Dandelions in a meadow outside Thunder Bay, ON

Dandelions in a meadow outside Thunder Bay, ON

Friday, March 12, 2010

Winner, or just plain old adequate?

One step closer to a definitive diagnosis for the coughing/stumbling dog, I felt something close to satisfaction at the end of the day. Back in my TV-less home I turned on the radio while I enjoyed a glass of Bear Flag wine, a very enjoyable blend of this, that and the other. It challenged my prejudice against blended wines as coverup for unsuccessful vintages from various vineyards and various years. But maybe I liked it simply because I know nothing about wines. Anyhow, the radio programme covered the latest development in the Canada Reads contest. Books, and very good books at that, are gradually being voted off the list to whittle it down to an eventual winner. What a White Liberal concept: winner vs. everyone else! So many pursuits and endeavours are no longer perceived to be worthwhile unless a winner can be identified in the end. How else do people know if they are any good?! Well, not everyone is a loser either; there is such a thing as a shortlist: the winners among losers? Now translate this into the culture of dog shows and cat shows... . How did the poor animals get pulled into this vortex of human vanity? Never mind that animals chosen to represent a pure breed are often far from fit - they are often far from viable. But as long as these animals are helped along by the humans who bred them, their existence does represent a form of evolution we have taken into our hands. Darwin wrote of the "survival of the adequate" (my italics), not survival of the fittest (a term coined by Herbert Spencer, nor Darwin).

This coughing/stumbling/occasionally vomiting/occasionally drooling dog's diagnosis has been a thorn in my side since it became clear this is not a simple case of kennel cough. I suspect him of a neuropathy that translates into laryngeal paralysis, possibly esophageal weakness, and hindlimb weakness (Ockham's razor tells me to find the simplest - in this case, the most inclusive - explanation). I also suspect him of hypothyroidism which would likewise explain his symptoms, and a comprehensive test in underway to rule that out. But I am warned, by wise and learned people, that treatment for either neuropathy or hypothyroidism may not alleviate his presenting symptoms. I do not live or work in the ivory tower; I will treat him anyway once I know what ails him. I don't care about winning; I just want to do a thorough, adequate, job.

Monday, March 8, 2010

The comparative virtues of aspirins, and an Old Country idealist.

Yesterday I got reassurance that if I never treat another animal they will still be well taken care of, I will not be missed. A woman ahead of me at the checkout started telling the cashier that her breeder had recommended this coated aspirin for her dog who had pulled a muscle. She was very proud of her breeder and very pleased with the advice she had received from her over the years. Upstart that I am, I had to pipe in and say that she needs to be very careful about giving aspirin to a dog and that buffered is better than coated because that will just slip through the dog's stomach before it has time to uncoat. I chose to remain undercover as to my profession; it would have been awkward to announce it. She said that mine was very good advice but she would stick with what her breeder had suggested. I keep forgetting that my answer needs to be voted "best answer" before it can be accepted. What kind of dictator do I think I am, to expect members of a free society to accept my word without putting the matter to a vote? A similar level of consumer freedom and empowerment applies to the diagnoses I put forth; these are often perceived as initial offers met with counter-offers fished out on the internet or suggested by breeders or people who own similar animals. As a former prof I explain my reasoning in as much detail as the owner will tolerate. On exhausting days I often feel tempted to choose one or two diagnoses from my differentials list that are most pleasing and comforting to the client; I have never given in to this temptation. As for prognoses, I will err in the "glass is half-empty" direction and prepare the owner for that, cushioning the blow of a sad outcome that I foresaw at least as a possibility. So far I have been able to maintain the dignity of a doctor while still ministering to the customer service aspect of my work. But I will admit that life, a.k.a. that which is not in our control, is often far wiser than some of our best laid plans, and in hindsight I am very glad the woman bought the coated aspirin which will hopefully just slide through her dog's digestive tract.

Yesterday I also got reassurance of another kind. This was on the way to the store with its aspirin encounter. Outside the store is a gas station, and outside this gas station a man was speaking on the payphone very loudly and articulately. He spoke loudly because he was passionate, and because his voice needed to carry across the ocean to Russia where his friend was listening. For once I was not embarrassed to see a fellow Russian in Canada; I was elated and proud. Because the subject of this man's monologue were the flowers he saw in Vancouver. He declared with the solemnity of a nuclear scientist presenting his discovery that never before had he seen such a variety of tulips in bloom. Fifteen minutes later, as we walked out of the store, the man was still there and still speaking. And the chestnuts, he said. A whole street lined with chestnuts! When I translated the eavesdropped conversation to my boyfriend he had to be cynical and suggest that this was all code for drugs and their delivery times, and no wonder he was using a payphone and not a cell phone, etc. But I'm confident the man really was talking about flowers; it's impossible for a Russian to fake this.

Friday, March 5, 2010

Saturday evening in spring.

"Canine patient"?! It's a DOG, for pete's sake.

In school we were taught to use certain words instead of certain other words. Avoid language used by the commoners, the unwashed masses. How else would clients know to respect us as doctors? And yet every day I see proof that our clients are just that stupid. They hear me say "cat" and "dog" left and right, and they still think I'm a doctor with advanced knowledge. I even go as far as to use words like "poop" instead of "feces," and still they are fooled, they ask my opinion, they listen to it. I come from a background in linguistics. There is more than one way to say many things and I try to remember to do this. Sometimes I catch myself talking in stereotypes and cliches, and feel disgusted. Often when I come home at night I have no energy or desire to use words, to write or to say anything. Then I wonder if my job is making me stupid and robbing me of the little imagination I have. On these nights I rent some movie and become a consumer of other people's language and ideas. It is so much easier to consume something ready-made than to create anything.

There are languages that contain tens, dozens of words for a seal: a seal moving in this or that direction, submerged in the water to this or that degree, in such-and-such position relative to the ice floes, with its nose pointing here or there, lit by a bright or dim or setting sun, and so on and so forth. This gets pretty elaborate. But I wonder if it leaves room for disagreement between two or more people as to which seal this one is. For the past three day I have been following a very frustrating case, one of those where most available in-house tests have been run or sent off, and still there is no answer. Throughout these three days I have been getting reports from the two owners. Comparing these reports gives the impression that two entirely different dogs are being observed; they just happen to look the same and bear the same name. Admittedly, this reflects on my own questioning ability or lack thereof. Tomorrow the dog is coming for a test that I hope will finally yield an answer. He is staying for a few hours for me to observe. Thus a third dog will be added to the first two. And maybe a fourth, if my boss has time to give me a second opinion :-) In the end I just want one dog and one working diagnosis and one course of treatment to follow.

Thursday, March 4, 2010

One for the reading list.

Here is a quotation I found in the waiting room of the city emergency clinic while waiting to borrow a bottle of methocarbamol for two quaking cats their owner had accidentally treated with dog Zodiac.

"We need another and a wiser and perhaps a more mystical concept of animals. Remote from universal nature and living by complicated artifice, man in civilization surveys the creature through the glass of his knowledge and sees thereby a feather magnified and the whole image in distortion. We patronize them for their incompleteness, for their tragic fate for having taken form so far below ourselves. And therein do we err. For the animal shall not be measured by man. In a world older and more complete than ours, they move finished and complete, gifted with the extension of the senses we have lost or never attained, living by voices we shall never hear. They are not brethren, they are not underlings: they are other nations, caught with ourselves in the net of life and time, fellow prisoners of the splendour and travail of the earth."
From "The Outermost House" by Henry Beston (1888-1968)

By the time I got back to our hospital with the medicine the cats had stopped quaking. Somehow they must have absorbed enough oral Robaxin despite drooling a river.

Back to the roots.

Could you still love an animal if you could never cuddle it?

This youngster's picture was taken on his "tutoring" day when he was about seven months old. He's a magnificent animal, already quite large for a 7 month-old, with long legs and huge feet. Unlike many dogs that are touted to be part-wolf (very popular claim in this neck of the woods), he actually is part-wolf. I do not know what he sounds like because he never barked or howled. In the exam room he would spread out on the table and settle into a nap while I was doing my thing. He reacted to nothing - not to temperature-taking, not to vaccines. In his kennel he spread out and settled into a nap. After his neuter he woke up, sat up, and settled into a nap. He took every opportunity to save energy. He did not address himself to anyone, complain about anything, or call any attention to himself. In fact he acted as if none of us was present, as if there was nothing to be expected from us. This dignity and calm acceptance were fascinating in such a young animal in strange surroundings. Many people would not want a pup like this, or the dog he would grow to be. He interacts with his family and accepts affection but does not return it in any obvious way, and nips quite hard with his incisors when he plays. (He did not attend enough of our puppy classes to learn bite inhibition :-) He digs up the ground as if it were a construction site. Fortunately for everyone he lives on an acreage. In him I had the honour of observing the birth of the dog - not yet dog as we know it, but already not quite wolf.

I caught myself wishing more dogs were like this; I've met a few such dogs, each very memorable. Very loyal yet somehow less dependent on humans, less apt to look with unconditional faith into our eyes (kudos to those who really feel they deserve such faith), less like the perpetual puppies we have bred them to be, more capable of playing all by themselves with no one watching. More likely to tell us if and when we're full of shit, and incapable of putting up with it. Cats seem to have retained this primitive independence (mistaken for haughtiness by people who take things personally) and that's one answer to why I'm more comfortable around them both as a person and as a veterinarian.

Tuesday, March 2, 2010

A detour.

A carefully planned hike took a life of its own when we decided to see the diesel donkey and the view from the top of a never-before visited hill. One of the many British Columbian sawmills operated in this forest sixty years ago and its owner blasted a road through rock to the top of a minor mountain that was given his name - DeBeck hill. The diesel donkey turned out to be a huge pulley used to clear felled trees out of the way. In local terms this forest-covered rock towering about 700 metres over the valley below is indeed only a hill. At the top of it are radio beacons and the trailhead of an extreme biking trail which turned out to be a dead end and made us retrace our steps all the way up the mountain (for it did not feel like a hill at that point) before we could descend. The rain was falling on the water of Alice lake and a rapidly moving mist changed the appearance of the sky and landscape by the minute. It's early spring and one of those days that looks like late fall. A grouse sounded his mating call - the first of the season.

Yesterday I received my first issue of the Journal of Feline Medicine and Surgery mailed all the way from Elsevier publishers in Germany, a little welcome into the world of cat medicine which may be my future. Many lay people are cat people or dog people, and so be it, that's an accepted fact or stereotype. They may poke fun of each other and that's the end of it. But when a veterinarian put in charge of protecting animals, assumed to be all animals, decides that they want to work exclusively with ...cats of all creatures, he or she often feels they have some explaining to do (which I promise to do later). And they no longer get to wear the terribly conceited T-shirts that read "Real doctors treat more than one species." So in a few months I may be no better than a plain old M.D.! :-)

Too tired to do any explaining or to write in complete sentences, but not too tired to sample some delectable unpasteurized cheeses from around the world. A sweet and ripe Ossau Iraty made from the milk of Basque separatist sheep, an 8-year old Cheddar from Quebec, a Papillon Noir Roquefort which my boyfriend keeps mistakenly calling Black Death, A Morbier Fermier made of morning and evening cow's milk separated by a layer of ash, and a Fontina d'Aosta whose rind is a joyful celebration of putrescence. If it turns out that I am entirely unfit for private practice, I'll become a lab rat and research how to fight allergies with food-borne pathogens in manageable quantities ;-)
Tomorrow is the start of a new working week.