The End of an Anatomy Era

Finally, the day has come that I have been looking forward to more than almost any other. Today was the day of my anatomy lab final.

That’s right. I am done with the anatomy lab! At least for the next four weeks. But I am more than willing to take what I can get.

No more afternoons spent inhaling formaldehyde or staring blankly hoping that nerves will magically reveal themselves to me, no more nights spent trying to cram things into a brain that just wanted to sleep until one in the morning... no more anatomy lab. And especially with all the time I’ve spent in there the past week, I am only too happy to not go back.

The past couple weeks really have been crunch time, with all of my teachers trying to get in their final quizzes and exams before finals week next week. But the one I had been dreading more than any other was anatomy. Mostly just because it is a hell of a lot of information, and I was not convinced it was humanly possible to learn it all.

My anatomy lab final consisted of 25 stations of radiographs, sagittal sections, transverse sections, dogs and cats, random limbs, brains, you name it, it was there. 100 questions in all, and over 2 hours spent answering them. 2 hours of pure anatomy agony. Somehow we are supposed to know how to find every single individual nerve and artery in every one of those sections, even though we’re looking at things we’ve never seen before, by “using our knowledge of the structures and common sense”. I’m not going to lie, it’s intimidating.

But it made me laugh, too, to stand there in lab feeling a humerus bone wrapped up in a sock- we had to figure out which bone it was and which side of the body it was from by touch alone-  and remember back to when we did this in our second ever anatomy class with the scapula bone. And I was sitting in class holding this scapula in my hands with my eyes closed, listening to my teacher explaining the various landmarks we should be using to tell which side was lateral, which side was cranial, and so on, and thinking that there was absolutely no way I was ever going to be able to do this. Tell which bone it was without looking at it? Impossible. Be able to tell which side of the body it belonged to by feeling miniscule little bumps and ridges on one surface or another? No. No, it couldn’t be done. 

And yet... somehow I did it. I don’t know how, but I did it. I managed to learn little bumps and grooves that seemed like they should be insignificant, I learned muscle attachments and functions, I learned nerve innervations and blood supply... the list goes on and on. And on and on. And now all I had to do was be able to find everything on the dogs and sections one last time and I would be done. It was the light at the end of the tunnel.

And now... I’m done. 

Granted, I still have the written portion of the final exam on Monday, but I’ve always been better at that part. I can learn everything we need to know, I just can’t always find it. And now I’m done with finding everything. It makes me so incredibly happy to be able to say that.

And even though I don’t want to think about anatomy at all over the next 4 weeks, even with the written portion of the final looming up soon, I have to admit that I think... I think I’m going to miss it. Not the formaldehyde smell, or the dissecting, of the hours taken from my life to study. I’m going to miss the hilarious and ridiculous things that happened in that lab while we were trying to learn. And just to give an example of how brainwashed we all were to think alike, there was one station with a couple brain sections and then, randomly, an elephant’s forelimb (which is taller than I am). And the way these tests work is to stick little pins in the structures we need to identify or describe something about or whatever it is, and we have a sheet with instructions for what we need to do with each pin. It was the “D” tag stuck in a carpal bone of this elephant’s forelimb, and the directions for D were to look ventrolaterally, and then identify.

And, in unison, me and the other two members of my anatomy group looked down at the ground- ventrally- and then to the right- laterally- where we finally saw the little green tag stuck in the elephants leg. 

Maybe it’s one of those things where you had to be there to get it, but we thought it was absolutely hilarious that we act like complete robots now with anatomy, like some sort of synchronized anatomy group.

Maybe you had to be there. But that’s what I’m going to miss... that and Shawn writing "corpus callosum of the brain" as one of our answers until I told him to change brain to telencephalon. His response? "Yeah, that sounds a lot smarter than brain." That's what I'm going to miss. Not enough to go back, though. Especially not with only a four week vacation until I'm back in there. But we had some good times.

 Now bring on the ponies.

and just in case you ever wondered what a brain section looked like

here we have the ventral surface of the brain and brainstem

and transverse sections of the telencephalon, diencephalon, mesencephalon, met encephalon, and my encephalon

It's All About the Experience

The one part about vet school I was really looking forward to, as I’m sure most of my classmates were, was the actual animal interaction. And that’s where the zootechnology class comes in. This class was designed to introduce us to different species and how to handle them. The first lab we did, I learned how to hypnotize a chicken. The second lab, I castrated a goat. This was obviously going to be my favorite class.

And it’s also a huge part of why I chose Oklahoma State in the first place. I still cringe when I think back on my UPenn interview, where my interviewer asked me what things I liked and what things I didn’t like about UPenn. I was stupid here- I told the truth. I told him I didn’t like that Penn didn’t really give any practical experience, and he went off on me big time. Apparently that was a major pet peeve of his or something. Obviously I tried to take it back because I didn’t want him being pissed off at me throughout the entire interview (since this happened to be one of the first questions he asked me, just my luck), but he wasn’t really buying it. And you know what, it was the truth. During my tour of the New Bolton Center (which really didn’t look that much better than DelVal with it’s dark, narrow hallways and rusted stalls) I saw third years palpating mares, and to everyone else this was such a big deal. Well, in my freshman year of undergrad I had already artificially inseminated a mare and foaled her out (and then repeated the process throughout my undergrad career), so I was less than impressed. So you know what, Mr. Interviewer? I don’t give a shit if it’s a pet peeve of yours that all incoming students what hands on experience. That is the entire point of school. Experience and learning.

I apologize for my digression. I think the point I was trying to make was that I really wanted some hands on experience, and that’s why I liked Oklahoma. Every Wednesday starting at 1:00 we had a different lab, and the labs rotated through most of the major species. Most of the labs revolved around learning how to take vitals for that species and the major management practices, and after listening to the lecture we took our stethoscopes and thermometers and listened to heart rates, breathing rates, took temperatures, and palpated. And even though it is the same process, I can assure you that taking vitals from a horse is different from taking them from a cow or from a dog. And I also got to tip a cow in my large animal lab. You can’t beat that. 

Another part of the course was being assigned to a week in the teaching hospital, doing rounds with the fourth years. Each day we were assigned to a different animal- a sheep, steer, alpaca, and goat, and we had to take their vitals and write up their SOAP, all under the watchful eyes of the fourth years. (And for those of you who don’t know, soap is subjective- how they look like they’re doing, objective- recorded vitals, assessment, and planning- anything that they need done or monitored.) And I’ll be honest, the first day I had no idea what I was doing. I started with Jake the sheep, and I couldn’t even find his heartbeat. It felt like all his wool was successfully concealing it from me. I think it took me close to 15 minutes to finally get a heart rate down for him, and the entire time I was searching frantically for this heart beat I was pretending to the fourth year that I’d already found it and was just counting. And I didn’t have much better luck on the second day with the steer (that time the student found it for me, saying his was unusually quiet, and I did hear it once she found it and let me listen through her stethoscope), but I gradually improved throughout the week. And then when I went to other labs, like my large animal, shelter, and equine labs, where we had to do in-depth physicals, I actually knew what I was doing. (And when I found the heartbeat on my steer during large animal, especially after having so much trouble in the hospital, I admit it, I did a little happy dance).

This is what I had meant when I told my UPenn interviewer I wanted experience. I want hands on experience, because you know what, it’s really not that easy when you’ve never done it before. And you have to know each species’ heart rate and what it should normally sound like. There’s no way you could enter the hospital in your fourth year for rounds never having done one before. Plus, during my dairy lab I got to milk a cow for the very first time too. Again, you can’t beat that. It’s all about the little things in life.

The other portion of this lab was communication. We have exam rooms in the hospital with cameras on all four sides where students can practice taking medical histories and doing physical exams, and then watch their DVDs and see how they did. Now, when I first found out I had to do this, I think I turned 3 shades paler and started hyperventilating in my own mini anxiety attack. I do not do well having that put on me last minute, and I hate feeling unprepared. But then you go in, and after fumbling over your words a bit (and in my case skipping over the entire rapport-building part- oops) you realize that that student you’re talking to is just another person, just another vet student who had to do the same thing you’re doing now and was probably just as nervous. And that little dalmatian is being so adorable running around and staring up at you with her tongue hanging out you just can’t help but smile and relax. And then what do you know, you don’t do a half bad job at getting a history. On the contrary, you get told that (aside from skipping the rapport) you did an awesome job. Now that is a confidence booster. Maybe I am in the right profession after all.

I’ve been thinking about this class a lot recently, especially with the end of my first semester coming up so quickly. With everyone (read, mostly my family) asking me what I’ve learned in vet school this semester, this class is the first class I think of. And it’s not that anatomy is less important than learning management practices or how to take vitals from different species (especially if you’re going into a field like surgery, in which case it is pretty much the only thing that matters), but to me it’s not necessarily more important, either. Overall, this is the third anatomy course I’ve taken, and the past two I took weren’t really any less detailed that this one is, it’s just that one was human anatomy and the other was equine anatomy. But I never knew how to take vitals from a cow or an alpaca or a goat before. And there’s just something about listening to a heart beat or lung sounds with a stethoscope that really makes you feel like you’re a vet like nothing else does. So when I think about my first ever semester in veterinary school, zootechnology and all the experiences I’ve had in this class are going to be what I remember the most.

hypnotizing chickens

castrating a goat

the alpaca we had to take care of at the hospital, and yes, he does spit

milking cows at the dairy

wrapping legs- poor horse. Every student had to do it.

San Antonio Calls...

One of the really great things about veterinary school are the opportunities. This weekend I got to go down to San Antonio for the annual American Association of Equine Practitioners convention. I had been excited about this since the president of our student chapter first announced it a couple months ago. And an 8 hour car ride and about 530 miles later here I am.

Even though we didn’t arrive in San Antonio until about 1:30 in the morning, the first thing Mike and I did was go to the riverwalk. I mean, you have to. And while everything but the bars were closed, the Christmas lights were still on (even though I am fully against Christmas lights before Thanksgiving, I will admit that it was very beautiful) and it was nice to not have to shove past people on the sidewalks, except for all the drunk people. But we found the convention center, I took my pictures as best I could at night, and I went back to the hotel excited for the next day.

Of course, the next day when I tried to find the convention center I got completely lost. I don’t know what it was about having the sun up that made me unable to get my bearings and find the right street. Eventually I just parked in a parking garage by the Hyatt hotel (which has part of the river running through it’s lobby, which is awesome) and walked from there. And somehow, by a stroke of luck I had lost the convention center but found the Alamo. So of course I had to stop for pictures and go inside. It’s not really much- a stone building with a courtyard and a museum that is really more of a gift shop than anything else- but I get to say that I’ve been to the Alamo, and that’s what counts. But really, it was a nice building too, just a lot of construction going on from the look of it. But no pictures inside, and no touching the walls, or they will come after you.

So after a little sidetrack I was back on a mission to find the convention center, and I was wandering up and down the sidewalks of the riverwalk trying to take pictures without having to stop. Finally I got there (about 2 hours after it had started) and went inside to pick up my registration packet. And then the fun started.

Trade shows are like playgrounds for adults. Lots of freebies, and (if it’s a subject you’re interested in) lots of new toys that you want to touch and play with. A lot of the vendors seemed to have endoscopes or other diagnostic equipment, which really doesn’t do much for me at this point since I don’t need it, but I did stop by Purina to see the new food samples (and get freebies) as well as a couple other stalls. That’s pretty much the point of a trade show, in my opinion. Freebies. My favorite was the free co-flex I got, which came in handy to wrap up the blisters I got on my toes from my shoes. And you know you belong in the equine industry when your first choice for a bandaid is vet wrap rather than actual bandaids.

I think the highlight though, by far, was meeting Kate Chenery Tweedy, the daughter of Penny Chenery, who was the owner of Secretariat, the greatest racehorse of all time. She was there signing copies of her new book, Secretariat’s Meadow, so of course I picked up a copy. And I got to talk to her about Secretariat’s life and his retirement, as well as equine nutrition and how it played a part in Secretariat’s death (apparently he weighed 1200 lbs when he went to stud and died- weighing 1900 lbs- from laminitis). We talked about the importance of exercise and understanding how that and nutrition and everything else play a factor. Really, it was such a joy to meet her, and I am just grateful I got over my shocked tongue-tied stage and got to say anything to her, let alone talk equine nutrition and management. And she signed my book “Best wishes in your DVM career! Keep Secretariat’s spirit with you! Best hopes to you- Kate Chenery Tweedy.” Yes, I am ridiculously excited about that.

And then there are all the information seminars. I went to a couple about breeding, having to do with improving semen quality through processing and about endometritis in mares (systemic vs intrauterine antibiotics). (Ignore my inner nerd coming out please) And it’s funny, but I used to hate breeding. But take enough breeding classes and foal out enough mares and I guess you begin to like it. Because now I like it. And it felt awesome to sit in that room with all these equine vets and listen to some of the top researchers and academics in the field and feel a part of it. 

And then after work (which really isn’t work) you get to play. So I hit up the riverboat tour, which was a lot of fun. I feel like the riverwalk is like idealized Europe but with obnoxious American accents. But that’s okay, because it really is beautiful, even with the Christmas tree and lights up before Thanksgiving. And the comedy club and the bars and clubs lining the riverwalk were the perfect end to the day. And at least I didn't fall in... apparently that happens a lot. Especially around the bars (wonder why).

The next day we hit up the Tower of the Americas for lunch, which is the space needle of San Antonio. I didn’t know that San Antonio even had a space needle, but they do, conveniently located right next to the convention center. It was like a giant sign in the sky you'd have to be blind to miss.

So we went up to the top of the tower, and I spent pretty much the entire time while waiting for our table and during lunch jumping up and taking pictures of San Antonio as the tower observation deck rotated. The views were spectacular, and oh yeah, the food was ok too. (Kidding, the food was excellent.) I have to say though, I do not recommend eating in a spinning restaurant after a night out drinking.

I managed to hit up the two seminars that I had really been looking forward to after lunch, the seminars on acupuncture. This was really why I had wanted to come to the convention in the first place. I am planning on getting certified after I graduate, and I loved hearing practicing equine acupuncturists talk about the recent case studies and the work that they do. I learned a lot too... I knew a lot about the basics they talked about and acupuncture for treating lameness, since that was my own senior seminar topic. But apparently acupuncture can treat a lot more than that, and can even help realign the body, which I hadn’t realized. It was the perfect seminar to end the day on before another 8 hour drive back home to Stillwater, 2 quizzes, and an 8:00 am class. 

The Alamo

The river running through the Hyatt

Making my way along the riverwalk to the convention center

Boat tour along the river

The Joys of Anatomy...

I really feel like anatomy deserves it’s own blog post. So many things happen in that lab, it would be impossible to document them all. But every now and then something really crazy happens that stands out. And I am not just talking about the freezer, which still hasn’t been fixed. It’s nasty. 

Anyway.

I feel like I should start with my very first anatomy lab, because it provides such a contrast. My first lab was simply skinning the forelimb of a dog, in preparation of going over all the muscles of the thoracic limb. At this point, it had been over 4 years since I had dissected anything in a lab, so I was a little nervous. And I wanted to make a good impression on my anatomy group so they wouldn’t think I was a dumb blonde. (I have given them reason to think that at several points, most notably when I asked if upper motor neurons were motor neurons or sensory neurons. In my defense, that was at like 10:00 at night after 4 consecutive nights of studying, and my brain was fried.)

So I may have been a little... overenthusiastic, shall we say, when attaching the scalpel blade for that first time. And in my eagerness to look like I knew what I was doing, I pushed a little too hard so the blade sliced right through the packet and into my index finger. I have to at least be grateful it was a scalpel, because it was a clean cut. But it hurt like hell.

And what a great first impression to make to my new anatomy partners, trying to skin a dog while having my glove fill up with blood. It was not a pretty picture.

It is completely unrealistic to go in there and assume that you will never make a mistake. Even today, 3 months into classes, I am still making mistakes. (At least this time I didn’t cut myself, however.) That is just part of life as a vet student. You are always wrong. Always. Even if being wrong means that you weren’t completely right, or you were incomplete. And just when you think you finally have something figured out you realize you never really knew anything at all.

It’s tough, and it takes getting used to. But at the end of it all, it is such an amazing feeling to sit down and be able to ramble off all of the nerves of the abdomen and pelvic limb and their innervations, and just have people stare at you in astonishment. Try it, it’s fun. My particular favorite is to go to the gym and start listing all the nerves innervating the muscles I’m working (or the ones that are hurting) and then laugh at the guys as they do completely pointless workouts that won’t actually help them at all. It is, pathetic as it is, one of the highlights of my days.

But back to anatomy lab. It’s amazing how you see yourself changing through the lab. And I don’t just mean by actually gaining knowledge and sounding professional when you talk, although that’s cool too. The little things change too. For instance, I now hate cats. And I used to love cats. But you can’t find ANYTHING on a cat. And I mean anything. One of my favorite moments is still, when dissecting nerves in the thorax, my TA told me to pull on the nerves with my probe. He said nerves don’t break, because they’re stretchy, but fascia will. So when in doubt, stretch it out. 

Well, let me tell you something. Nerves do NOT stretch in the cat. At all. They definitely break. And then what? Here you are trying to study something literally the size of a strand of hair, and it snaps on you. And then it somehow disappears into the muscle like it’s purposefully hiding from you. So now what?

Nerves are the worst, but arteries are not much better. And neither was the abdomen, which at this point has pretty much completely rotted out, making things indistinguishable. There is just nothing good about cats in anatomy. Nothing. And I have to be honest, it does make you begin to dislike them in general when you have to spend so many hours frustrated and fighting with them.

Dogs are better only in that they’re bigger and it’s easier to see things. But the way they teach you in anatomy is to have you read a dissection guide and find everything on you’re own. We’re not really taught anything. So every structure we find has us saying, “Well, I think this could be it... I think.” 

I think. That is the story of my life in anatomy.

It wasn’t so bad with the muscles, but do you have any idea just how many nerves are in a dog? Let me give you a clue. A lot. So when you are looking for one specific nerve it is pretty much impossible to tell if you found the right one or not. And don’t even get me started on nerves on transverse sections. They are the bane of my existence. My crowning moment of glory was to be able to find the vagosympathetic trunk dorsal to the common carotid artery. And let’s be honest, if the arteries didn’t fill with red latex, I wouldn’t have been able to find it.

But through all of the frustration and anger and anti-cat plotting, lab can actually be a lot of fun. You have to look for the little things, things that probably would not even be as funny if we weren’t all so exhausted all the time. Things like spilling intestines or making a complete fool out of yourself by telling the TA you were only testing him by saying a random bit of fascia was the sternothyroideus muscle. 

And that’s what it all comes down to, really. Because if you didn’t know how to laugh at yourself and your mistakes it would really run you into the ground quickly. But at least I can put on and take off scalpel blades now.

Learning the muscles of the forelimb

The Beginning

It’s hard to believe that there are only 3 weeks until the end of my very first semester of veterinary school. It feels like only yesterday my legs were shaking as I walked down the stadium steps to introduce myself to my classmates, and only last week when I was so nervous in my first anatomy lab that I cut myself putting my scalpel blade. If nothing else I can at least say with confidence that I can put on and take off a scalpel blade without cutting myself. 

Trying to look back on those first weeks is like trying to remember a dream. I was in such a state of shock at actually being there that there were several moments within the first month or two when I would suddenly look around the classroom and just think “Wow. I’m in vet school. How the hell did I get here?” I mean, I’d only been working toward this goal for my entire school career. I know a lot of people say that, but it’s true- every decision I had ever made school-wise was to get me here. And here I was.

What I do remember from that haze that is the beginning is making a lot of mistakes and having a lot of laughs with people I am already great friends with. And I have to be... I spend at least 28 hours a week with them, not counting all the extra studying hours. And I try not to remember then nights in the anatomy lab until midnight. It’s a self-preservation thing.

I would say it is a bit of a culture shock... not just moving from Philadelphia to a small college town in Oklahoma, but also the amount of effort required compared to undergrad. On my first ever exam, which happened to be in physiology, I thought I could study the way I had studied in undergrad and everything would work out just fine.

That was mistake number one. Luckily I’m a quick learner.

The level of detail we have to know is astounding. I’m not going to lie, I have moments in class where I think there is no way that this is ever going to help me. And you know, I still don’t know if it will. I remember when the old dean of the vet school came in to start teaching us neurophysiology, and he said “I wouldn’t be able to tell a G protein from a G-string.” (This was the test I failed, incidentally- and I still couldn’t tell you what a G protein is.) But I am surprised at the amount of material I’ve been able to soak in. Especially in anatomy, but if you want it to stick you better be prepared to spend at least 15 hours a week in the lab, and sometimes that is not the easiest thing to do. Especially when the freezer stops working, and the smell of the lab pretty much permeates the entire first floor of the building.

But that’s vet school, I guess.

Overall, I’ve had a blast so far. I wouldn’t want it any other way. Especially when mail gets accidentally addressed to me as “Dr. Kristen Brett.” How could that not put a smile on my face?

But I still have three and a half years to go before I actually get to that point, and this blog is going to be my account of the crazy ride that is veterinary school, from anatomy lab to goat castrations to trying to get the vitals of an alpaca doing its best to headbutt you in the stomach.

Vet school is definitely anything but boring.