit of luck. And there is a nice adrenaline rush associated with it all too.
We walked in this evening to a critical case that was being managed by the new emergency and critical care specialist at SGU. A young kitten had been attacked by a dog and was fighting for life. The kitten was obtunded (practically comatose), had neurological deficits, had no deep pain in the hind legs, and had a clear puncture wound in the abdominal region. When we were rounding cases with the doctor, he told us that rather than tell us what was going on with the case out right, he wanted us to perform a physical exam and review the radiographs and blood work with him and tell him what we thought was going on. Unfortunately for this kitten, the dog had done a lot of damage to the lumbar vertebrae and had crushed the spinal cord in at least one place. It is cases like this that make me so grateful that we have the option of humane euthanasia in veterinary medicine. The owners opted to euthanize the kitten (sad outcome but really good teaching case).
The next interesting case we saw was a suddenly neurologic papillon. The owner thought perhaps the dog had fallen and hit her head, but the doctors think that something else is going on. As we were working with the owner and on the dog, another dog came in that had tried to eat a cane toad and was now actively seizing. It took a long time to stabilize that dog, but he was doing A LOT better when we finally left for the night. He is also really cute! Both of the neurologic dogs were doing a lot better with medical treatment and medications when we left a little while ago :).
Case number 4 of the night was a dog that was seen being hit by a car. A good samaritan brought the dog in even though he had no idea who the owner was. Unfortunately for the dog, he also had paralyzed hind legs and no deep pain in his hind end. We did a quick physical exam, gave him some pain meds, and took radiographs to asses the damage. The radiographs showed a completely crushed and displaced spinal vertebrae which meant that he had very severe spinal cord damage. Outwardly, the dog was showing signs of Schiff-Sherrington spinal damage (if you're a pre-vet or vet student, go look it up!). It is heart breaking to have to euthanize such a young dog (we estimated him to be about 1 years old), but I am grateful that he is no longer suffering from the intense pain that he was in when he first came in. I was easily able to place a IV catheter in his leg (small victories).
Okay, I think I am finally ready to go to sleep. Hopefully the rest of the night will be uneventful because I have the phone! I am really not looking forward to having to get up at 7:45a to take the phone back to the clinic for the next shift! Usually it's not a big deal to get the phone back in the mornings on Mondays because as soon as the work day hits, the phone service switches back to the main hospital phones instead of the on call phone. Oh well. I am going to be exhausted!!
I owe a HUGE thank you to anyone I have ever worked with or shadowed because you all have taught me SO MUCH! I am so grateful to have the knowledge and skills that I have-and you all have been wonderful teachers whether you realized it or not! Feeling confident and know what to do is an amazing feeling and I am so lucky to be able to step into these sorts of situations and feel comfortable doing everything I am needed to do. THANK YOU!!!
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