Thursday, October 31, 2013

The World Revolves Around ME.

Sent in by a loyal reader:

After a terribly long day at work last week, I came home for dinner and time with my family.  Helped my son study for a spelling test, read to all of my kids for a bit, and then I finally sat down at 10 pm to speed through my favorite show while my wife finished up in the kitchen.  

For some reason, she decided to check our home phone messages - something we don't do on a regular basis because, well, we just don't.

The last three calls were from a client - a client sitting outside of my clinic, wondering why nobody is there to let her in to get her dogs.  Did I mention she FORGOT to pick them up by closing time?  We closed at 7 and she FORGOT to get them.  

The first message from her was at 7:30 pm.  Did I mention we close at 7 pm?

So I called her at 10 pm and informed her that it was her responsibility to show up on time, before we close, and that no, I would not be meeting her at the clinic right then for her to get her dogs - the dogs she FORGOT at my clinic.  She was angry and amazed that no one simply waited for her to show up.  But I didn't give in.

People seriously know NO boundaries. 

 (Thanks for the entry!  And No, people seriously do not know what "boundary" even means!)

Tuesday, October 29, 2013

Geeks and Dogs

Seen on FaceBook, presented without comment.

Initial post:
Here's one for you types that dabble in physics: A queen size bed (B) is 4,560 square inches in area. A small dog (D) - we'll call her Nala - comes in at 304 square inches lying down; including tail. So D = B(.066667). But something happens to this area ratio over a given time (T), where T is generally a duration from about 10:00pm to 6:00am: During that time T, the perceived ratio of D to B increases exponentially, peaking at a ratio of D = B(.25) at around 3:00am. Is there some natural phenomenon that explains this? A lesser law of Newton or something?
You are missing several factors in this equation. 25 years of private research has also revealed the D can sustain an increase in Mass approximately 4 fold.

After the increase in area and mass, D can also change state to an amorphous semi solid. T
he state change seems to be associated with planetary, thermal or luminal changes. It is noticed most around sunrise local time.

With the change of state, when the owner of B ("O") attempts to push D out of B, O will notice the changed state, akin to pushing on Jello.

The positive news is that science may have a solution. If O can successfully navigate their way out of B, O can apply substance T to reverse the areal, mass and state changes in D. T is almost always a semi nutritious food based substance.

The resolution is initiated via auditory stimuli to D, such as yelling "Treat" (colloquial term for substance T), or rapid loud movement of a firm container of substance T.   See Pavlov.

Resolution of the changes is immediate. Science has been unable to determine any side effects to the areal or state reversion. Side effects to the mass reversion are common. It is believed that Force (F) is involved. It appears that any gain in mass while on B is immediately converted to Acceleration (A) when substance T is applied. Current research suggested this change follows F=M*A, where F is constant, and decrease in Mass leads to increased A when exiting B, and vice versa. Clearly D is a Force to be reckoned with.

Tuesday, October 22, 2013

Good help is hard to find

I have the decidedly unpleasurable job of working with someone I actively hate. This is very weird for me. First of all, I generally do not HATE people. Yes, there are people that I like more than I like other people, but usually I like everyone I work with. On rare occasion, I dislike someone I have to work with, and that is of course unfortunate but part of life. These days, well - actually feeling hatred for someone is so disturbing. I pull into the parking lot, see her car, and start bubbling with rage and wondering how I will get through the day. I hope she will fall ill and have to leave. I fantasize about sending her home and just working on my own. It's terrible, just terrible. I don't know what to do with this feeling.

She's not only has a generally unpleasant demeanor (she babytalks constantly, she never shuts up, she has no conception of personal space) but she is ignorant and incompetent and sadly, I am not The Big Boss, so I cannot fire her.

We call her BTT (babytalk tech) for short around here. None of the other docs let her do any patient care while not being directly supervised, none of us let her calculate drug doses, none of us let her administer medications we haven't handed her directly - she can't be trusted to do these things. Despite having to supervise her so heavily and having restricted her duties as much as possible, she still continues to drive me UP THE FUCKING WALL. Ahem. Sorry for the outburst.

So, yeah. In recent past:

A giant-breed dog presented with a laceration of a toepad. My intent was to sedate him, infuse a local anesthetic, & repair it with just two stitches. I asked her to hold off a vein for me and she started to do so but then let go of his leg JUST as I was about to inject, telling me she needed a tourniquet. I felt that a tourniquet was (a) not needed and (b) going to be a problem as she would then need to release it without his leg moving/dislodging my needle, & told her so, but she (in baby talk) told me that her thumb was just getting TOO TIRED and she refused to proceed without the tourniquet, which she was trying to apply as I was sitting there on my haunches in front of the dog telling her to stop it. The dog freaked out because she pinched his skin with the tourniquet and started attacking us, requiring muzzling and then IM sedation with very high doses to overcome his catecholamine surge. So then of course he took forever to recover. I was outraged. Frankly I am still outraged.

A client came in for "I think I pulled my cat's nipple off!" and apparently she did not, in fact, pull the cat's nipple off. I was in my office typing up charts when BTT came in and said "good news! your next patient doesn't need to see you, she thought she pulled off a nipple but it was just some waxy debris stuck to the fur." I said "is that all it was in for? you can send it home if it doesn't need to see me," because I was backed up with my charting anyway. She said "ok" and and walked out. Then she came back THIRTY MINUTES LATER and asked me when I was going in to the exam room to see that patient. The two other staff members and the boss, who had witnessed our previous interaction, were all completely gobsmacked. We thought she had sent that patient home! She denied having said anything about me not having to see it.

We had a Scottie whose calculated dose of dexdomitor was 0.07 ml, and BTT gave her 0.7 ml. As if that isn't bad enough, it was the third time we know if that she was off by a decimal point in that way, but it was the first time she'd actually ADMINISTERED it before being stopped by a supervising doctor. She has also been known to put the wrong size of pills in bottles to go home with patients. Now, with the dexdom overdose, she DID realize AFTER she did it that there was a problem, and the patient was successfully treated and went home none the worse for wear. But these incidents are so disturbing to everyone, yet she has not been fired. It's mindboggling. Meanwhile, she points fingers at everyone else.

One time, a puppy came in for a first visit, whose owner had registered him as being 12 weeks old. Upon review of the paperwork the owner brought, BTT found that the puppy was actually 14 weeks old. She had a huge hissy fit, yelling at our blameless receptionist that she needed to be more careful about putting dates into the record. Of course the receptionist had put in the birthdate the owner had given her. The owner had made the mistake and freely admitted it. BTT ranted and raved over this "dangerous error" for a good hour and a half. It was really unnecessary.

My diagnosis is that this person has a PITF deficiency. But, the boss says, "good help is hard to find," so we're stuck with her. I say, "some kind of help is the kind of help that helping's all about, and some kind of help is the kind of help we all can do without!"

Saturday, October 19, 2013

VBB - Change of pace - Residential branch

Note to readers: I realize we've had a little hiatus here. There has been some upheaval among our collective. Apologies for the lack of content. Today's post is not your typical veterinary whingefest - today, we are discussing the only primate species we cannot legally diagnose or treat. We'll return to more of a veterinary focus shortly thereafter. Thanks for your understanding.

Here at the VBB residential branch we just hosted a small overnight soiree for 4 x 5th grade girls, plus the in-house crew. Preparing for something like this involves a massive effort - after all, when you're having guests, you need to clear a path to the bathroom. But somehow we prepared and were ready and waiting for the guests to arrive at 5 PM on the appointed day.

The clock ticked 5 PM. The doorbell rang. Our first guest! Her mom briefly chatted with Dr. VBB & then made her merry escape, while the girls ran off giggling to start having fun. Over the next hour the other guests trickled in, but before the last one had even arrived, we had our first crisis. "Moooooo-ooooooom!" came the plaintive cry.... "Sarah can't find her glasses!" *sigh*

I tried to pass the buck. "Oh, she probably just forgot to bring them. She couldn't have lost them already. She's only been here for 10 minutes and you've only been in one room of the house. Surely she didn't bring them..." but to no avail. "Look mom!" said my beloved but smarter-than-me offspring, whose nom-de-blog shall henceforth be Rachel (I always liked Jennifer Aniston's hair on Friends!). She shoved her (used, handed down) iPhone 4 into my face to play me a video she'd taken of her friend running up the stairs right after arrival - the glasses clearly visible on her cute little face.

*sigh* Where did  I put that bottle of wine I opened when I was making stew earlier?

Meanwhile, we were still waiting on the final guest at 6 PM, but the crowd was getting restless from the smell of the pizza waiting in the oven warmer. "Dr. VBBeeeeeeee! We're STAAAAAARVING!!!!" was their war cry, and the cut up apples and/or salad I offered seemed to be invisible to them. In an effort to forestall a coup d'etat, Mr. VBB & I started slinging pizza. The doorbell rang just as the last slice was placed on the table & thank goodness it was our last guest. Mom was suitably contrite, although she did attempt to blame-shift their tardiness onto the Ikea furniture people who showed up late and took forever. Although unclear on how that interfered with her ability to phone or text or email or even send a carrier pigeon to say she'd be an hour later than she had said she'd be, I smiled & nodded and brought the child in to join her friends.

Now, I've known this girl for seven years. She's been to our house before. I knew she had some issues but I didn't know how much worse they'd gotten over the past year. She's like a young, female, Woody Allen. So, Woodina looks at the pizza in front of her and says "I don't think I feel hungry. My reflux is acting up. I'm going to just sit here for a while." OK then. Everyone else is eating and laughing and Woodina is sitting there looking a little sad. I asked her if I could get her anything or do anything for her -- "No. I'm fine, thank you. But just so you know, I brought some alcohol wipes & bandaids with me, because you never know when you need them." OK then! But in about 5 minutes she wanted to call her mom. She called her mom (who I happened to know was on her way to meet friends for dinner out) and asked to be picked up. Mom said nope, stick it out a while longer. Crying ensued. I intervened by showing her our cat, Wilbur. Woodina loves animals so she cheered up a little bit and returned to the table.

The meal ended, the girls began watching their chosen entertainment - Camp Rock.  During the movie Rachel's iPhone (which I had taken away after she'd shown me the video) started to receive texts from her friend Jezebel, who is sitting next to her on the sofa. "No afence, but this is BORING!" "do you like this 4 reel?" "This movie is immachurr." I need to speak to the girls' English teacher, obviously.

I walked over to where the girls were sitting on the sofa (several feet behind Sarah, who was sitting up close to the big screen tv due to having lost her glasses....) & inquired of Jezebel "hey - looks like your phone is distracting you from the movie. Want me to put it over there with Rachel's?" She said "no, I need it here. I am texting. About private things, from my private life." OKaaaaaay. Whatev, as the kids say.

Meanwhile Mr. VBB finally finished making the popcorn I told him to start making what seemed like a million years ago. I poured it into the cute little popcorn boxes I'd bought & started handing them over to the girls. Rachel immediately needed more melted butter. Woodina wasn't sure if she should eat it or not but decided to try it, and then started to worry that she'd made the wrong choice, because it might make her have reflux, and she wanted to discuss it with her mom. Sarah dropped some pieces and couldn't find them on the carpet because she couldn't see. Jezebel said she can't have popcorn because of her braces but she can have pretzels or chips if we have those, and then texted "WTF popcorn" to Rachel's phone. I deleted that text.

The doorbell rang again. Who could that be? Oh. Right. The dogsitter was returning DBB after a hopefully-exhausting day at Dog Camp. There was a joyous kerfuffle as the girls all received slobbery-faced kisses and then DBB retired to her usual retreat under the kitchen table for a nap.

FINALLY the movie was over & it was time for ice cream sundaes and the obligatory happy birthday song. I'm pleased to report that was largely uneventful, although Jezebel thought our flavors (salted caramel, mint chocolate chip, chocolate, and coffee ice creams) were weird and abnormal, while Sarah was just a little bit sad about the salty part of the caramel. Rachel opened her presents and everyone squeed excitedly over them. Well, except for the Rainbow Loom - I think everyone in the room already owned at least one and I know we already had four of them in our house before this new one which we can hopefully regift. Although now I'm wondering - maybe this Loom has been regifted a million times already. Maybe all the moms are just passing it around. Maybe I need to BREAK THE CYCLE! Heh. Anyway. Then they (FINALLY) disappeared into the basement to play with the new toys.

At some point Rachel's little sister Leah came up hysterically crying. Our guests graciously talked her back down and things were quiet for about an hour. Bliss. Woodina did call her mom about every 20-30 minutes because she missed her so very much.... and then eventually at about half past midnight, she couldn't take any more, and demanded to be picked up. Her mom arrived with their dog in tow, and informed us it was just as well Woodina needed to be picked up, because Fuzzyface had been unable to sleep without Woodina to cuddle. Bleary-eyed, I suggested that next time she simply bring Fuzzyface to our house. I may live to regret that one!

I passed out on the sofa at about 2 AM, and woke for the final time (after several interruptions because of the cat being a CBB & jumping on my face) at 6 to peals of laughter emanating from the basement campgrounds. Goody. I have enough time to shower before work! Oh wait. Sarah heard me get up and came upstairs to ask if we'd found her glasses. Cue another full-house search that completely failed to find the glasses, but succeeded at using up every last minute before I had to head to work.

I woke Mr. VBB and put him in charge of breakfast and headed over to VBB central. Today's agenda includes several new puppies and an obstipated cat. I hope no one notices I'm rumpled, crabby, exhausted, and wearing yesterday's clothes.

Late-breaking news: Mr. VBB texted me a cute picture of the mob having breakfast. We'd offered bagels & cream cheese or butter, assorted fruit, two types of cold cereal, milk, orange juice, or oatmeal. Jezebel had, however, requested (and received) a swiss cheese omelet. She did eat the entire thing without complaining, though. Good for her I wasn't in charge of breakfast is all I can say! I can't wait to see her Instagram feed when I check Rachel's phone later. I will totally bust her if she has posted anything negative about this party!