"And, when you want something, the entire Universe conspires in helping you to achieve it." -The Alchemist, by Paulo Coehlo

Wednesday, February 19, 2014

Tales From The Trenches: A Vet's Tech

I have a story of a recent work occurrence for you guys in the works. It's a really, really good one with a happy ending that happened last week, but we've had such a bad run of deaths ever since that one case, that at the moment I don't even want to think about my recent ER experiences, much less talk about them. It's nothing that anyone has done wrong, we've just happened to have some really, really sick patients. (I probably should talk about it, but I prefer to set things aside while they still hurt and then bring them out to look at and talk about later, when I feel better prepared to deal with them. Death is a big part of this particular branch of veterinary work. I gladly accept that the reality of death affects me. If the day ever comes when a patient's death doesn't affect me, that will be the day when I move on to something else.)

In the meantime, I have this story that I was saving for when something like this happened. It's a good one about one of my favorite doctors ever. :)

During my two years of tech school I gained a surprising amount of work experience: first, because every semester we were assigned to a different clinic or hospital for our externships, and second because I moved up the ladder work-wise. If I couldn't move up to the next step at the place I was currently working at, I moved on to a different hospital, which was expected and understood by my employers. I left each hospital on good terms and up until the moment I left Florida, I would still get calls from old work places wanting me back!

That first specialty hospital where I worked at as an assistant didn't cross-train assistants; I would have only been allowed to do technician stuff (like draw blood and place IV catheters, run bloodwork, do treatments, etc,) after my graduation from school. I did not want to be one of those techs that graduated only ever having placed a handful of IV catheters, so I applied at a general practice that was recommended by one of my professors.

This is where I met Dr. C, who would become my mentor as I grew up as a tech. He was the youngest doctor in a small practice. Unlike a lot of vets that stay in general practice, he had completed an internship at a specialty hospital so his knowledge was above and beyond your average general practitioner's.  He was Brazilian with the particular brand of silly craziness that accompanies some of us Latinos. He could go from 0 to 10 in a split second and some of the techs were afraid of him. Despite my inherent shyness and insecurities at being a brand new tech, Dr. C was my favorite to work with; I was the one of the few who found his high strung nature hilarious which in turn, I like to think, made him laugh at himself more often. I admired him for always doing the best he could for his patients. He was the first doctor I ever heard say, "Ma'am, I don't know what's wrong with your dog." It takes a huge amount of humility to be able to say that to a client. Working in critical care now, we get so many trainwreck cases from general practitioners who refused to admit they didn't know how to fix a patient and just made him worse in their efforts. Dr. C might not have always had the answer, but he knew which specialists to refer that patient to so the client could get the answer they needed in a timely manner.  I think part of the reason why I enjoyed working with him so much was because I could see myself being just like him if I had decided to become a veterinarian.

I often worked the closing shift on Fridays with him, which invariably meant that we would have emergencies come in. He always jokingly blamed me, because this would only happen when I was working the evening shift with him! A lot of general practice techs are trained on the job. Dr. C had trained most of the techs at this hospital and was used to having to jump in and do things himself when anything out of the ordinary walked in the door (the best doctors really are the ones that can do all of the technician skills well-if you work in a state that doesn't require tech credentialing, you will most likely be training your techs yourself at some point. Dr. C had teched for years before going into vet school). Which meant he'd also get so keyed up having to both call the shots as the doctor and do all of the tech stuff. The more agitated he became, the calmer I became, until one day in which I was feeling especially confident, I told him, "Dr. C, I got this. Shoo! Go do your doctor stuff." He actually stopped scrambling, listened, and walked out of the room to go talk to the client. I got one of the kennel girls to hold the patient for me while I placed an IV catheter. He stopped getting so agitated after that. Every once in a while he would still jump in, and there were still times where I really did need his help. But those Friday evening shifts just continued to cement my love for emergency medicine.

Since I was in school, Dr. C quizzed me no end. If I didn't know the answer, he wouldn't give it to me. He'd make me look it up and would expect to have the answer to his question next time we worked together. Sometimes he would forget the question, but I always came back with the answer, and we'd discuss that answer based on his own knowledge and experience as a vet. It made me excited about learning more. And it really helped solidify what I was learning in school as I applied it to cases we were seeing. This made a huge difference when I took the Veterinary Technician National Exam (VTNE) - most of what was on the test we had been taught in school, yes. But there was pretty much a question for every single case that I ever discussed with Dr. C. I got among the highest scores in our class. I thanked Dr. C afterwards.

Myself and Mio, my best friend from tech school (who funnily enough is also Puerto Rican!) immediately after the VTNE exam. Can you tell we had just finished? Can you tell we felt we'd done well? Lol
In the beginning, one of the hardest things for me to learn was to get jugular blood samples. In general practice, it is common to just draw blood from a leg vein, especially when you're just doing heartworm tests or basic bloodwork on a healthy animal. Dr. C insisted that I learn to pull blood from jugulars. In the beginning I resented him greatly for this, as he did not demand this of the other techs. Every time I went to pull blood from a dog's neck, I winced visibly because I kept imagining that needle going into my own neck. That empathy made me timid, which made it that much harder to dominate this skill. Dr. C would hold the patient himself and talk me through it. If he wasn't holding the patient himself, he'd stand behind me and watch what I was doing. This didn't necessarily make it easier, as of course I'd get even more nervous under the pressure to do this right! We went through this every single shift that we worked together, until I started being able to momentarily push that empathy aside for a second and started to successfully obtain samples from jugular veins.

Jugular blood draw on a greyhound
I think that he always knew that I would not be staying in general practice. Being able to pull blood from jugular veins is an essential skill for the specialty practice vet tech, especially those working in critical care. The jugular is one of the largest easily accessible veins on the patient, especially in dogs. In specialty practice, leg veins are saved for IV catheters; even on healthy animals coming in for a recheck, you don't pull blood from a leg unless the patient has or is at risk for a clotting disorder. Only in those cases do you obtain blood from a leg vein.

I've gone on to train techs myself in this skill. Every time I see a new tech being timid or having a hard time getting a blood sample from a jugular vein, I smile and remember what Dr. C taught me. And pass it on.

There are still days when I miss working with just one doctor whom I know inside-out, and there are days when I still miss working with Dr. C in particular. After years talking about doing it, he is finally opening up his own practice in Miami! I don't doubt he will be immensely successful at it. He's a good doctor and his clients love him.

I will always be grateful to him for everything he taught me, for believing in me, and for helping me to continue learning and growing as a tech. Two years later, he got me the job at the Fort Lauderdale specialty hospital that would be the big turning point in my career. It was a start-up practice where I only had 4 years of experience to the other techs' 10+ but they took a second look at my resume and called me in for an interview thanks to Dr. C's references. I had the wonderful opportunity of working with two of the gods of veterinary emergency and critical care, an opportunity that would change my life forever.

Cageside rounds with Dr. Z (that's his hand held out while explaining), Dr. C's own mentor!
But that's another story. ;)


  1. What a great way to learn! He sounds like a Dr. who really knew how to push just enough. I'm proud to report that I can draw a jug :) Even did it on a tiny kitten once.

    1. Awesomeness! :D Puppies and kittens are the hardest!

  2. Life is so much better with mentors. It's such a struggle to find someone who you wish to emulate and it sounds like he taught you a ton.

    Love the picture of you and your bestie.