“I will never be the woman with the perfect hair, who can wear white and not spill on it.”

i don't know if i've ever mentioned this - but i'm something of a sex and the city freak. ok, i don't sit around pining for the good 'ole days when SatC was on HBO. in fact, i didn't ever see the show until about 3 years after it went off the air when i started watching them on DVD. i've been a convert ever since. i can't exactly explain why. perhaps just because HBO does shows so well. i also loved the sopranos and band of brothers. at any rate, i own all of the seasons on DVD and i still watch them frequently as sort of a comfort thing. they're the equivalent of meatloaf and mashed potatoes for me.

and tonight is the premier of the movie!!! i still lacked season 5 (my least fave season) and part 1 of season 6 up until last weekend. jim bought them before me. and they came with free tickets to the movie. so tonight - myself and alisha and alison will all attend:) and yes, i'm sort of dressing up. just like the trekkies. except without the light sabers and cloaks. and more with really neat, hot pink stilettos.

hard decisions

one of my closest friends from vet school is currently faced with a very big dilemma. it's a quandary that will face us for the rest of our lives - because we are veterinarians. to euthanize or to push on with treatment in the face of grave illness?

about 6 months ago, she went to NYC to do her externship at the animal medical center in downtown manhattan. shortly after she left, her catsitter found sam - her 8 year old cat - dragging his rear legs and vomiting. he was admitted to our school and found to be in acute renal failure. after several diagnostics, it became apparent that he had a ureterolith (stone in his ureter). this obstructed flow from that kidney to the bladder - in essence forcing the kidney to balloon up with urine backflow and become dysfunctional. cats can usually handle this. it's not uncommon to xray a cat for some other reason and see what we call "big kidney/little kidney syndrome" - in which one kidney has shut down for whatever reason. this problem is typically asymptomatic for a long time, because the other kidney can compensate (god gave us 2 for a reason). should the other kidney ever begin to fail - then the cat is in trouble. in sam's case, one kidney was obstructed. his other kidney should have compensated. but it was failing too - for what reason we weren't (and currently aren't sure). further, the ureter that had the stone was torturous and enlarged, evidence that there had been previous injury (likely other stones). sam's prognosis was poor. he was placed in ICU, where he remained for 2 long weeks. he was very ill - uremic even.

uremic is a description of what happens when the kidneys can no longer function as they should and filter blood. toxins like BUN and ammonia build up in the blood, circulating to other organs of the body. clinical signs are wide and nasty - as one would expect as a result of circulating toxins. vomiting due to the action of uremic toxins on the brain, gastric ulceration due to the lack of the kidneys filtering out gastrin (a substance produced by the body for the stomach/food degradation), ulceration of the tongue and lips due to the toxins, and a whole host of other terrible side effects. kidney failure is an awful way to die.

sam hung on and actually pulled through his acute renal failure (ARF). his bill was $2000, but he seemed to be recovering well - despite picking up a nosocomial herpes infection from another cat while in ICU (like people picking up staph infections in the hospital after surgery). he'd done well up until the past few days.

the problem with cat kidneys is that once they fail - they will fail again inevitably. many cats that have acute renal failure can recover from this with aggressive renal support- massive doses of IV fluids, pain medications, appetite stimulants, and the like. unfortunately, even if they pull through the ARF, they will likely suffer chronic renal failure. cats in particular are prone to kidney problems. no one knows why - although there are theories floating around out there. some maintain that cats should be fed moist diets (canned) because they do not voluntarily drink enough water to keep the kidneys well-perfused. but the theories abound and no one really knows for sure.

at any rate, sam became a chronic renal failure kitty. as dire as this sounds, cat can often do quite well with CRF for some time. i've seen cats last 2-3 years with CRF. sometimes they go into acute renal failure again - where the kidney values shoot through the roof and the uremic syndrome returns. this is called acute-on-chronic renal failure. and sadly - that has happened to sam.

and now my friend is faced with a heart-wrenching decision. she just graduated from vet school with a significant loan burden. her credit is in not so hot shape. her credit cards are maxed out, and she's about to move to NYC for an internship (which pays a paltry $23,000/year). she already paid $2000 for sam's first ICU visit. that bought him a mere 6 months. so she turns to me and asks - should she press on? should she stop and euthanize sam?

i firmly believe there is no right or wrong answer here. and that is what makes being a vet so hard. how do you tell owners - when they look to you as the doctor and ask - that this is so? that letting go is okay but that not letting go and fighting is okay too? and what about when you're wrong? what about when you keep treating, and the animal does worse and worse? or what about the times you'll never know about - when you could have fought through it and brought the animal back to health? that's the thing about medicine. we're doctors - not fortune-tellers. we have to base our answer to this question on experience with certain diseases, with probabilities, with papers and research - but in the end - we're feeling our way too. added to the burden of making the right decision for both the owners and the animal is the burden of financial concerns. it makes many people feel terrible to consider finances when discussing the life of a beloved pet. many will throw away thousands treating a condition that will - in the end - claim the life of the pet. others will not. either way - it makes everyone in the situation (including the vets) feel terrible to base the decision of life or death on financial concerns. at the moment, there is no way around this fact.

sam will always be a renal failure kitty. his kidneys were badly damaged in the first bout of acute renal failure, and they will have been by this second go round as well. does that mean that he can't be treated and managed through this acute episode and have a few more good years? no, it doesn't. there's just no way to know.

sam is being euthanized in the morning.

life would be a ding-a-derry, if i only had a brain...

the title belies my true attitude. i had a shitty day. well - with the exception of a nice dinner with my in-laws and the arrival of our mercedes benz SUV. sounds like it should have been swell, eh?

this morning, i drove sam and my friend over to school. our favorite professor (whom the three of us are having lunch with on monday) had her incredibly skilled technician place a catheter to save us the strain (and because this woman is amazing with her hands - she never misses a catheter - and it's like watching an incredibly skilled artist). afterwards, they handed us the propofol and fatal-plus and left us to our sad duty.

of course - on the way there - i was distraught. i had an extremely important 11:00am appointment which i could not miss. the euthanasia was scheduled for 9:30. i hadn't been to alisha's new place (she recently moved in with her boyfriend), so i google mapped the address. for some reason, google found the wrong address. it was 7:00am in the morning, i'd slept terribly (about 3 hours of sleep) and i just read the directions without looking at the address - and thus wound up about 20 minutes beyond her house in BFE. i turned around and found the place - and then we were late - which i hate. i was driving fast to get to school, not only because we were late but because i couldn't be late for the 11am appointment yet i didn't - OBVIOUSLY - want to walk out of the euthanasia mid-way. further, sam was distraught in the car (as most cats are) - and alisha just held him and cried. i breasted a big hill before our exit and coasted down, forgetting that the speed limit had been recently dropped. sure enough, a cop waited at the bottom and didn't hesitate to pull me over for going 75 in a 55mph zone.

he was going to let me off. i could see it in his eyes when he looked at alisha and sam in the passenger seat as i explained the situation. and then he asked for my insurance card. like a good tennessean, i am insured - as is the law. i fumbled around in my wallet and produced my card. only to find i handed him the expired card. more fumbling. i found another card. also expired. i had no proof of insurance - despite being amply insured. it was right around that time he mentioned that my tag was also expired. i'd known this. it expired during vet school (in february -when i was in the barn - i.e. hell). and then i'd just never had a chance to renew it. since graduation, i should have - but i figured i'd gotten this far - and we were getting the mercedes that VERY DAY. with the 3 strikes, i think the cop thought his hands were bound. he was very polite and dropped the offense to 66 in a 55mph zone - which takes me out of the 15-20 mph over bracket - which is usually $150-200/ticket. sigh. my insurance is going to go up. this is the 2nd ticket in 7 months or so. i really have a lead foot. at least it was legitimate.

anyway, after the distressing euthanasia (i managed to hold it together fairly well), i had some personal things to attend to (also extremely emoti0nally exhausting and which i won't discuss here) - and then went home for a bit. i was drained, because i slept poorly last night and was spent. as a result, i lapsed into a brief coma before jim's dad called to tell us they were in murvul with the mercedes. we met them there and had dinner together, which was lovely.

the ONLY bright spot today was driving our new car home. i've never owned a nice car. not really. and i've always made a sincere effort to not be materialistic. but it's such a nice vehicle. 10 years old, heated leather seats, a sun roof, everything is power, everything works, i have A/C that is reliable. i have a car that hums quietly on the road. one can have a conversation at a normal level of speech (rather than scream over the unfortunate wind noise that seems to be the bane of the station wagon's existence). i hadn't been particularly excited about the mercedes previously. it's big, it likes it's mid to high grade gasoline, and it's hard to work on for my husband. but as i drove home in its cool, quiet, sleek interior, i felt a tiny, tiny bit better. i think i'll lightly embrace my materialistic side and just enjoy the nice car for once.

busy as the proverbial one-legged man

to say i've been busy would be an understatement of massive proportions. i redid my new chair, and then i got super-zealous and redid my dresser. it was a ton of work, it took 2 days of concentrated effort. the "good" thing was it started raining early saturday morning. as a result, i moved the yard sale into the carport. it worked out well, because i could work on the dresser while people shopped. it was also hot as blazes sitting in the direct sun. the temperature itself was only about 80 degrees, but sitting right under the sun...i was cooking. i have a nice tan now. however - i was closely eyeing my skin this morning whilst showering. not because i'm superficial, but because i was trying to scrape the 4 colors of paint on my body off of it. i noticed that after getting tan in the sun, my skin looks a little rough. it's easier to see fine lines.

oh and between all this painting and yard sale fun, i've been showing the house to prospective renters (for my landlord) and packing and cleaning constantly. i'm tired (as evidenced by my four hour, flat-out nap today).

we made around $200 at the yard sale (i'm very motivated to get rid of crap). we still have a fair amount that needs to be sold, so i think we'll be making a big donation to salvation army. jim also sold an old kayak that has been taking up space in the basement with the ones he does use. we got $200 for it and $20 for an old skirt. so yay! money to help us move.

we did brunch this morning. spectacular as usual (at our local trendy hippie spot - tomatohead). tomorrow, we're going home in the evening for a memorial day bbq. ahh....do ya'll have ANY concept of how glad i am to be OUT of vet school FOREVER??

sorry about the before dresser picture - the camera battery was dead before i started working, and i was so eager to start - i didn't want to wait. so that's alison (my bff) modeling the dresser in my blue dress. the before picture of the chair is one post down. i think i've found a new hobby.

what do a bee and myself have in common?

busyness, by jove - busyness. what have i been doing with my time, you might ask?

well - since we have a moving date and a house, i've been packing, cleaning, and preparing for a yard sale on saturday. yay! stuff will be sold. what isn't sold will go the way of the goodwill. down with clutter!! it doesn't look like we have that much stuff, but i'm still working on the living room - and i've been working (granted, disjointedly) for 3 days. i'm still not finished. t's disheartening - moving is. it takes so long, and you start to think that you're a total and complete slob - no matter how clean you attempt to be. i mean - i clean on a daily basis. sweeping and that sort of thing. i realize we have 7 animals running around this place, but still - i clean all the time. and yet - when i move the books from the shelves - there are dust bunnies at every turn. DUST EVERYWHERE. it's driving me batty. it looks like i'm some sort of total and complete slob.

sort of related - domino is one of my favorite magazines as of late. it's a home decor rag. looking at the beautiful designs - the stunning houses with funky but inviting decor makes me salivate for decent furniture. never one to buy expensive furniture (with the exception of our bed and mattress) - jim and i have many, many cheapo pieces of furniture. we also have quite a bit of hand-me down furniture that's perfectly functional but outdated in paint, etc. we have nice (but cheap) bookshelves from target and that sort of thing. we also have some decent furniture that's in poor shape - like my dresser (i purchased it from goodwill for $10 back in the day). at any rate, reading domino magazine has given me the courage to try and redo some of the smaller pieces of furniture myself. for instance, we have a heinous, gigantic, 70's era dark wood dining table. i would love to replace it with something more modern and attractive. unfortunately, i do not have $200-1000 to plunk down on furniture. luckily, i won't need an official desk where we're moving, so we're going to use jim's desk (which is really a dark walnut dining table with simple, clean lines) as our table (and he will inherit my old desk). i've been haunting goodwill/salvation army/KARM/and AmVet for cheap mismatched chairs that i can paint and re-upholster to make a non-matched but uber-cute set. above is the first victim - before and after. i'm really proud of the outcome. so much that i'm on a rampage now. we have two little end tables (see one in the picture) that we inherited from jim's parents. they're quite functional and sturdy, but the stain is peeling away and they look a bit ragged. no fear! i painted one today. it looks great. when i'm finished stenciling on it, i'll post pics of it too.

must give a shout out to lowe's - they were totally helpful, given that i know absolutely NOTHING about painting and had to ask a thousand questions like how and why to prime wood and what kind of paintbrushes should i buy and is staining wood hard and do i have to strip it first or something...and on and on and on.

i'm turning into a domestic goddess, as my mother phrased it. i've been cooking breakfast and dinner almost every night. i tried a stuffed chicken breast marinara recipe which turned out well (stuffed with spinach, mozzarella, ricotta, etc). currently, a meatloaf is aromatizing the house. i don't think i've EVER made meatloaf. it was never one of my favorite dishes. although my mother-in-law has a spectacular recipe that i need to try. luckily, i have a husband that is totally down with eating whatever i cook. unfortunately, he's not the most discriminating guy in the world - though i love him so:)

kitten went to his new home yesterday. it was like ripping a band-aid off. i had to leave him with his new owners. a veterinary technician from school took him home, so i know he'll have a good life. i do miss him so, though. he was a nice little diversion to have around. he loved the moving boxes and took great pleasure in hiding behind them, only to come prancing out sideways with his back arched... **sigh** i wish i could keep them all.

anyway, i have painting to finish. later.

... and we all fall down ... down

these past few days have been busy busy busy.

saturday heralded our first camping trip in a very long time. the BH wanted to kayak the cheoah since this is the last scheduled release for the summer. since he was going to run it both saturday and sunday, i decided to traipse along and hang out on santeelah lake while he did that. saturday was absolutely stunning. our campsite was directly on the water - water so clear and blue that you could see all the way to the bottom at 15 feet deep. i left the camera at home, so you'll have to envision the vista our tent afforded us. on unzipping the flap, one could stare across the peaceful, blue lake to the nearby bursting with green-ness mountains ringing it. i spent a few peaceful hours floating on the lake, worshipping the devil god of melanoma and enjoying the spring breeze. at around 4:30, we (the wife and significant other of jim's 2 kayaking buddies) decided to drive down to the river and see if we couldn't catch the boys running bear creek falls - the biggest and baddest rapid (at least - visually) on the river. luck was with us, as we only had to wait about 15 minutes before the BH and his kayaking buddies showed up. the video above is bear creek falls, although that is not the BH running it. he does it with much more style:)

saturday night was spent sitting around a campfire eating weenies and s'moreos (what happens to s'mores when you don't have access to graham crackers but have to instead rely on oreos). we also got ... eh ... inebriated. what else is camping for, after all?? the next day, we drove into robbinsville for a greasy, southern style breakfast, then the men dumped us again for a day running the cheoah. i had big plans that involved the lake, the sun, and more sun-devil worship. the weather had other plans, unfortunately. the day stayed shrouded in grey. shortly after the boys left us, it began to rain in earnest. not to worry - the kitten (whom i haven't found a home for yet) and i stayed in the tent, with the flap open, watching rain fall on the lake, finishing my book, and napping. it was quite relaxing - one might even say rather decadent. i love this whole not being in vet school anymore thing.

today, we got up early and went to chatty to look at a house we found online. it's great, and we decided to rent it. the neighborhood is lovely, full of huge, green trees, neat houses, and old people. it's a 7 minute commute to my new job. the house itself is 3 bedroom 1 1/2 bath with an extra room off the kitchen big enough to be a study or an extra living room or something like that. i'm pretty content with it, although the kitchen is a bit small. we're supposed to move in around june 7th, so the next few weeks will be spent packing, cleaning, and throwing crap away. i plan to throw A LOT of stuff in the trash. i refuse to succumb to the pack-rat tendencies that plague my otherwise perfect family.

chattanooga is a great town. jim and i spent some time roaming the streets of downtown, and it's a really incredible city. both of us kept commenting on how much it reminded of us asheville (indisputably our favorite town). i'm really excited to be moving there. we found a little greasy spoon diner already that we will probably frequent (the longhorn restaurant). small, quaint, with vinyl covered barstools, a homemade cake under a glass cakebell, friendly service, and greasy, southern food...it was perfection.

and on that note, i have some closets that could use my distracted attention...

tell me where it hurts...

is a book about being a veterinary surgeon. while hanging out with the better half (BH from now on) at Barnes&Noble yesterday and being pretentious white people (see: http://stuffwhitepeoplelike.wordpress.com/ for a summary of these things), i picked up this new book. i don't think it's particularly well-written, and i think the surgeon writing it might be something of a prick, but on the other hand, i kept chuckling out loud at some of the patients and clients he described. it was bang-on, if nothing else. thus - for anyone interested in vet med - or for anyone in vet med - if you want a laugh and to feel smart when you correctly diagnose his patients before he does (in the book) - give it a read. it's fast, if nothing else.

sundries...

so predictably, graduation has been somewhat traumatic. you can want something, yearn towards it, and still have trouble accepting it when the reality arrives. hooding itself was rather anti-climactic and frazzling. my grandparents came from florida, my in-laws from east of here, my parents, my siblings (all 4 of them), and my 2 best friends also came. it was very busy. i felt like i saw everyone and talked to no one for more than 30 seconds. the whole affair was very rushed and chaotic. but i was still grateful that i got to see everyone - as briefly as i did. and it was immensely gratifying to see and be reminded of my support system so tangibly. i am very lucky.

i haven't been doing much with myself since i graduated. moping around and feeling lost. this morning, i snapped out of that. i had a productive day - getting all of my licensure information in line and ready to mail, going to the bank, dry cleaners, and whatnot. i spent a few hours at barnes and noble reading cookbooks and other fiction. i stole 2 recipes which i tried my hand at tonight: kentucky okra, tomato, and corn stew and baked cheese olive balls. the stew was too sweet for my tastes - but the husband enjoyed it. i liked the olive balls a great deal - little flaky balls of cheesy and olive-y goodness. it was a simple recipe too. i also made a rump roast. it was quite decadent. tomorrow i'm going to try something with the yummy looking pineapple i purchased.

i finally finished ian mcewan's 'atonement' - not for lack of wanting to do so. it's been living at my brother's residence ever since the baby was born. i went and babysat for them the other day, spending 2 hours with my adorable niece while they grocery shopped. i also reclaimed the book and finished reading it. mcewan is an undeniably talented writer, but i never connect with his characters. i understand them in the abstract, their feelings, their torments...i can almost empathize with them but not quite. that lack of empathy is what always leaves me cold about his books. although both it and 'enduring love' were good.

i'm reading "better: a surgeon's notes on performance." it's riveting. it also really makes me want to write a book about vet school. the author's writing style is evocative and reminds me of my own. his stories - though dealing with human patients - are very familiar. it's a best-seller. if people like it so much, perhaps a book on veterinary medicine will be as popular. after all, everyone i meet is fascinated and/or inquisitive about my profession. i can't count how many people have told me "i wanted to be a veterinarian."

oh and as a nice graduation gift, my in-laws are giving us their older mercedes M class SUV. it's not really a car that's eh...smart for us. with gas prices what they are and the large tires that probably cost a tad more than my ford escort's. but it's in great shape, well-taken care of, and it will be my commuting from home to work car. so the gas shouldn't be bad. a big shout-out to the in-laws for thinking of us. pretty soon i hope that we won't need hand-me downs anymore - but until then - thanks and we love you:)

oh, the video i have posted in the sidebar is from our senior roast. watch it - it's pretty dang good. we made it as a farewell/homage to vet school. the whole thing is filmed in the main corridor of the good 'ole UTCVM and the prep room (anesthesia). those are my classmates. and how i'll miss them (contrary to what i once thought). the goofy and talented blonde in 80s get-up lip syncing is dr gordon (how weird to say that). she was the brains behind the whole thing - and it turned out smashingly. i'm not in the video (but my 2 best friends are - the girl in the cowboy hat - deb, and the blonde with pigtails - alisha), i slept through it because i was on overnights. i am featured heavily in the true roast video, where we made fun of our clinicians, interns, and residents, as well as the grueling road that is vet school in general (read: lots of laughing at how awful the barn is). however, that's not posted on youtube yet. if it is, i'll add it here so that ya'll can make fun of my terrible (read: lacking) acting skills.

toodles.

and........................scene

this morning was my last morning in the barn...or anywhere in the vet school. i am officially finished. it's over. i walk across the stage in 3 days.

I FINISHED VETERINARY SCHOOL.

oil and water

i am the oil. everyone else in my life is the water. i don't know if it's because of my imminent graduation or my period or the huge changes pending in my life - but i am the oil these days. the rest of the world is the water with which i am thrown. i'm on a rotation with a good friend. we keep striking against each other like matches against flint. and jim - god - all we do these days is argue. we're considering buying a house. i came home with information, excited at the prospect of what finally feels like an adult life - and we wound up in an argument. seems to be the theme these days.

what is wrong with me lately?

i gained 5 lbs on my critical care (overnight) rotation. likely because all i did was eat to stay awake. it's made my self-esteem plummet - especially knowing i'll see my family in less than a week at graduation and have to hear that i'm stocky, i'll always be stocky...blah blah blah. i think i'd be okay with my body if my upbringing hadn't skewed me so badly and made me so self-conscious of how i look.

i shouldn't be depressed. i should be happy. i'm on the cusp of my professional life. 6 years ago - lost in the human medical insurance field - i was miserable, confused, searching for a job that i thought would bring me fulfillment. and now - here i am - about to be fulfilled. i don't deal well with change. and it's coming at me fast. i'm just not a very adaptable creature. evolution should probably have already weeded me out...

it's funny. as hard as the last 2 years have been - ever since my life came semi-crashing down - and as much as i swore i wanted to be away from the vet school - now that it's almost here, i'm scared. scared and sad and ... something else that i cannot put my finger on exactly. i don't want to say nostalgic. it's not quite that. it's nostalgia and fear and yearning and regret and wistfulness and wonder and loss - all at one time. there is no word for that.