Tuesday, March 25, 2014

Hippo-crits abound...

Veterinary medicine is often divided into multiple categories. The most common being "big" and "little".  

There are separate divisions for zoo, wildlife, aquatics, public health, food safety - we are a multi and varied, talented bunch. But for today's discussion, we'll start with big and little.

In vet school we learn about the big and the little. In theory, you're able to treat anything when you graduate. Some people choose more training after school and will do an internship. Here you pick - big or little. And focus more on your area of interest. And then, if you're really ambitious and in complete denial how quickly interest is accruing on your loans - you do a residency. Here you're even more specific: big medicine, small surgery, hearts, eyes, blood. Then, after jumping through a series of hoops depending on the specific specialty, you get to call yourself a specialist and put extra letters after your name. Sounds great, right? Um - no.

I have some experiences in these areas and one of the things I want to do is share those experiences so that future vets might know what they're getting themselves in to. And, well, because when I tried to go through the proper channels for help, I got none. So, fine. I'll tell my story in another way. I have no illusions the people who behave poorly will ever read this, and if they do, they'll not recognize themselves. For those who have the ability to self reflect don't need to be told they're heinous. They can recognize it themselves. But I digress...

To read a truly awful, but all too common account of one DVM's internship experience, click here

And here is a fairly innocuous story from my own residency, as a stand alone incident seems harmless enough but highlights the inability to recognize a teachable moment, and general lack of respect for the well-being of the trainees under their care.

I took a bit of an unusual path, and my internship wasn't entirely focused on big. It was focused on big wildebeest, with aardvark, rhino and giraffe thrown in there. Now, I like wildebeest, rhinos, aardvark and giraffe, but I also like hippos. So when I did my residency, I looked for one with some hippos as well. When I applied I was very clear - I like hippos, I want to learn about hippos but I don't have a lot of experience with hippos. When I interviews, I verbally expressed that sentiment to all the faculty I met. Repeatedly, they said, "Oh, that's okay. We'll get you crackin' on the hippos in no time! Just excited to have an applicant with interest in, and experience in, more than just hippos!" Sweet!

Fast forward about 10 months, and things are already getting rocky. More on that later but this particular story involves a series of sick baby hippos, me being the only person on call over a holiday week-end and getting ZERO support from the faculty. See, these very valuable, and very fragile, hippo babies were getting sicker and sicker. The owners kept bringing in pair after pair after pair - clearly there was an outbreak! We worked around the clock to try to save them, and as new ones came in, I'd examine them, confirm my thoughts that it was the same disease and, based on previous treatments, make a plan. Which I then had to present to the senior clinician for approval.

One of the joys of an internship or residency is getting to know, and tailor your plan, to which senior clinician is on. Some like pink drugs, some like white drugs and woe betide ye who forgets who likes pink or white. Well, on Saturday and Sunday of the holiday week-end, Dr Wimpy was on. Dr Wimpy likes to treat sick baby hippos with 1 pound of pink powder twice a day. So all the hippos got 1 pound of pink powder twice a day.

Early Monday morning, yet another baby came in. But now, instead of Dr Wimpy, it was Dr Crabby on clinics. I formulated the plan that had previously been working, the one Dr Wimp approved of, and presented it to Dr Crabby. Dr Crabby approved the plan, and we proceeded to treat the baby hippos. 

I feel, at this point, it's worth mentioning that every single baby hippo got better and went home.

However, 6 months later (yes, 6 whole months) during one of my performance reviews, Dr Crabby told me that I was a substandard clinician. Why? Because treating baby hippos with 1 pound of pink powder is unacceptable. Dr Crabby likes to use 2 pounds of pink powder, and I should know this. The fact that I didn't know this means I was unfit to treat hippos.

What was never fully explained to me was why, why, why did Dr Crabby approve the treatment plan if she prefers 2 pounds? I don't know, I'll never know, and I did, in that moment, actually stand up for myself and point out the loss of a teachable moment. Which, in hindsight, probably did not endear me to them anymore than I already was. But I don't care. It was bull, they knew it, and I called them on it. Huh. Probably why I'm not in academia anymore.

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