The Doctors’ Meetings

Every other Friday, before each doctor sets out for the day’s appointments, the four of us meet at the only diner in town. Our practice sits on the edge of a quaint town with no need for a single stoplight or stop sign. One of only two restaurants, the diner is nestled in a row of buildings that look straight out of a stagecoach western. State patrol frequently choses this humble eatery as the location for their change-of-shift. On those particular mornings, the diner’s small gravel parking is overrun by patrol cars. This is also the only time when the town experiences traffic as a result of overly-cautious commuters going 10 below the 25 mph speed limit.

Our doctor meetings are held over breakfast, with discussion prompted by 2 or 3 items on the “doctors meeting list” or DML. Items that make it onto the DML come from a wide range of topics, vary in importance and certainly are not guaranteed to stimulate rivoting conversation. Over the past couple months, items on the DML have include updated pricing, barn packages, changes to inventory, on-call schedules, charging tax on products, assistant performance issues, standard protocols for packing equipment, damaged or missing equipment, new drugs we’d like to have on hand…etc.

Once the items on the DML have been checked off, there is an end to the meeting formalities. This is when the meetings get interesting. This is my favorite part of the doctors meetings, when I get to revel in the hard-earned wisdom of seasoned vets.

Case discussions.

It starts off with one of us seeking input on a particularly challenging case. Without fail, it leads to the opening of the case discussion floodgates. In discussing one case, someone inevitably remembers a case they would like insight on…which triggers another doctor to bring up their recent patients and so on.

I call it the case dominos effect.

These dominos turn half-hour meetings into 1.5 hour meetings, subsequently making us all late to our first appointments and causing a chaotic post-meeting scramble in the office. While fascinating and rich with info, there is another reason I look forward to these talks. Its the environment that has been created for the conversations. The table is a safe place to talk openly and without fear. There is no room for judgment, shaming or belittling. These moments are key to nurturing a honest, sincere comradery between colleagues and fosters a strong sense of moral and unity…things I have rarely seen in multi-doctor practices. In an effort to net suggestions or help from our combined 48 years of experience, we also create a robust support system and receive encouragement.

And there have rare occasions when our conversation divulges to less professionally astute topics in veterinary medicine, like the newest gossip about neighboring vets and practices. That’s a subject for another time, and a deserves it’s own blogpost.

And if the DML is blank? We still meet for breakfast because that’s just a pleasant way to start the day.

Treating more than the horse

We treat more than pets. Legally, of course. The person attached to our patient is just as important as the patient itself. Whether it is an annual exam or late night emergency, attending to the client is, in essence, attending to the patient. Help the client to help the horse. I think there are floating misconceptions among some vets, and about vets, that our profession only serves the patient part of the equation. By ignoring, negating or dismissing the client half of the equation, I believe vets are neglecting the very reason we even have a patient…that someone reached out to us.

Why did you become a veterinarian?

I’m always curious to hear other veterinary professionals discuss their reasons for choosing this profession. By far, the overwhelming majority of answers are centered around a core feeling of compassion/love for animals, coupled with a desire to maintain, improve and advocate for animal health. On a rare occasion, I hear a starkly different answer along the lines of “because I don’t like people.”

People and Medicine

The “because I don’t like people” reason strikes a contrast with the more common reason. Firstly, it comes off as void of sentiment and does not even mention a regard, concern or care of animals. In fact, there is no mention at all of the locus- animals. Second, the veterinary profession is comprised of and dependent on people. People infiltrate the entirety of veterinary medicine, filling diverse roles such as colleagues, professors, CE conventions, receptionists, assistants, lab technicians, owners, trainers, buyers, caretakers, transporters, state and federal government personnel, pharmacists, sellers, externs, drug reps, students…

There’s comical memes out there about this very reason for becoming a vet. Or similar ideology such as “the only thing I like about you is your pets.” I appreciate the humor. Truth is, this is a sincere reason for pursuing a DVM according to some. I’ve never heard a practicing veterinarian cite this reason. The only subset of people I’ve heard use the “Because I don’t like people” are vetmed hopefuls.

Ideal vs. Real

Veterinary hopefuls seeking a career free of people, are bound for personal and professional disappointment. Travel the road to DVM long enough, and it becomes unmistakably clear that the there can be no veterinary field without people.

Over the last year and half in private practice, especially as an equine practitioner, I have become increasingly aware of the importance of people skills. Not just refined communication skills and strong bedside manner, but the ability to perceive, listen, collaborate and recognize client needs. Especially as an equine practitioner, we are on the forefront of this interface and often times dealing with all interactions one-on-one. Back to the basics, there would be no patient if there was no owner caring to have their pet seen.

Don’t like people? Doesn’t mean you aren’t capable of being a veterinarian. There is already a tremendous, seemingly infinite list of inherent challenges that come with the job. Adding another parameter obstacle, not only increases this weight of challenges…but I imagine it becomes a thief of what would otherwise be some of the richest, most rewarding experiences in veterinary medicine. Even more detrimental and profound, is what this limitation means for the care of the patient, quality of medicine and overall health of the profession.

I’ll say this. You don’t have to be a social butterfly or extrovert. Plenty of “I”s in the vet field. But if you don’t like people, maybe one of the most rewarding outcomes of joining this profession will be a change in heart.


ambulatory,anecdotes,doctor,animals,associate,associate veterinarian,barn,conflict, health,death,Equine, equus, equine vet,client,owner,,equine veterinarian,farm call,field,horse vet,horses,horse,diagnosis,treatment,medical,mobile vet,new vet,case,patient,quality of life,vetmed,sick animals,story,vet,vet assistant,vet life,vet practice,vet tech,veterinarian,veterinary,veterinary assistant,veterinary medicine, vetmed, dvm, vmd, communication, people, vet hopefuls, future vets, clients, client-patient, people skills, don’t like people, advice, suggestions, recommendations, career, goals

Thomas

There are certain patients and clients you know you’ll never forget. Some cases that almost haunt you, arising from the subconcious on a whim. Little reminders seem to be hidden in tiny corners and crevaces of every day life. Whether its meeting a person or horse with the same name, diagnosing another patient with the same disease, or even sitting at AAEP lectures with the topic being similar in nature…a horse with a similar disposition, or sometimes just a single word on a billboard. It seems just as time has gone by, there is a reminder somewhere that brings the memories trickling (sometimes flooding) back.

This is the story of Thomas, one of the cases that for many reasons, I will not forget.

I first met Thomas in January for a routine dental and vaccines. His owner, Emma, had been referred to me by the practice that performed his pre-purchase exam only a month prior. His PPE had gone smoothly with no significant abnormalities found during the extensive work-up. The owner wasn’t able to attend this first appointment, but the trainer was present. She lead the handsome young gelding into the washrack. Just watching him walk into the washrack, I could see incoordination and exagerated gate in the hind end. His hind feet were parked oddly out from under his body, with his front feet almost ontop of one another. He stumbled and stepped on himself multiple times in the 5 minutes I spent observing. He had a slight head tilt to the left and the left side of his lower lip drooped. The nature of the appointment instantly changed, with the focus turning to neurological examination instead of a routine dental.

The findings of the neurological exam revealed cranial nerve deficits, especially noteable on the left side. Facial nerve paralysis, the head tild and decreased pupillary reflex times were the most significant CN abnormalities. On dynamic assessment, he had a grade III hindend ataxia and grade II bilateral forelimb ataxia. He had assymetrical muscling of his gluteal muscles, with the right being much more extreme than the left. He had marked weakness during the tail-pull to the right, at one point he almost fell over. Given the cranial nerve deficits and generalized ataxia, we decided to rule out a top differential of EPM. He had neck radiographs taken at the PPE, which after second review, were normal. No traumatic events were in his history.

His EPM titer results came a week later. The titer levels were high, indicating a 95% likelihood that his signs were attributed to EPM. We moved forward with a standard treatment protocol of daily Ponazuril and Vitamin E. In a month, we would return for a recheck neurological exam.

We continued the Ponazuril another month, during which his imrovement plateaued. Emma, opting to give him every fighting chance, elected to try another EPM medication called Protazil. After a month on the protazil, his recheck exam found significant improvement. His neurological signs had improved enough that now a right hind limb lameness became apparent.


5 months later

Now 5 months after diagnosing the EPM, with most of his facial nerve and ataxia signs resolved, we moved forward with his routine care. His vaccines and dental went without complications and he continued to receive his bodywork and acupuncture. I’ve held some skepticism in thepast, but the bodywork and acupuncture had a profound effect on his physical and mental state. He looked brighter, moved easier and the right hindlimb lameness was resolved.

A month later, I received a text that he had relapsed. The same day, I went out to exam him,. He was dull, quiet and his neurologic abnormalities at returned worse than before. After heavy consideration, Emma made the difficult decision to let him go. Unfortunately, for insurance to cover the costly treatments and reimberse for all the money spent, a necropsy at a certified facility had to be performed. I won’t name the insurance company, but I will say that how all the details were handled was grotesque. The insurance company required that Thomas’ necropsy be performed with 8 hours of his euthanasia. Since the only lab near by was 6 hours away, and since Thomas was not safe to transport, it took detailed coordination between all of us to meet the time constraints. In the veterinary field, you develop a way of talking about these things in a tactful, professional manner. I have never had a client involved in the details of this process, and honestly, I had never been involved in planning such intricate, time senstive logistics. The whole process was heartbreaking and gruesome for Emma, a nightmare for anyone whose beloved companion becomes an object, entity or commodity to company policies. I admire her and all of the strength she clearly showed through this painful process.

To meet the time constraints and laboratory hours, we had to euthanize Thomas in the middle of the night. After working that day, I set my alarm for 12am so that I could make it to the barn by 1 am. His transportation (provided by my assistant) would deliver him to the lab between 7 and 8 am. I set the alarm, just in case…but I definitely did not sleep. I had discussed his case with multiple internists, researched novel treatments so extensively that anytime I went onto google, it asked if I wanted to search new research in EPM. Although I was confident in my diagnosis and that the treatments we had done were the present gold standard, there was still that little voice whispering “but maybe…”

We arrived at the barn just before 1am. We placed the catheter, sedated Thomas and lead him out of the barn. Fog had crept in and it was starting to rain. Then, it started to pour. I remember the syringes being slippery, and all of us squinting through the beams of the headlamps as we laid him down under using anesthetics. He went down gently onto his side, deep in a sleep state, before Emma gave the gesture to give the final injection. Within minutes, Thomas was gone.


Answers

It was 2 weeks before the necropsy results came back. The trouble with EPM, is a definitive diagnosis is not always possible even with necropsy and microscopes. The chances of identifying the organism, especially after months of treatment, becomes slim. My fear was that the necropsy would not identify the organism anywhere, and determine the cause of his neurological disease indeterminant. When I read the results, my heart sank. No EPM organisms had been identified on necropsy and histopathology. But down, at the very bottom of the extensive report, a note said that the abnormalities found in the spinal cord were consistent with those seen in EPM.

We had all reached a point where we wanted answered. We wouldn’t get the answers as to why he suddenly relapsed, or why he didn’t respond to treatments like some horses. EPM, the heartbreaking disease that it is, can do anything at any time…making it a challenge and yet another disease warranting further research.

We did not get the answers we wanted, but we did get the answer we needed.

At a horse show a couple weeks ago, I ran into Emma. We small-talked a little, and she hugged me before we parted ways. She expresed sincere gratitude for my efforts. She said one day she might look at bringing another horse into her life, but that she isn’t ready. I returned the hug. Sometimes, at the end of it all, that’s all you can do.


Click here for information on Equine protozoal myeloencephalitis (EPM)


ambulatory,anecdotes,doctor,animals,associate,associate veterinarian,barn,conflict,EPM,equine protozoa,protazil,ponazuril,marquis,infectious disease,possum,necropsy,insurance,health,death,Equine,equus,equine vet,client,owner,heartbroken,equine veterinarian,euthanasia,euthanizing,farm,farm call,field,horse vet,horses,horse,reminder,memory,remember,life,midnight,diagnosis,treatment,medical,mobile vet,new vet,case,patient,quality of life,vetmed,sick animals,story,suffering,vet,vet assistant,vet life,vet practice,vet tech,veterinarian,veterinary,veterinary assistant,veterinary medicine,vetmed,dvm,thomas,emma,forever,loss,grief,mourning,

When we cannot save them all, but we can save some

Like many rescues in the area,”Starfish Rescue” used to rotate through all the local vets. Almost as if going through phases. Before I eve stepped foot on the property, I was warned ahead of time. One, their bill is outstanding at over $5,000 owed. Two, overcrowding. Three, don’t be surprised if compliance is low. Four, don’t get sucked in.

My first time arriving at the rescue was in response to a horse that was down and seizing. We never determined the cause, and he never seized again. My second visit, months later, was to recheck a laminitis case that my colleague had seen a couple of weeks prior. The mare had recently had her feet trimmed, and Maureen (owner of the rescue)reported the mare was still having difficulties walking. It was difficult to focus on the laminitis over the glaring neurological deficits. After a full neurological work-up, EPM was at the top of our differential list. With titers returning at >3500 with two subspecies, we felt comfortable with the confirmed diagnosis and began treatment.

Over the next couple months, I attended several more emergencies at the rescue. Sick foals, colicking mares, face wounds, terrible leg wounds, even a sweet gelding hit by a car…cases I will never forget for both good and sorrowful reasons. And trying to make a difference, while balancing financial constraints with high quality diagnostics/treatments means a lot of advanced diagnostics went under the radar. With a limited budget composed of donations, it is a different challenge all of its own trying to negotiate and prioritize which horses to treat and which horses could not be saved…especially when the rescue’s conviction stands behind saving them all.

Early on, my recommendations based on poor prognosis (septic joints, fractured joints) was unheeded. It would take weeks for the rescue to come to the same conclusion, with the euthanasia being performed by the same person who picks up the horses afterwards. A bullet to the skull can be an effective form of euthanasia, but when it goes terribly wrong, it can be one of the most inhumane ways.

6 months in, and I have earned their trust. Early on, I would have to defend every diagnostic, medication, treatment protocol and justify quality of life concern. Now, not only am I greeted with open arms, but their compliance with my instructions and view of my professional opinion, does not waver. It is amazing what time (on and off the clock), patience and a whole lot of energy can do for a relationship, especially a professional veterinary one.

There have been cases that tugged my heartstrings, and cases that I spent night after night attending. We have lost some horses and saved some horses, but with every horse, we have always tried our best. It was some of these strange cases that I further expanded on my skill set, performing joint lavages and regional limb perfusions. With money a constant wall we are up against, I’ve put in many calls to specialists and board certified surgeons/internists. I am thankful for both their time and energy, and the helpful advice that has led me to treating cases in unconventional, yet successful manners.

So, although I didn’t know it when I showed up at Starfish Rescue the first time, it would come to be one of those places with some of the most sincerely compassionate people I have ever met…and something I have wholeheartedly become thankful for this year. And it reminds me of medicine in general, that we cannot save them all, but we can certainly save some.

Case of the Mondays

Like most things in life, do something long enough and often enough, and it gets easier. Drawing blood, placing catheters, passing a nasogastric tube, suturing…do it often, with a goal of doing it well. Then, there comes the added benefit of confidence. And there’s no better way to appreciate a skill, than to have acquired it and then lost it. About halfway through a “typical” day, I was made aware of those skills I take for granted.


BAL Gone [every kind of] Wrong

It started with performing a bronchoalveolar lavage on a gelding with intermittent coughing over the past year which fluctuated with weather, exercise and environment. With non-specific findings on ultrasound, we proceeded in our diagnostic plan to determine the nature of the cough. We elected to retrieve a non sterile sample from the lower airways to evaluate for RAO and IAD. I’ve passed an endoscope countless times, and performed it successfully and easily enough that I consider it at acquired, reliable skill.

By the conclusion of the BAL, I felt like I had rehearsed for a performance demonstrating everything that could not go right. The highlights of this performance included:

  1. BAL tubing hit the ethymoids, causing a profound nosebleed
  2. Projectile, unrelenting spraying of clots across self, assistant, owner, trainer and three innocent onlookers
  3. BAL tube entered the esophagus, rather than the trachea
  4. BAL tube retroflexed and came out the oral cavity
  5. BAL tube severed by teeth when traveling through the oral cavity
  6. BAL tube #1 ruined, retrieved BAL tube #2
  7. BAL tube positioned correctly in trachea, cuff would not inflate
  8. BAL tube #2 leaky cuff confirmed
  9. Continuation of #2 problem (Projectile, unrelenting spraying of clots across self, assistant, owner, trainer and onlookers)
  10. BAL tube in position, cuff inflated, saline injected in…unable to collect any saline
  11. Added more saline through tubing, retrieved <40 ml

I was relieved when the whole thing was done. After all the above complications, at least the sample was collected and submitted. What else could go wrong? Then, I got the lab report stating:

Sample has insufficient cells, inconclusive. Recommend collect second sample for analysis.

This was just the first appointment of the day.


Miscommunications, mistakes, mishaps and misfortune

When not a soul could be found at our second appointment, I called the owner. Turns out, the appointment had been rescheduled to the following week…news of which, didn’t happen to make it to today’s day schedule.
20180810_195506-01241677396.jpg

Our third appointment canceled.

Our fourth and fifth appointments had the wrong addresses (showed up at a neighbor developement and then mistakenly went to the owner’s house instead of the boarding facility).

Collected the wrong blood tubes, forgot to dispense a medication refill, double-charged on an invoice, made at least 12 U-turns…

And the cherry on top? At 6pm, as we’re wrapping up at the last appointment and about to begin our 90 minute drive home through late rush hour traffic…my assistant hesitantly asks,

“Hey, have you been having problems with the gas gauge?”

I hadn’t. No one had. About 4 minutes later, the thing we were dreading came to fruition. We ran out of gas.


ambulatory, anecdotes, doctor, animals, associate, associate veterinarian, barn, conflict, creepy, death, ER, emergency, Equine, equine vet, equine veterinarian, euthanasia, euthanizing, farm, farm calls, field, halloween, horse vet, Horses, horse, humor, life, midnight, mindhunters, mobile vet, netflix, new vet, nighttime, Patients, colic, quality of life, vetmed, sick animals, spooky, story, suffering, vet, vet assistant, vet life, vet practice, vet tech, veterinarian, veterinary, veterinary assistant, veterinary medicine, vetmed, dvm

Mindhunters and Midnight Calls

For my first on-call weekend, I was co-pilot to one of the associates and assistants. Around 11:30pm, as we were wrapping up our 4th emergency of the day, we got an ER call for a horse in respiratory distress. The first address we arrived at was in the middle of a suburban neighborhood, obviously the wrong address. We idled in the couldesac while the associate, Dr. Kepper, struggled to get the correct address. It seemed no one on the phone knew the address for the residence, althought they confirmed the horse was in fact at their residence.

After 25 minutes of wrong turns, u-turns, and sleuthing via google maps, we made it to the right road. We drove quickly down the paved road, passing occasional looming, dimly lit mansions. When the driveway ended, we parked in front of a run-down expansive ranch home. None of us got out at first. We just watched the events unfold infront of us. Our arrival sparked some confusion amongst the obviously enebriated residents. Enebriation, not uncommon for late night calls, usually owners who opened a bottle or two of wine before discovering their horse had a laceration or bit of colic. But it didn’t take long observing this group of random strangers, that enbriation was a little too soft a word. Their movements were, for lack of a better word, tweaky. Their speech was incoherient, thoughts scrambled. I wondered how they had managed to call us, let alone find our practice online.

I am going to preface the remainder of the story with this small tidbit: Earlier today, I had binge-watched the second half of Netflix’s season one of Mindhunters.

One man, in his mid 40s, approached us. To access the back pasture, they had to move a truck which blocked the driveway around the back of the house. We did not think much, until a scrawny young man and man in his mid 70s came wandering through the overgrown hedges of the front lawn. From somewhere in these hedges, they produced jumper cables.

Dr. Kepper wasn’t about to wait for these shenanigans. “We’ll just walk. How far is the horse?”

The central area of the house was mostly windows with a large atrium garden. With every light on inside you could see the entire layout of the home. Dark is dark, I’ll admit. But it wasn’t until I got outside that I realized just how dark the night was. No moon, no stars, just darkness above and around. I grabbed the headlamp and Dr. Kepper carried her laptop as a makeshift light source. The guy lead us around the side of the house, wading into darkness and unknown terrain. In the light of my headlamp, I saw he had his shoes on the wrong feet, the last half of the shoelace strands worn off. He wore one dirty sock. I glanced inside the house in time to see a figure of a woman sitting on the floor rocking back and forth anxiously.

Uneven steps led down the side of the house past windows of the daylight basement. One of the windows in the basement had black, metal bars on the inside of the glass. The room was empty, but I could see a jail-style door on the opposite wall. On the other side of the rod-iron door was a normal door. No one else seemed to notice the homemade “cage.”

This was the point at which Mindhunters triggered my rampant imagination. We continued in silence down behind the house, through the middle of a pasture of unknown proportion. The only noise was the sound of us slushing through damp, tall grass. After several minutes, an old barn loomed ahead in the glow of my headlamp. Dr. Kepper marched on, following a couple yards behind the man. The barn had two big doors, but the first thing I noticed were the many, many locks and bolts and chains on the outside. It as not necessary to count the number of bolts, padlocks and chains to know that it was excessive and albeit, alarming.

The man was heading straight for the barn, Dr. Kepper striding behind. The assistant shot me a “this is #$%@ing sketch look.” I mouthed back “I will not go in there.”

Just as we thought he was going to start unlatching, unlocking the doors, he turned and lead us beyond beyond broken fencing into another expansive field. If possible, this field felt even darker than the first. I couldn’t see the house behind us anymore and I kept looking over my shoulder to see if anyone was following us.

This was when I began to wonder if there even was a sick horse here.

I kept checking behind us as I followed Dr. Kepper’s laptop glow. Just as I was going to ask how much further to the horse, a shadowy figure came into view. I feel kind of ashamed to admit it, but it was a wave of relief that washed over me the moment I saw the down horse. Then that relief vanished, and we all launched into emergency care mode.

The mare, down and unresponsive, had labored breathing, no CRT, a heart rate of 80 and weak peripheral pulse. She was matted, sticky with sweat that had cooled, and her muscles were rigid. It was very apparent she had been suffering for some time. Her body was covered in wounds, the ground around her torn up from her thrashing around. After discussing prognosis and options, the owner elected for euthanasia. Although a sad ending, the ability to bring an end to her drawn out suffering was the most compassionate thing we could do. While the owner disappeared into the darkness, we sat with the mare for a few moments before confirming she had passed.

Silently, under the glow of the dying headlamp and Dr. Keppler’s laptop, we navigated our way back to the truck. After loading up, no one said a word until we had some distance.

“I know no one attacked us or threatened us, but I just have the feeling that we narrowly escaped with our lives.” I said, and a some laughter lightened the heavy mood in the truck…right before Dr. Kepper’ phone rang with the next late night emergency.


ambulatory, anecdotes, doctor, animals, associate, associate veterinarian, barn, conflict, creepy, death, ER, emergency, Equine, equine vet, equine veterinarian, euthanasia, euthanizing, farm, farm calls, field, halloween, horse vet, Horses, horse, humor, life, midnight, mindhunters, mobile vet, netflix, new vet, nighttime, Patients, colic, quality of life, vetmed, sick animals, spooky, story, suffering, vet, vet assistant, vet life, vet practice, vet tech, veterinarian, veterinary, veterinary assistant, veterinary medicine, vetmed, dvm

Out of the Woods – Creepy Farm Call #1

In the spirit of Halloween, I was thinking back to some of the more creepy farm calls I’ve been on in the two years. I definitely place this one in the top 5, but certainly isn’t the scariest or eeriest story by far. Saving that story for a future post.


Last June, I was sent out on a very remote farm call…almost an hour into the middle of the woods. Our appointments in google calendar were also linked with Google maps, so that navigating to the next call was automatic. I rarely entered in or checked a destination address. I passed through a couple neighboring towns, and then through small “ghost towns” …old wooden buildings with the planking peeling away and paint long gone, old decrepid cars with all the tires flat. If listed, town population signs never sported a number over 300.

Cell service became intermittent, and then non-existent once I turned off the highway onto a paved road. After 15 minutes, the paved road turned to gravel, and after passing a ntional forest sign, I started passing foresty service roads. After 30 minutes, I still hadn’t passed a single house as I wound down through a valley along a wide, fast-paced river.

The appointment was for a feral, lame horse. The horse had already received 2 tubes of dorm gel prior to my arrival. I had tried to find this place before, but after an hour of searching, called it quits. We arranged for one of the owners to meet me today, the spot I quickly approached (a Y in the gravel road with a tree inbetween the forked paths). He waiting there in a weathered mid 80’s ford truck. He had already turned around to servce as the pilot car, and a plume of exhaust fumes serged up from where the exhaust pipe would’ve been.

We didn’t pass a single house, driveway or other sign of residence. Gated and overgrown logging roads intersected the gravel road, which wound deeper and deeper into what I presume, was still national foret land. The gravel road faded to dirt road, and as we came around a sharp corner, his truck suddenly disappeared from sight. I hit my breaks to see his exhaust plum leading my like an obnoxious bread crumb trail. He veered down a dirt path, certainly no road. An assortment of dust-laden vegetation crept far enough over the path to make it invisible. I remember thinking they didn’t have a mailbox, and that I was probably coming up on a squatter compound…but squatters or not, they had a horse that was severely lame.


The truck stopped at a widening of the dirt path, and then pulled away to park amongst an assortment of rusty, scrapped and stripped cars, trucks and vans. Dispersed beyond the cars, amongst heavy tree trunks with low lying branches, were 5 large tents. Picture safari-style hunting tents…aged, mossy, holed and sagging canvas between the frames. Beyond the tents, a small paddock was built with an assortment of scrap metal, poles, logs and other makeshift materials. The guy said nothing and disappeared into a tent. All the tents had ventilation through welded pipes, the canvas material cut to give the steaming pipes a wide bearth.

An older woman was standing with the horse, and motioned for me to come over. I got out the basic tote, head lamp and wandered through the brush to the coral. The horse’s hooves were overgrown to the point of making 6 inch long skis, with the toes almost curling back like elf shoes. With the horse sedated, I could complete my exam and figured the lameness was a result of the unmanaged toe length and laminitis. It was while I was discussing this with the owner that I motion caught my eye. From all directions in the woods, coming around and between massive tree trunks, people slowly emerged. Men and women, ranging from (my guess) early 30s to mid 60s, silently made their way out of the woods. Some of them didn’t seem to notice I was there, others shot furtive glances. One by one they disappeared into various tents. If any of them spoke a word, I certainly didn’t hear it.

My heart was racing at this point, and I felt vulnerable and exposed. The only thing I could think to say was that I was going to grab my phone from the truck (not that it had cell service or would do any good). I got to the cab and grabbed the only real defense weapon I had. It was a can of mace my friend had gotten me after I was attacked by a farm dog a couple months earlir. As I was returning, one of the flaps to the tent was flapped back. Inside, there were large burn-barrel with lids…5 or six with pipping going towards what I assume isthe main pipe coming out the top of the tent. I glanced to make sure the vet bed was closed, ie locked. It was.

As I finished discussing my recommendations, the various tatter-clothed people emerged from the tents one by one. They randomly accumulated around the bed of the vet truck, looking it over curiously. They were 5-10 feet away from the truck, inspecting it and ocassionally me. I confirmed no cell service, and never wanted a distress beacon so badly in my life.

The owner went to retrieve her checkbook while I settled into the truck. Like every time your heart is pounding, pulse bounding, adrenaline serging…minutes in panicked reality feel like hours. This situation, no different. I sat there, on the verge of fleeing but forcing myself to wait. No one said a word amongst the six or seven scraggly, barefoot men that lingered around the truck. Women arrived, check in hand, and and said the guy who brought me here was just turning his truck around to show me the way back.

$%@$ that, I thought. No people or cars were behind me, and all I could manage to say cooly through the cracked window was “I’m good.”

I didn’t know that little ford vet truck could go so fast in reverse, and I’ve certainly never driven in reverse that fast for that long in my life.


ambulatory, anecdotes, doctor, animals, associate, associate veterinarian, barn, conflict, creepy, death, ER, emergency, Equine, equine vet, equine veterinarian, euthanasia, euthanizing, farm, farm calls, field, halloween, horse vet, Horses, horse, humor, life, midnight, mindhunters, mobile vet, netflix, new vet, nighttime, Patients, colic, quality of life, vetmed, sick animals, spooky, story, suffering, vet, vet assistant, vet life, vet practice, vet tech, veterinarian, veterinary, veterinary assistant, veterinary medicine, vetmed, dvm