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Life after graduation - Eleanor Gough

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  • 08/03/2019 11:53:00
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Life after graduation - Eleanor Gough

July 2019

How important is it to always know the right answer? I mean, how important is it really ?

For example, how do you put a purse string suture in a hamster with a prolapsed rectum? How many 20mg Fluoxetine tablets does a German Shorthaired Pointer have to eat before you get worried? What do you do if an owner gives an 800x overdose of enrofloxacin to a cockatiel?

Now, it’s possible I missed the lectures that would have provided me with the answers to the above. But every vet ever has been asked questions that they would never have considered... and were it not for the agency of our patients and the beautiful eccentricities of our clients, we might have remained in blissful ignorance. Alas, it was not to be.

Veterinary medicine is awesome in its variety, yet baffling in its scope. And something that our profession of chronic over-achievers has to come to terms with is this: you aren’t always going to know the answer. At least not straight away.

It’s something that we seem to expect of ourselves, and that our clients have come to expect of us too. How many times have you been pressured to make a diagnosis based on just a clinical exam, with no investigations? Worse still, how many times has a friend (invariably someone who hasn’t spoken to you in over a year) sent you a picture of their animal via social media, looking for a quick diagnosis and a quick fix? But I’m not an oracle. No vet is. I don’t have x-ray eyes, I've yet to establish if I can taste glucose in urine like ye olde physikas (to which I am happy to remain ignorant) and I certainly have not been blessed with "the sight."

Point is, I don't have to always know the answer straight away. It's knowing where to look for the answers that is important. So I'm not going to give myself grief over the many things I don't know. Instead, I am grateful for the wisdom of senior colleagues, the breadth of available BSAVA manuals and the Veterinary Poisons Information Service (not a sponsor), who must be sick of hearing from me by now.

I never found out what happened to that cockatiel. There will be many other things I never know. And that's okay.

 

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April 2019

Some people NEED their pets. They need their pets because they simply have no one else. We have one such client on our books. They are not well off at all, but their dog comes before everything else. Their canine companion even eats before they do. And when the dog became unwell, there was never any doubt that a vet would be consulted.

As it turned out, the dog had diabetes mellitus - he wasn’t in full-blown DKA, but was extremely ill nonetheless. He had been drinking incessantly until he vomited the water back up and, by the time I saw him, was completely collapsed and poorly responsive. I had a frank conversation with the owner about the costs of managing an unstable diabetic, however the owner was very clear: no matter what, please help my dog.

So I did. Having not managed one of these cases before, and Sod’s Law stating that this dog HAD to get sick when my senior wasn’t available, I called around for advice before setting out on treating this case that would make-or-break my early career.

By some miracle, we stabilised the dog and got him to a point where he could go home. He has since been on injectable insulin and, after much strife, we found a dose that maintains his weight and manages his clinical signs. However there was still the issue of the bill. The bill was no laughing matter and I knew there was no way that the client was going to pay it off any time soon, especially considering the ongoing medication that the dog was now on… Then something incredible happened.

Another client of ours came in and paid off most of the bill - several hundred pounds. Their only request was that they remain anonymous.

This was to be their big humanitarian gesture - the one secret act of overwhelming kindness that they could look back on and be proud of - and it was to pay off a bill that I ran up. Me. Clueless, inexperienced, new graduate me.

I cried.

The imposter syndrome was overwhelming. All-encompassing. I didn’t deserve the “Doctor” title that I plastered on my debit card and car insurance policy in July 2018. The guilt threatened to swallow me up. It was only through reaching out to colleagues that I was able to rationalise my thoughts:

The dog was sick. The client asked me to fix it, so I did. They are both now happy and well. By focusing on the outcome, rather than the process, I was able to consider that I had actually done well.

I would strongly encourage anyone else who is experiencing imposter syndrome to reach out to colleagues. Everyone in the profession has experienced it at some point, and talking to someone else can help you to look at things objectively. You are not alone.

 

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February 2019

Fresh off a weekend on call when everything went wrong. If this isn’t the time to share and ‘reflect’ then I don’t know when is.

My name is Eleanor - “Elmo” to friends, “El” to clients - and I graduated from the University of Bristol in July 2018.

I have been working for 6 months in an independent practice in Burnham-on-Sea, where I am supported by a wonderful team.     

Nothing could have prepared me for last weekend.

In the veterinary field, our workload is unpredictable. I accept that. Some call it a “surge phenomenon,” some are happy with just “sod’s law.” However when the consult list goes from comfortably sparse to overflowing with complicated cases, I can’t help but struggle to keep my cool. On Saturday I found that half my brain power was spent battling against my own mind. Trying to work through problem lists, differentials and investigations is difficult enough, without unwanted thoughts creeping in. “You’re running late. Why haven’t you worked it out already? A more-experienced vet would have done this by now” etc.

Thank you, Captain Obvious. Of course a more-experienced vet would have fewer issues. But it’s amazing how logical statements can feel like the most cutting criticisms when you’re under pressure.

My nursing team got me through the spaniel caesarian. And my mentor arrived afterwards to offer words of encouragement and to handle the owner of the dog, who just had too many questions for me to answer coherently at 6.30pm, having not had time for lunch.

Never underestimate the rejuvenating power of a ham sandwich left over from a lunch and learn.

Of course, on top of everything else, we had run out of labels for the label printer. Good thing I hadn’t made any plans for all of my spare time that day. For everything I prescribed I had to write the label out by hand. Which is fine until the Cavalier King Charles Spaniels come in for their monthly emptying of our pharmacy. I’m sure there are vets who remember the good old days before label printers and who would give me grief for complaining about this, however for me, two overarching thoughts coursed through my mind. Firstly, what on EARTH has to legally be on a label? We had a seminar on this at university so I absolutely should know this already. You can be confident that I went full “new-grad” and just copied from an old label I found down the back of the desk.

Secondly, what if word gets out that we’re doing handwritten labels now? What kind of modern, kooky expectations are our clients going to have? Are independent practices comparable to independent coffee shops? Tune in next week when we will be offering a 10% discount on ranitidine solution if you bring your own “keep cup” and I will be consulting from atop an exercise ball.

 

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