The End of Week One

Note from the previous day in Dermatology: everything gets an injection! Dr. Nagarajan says that if they don’t give an injection the owners will ask why they aren’t getting one. Most of the dogs just get a Vitamin A, D, and E mixture. This reminds me of stories from James Herriot.

On Thursday Dermatology was very slow; the whole hospital was very slow. It had been pouring in the morning and the rain keeps clients away since not very many have cars. We have to make sure to not wear sandals today to avoid getting Lepto. Instead of staying in Derm, Amber and I followed a case of massive abdominal edema. The dog looked terrible; it was just laying on the table using all it’s energy to breath against all the fluid build-up. We saw it get an ECG (it had junctional VPCs), an echocardiogram (pretty much everything was wrong with the heart…), and an abdominal ultrasound. It had congestive heart failure and even though we didn’t follow the case to the end, that dog was on its way out. When we went back to Derm Dr. Nagarajan was being filmed in a program for a kids TV show. Apparently a boy wrote into the TV station saying he wanted to be a veterinarian and wanted to know how; so the TV program set up some filming in the hospital.

As we were about to leave for lunch Ana and Carrie invited us to join them on an invitation for coffee and sweets. 2 students from Oman were working with them in Orthopedics in the morning and invited our group. They were very nice and made us coffee and served dates and tea biscuits. However, we did feel pretty stupid when we asked where they were from, they said Oman, and we asked where that was in India… I need to brush up on my geography.

Thursday morning (5 days into our trip) marks the first episode of getting sick. Jennifer unfortunately was the worst; high fever and not feeling well. She took Thursday off to rest. And the rest of us were not feeling our best, but it seems to have passed.

Just a general observation about India: everything is dirty. I noticed it a lot at the beginning, then stopped, but if you sit down and just take in your surroundings it hits you. The vast majority of everything is old and worn. It all looks like it’s remnants from the 1970’s (and probably is). But that’s the norm here. If any of these rooms or buildings were picked up and transferred to the USA it would look so out of place and run down. The standards here are just at a different level.

When we arrived at the hospital Thursday morning there was a dog who was very sick laying down on the side of the front entrance stairs. It was behind some motorcycles and at first I thought it was someone’s dog and he just was checking in still. But others had seen it at the hospital (however inside) the day before, with no one with it. He was a beautiful Doberman, but he obviously had Distemper. His eyes were sunken and he had the typical muscle twitching. Dr. Subbiah made some phone calls and then a woman (who I’m pretty sure works at the hospital) called some other people and stayed with the dog. It still didn’t get picked up for hours later. I didn’t take a picture because honestly I wish I could forget that poor dog’s face; his eyes just looked sad. I can only hope he was so far gone that even though he was conscious he wasn’t really feeling anything. The amount of Distemper here is emotionally overwhelming.

Thursday afternoon we were told to go to the orthopedics theater (they call the rooms they do surgery in “theaters”) to watch an external fixator be placed. The surgery had started at 11:30 and we didn’t arrive until almost 2:30, so it was basically over. But we got to see them do the final adjustments and place the bandage. The dog had broken its front leg very badly and an external fixator is used to help hold the bones in the correct place while they heal. They only just started using external fixators here 8 years ago; up until then everything was fixed with plaster of paris. (We have been using external fixators in the USA for decades).

We got to come home early (which was a relief to all) and were soon after taken out shopping with Ruby. She took us to a big mall in Chennai, which was a lot of fun and much less crowded than the department store. I mainly window shopped and mentally noted what might be best for me to come back and get later. The only thing I did get was some coconut macaroon cookies from a place called Cookie Man and advertised itself as having authentic Australian cookies, whatever that means. Ruby also bought us all ice cream or juice (I got a pineapple/mango smoothie).

I managed to stay up until about 11:30pm Thursday night (better than crashing by 9pm most other nights), but that may have contributed to me sleeping through my 6am alarm. Luckily, the power went out at about 6am, so at 6:30 the room was rather hot and I woke up. Amber and I started on small animal surgery this morning, and it was quite a busy day (they do the majority of their surgeries on MWF). We initially met and observed a man (named Krishna) and his dog who had a histiocytoma. The tumor was preventing normal urination and so it had to have its bladder expressed by a metal catheter. I would say about 1.5 liters of urine came out of this dog. It must have felt so much better when it went home. The owner was very nice and spoke to us for a while. He spoke English very well and apparently his daughter lives in LA. He had a metal name tag on his dog’s collar which he showed off proudly (his daughter sent it from the USA, since they don’t have metal dog tags here).

At around 9am we went to the surgery theater and watched 6 different surgeries within 3 hours. They had 2 table side by side and 2 doctors. One doctor did 2 of the surgeries, and the other did 4. We saw a spay on a stray cat (they used a right side technique instead of midline so that the cat couldn’t mess with the stitches as easily), a closed pyometra removal (infected uterus; essentially it is just a very difficult spay), a cryptorchid neuter (when one testicle has not descended, so they have to find and remove one of them from the abdomen), a c-section on 2 dead kittens (but they didn’t spay the cat at the same time), a prolapsed perineum (push back in, sew up), and an elbow hygroma (an inflammation of the bursa/sac. It gets filled with fluid. It literally exploded all over the surgeon during removal).

Right now is our lunch break (12-2) and then we are going to parasitology and some lecture in the afternoon. It has been a long week, but since we don’t get weekends off there is no rest for the weary.