During our small animal rotations, we are randomly “drawn” for ICU and ER student shifts. The shifts are either weekdays 5-8:30pm or weekends from 8am-2 or 2-8pm. We also have back-up surgery and neurology shifts. It ends up being an extra 4-12 hours a week on top of our regular rotation hours. I actually don’t mind being the ICU student, primarily responsible for returning emergency (and definitely non-emergency calls). Usually, I get a second wind on ICU due to the adrenaline surges that come through the doors.
However, this past week on my ICU shift, I was exhausted. I landed the 2-8pm shift and it was about 5:30 p.m. when things really started getting hectic. Although the ER student usually sees all the cases, if things get a little busy I will try to act as an appointment buffer before finally calling the backup students in.
6:00 pm: I received a message from the answering service that someone called with a dog that is vocalizing in pain and cannot move it’s neck. I briefly spoke with the ICU doctor before returning the call, anticipating this would be an emergency visit. Expecting a frantic owner, I was surprised to hear a laid-back woman who diligently began to explain the course of events:
Two days ago, the Ms. Smith (not her real name) noticed redness below the eye, maybe on the sclera. Nancy (not her real name), a young adult large breed intact female, has otherwise been healthy and had no other foreshadowing clinical signs. No current medications, no history of trauma. Today, when Ms. Smith went to look at the eye, Nancy was reluctant to have it touched and yelped. When Mr. Smith came to look at the eye, the same behavior was demonstrated. There is no swelling, redness or discharge in the vicinity of the eye. Ms. Smith was confident Nancy had no changes to her eye sight. And aside from the eye, Nancy has been acting normal.
Hearing this, I thought I must be exhausted…I completely missed the part about the neck pain. I asked if Nancy was able to move her neck which prompted more information:
Tonight, Nancy was fed according to the normal routine. Food was placed in her bowl and the bowl was on the floor. Nancy went to eat out of the bowl and suddenly jumped back with a yelp. She refused to eat from the bowl but would eat food from the owner’s hand.
I’m thinking a neck injury, that the eye might be unrelated. I confirmed with the owner, “The message I received said the dog is unable to move it’s neck and is screaming out in pain…”
“Oh, I just wanted to make sure that you guys called me right back.”
The owner’s only concern at this point was the eye, which, don’t get me wrong…you don’t wait when it comes to eyes. I went ahead and explained that we recommended coming in, that we’re 24 hours. We also have a $100 flat emergency fee that includes no diagnostic work-ups or further testing. The owner was about to come in until this point. She asked if 9pm tonight would be okay. They had guests over for dinner and she didn’t want to inconvenience them. I repeated we’re 24 hours, and said without knowing the extent of the eye problem, it might not be advantageous to wait. Ms. Smith then developed a plan that she would arrive at the vet school around 9 pm tonight. Or, she might arrive around midnight if dinner ran late. Or, they might come in tomorrow(sunday), unless Nancy improves in the next couple hours…then they would come in on Monday.
This procession happens a lot, with more often than not the owner not coming in.
At 7:00 pm, the front desk paged me to let me know the neck injury case was in. I didn’t know of another neck injury case, so I hastily got the ER student off in their direction. Come to find out, the walk-in was the dog with eye pain. Exams, sedation, IOPs and stains later, we were still uncertain about what was going on. So, I went out to the lobby to update the two guys who brought the dog. Mr. Smith and the dinner guest, I assumed.
I let them know it would be another 30 to 40 minutes. They asked if there was a vending machine, which I happily led them to. “Better yet, is there a bar around here?”
There’s 7 bars in town. They asked where one is that is both easy to get to, and that I would recommend. Believe it or not, this isn’t an uncommon occurrence when owners are waiting.
Enthusiastically, I said “Yeah, by far the best bar in town is My Office.” I was letting them in on my favorite bar, one frequented by locals rather than undergrads. It was the first bar I had gone to when I turned 21 and a bar I had been going to ever since.
Silence. Both guys exchanged glances, then grinned at me. “Bet they have good cocktails.”
I kept smiling but thought who orders a cocktail at a bar? But, whatever rocks his boat. “Never had their cocktails, but you can’t beat the Jack in coke or Washington red apple.”
Then, it dawned on me while they were chuckling. They thought I was literally talking about my office. I assured them it’s a real bar, barely 5 minutes away. They weren’t buying it. With plenty of calls to make and patients to treat, I pardoned myself from the chuckling men. Horrified, embarrassed and feeling slightly unprofessional about the confusion that my answer had caused. The rest of their visit, the guys teased and watched me through the ICU office window. All in good fun…
“They are going to leave you the best review ever.” My classmate said. “I’ll bring my dog in any time if that vet school chick who’s office serves as a bar is on shift.”
I got a good laugh out of the deal. But definitely relieved that my last call was 8:30pm and not 1:30am.