Best Surgery Lab Ever

We had about the neatest surgery lab today. I got to do all the procedures I hoped to do.
The list:

Distal check ligament desmotomy
Lateral digital extensor tenotomy
Medial patellar desmotomy
Lateral partial splint bone removal
Medial palmar digital neurectomy
Eye enucleation
CSF tap

A bunch of jargon, I know, but it was really neat. Dr. Hilbert, the Australian fellow from the nighttime colic surgery, came in to help Dr. Huber (who met Hilbert when he worked in Australia for five years). Hilbert is enthusiastic (he even walked SS through a laryngeal tie-back surgery on our pony!) and a great teacher. It was fun to hear Drs. H&H giving each other a bad time -- and on occasion Dr. Huber would launch into some ballad when someone got CSF flow or some such. It was grand.

Birthday Surprise

My friend JG invited me to eat breakfast with her on Saturday, my birthday.

The day dawned and I trekked down to Shari's to meet her. Whaddayaknow, but I see extra people in her car and then all sorts (no Y chromosomes involved) of persons pile out of two cars and I am informed that we are not eating at Shari's but rather going to J&O's for brunch. 'Twas rather a surprise.

JS (my house mother) went to all sorts of effort making a really nice brunch -- coffee cake, appetizer, the whole bit. I was showered with cards, given some nice gifts (yay, now I have two plants for my room! I don't know why it took me so long to realize that plants would be a nice addition to my abode, but the reflection of carnations in my mirror finally suggested the idea.)
JS even thought to invite CS from across the creek, and AS (JS's sister-in-law) got wind of my birthday and provided a card.

LT emailed from across the US, CB emailed from Corvallis, Grandma V sent a card from Cali, and I got an REI Gift Card from my parents (they couldn't possibly go wrong there -- REI never fails to intrigue me with their neat outdoors equipment, et cetera).

I felt very loved indeed.

Brother's Age Minus 2 Years

I am feeling very loved today. I'll write more about it after my large animal medicine exam. (No, it's nothing romantic -- just the result of having a birthday and nice friends.)

Word of the day: cicatrix (because it sounds so strange). Guess what it is, then look here.

This Mornin'...

No school this morning ='d delightful opportunity to read a novel (I'll get on the Large Animal Medicine studying this evening). I found "'Lena Rivers" in the library of my houseparents (which doesn't mean that they would endorse the book -- it wasn't theirs originally) and have been making some steady progress through it. A fabulous Cinderella-type story (someone needs to think of some new story lines to furnish new stereotypical books), with a fair bit of suspense, a very large dose of intrigue (it's the wicked aunt and cousin in this book) and relationships getting ruined, mended, rent, etc.

I am impressed by the utterly poor communication and extensive secrecy that occurs in the story. It is astounding how slow some of the characters are to see through the aunt/cousin, and how they actually believe information obtained from those sources. Not only do they believe the information, but they make life-changing decisions based on it. Impulsive and air-brained -- both women and men.
Some degree of skepticism is good, especially when people earn it.

Lame

Lameness exams are kinda fun, but I need to become a lot more familiar with normal (and abnormal) horse movement before I take off into the real world. Thankfully, I'm taking Equine Lameness next spring.
Today in surgery lab we did exams on four horses. My group figured out the general area of lameness on three of them. On the fourth, we found the most acute cause of potential lameness but failed to find the more chronic cause.
A first for me today: doing a shoulder flexion test on a horse. Pull a front leg forward, hold on for a minute, let it go and see if the lameness gets worse.

It's only 5:20 pm on a Tuesday and I can (may) actually go home. Yippee!
And I hear tell that there is no class tomorrow morning -- study time, yeah!

Ancient

Today my lab had a birthday potluck for HC and myself. It was very nice of them, given my record for leaving old bacterial cultures around the lab, leaving plates in the incubator for weeks, and not getting over there much to do research.
They got us both red carnations -- sniff -- I haven't been given flowers since my graduation from GFU almost three years ago.

On my birthday I will be 8 days more ancient than I am now.

I managed to work in that lab for over half a year without a couple of the members knowing my age. I guess I more or less assumed that everyone knew the general ballpark of my years, but one lab member was very surprised to learn my age and another said it fit more with the age he thought I looked but assumed I could not be.

Siletz Valley

Small animal nutrition class came to an end. I rounded up some journals and vet school application guides, had the vet school info poster added to the horse bones, dog skull, and half horse hoof in my car, and headed out for Siletz Valley School. Today was their career fair, and I volunteered to present veterinary medicine.
It was a very scenic drive -- out through the countryside, evergreens abounding (except for the sadly clear-cut areas), "blue skies smilin' at me" (not in the Valentine's Day sort of way, for any of you who know the song.)

I had gotten directions from Mapquest but initially figured I wouldn't use them as they appeared to lead over some semi-non-existent roads out in the forest. I thought Hwy 229 would be faster. However, someone else told me that the back way would be faster, and knowing no other back way I decided to try Mapquest's.

I found Pioneer Mountain Loop (the very term "loop" made it seem a bad choice) and followed it.... until it came back out on the hwy where I had started. I was supposed to take PM Loop, turn ambiguously "Right", take a slight left, take Camp 12 Loop (another umpromising name) to Hwy 229 which goes into Siletz. That whole list of directions was to occur in about 6 miles. Sadly, I didn't find the ambiguous right (maybe it was someone's private drive -- I need to go back and see).

I arrived late at the fair (!! :(( ), but still had some positive interactions with the students. Some were quiet, others very talkative (like "once I saw a chicken that was half-eaten and there were a bunch of eggs inside it" or "once a horse died and my dog ate its foot" or "have you ever seen any sick rottweilers?" or "how many animals do vets save every year?"). I showed 'em the bones, talked about laminitis in horses, told them vets are teachers, talked about the role of vets in public health. Some of the children actually paid attention.
Toward the end this girl came over, sat in my seat (which I wasn't using anyway) and asked if she could use my stethoscope. She proceeded to try to listen to her heart (and declare that it must not be beating), then made noises into it and made a couple other children listen (if you haven't ever experienced that, it HURTS the ears). I confiscated the scope.

I think I prefer interactions with people I know I can continue to have a relationship with -- what is one short encounter? -- but it was good over all.

Some interesting comments from the children (They are so candid! It's great.):
"Why do you smile all the time?" (My response: "Maybe I can't help it" -- which is true aside from some herculean effort -- sort of -- and completely true when I am not focusing on not smiling.)

"Why do you wear that on your head?"
I answered, and the girl "thought" maybe I wore it to keep the blood out of my hair when I work on animals. Actually, I guess I wear it because I am already covered in blood.

Another girl: "why do you wear that on your head?", and then went on to say "I'm not used to being around people like that."
I had wondered how weird they would feel about me, but it didn't seem to make them shy.

***
I was so close to the ocean and had a few minutes before I needed to head back for work, so I went to Newport. I took a scenic drive around part of Yaquina Bay, then parked at the historic bayfront and took a stroll to see the sea lions. It's sort of strange touristing by myself, much more fun to have someone else (e.g. my brother) along, but it was quirky and fun to go alone. I got some salt water taffy to be the quintessential Newport tourister.

Church Vision

PT of Hopewell MC spoke Sunday night about Romans 14:17:
"For the kingdom of God is not meat and drink; but righteousness, and peace, and joy in the Holy Ghost."

He mentioned that it is not ultimately important whether his wife wears a cape dress, what car he drives, whether he uses the Internet (for you non-Mennonites, that's an issue in some such churches). What matters is following righteousness.
He also referenced the scenario when there is a choice to be made about whether or not to do a certain thing when you are unsure. To a lot of people, the best choice is to refrain from the action. Is that Biblical? It was the weaker brother who would not partake of meat.

To add some of my own thoughts to his comment, we may actually inhibit the work of God through our lives by refusing to do certain things. For an extreme example, suppose there's a person who refuses to drive cars because they get him places faster and therefore keep him from more quiet time with God. Because of that, he sticks within a 10 mile radius of his homestead 95% of the time and does little positive building in the kingdom of God. He probably prides himself in abstaining from cars, thinks he is very holy, but in reality he is burying the treasure God gave him and not doing the work of a Christian.

If a person lives the life of a semi-hermit for fear he will lose his eternal life, he will not lead many souls to God. Think about it -- he is actually valuing his spiritual life more than that of others. Of course, there is a balance in such thinking -- we by no means should walk on the outskirts of what is holy. But if we are out there working for the salvation of others, we will actually be less likely to grow spiritually cold than if we keep our faith to ourselves.

I was very impressed by the comments PT made. I feel strongly that if the members of my church take them to heart and allow them to positively affect their lives, our church could really go (good) places.

Fun Stuff

We had another sheep lab. I "got" to be anesthetist -- which is still more stressful to me than surgery.
Everything went well -- the catheter slid in easy as pie, the sheep didn't wake up on the surgery table, and we put him on a ventilator (so I didn't have to keep track of respiration).
HN and LO did a rumenotomy. Basically, they cut a hole in the rumen and felt around inside (I got to as well). Because of the non-sterile nature of rumen contents, they first sutured the rumen to the skin. Then they cut a hole in the rumen and inserted a wound ring into the hole to keep the surrounding externalized tissue free from rumen material. They had to get new gloves and use separate instruments to close body wall layers.
This surgery is done to lance abscesses in the reticulum, place fistulas, etc.

We also castrated the ram.

Now I must immerse myself in small animal endocrinology in preparation for tomorrow's delightful exam.

Dunked

Yesterday I attended my friend JK (Janice)'s baptism at Southside Community Church. It was the second immersion baptism service I recall attending.
I drove to her house and ate breakfast with a variety of her friends and then waltzed down to the church. Services are held in an old house made church-like by the addition of a tower and steeple. The auditorium was lined with knotty pine and possibly 20x50 feet in size. The room was relatively well-filled, some substantial portion of the attendees being children bussed in from Corvallis (hmmm, maybe we should do that at Hopewell MC).
The atmosphere was casual and the two pastors played guitar and bass in the worship band. (Is casual dress appropriate for church? Does it promote diminished reverence or suggest a lack of respect for God? If church is important to us, it seems like we would want to dress nicely (or at least neatly) to attend -- on the other hand, clothes is not the focus of church and it is certainly not the most important preparation for attending.)

It was an edifying and interesting experience -- and Janice had the largest fan club of all the baptized people. AK & KR (both vet students), J&C C (at whose house we have our vet school Bible studies), and our beloved anatomy teacher TC were in attendance. JC gave the announcements at his church and then left to come to the baptism; Dr. TC was pressed for time but made it anyway. Janice also had a couple relatives and non-vet school friends there. The turn-out was impressive.

Computer and All

One of my pet peeves is when a person says something, I say something else to add to or clarify what they said, and they say "No" and then proceed to say something that agrees with what I just said. It is maddening/frustrating because it shows they weren't honestly listening. Of course, sometimes it might be my fault because I don't say what I mean in an easily understood manner. And ultimately, it is my fault if I become irked... I'm not certain that this pet peeve is based in pride, but it is magnified by it.

***
Today I joined CS as she shopped for a computer. We ended up going down to Best Buys in Eugene. This one fellow there (that's a nice dangling phrase), I asked him some questions about the reliability/repair frequency of the various brands of laptops. I actually expected that he wouldn't know much, but he expostulated on the subject using statistics and a clear grasp of the material. It was pretty impressive. (Somehow this reminds me of the Stoker's VitaWorld occasion -- sometimes I avoid salespeople like contagious ecthyma on a sheep -- other times it's fun to dialogue about the products and act like I know something.)

Parable of the Talents

It used to be one of my pet peeves when people used the parable about talent stewardship to teach good stewardship of money. That wasn't Jesus' main point -- he was talking about the kingdom of heaven. God has given it to us -- do we hide it under a rug or share it with others? Shove our Bible on a shelf or memorize it and apply it to our lives?

We don't use the wise man/foolish man rock vs. sand parable to teach people that it is sin to build on a sand dune.

I still think people should stress the heavenly kingdom aspect of the talent stewardship parable.

But it got through my thick head recently that it's okay to apply it to monetary stewardship, too -- so long as people are clear about the logic used to make the application. Money, time and strength have a place in the parable, but that place is not the place of the talents. The kingdom of heaven is the talents while my money, time and strength are the feet that took the talents to the banker, the mind that planned a good way to invest it, the guards that kept it safe enroute.
Make the Kingdom the fulcrum of your life, and you will be by nature a good steward of money. Make the latter your fulcrum, and you may miss a chance to further the kingdom as you pinch the pennies.

Sheep Surgery

It so happened that we got the sickest sheep of the whole bunch*.
Foot rot so bad it didn't want to stand, body condition score of 1, drooling at the mouth (would that be rabies, orf, or ovine viral ulcerative dermatitis?). And I was supposed to do surgery on the beast and expect it to stay alive.

Actually, it was sort of a goof that we ended up with the fellow. There were extra sheep and we would have used one of them, but they weren't held off feed over night.

It took forever to get the jugular catheter in because his blood pressure was so incredibly low.
Dr. Riebold joke about needing a gas mask because the sheep stank so much.
The ram drooled plentifully on my dress as I restrained it.

Anyway, we opened the abdomen enough to insert an arm, and got to feel around for the liver, spleen, cecum, etc. I'm not experienced in intraabdominal sheep palpation, so it was a pretty new and valuable experience. It is often advised to use the same hand whenever you (ha!) palpate so that you engage the same part of your brain each time and can trigger memories of structures felt in the past. Everyone should have an opportunity to look in a sheep abdomen.

We then did an abomasopexy (the abomasum is the ruminant true stomach) via a right paramedian approach (look at this nice slideshow if you want the literally gory details). It's a procedure done for cows with left displaced abomasums -- this issue is common in cows, so it is wise for vets to know how to do corrective surgeries.

The trick is to suture the abomasal wall to the abdominal wall without including the abomasal mucosa (i.e. inner lining). You do that by "slipping" the mucosa with your fingers.

I did a five layer closure (phew!) -- internal rectal sheath incorporating abomasum, rectus abdominus muscle, external rectal sheath, subcutaneous tissue, skin.

Our sheep recovered and is actually doing better than he was before the surgery.

We were the lab clean-up crew, so we didn't get out until ~9 pm.

* Which reminds me of "The sixth sick sheik's sixth sheep's sick."

Judge Not What?

It can be very gratifying, illuminating to look at a passage in light of the surrounding text. We were studying James 4 in a Bible study recently, and it dawned on me that my usual interpretation of vv. 11 & 12 may not be correct.
Those verses have been confusing to me ever since I really thought about what they meant. I always assumed they were telling us not to speak ill of/judge the sins our brothers commit. Now I'm not so sure. There might be other verses (e.g. Matt 7) that touch on not judging the sins of others -- ultimately it is up to God -- but in this context, how would I be speaking evil of the law if I was judging my brother according to it? It just didn't make sense.

So we were studying the first part of the chapter and I was reading toward the end, and maybe that helped me consider the latter parts in light of the former.

James is chiding the Jews for the internal wars that arose from misplaced desire. They were envious (related to pride -- just think about it briefly), so James exhorts them to draw near to God and be humble. Then, right after telling them to be humble, he jumps into the section on not speaking evil of each other. Here's what I'm thinking: he was not referring to speaking evil of sin, but speaking evil of the opinions and actions of others which are not contrary to Scripture. Different ways of doing things. Persons often become proud of the way they worship God -- "my songs are the right ones, my style of communion bread, my pat prayer phrases, my bench style, my liturgy, my covering strings, my Christian school curriculum, my la la la." Give me a break -- is that the focus God wants us to have?
It is important to choose an appropriate curriculum, sing worshipful songs, speak truthful liturgy. But to be proud of those things? If you're proud of them, you might be devoid of the Spirit of the Christian life. You might miss the whole point of living for God.

1 Cor. 12:4-6: "Now there are diversities of gifts, but the same Spirit. And there are differences of administrations, but the same Lord. And there are diversities of operations, but it is the same God which worketh all in all."

And if I judge my brother who wears checkered socks because they remind him of a chess board which reminds him of the Christian warfare... and I think they suggest strongly the 70's which reminds me of the drug culture, and therefore think he should not wear them -- then I am speaking evil of the law of God (his conscience) because I am not making room for the wearing of checkered socks, nor yet for the conviction to wear them. Do not put God in any more of a box than he has built for himself (which = no box at all). The Bible provides a general formula for life, but only God can supply the specific parameters for each person to result in a balanced equation.

(Baptism is "another" good example. Three times forward, one time backwards, immersion, buckets of water...)

Because these issues are not directly addressed in the Bible, it is appropriate to dialogue about them but not to arrogantly force our opinions on others. Such could encourage a brother to violate his conscience and therefore sin. "Therefore to him that knoweth to do good, and doeth it not, to him it is sin." James 4:17

Am I way off? Let me know!

P.S. My brother does not wear checkered socks (unless living in PA has corrupted him more than I am aware :) ).

So It Is

"So do we sing the "do," Joe?" -- me, yesterday at singing practice as I inquired about a change in the refrain of song. Accidental rhymes are fun.

Our ponies have been taken away for a time and now we get to do surgeries on rams. You may recall from the llama biting episode that I had a literal "run-in" with one of the vet's rams. Therefore, I am a bit squeamish about such beasts, but I am still planning to enjoy the next two labs.

I have 9 days until my next exam. I look forward to having TIME to study, prepare for a middle school career fair and write a song.

Galavanting

Today in ruminant nutrition we went to the Van Beek dairy in Monroe and Union Point Custom Feeds in Brownsville.

The dairy was typical, from my limited knowledge (I've been to 1-2 commercial dairies in my life), except that the cow milking stanchions were on a continuously rotating platform. Apparently it makes the milking process faster (cit. this webpage about the Van Beek dairy).

I'm learning to like the smell of silage. Canola meal is another issue -- I thought it was poultry manure from the smell (and look). Believe it or not, cows are fed poultry manure as a feed supplement. It is a good and inexpensive source of energy, protein, and minerals*. Talk about stewardship of resources -- it's a great idea -- I'm just glad I'm not a cow.

The feed mill was neat -- the establishment has the capability to make steamed pellets, rolled or cracked grain, la. Very educational and the couple reminded me of my maternal grandparents. The husband definitely the techie, into his machines, more of the "farm" idea. The wife a little more of a talker, probably taught school in her younger years, more refined.

A neat trip over all.

Trephination

Remember hearing about "ancient" cultures where they drilled holes in skulls to let the evil spirits escape? Trephination?

Well, Tuesday I bored a hole into our pony's skull using a 9/64" Steinmann pin.

Only, it's not as bad as it might sound. I entered the caudal maxillary sinus (which communicates indirectly with the nose), not the cranial vault. I flushed fluorescein dye through the hole, and saw it exit via the ipsilateral (that's a great word) nostril.

Why couldn't they have made the pin 1/8" instead of 9/64? Your guess is better than mine.

We also got to endoscopy our ponies -- we looked at the larynx, the ethmoid turbinates, and inside the guttural pouch (through which run five cranial nerves, the internal carotid artery, and the maxillary artery). As a side note, horses may bleed to death from the growth of fungal plaques on important arteries in that pouch.

One Stone, Many Ripples

This is the (you decide what kind) essay I wrote for the AWV scholarship. I wonder how well the "love of God" will go over when it is reviewed? I guess they might as well know who I am...

I scan my surroundings, I lift my eyes to encompass America, and I look beyond. I see a world hurt by war, power, and the selfish designs of men. The world needs people motivated by love, ready to give their lives for the lives of others and show them how to LIVE. I am one small pebble. But as I skip across the lake, the world, empowered by the love of God, ripples will spread farther than I can imagine.

Lasting peace does not come by force, but by mutual understanding and effective communication of love. I want to go to third world countries and teach better husbandry and health care to enable the natives to prosper. We together can discover the best way to raise native species in their climate. I will learn from them and encourage them to retain valuable aspects of their culture and technology.
As a veterinarian in America, I will connect with farmers and teach them better ways of sustainable agriculture. Because of drug resistance, we need more livestock producers willing to manage animals effectively to decrease the need for antibiotics and anthelmintics. I believe that better management will result in happier animals and healthier people.
I look forward to more opportunities to share my knowledge with future farmers (cit. my upcoming presentation to Linn County 4-H’rs — see resumé) and invest generally in the lives of our nation’s youth.
My passion for learning draws me to higher level academia where I would some day love to teach. I will encourage my students to build high goals for themselves as I have for myself and I will work with them to determine a calling appropriate to their lives.

One stone, many ripples.

I have big plans for the future… am I prepared to effect them?
Skips of the past have seen me organizing teams for overnight foal care in the teaching hospital, travelling to Scio to learn from a farmer who uses draft horses (that’s one option for promoting sustainable agriculture), staying late into the night to watch an intestinal anastomosis in a colicking horse. Last April four other students and I toured the Oregon Country Beef (OCB) feedlot in Boardman, OR and learned about their minimal antibiotic-use program. We also heard the OCB rancher’s perspective when we stopped at an OCB ranch to dialogue with him and his wife. I have honed my communication skills teaching 4th-6th grade Sunday school at church and presenting my research at numerous events. I have proven my ability to multitask by attending veterinary school, doing research, and working two jobs. I am actively involved in five campus organizations. And I was [...] my class as of May 2005.
My preparation has been good and I look forward to its continuation. Will you play a role in that process?

One stone, many ripples... Here I go!