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Archive for January, 2011

Thinking aloud

Or at least in print. Dyslexic genes notwithstanding, talking things out, or in lieu of that, writing them out, seems to help me. My boy dog has an appointment with a local dog training facility for an evaluation this week with potential private lessons down the road. I need to figure out how best to tell them what the issues are, and what I would like to get from them and work on with said dog.

His history: I got him at 2.5 years old, when he was nearly on the kill list for his behavior. He was a wreck. Barked at everyone, was terrified of everything and completely undisciplined. He had no reliable trained behaviors and would run away and hide and growl if you told him no or moved towards him quickly. He also had some pretty severe separation anxiety, which we seemed to have resolved and was an inveterate counter surfer, which he is mostly fixed. He is finally off clomipramine and his medical issues are under control.

The good: He gets along great with my cats and my other dog (who is very pushy), he is cuddly, is easy going in the house but playful when appropriate. He helped me raise a litter of bottle baby kittens and is trustworthy around my birds (budgies). He is even great with my current roommate’s three kids. He also lets me do anything I want to him, including brushing, nail trimming, ear cleaning, and even brushing his teeth. He is great with anyone he knows well and just wants to be loved on.

The bad: He goes nuts on leash when he sees strange dogs (whining, barking, lunging). He barks and growls at strangers and has even nipped their sleeves. He thinks he hears noises and will get all anxious and bark and pace. He will act like Cujo (barking, growling, jumping) if he is in a kennel, crate, or behind a fence and anyone comes near from the other side be it man or dog.

What I want: For him to walk past other dogs on the sidewalk with quiet interest. For him not to be Cujo if he’s on the other side of a barrier. For him to ignore strangers or meet them without barking/growling.

What I would LOVE (I’m talking dreams here): For him to be able to meet strange dogs politely and be off leash, for him to greet or just avoid strangers. For him to be just interested on who/whatever is on the other side of a barrier.

Other notes: He doesn’t have much initiative. He is scared to make mistakes and will just stare at me rather than trying something new if he’s not sure exactly what he is supposed to do. He’s not normally hard-headed, but when he gets into one of his freakout modes (strange people/dogs/barrier) I can NOT get his attention with anything I have tried (any treat/chicken/cheese or corrections). His little brain just goes out the window. He has done training classes (beginning and advanced obedience, intro and beginning agility), and even there, had a very difficult time focusing on me and whined and paid attention to the other dogs constantly (mostly ignored the other handlers). He was like a horrible case of ADHD.  Believe it or not, he did pass a CGC test because the other dog was very good at ignoring him, so he was able to control himself better and stay sitting long enough for me to greet the other handler.

 

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Internships are about experience, unless you’re going on to a residency. Which most people aren’t or can’t anyway. Why would you want to get crap pay for experience you could (in most cases) get elsewhere along with better wages, benefits, and where you might even get treated like a real person?

Saying something like this is unpopular and frowned upon. But I still feel like it’s true. So long as you have good mentorship, does it really matter if you’re an intern or “just” a newbie associate? And don’t tell me that the ‘mentorship’ part is the difference. There are awesome mentors both in official internship slots and at private practices. There are also crappy places on either end.  And sometimes it’s not even that there are or are not good mentors so much as a problem meshing and working well together.

I just don’t get it. I could see myself specializing a couple of different ways, but none of them involve going into a random internship for general experience with no plans of residency.

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Today was an interesting day at the hospital. It was interesting on the medical side since I got to play with some of my favorite toys: allergies/dermatologic issue and behavior medicine. There were kittens too, which is always a nice bonus. And some blood draws that made me feel like I might be a doctor yet. The terrible, no good, very bad case from Monday is stable and happy, and seems to be doing quite well. It appears that no more urine is leaking into her abdomen at least. If the ureteral reimplantation takes is still yet to be seen. If not, she’ll have surgery to take out that kidney next week. She is happy and playful though, and as usual, her appetite is voracious. Today was busy in part because it’s the edge of a three day weekend, when everyone realizes, “Oh shit!” and decides to walk in at once. Finally got to leave after 13 hours today.

So, it would be fair to say it was busy, and even somewhat stressed since we had some legitimate emergencies come in including a foreign body ingestion and a basketball sized spleen. Also had a ginormous retroperitoneal abscess and an anterior lens luxation. Neat cases… in the medical sense any way. We have to handwrite our files and our discharge instructions though, which is a curse for me. I cannot write quickly. I joke about being dyslexic sometimes, but sometimes I wonder if I should do some research.

Reading, silently to myself, has never been a problem. Not a problem that I remember anyway, but I was a shy child and practiced a lot. Reading aloud is torture. I skip words and half sentences and I hate it. Writing is much the same. I don’t write things in the correct order. One particular doctor was looking over my shoulder as I wrote out a prescription today. I was writing in the patient’s weight (23.6kg) and wrote the ‘3’ first, then the ‘2’ and then the ‘.6’ which earned the comment, “dyslexic much?” I dunno.

Maybe.

I then got the drug all jumbled up as well, which made me wince. I didn’t mean to write the letters or words in the order I did, that’s just how it came out, and I have to be very careful not to skip ahead and leave words out when I’m writing. I have a helluva time saying things in the correct order too. You know that joke about drunks who are switching parts of or entire words around? I do that normally. Especially if it is something like “neoureterocystostomy” which, I later learned, is actually “ureteroneocystostomy” and I just had switched it. In other words, I am not so think as you drunk I am. On a daily basis. What really gets me though, is that I will even do it with a freaking keyboard! That ‘remember’ a couple of sentences ago was originally typed in as rememper. Thank MS for spell check. Oh, and could we get rid of the whole pbdq thing too? They are not my friends. In real life they wind up being a ball with a line straight up and down bisecting it (think of the greek capital phi) or being completely scribbled out so I can start over.

At least with keyboards and electronic records, or even a word program I can type and print them out with, records and discharges are less painful, way faster, and far more readable for any poor sap who needs to extract information from them.

ETA quotes/links that interest me:

Signs/symptoms: letter reversal or mirror writing, difficulty with word retrieval or naming problems (which is easily overcome, just describe what it does or looks like and people will give you the word), difficulty distinguishing between similar sounds in words; mixing up sounds in polysyllabic words (auditory discrimination), for example, “aminal” for animal, “bisghetti” for spaghetti (Doesn’t everyone do this? Most people seem to think it’s funny), and difficulty reading out loud, reading words in the wrong order, skipping words and sometimes saying a word similar to another word. Apparently dyslexia actually runs in my family too… as in, my dad. Still don’t think I’m actually dyslexic though… I can read, and well, after all. Isn’t that one of the big things?

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I like the idea of monthly resolutions much better than New Year’s ones. I like the idea that each month is a new chance to start a new habit or change an old one. Granted, really, you can resolve to do something any time of any day, but having a sense of routine and weight with it does help. You can’t do too much though. Habit is a powerful force, and if something does not become habit, you will not keep doing it, so you need to keep the resolutions you make down to two or three so that those ones even have a shot. But if you do them monthly, then you’ve got twelve chances to go for it. Divide and Conquer!

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I LOVE Doctor Who.  The Ninth Doctor is MY doctor, for quite a variety of reasons. It took me ages to forgive David Tennant, though I do love him as well now. The new guy seems pretty awesome as well. But the Ninth Doctor is still my doctor. This musing came about as I searched the hospital for my doctor, the doctor who was working with me on a particular case- I was looking for a double check on the prescription I wanted to order and signature for one of my patients and came to the room where my doctor, my clinician, was supposed to be. She wasn’t. Someone else was. “You’re not my doctor!” I exclaimed. Raised brows and a quick and giggling exit later and I was off in a mental journey in the TARDIS.

Nothing like a DW marathon day to make life a little happier and the imagination a little more active. If I had been born earlier, the Fourth Doctor would have been mine. As it is, I’ve seen all the old episodes I could scrounge up and love him dearly as well. I think it’s the wonder, the wonder at all the universe. In so many words, fantastic! The Tardis wikia describes the Tenth Doctor, “a bit of…a cross between his Fourth and Ninth incarnations.” Perhaps that’s why I can forgive him for surplanting my Doctor.

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