Language Barrier

photo courtesy of thejetsetpets.com

“The United States and Great Britain are two countries separated by a common language.”

 -George Bernard Shaw

“We have really everything in common with America nowadays, except, of course, language.”

 -Oscar Wilde

One summer, my wife’s college internship took us to Atlanta for a few months.  I was between my first and second years of vet school and got lucky enough to find a job in a clinic north of the city.

I was at an awkward stage- just educated enough to be dangerous.  Fortunately, the two doctors at the practice, Dr. H and Dr. M, were very patient with me.  While I was assisting with surgery or cleaning teeth or running labwork, they put up with me picking their brains.  Both of them were absolutely brilliant at interpreting diagnostic testing (bloodwork, etc.) and took the time to explain things to me.

I wasn't the only person to benefit from their tutelage.  Another veterinary student had a summer job there as well- Her name was Barb, and she was a third year student in the U.K.  As I recall it, she was from outside London, and was going to graduate school at the University of Edinburgh in Scotland.

She flew into the States on July 4^th, which I thought was ironic.  In a rare display of restraint, I decided not to wish her a happy Independence Day.

Barb was likable and quick-witted, but I had trouble understanding her speech. There were three reasons for this:

1. Brits use a very different vocabulary.  It’s not a bus, it’s a lorry.  He’s not an alcoholic, he’s a bumper.  It’s not a bathroom, it’s a loo.  Several times a day, we would have to try to figure out what the other person was trying to communicate.  Common language?  Hardly.
2. Pronunciation.  Something as simple as asking for iodine became a head-scratcher when the other person pronounced it “E-oh-deeen”.  
3. She had a habit of speaking very quickly when excited.  When you compound this with the other issues, hilarity and frustration ensue in equal measure.

We worked together pretty closely for a few weeks.  We would compare what we had learned so far in classes and our differing experiences in clinics up to this point.  One day, I asked her where her education was taking her when she returned to the U.K.

“I’m going on holiday, and then I am bound for abattoir.”

I went into translation mode.  Holiday equals vacation.  Got that one.  “Abattoir” was a different story. I took two years of French, and the pronunciation was French…

“Is that in France?”  I asked the internationally-traveling vet student.

Barb looked at me as if I was from Mars. That (as well as the immediate snicker from Dr. M) told me that I was off base. She composed herself and explained to me that abattoir is another term for slaughterhouse.  Veterinarians in the US and U.K spend time in slaughterhouses/abattoirs as part of the food safety training we receive.  My bruised ego and I realized that we would be scoring no points for the Red, White, and Blue that day.

The only real revenge I got was when she had a day off and decided to go sightseeing in Georgia. She wanted to see Stone Mountain and find some trails to hike.  Not being familiar with the native animals, she asked the logical question… do we have any animals she should look out for on her hike?

Me: “Well, we have bees, wasps, and hornets.”

Her: “Okay.”

Me: “… and a couple of venomous spiders- the black widow and brown recluse…”
 

Mild concern started to appear on her face. “Right-O. I’ll just stay away from spiders, then.”

Me: “Oh! We also have three types of venomous snakes, with a few subspecies.”

Genuine alarm now.  Her eyebrows were rising higher with every word.
 

I continued: “There’s the rattlesnake, copperhead, and the water moccasin. I almost forgot- we have scorpions as well, but they’re not as bad as the snakes. You might see a black bear if you go far enough North, too, but that would be unusual.”

I don’t know what pushed her over the edge- the snakes, the scorpions, or the bears.  The expression on her face told me that she was seriously reconsidering her plans to see nature in the New World.

“How do you people even live here?! Everything here wants to kill you!” she shouted.  We both laughed.  I thought of it as a victory for the local creatures. In my mind, Georgia black bears were having The Second Tea Party in Lake Lanier.

One afternoon during her final week in the States, I looked from the back of the clinic to see Barb do a double take over something she was seeing out the front window.  Her mouth dropped open.

“What’s going on, Barb?

“Therearetwoyouthsontheroad, withacatinapram!”

“What?”

“Therearetwoyouthsontheroad, withacatinapram!”

I couldn't make it out. I went up front to see what was going on.  On the 4-lane highway out front were a young man and woman pushing a baby buggy down the roadside.  From inside the buggy, a cat’s head slowly rose up and looked around like a periscope on a submarine.  They turned into the clinic driveway, and I watched as the cat’s head sank slowly down again.

Now I understood. “There are two youths on the road, with a cat in a pram.” She was trying to tell me that there were some kids on the highway with a cat in a baby buggy.

I don’t know why she didn't just use plain English.

Things you learn at funerals

 

 photo courtesy of probioticsmart.com

Odenville, Alabama is a small town. We get to know a lot of people really well- we see their kids at basketball practice, we run into them in restaurants, we know when they are sick, and we know when they pass away. I usually attend a few funerals a year for clients that have passed on. A few weeks ago, I attended a funeral for a man who had been a client for seven years.  

 
In some sense, it was exactly what you would expect- friends and family in small circles around the room, talking in quiet voices. People were signing the guest book and sitting to watch the slide show being projected in the front of the room in a loop. What caught my attention was the number of pictures devoted to his little black and white dog, a constant companion through a long illness.

The dog had come to him as a puppy in 2009. The dog’s name is Little Man, and his personality is… complex. I won’t go into any details other than to say that his medical record has a warning that says the following:

 

WATCH OUT HE WILL EAT YOU!!!!!

 At the funeral, I met several fellow victims of Little Man. One even showed me where she had still-healing bite marks on her arm. I heard stories about him guarding the sick bed and not allowing the Hospice nurses to get close to his owner. All of the stories I heard were delivered with a smile, and there was a reason for that.  

 

The reason was summed up in a picture hanging in the front of the room. When I saw it, I stared at it for a little bit and realized how important Little Man was. The picture was taken not too long before my client passed away.

 

He was sitting on the edge of his bed. Disease had clearly taken its toll on him, the way that cancer always does in the end. In his arms, he was holding Little Man out toward the camera. It was like he wanted to have a picture made of just Little Man, to remember him that way. I won’t forget that picture- it seemed to sum up everything about the relationship that the two of them had.

 

I don’t think of Little Man in the same way anymore. Not after seeing how important he was, attitude and all, to the man who wanted him as a companion during his remaining time here on Earth.

 

Our Chicken Adventure

Earlier this year, we wrote about the Bean family’s first attempt at raising backyard chickens.  We are happy to say that all 13 chickens that we brought home are alive and well.  We are not happy to say that we are still eggless at this point.

Our plan to have pets who lay eggs has fizzled into a plan where we keep 13 freeloaders who eat (a lot!) and require their area to be cleaned frequently.  Please don’t get us wrong… we enjoy the chickens.  They can be comical and sweet.    Brownie, the smallest hen, sits on our shoulders and peeps at us.  If offered the chance, she will fly up and rest on an extended arm like a falcon.  Rhody, the rooster, fusses for a good 5 minutes when we put him up for the night.  He seems to think he is an outdoorsman and wants to sleep under the stars (bet that will change with the weather!).  Hershey, our barred bird, seems to be at the top of the pecking order even though the white hens are a good pound heavier.  (We are afraid that Hershey may be a rooster… it’s a little early to tell).  The white hens who make up the rest of the flock all look the same.  Since we can't tell them apart, we have named them all Sheila.  While they seem nice enough, the only real personality trait that they display is hunger.

Anyhow, the chickens are alive and well… just highly unproductive…

Having a Dad that's a Doctor

We have a guest blogger- Dr. Bean's son!  He volunteered to write this blog during one of the mornings he spent at the clinic.

Having a Dad that's a Doctor-

It isn’t easy having a doctor as a dad.  I don’t get to do all the things I want to do when he is on call, like play Magic the Gathering on Saturday night or go fishing Sunday afternoon.  But I do get to see cool animals like baby chicks, chickens, deer, cats, dogs, goats, and rabbits.  And because he’s a doctor, I am going to have a little farm with the baby chicks and a full grown chicken named Rhody.  And I have chores to do at the clinic like opening boxes, unfolding newspapers for cages, and doing laundry.  It isn’t easy, but having a doctor for a dad is exciting.

How We Spent Our Summer Vacation

Our son is always coming up with a scheme to make money or start a new business.  He dreams of becoming a farmer so the money-making ideas usually have an agricultural bent.  After a recent trip to his grandparents’ house and surveying their cattle herd, he decided that he really needed to invest in a calf to raise for beef.  He had grand plans for keeping this calf in our yard…  which is not large, and is in the middle of a heavily wooded subdivision.  Our neighbors currently tolerate the toys and bikes that litter our yard- a calf (and soon to be cow!) would probably not endear us to them.

 

We want to encourage our son in his path to be a farmer and businessman so we have reached a compromise- and embarked on a new adventure.  We are currently building a chicken coop to raise hens (no roosters!) in the backyard.  Our hope is that we will soon have four to six egg-laying pets that will teach responsibility and animal care.  Now- this is not just any chicken coop.  Because we don’t want to limit the building’s purposes or the size of our potential flock, we are building an 8’x8’ coop.  It will be the Taj Mahal of coops- we hope the girls will appreciate it.

 

Providence has also intervened and brought us the first potential member of the feathered family.  This young chicken needed a new home and some healing after a run-in with a dog.  She’s a sweet girl and may be destined for the Bean Chicken Ranch.

 

We’ll bring you more pictures and updates as we progress…  Cross your fingers for us!

How to disgust clients and horrify people

New puppy visits make my day.

I usually get to check out a playful little creature that wants nothing more than my full attention for a few minutes. When I’m doing the physical exam, I rarely find any serious problems.  I get to talk to clients in the lighthearted way I do when things are going smoothly- I can relax, because I don’t have to give anyone bad news.

One day recently, I was doing one of those appointments. I had never met the client before, and was very conscious of the first impression I was making. The Ewok-looking puppy on the table had done its best to lick me to death and was very happy to hang out in the technician’s arms while the owner and I talked.  We discussed the vaccines and dewormer I had just given the new addition to the family.

“Oh yeah, I saw a couple of worms earlier this week. They were really long. What were they?”  the client asked.

Uh-oh.

“Those were probably roundworms. They’re very common in puppies, and the dewormer that we gave will kill them. You’ll probably see more tonight, and that’s OK.  If you will, please get your kids to wash their hands especially well for a few days until the dewormer has time to kill them all.”  I replied.

The look on her face had changed instantly from cheerfulness to concern. “Why? Can my kids get them?”

“Well, yes they can, but deworming and good hand washing are the best ways to make sure that it doesn’t happen.  It’s not common in healthy children and people with normal immune systems, but it never hurts to be cautious.” I was trying to hard to keep the mood light. I was about to fail, and I didn’t know it.

“What happens? What should I look for?”

I sat down in one of the exam room chairs. I had to find a way to give necessary information to the client while not sending her into a full panic.

“Well, a few things can happen, but one of them is that they migrate into a child’s eyeball and cause blindness.” That statement had the effect I was afraid it would. The woman’s jaw was slightly open in an expression of disbelief.  This was not what she expected to hear… her puppy, the epitome of cuteness, was harboring eyeball destroying monsters. And it slept in the bed with her children. So much for the light mood.

At this point, I figured I had nothing to lose, so I just told the client what I was thinking.

“You and I just met, and I hate having conversations like that with people that don’t know me very well. The problem is that if I don’t have those conversations, I’m just not doing my job- and I haven’t done either of us any favors.”

Thankfully, she understood that I wasn’t trying to scare her or exaggerate things, but she had asked me a direct question and expected a direct answer.  I just felt awkward having to give it to her.

I try not to frighten people, especially on their first visit with us. Sometimes, it just doesn’t work out that way.  Maybe, just maybe, I didn’t scare her away and I’ll get to see her and her Ewok again.

The Weirdest Case: One Sick Puppy

We have a guest blogger!  Dr. Jordan Towns wrote this piece about one of the stranger cases that we've seen in a long time.  This case has a happy ending and we've been delighted to see the patient for something as mundane as puppy shots and boarding since his first troubles.

a happy & healthy Max

It had been a fairly uneventful night on call when one of the weirdest cases I had ever seen fell into my lap.  The ring of the emergency phone startled me from the mundane task of checking e-mail.  I listened to the list of odd behaviors and symptoms, and promptly called the concerned owners back.  The patient was a young Labrador puppy named Max.  Until that night, Max had been the typical Lab puppy: energetic, loving, and happy, with a bottomless appetite.  However, when the family had returned from work that afternoon, Max was not acting at all like himself.   He was lying around looking uncomfortable, and he hadn’t eaten at all that day.  Something was definitely wrong.

When I met Max’s worried parents at the clinic, I immediately noticed that Max was a very sick puppy.   He tensed when I touched his abdomen, indicating to me that his abdomen was very painful.  Luckily – or so I thought – there is a relatively short list of problems that are likely to cause a sudden onset of a bad belly-ache in a puppy.

Usually a puppy with a sudden belly-ache has either swallowed an object (like a toy), eaten something that didn’t agree with them, or developed a condition called an “intussusception”.  Intussusception was likely; it’s a condition where a portion of the intestine actually telescopes inside another portion of intestine.

The bad news about these potential diagnoses is that they usually require surgery.  However, the good news is that surgery can provide a cure.   The exam and x-rays pointed to an obstruction or intussusception; it was soon clear that surgery was the only way we could pinpoint Max’s problem and fix it.

Max’s parents readily agreed to the surgery, so it was now time for action.  Max was very sick, so he would need a skilled anesthetist to monitor his condition throughout the surgery – this is where Jana, our on-call technician, was ready to help.  There was also a good chance that two people were needed to complete portions of the surgery, and Dr. Bean was happy to come in and assist me with this.   Max was prepped for surgery, and our search for Max’s problem began. 

Soon into the surgery, we noticed that Max’s bladder was enormous - and unhealthy.  It appeared that Max had been unable to urinate, causing his bladder to fill and stretch until it was causing the symptoms that his owners had noticed this afternoon.

This was not what I expected at all.  In fact, this problem is considered extremely rare in a young puppy.  This was certainly not on my radar!

Something had blocked Max’s ability to urinate… and we needed to find out what.  After we removed the urine from the bladder, we noticed many white crystals floating in the urine.  At the time, we did not know exactly what these crystals were, but it certainly seemed that they had been the cause of Max’s trouble.  After returning the bladder to its normal size, we finished the surgery and woke Max up.   We saved the urine sample so that we could send it to the lab the next day.  By doing that, we might be able to determine what the crystals are made of, and what we could do to prevent the same problem from occurring again in the future.

While the surgery revealed the issue and solved Max’s discomfort, we still had concerns.  There was a possibility that the blockage had caused severe and permanent damage to his bladder, meaning that Max might not be able to urinate on his own.  We made the decision to leave the urinary catheter in place for a few days and provide supportive care; this would give Max’s bladder an opportunity to heal.  At that point, all we could do is hope and pray and wait. 

The next morning, Max was acting just like a normal Labrador puppy again – barking, eating, and walking about his kennel asking for attention.  While we were all excited to see the progress, we knew that we’d still have to wait a few days to find out if Max was really going to be okay.  The test results returned and gave us some clues as to what caused Max’s problem.

It appears that Max had a urinary tract infection that created an ideal environment for the crystals to form in his urine.  Although this was still an unusual occurrence in a young puppy, we were happy to have some answers.  Max did very well throughout the rest of the day.  That night, however, he managed to pull out his urinary catheter.  It had only been 24 hours since the surgery, but I was hopeful that his bladder may have healed quickly and he would be able to urinate.  However, that was not the case – the next morning, Max seemed uncomfortable and appeared to be straining.  A quick ultrasound revealed a very full bladder.  Max was still unable to urinate on his own.  Max was anesthetized once again, and the urinary catheter was replaced.   He would need to remain with us for a few more days.

Max continued to act like a normal Labrador puppy over the next few days.  That Saturday marked Max’s 5^th day at the clinic, and he was starting to get a bit restless (well, he had been restless… he is a Labrador puppy, after all!).  Max’s bladder had been given 4 full days to heal, so the decision was made to remove the catheter.  Prayers were said, and the catheter was removed.  Within a few hours, to our joy and excitement, Max proved that he was able to urinate on his own.  Max’s parents were ecstatic to hear the news – their beloved Max could come home!