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.


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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.


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That moment when you’re really glad you did…

Having never performed field castrations completely on my own, I served as the anesthetist while my boss performed the routine surgeries in barn pastures and backyards. Although her castration tool-of-choice is the Henderson drill, she took to demonstrating the different surgical techniques (open vs. closed) and cycled through the different types of emasculators with each castration. After watching five or six castrations, the opportunity for me to perform my first castration presented itself in the form of a laid-back, confident client and healthy six month old Thoroughbred colt. My boss kept a watchful eye from her position at the neck of the horse, while I talked my way through each and every step of the procedure. For the entire 20 minutes that it took me to perform the castration, my heart felt like it would pound right out of the chest. My hands trembled the entire time, and it wasn’t until I was done that the client said I did a thorough job. She said she knew I did a thorough job because apparently I narrated step-by-step the entire surgery. I was so focused, I wasn’t even aware that I’d done that. My first castration went well, and was without complication. Now, it was just a matter of getting a few more castrations under my belt before I’d be performing them solo in the field.

Unfortunately, starting out as a young doctor and being new to ambulatory practice, I ran into some difficulty getting consent from owners. On multiple occasions we hit this roadblock, when clients were not on board for allowing a “fledging doc” cut their colt…regardless of the well-seasoned and experienced veterinarian watching my every move over my shoulder. Each time the plan changed, the itch for experience got stronger and stronger. After 3 months, and having watched over 15 castreations, I was chomping at the bit.
When we showed up on the small mom-and-pop farm, the plan was for me to make another notch in my castration belt. The horse was a 5 year old Arabian stallion, recently purchased and barely halter-broke. He was so high strung and wire, that just the act of sedating him alone, was quite the feat for my boss and I. This ordeal was enough to change the minds of the clients, who recanted their original offer for me to perform the castration. I settled into my role as assistant and anesthetist, and tried to push the itch out of my mind.

Several rounds of sedation later, the colt was sedated enough to anesthetized with my boss’s ketamine protocol. He dropped quickly to his side, and we got to work positioning and scrubbing the incision site. Within a few minutes, he was starting to wake up from the anesthetic. My boss is one fast lady, and it takes her less than 5 minutes to castrate a horse. She placed the Henderson drill and spun each testicle off, she checked from hemorrhage and then gave him a rinse. About the time he was getting his antibiotic injection, the gelding was strong enough to push me off his neck and stand to his wobbly feet. My boss took his halter, and I helped balance his staggering hind end as we made our way toward the barn.
As he took several steps, a normal amount of blood slowly dripped onto the gravel..leaving a breadcrumb trail of red droplets. By the time we’d gone 150 feet, the slow drip became a fast drip…which then became a weak trickle of blood. In the stall, I called my boss’s attention to the steady stream of bright red blood coming from the incision site. I rounded up some gauze and fed it along as she packed it into the incision and simultaneously dodged his attempts to kick her. As she packed more gauze, the amount of bleeding increased. The gauze was drenched, and after packing three rolls in there, the bleeding was not improved. He was more awake at this point, and took to slamming us against the stall wall.
After several minutes, it was apparent the packing wasn’t going to be enough to stop the bleeding. A large blood of blood had accumulated, and the rate of hemorrhage was even greater. We made the decision to anesthetize him again in order to explore the incision and locate the source of the hemorrhage. The boss drew up the drugs, and we didn’t waste any time laying him down again. The amount of blood and the fact that he was only lightly anesthetized made identifying the bleeding structure difficult. Without good visualization, we worked somewhat blindly. The boss clamped some hemostats down on the part of the cord she could find and left them while she packed around the instruments with gauze. No sooner had she gotten the gauze mostly into the incision, did the gelding try to jump up onto his feet. I struggled to hold him down while the boss unclaimed the hemostats and packed the rest of the gauze. He nearly launched me over his shoulder as he made several attempts to stand. When he finally stood, the bleeding appeared to have ceased. Everyone breathed a sigh of relief, and the owners, my boss and I guided the horse to his stall for a second time.

I was in the middle of cleaning instruments when I heard a commotion from the barn. The owners went running past me towards the barn, and I could hear someone yelling help. “We’ll just euthanize him” the owners was saying as we all ran towards the barn. I had obviously missed something, and didn’t know who or what was being euthanized. “He’s going down!” The owners sounded panicked, and I arrived at the stall to see the gelding buckling his knees. “Just euthanize him on the lawn.” The husband said decidedly. My boss was helping to hold the horse against the wall of the stall. She looked mostly confused but there was a hint of some other emotion I couldn’t recognize. From between the gelding’s legs, blood was gushing down and into the shavings between his feet.

“What option do we have? We can’t put any more money into this.” The clients kept saying. My boss was now looking concerned, a look I haven’t seen too often. She usually exudes confidence, but definitely didn’t exude that when she was studying the profuse amount of blood coming from the incision site. The hemorrhage was significant enough that now I felt the real weight of the situations urgency.

“Your options? The referral hospital for surgery. Or we can euthanize him. Or we lay him down again?” The owners quickly shot down the hospital option due to finances and said to just euthanize him…and quickly before he collapsed in the stall and further complicated the situation. “Euthanize him?” There was no hiding the surprise in my voice. “We’ll just lay him down again.” I said. “I’ll draw up the drugs.”

“A third time?” The wife asked me.

“I’d lay him down 5 more times before going the euthanasia route. After I give him the drugs, he’s going to be out for awhile. He’ll be in a very deep sleep so we’ll have time to really get in there and find the bleed.” A Drew up my anesthetic protocol, a combination of ketamine and diazepam that put the gelding on the ground again, this time in a very deep slumber. After performing over 200 anesthesia at the internship, I developed a dependable anesthetic protocol and I have complete confidence in both my drugs and their dosages. My go to IV pre-mads are butorphanol and xylazine, and my induction drugs are a combination of diazepam and ketamine. A small bump of ketamine extended the anesthesia time, and kept the gelding out for the entire time that was necessary. My boss explored the incision site, welding handfuls of clotted blood and searching for the source of the hemorrhage. At one point, the gelding was so still my boss asked if he was still alive. As if right on cue, the gelding took a slow deep breath. I rinsed the area as my boss explored the cavity, feeling around blindly. When her gloved hand emerged, it was holding the end of a large bleeding vessel and shredded wisps of soft tissue. The testicular cord had been torn, which had resulted in the hemorrhage. My boss placed three transfixating ligatures, and afterwards we both studied it for bleeding. When no bleeding occured, she let the cord recede back into the incision.

“In 20 years, I’ve never had this happen.” My boss admitted. You bet we high-fived right then and there, bloody gloves and all. I was mostly just relieved. Hemorrhage is a real potential complication of castration, and it was the first real “bleeder” I had seen. While he slept off the drugs, we placed an IV catheter and started him on fluids. As the gelding recovered from his third round of anesthesia, we walked him back to his stall.

“Well, that’s one way to get to know the new vet.” One of the clients said as we packed up. “We were ready to euthanize him right here.”

“Well, not with Dr. Morgan here you weren’t.” My boss said as she gave me an appreciative look. Both clients gave us hugs, followed by a series of thank yous.

“Can tell you’ve done the whole anesthesia thing once or twice.”
I had to laugh when the client said this. All the hours spent running anesthesia during my internship, wishing I was doing anything but anesthesia. Counting down the days til I could turn in my anesthesia badge and never set foot in the anesthesia room again. And here I am, 5 months later, having one of those moments when despite all the weaknesses, hardships and trials that surrounded the internship experience, I’m really glad I did it.

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