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Vet Talk

Nothing is Routine
May 25, 2015 (published)


“At first it’s all ‘oooh’ and ‘ahhh.’ Then comes the running and the screaming.” I'm paraphrasing one of my favorite lines from the second Jurassic Park movie.

This is how I feel about the word “routine.”

I’m a huge fan of experience, practice, and even protocols. I believe that repetition builds skill. However, the expectation of predictability fills me with the dread of a thousand velociraptors.

There are benefits to a routine – something repeated the same way each time, improving muscle memory, skill, and consistency. In a perfect world, a routine would produce a consistent outcome. Every. Time.

The word itself conjures images of dance or figure skating – a process that is flowing, well-rehearsed, seemingly effortless.

But most of us watch figure skating for the same reason we watch car racing or disaster movies. It’s not about the predictability and skill, it’s the sudden, unexpected disasters that make us sit up and take notice.

Just as myriad factors contributed to the eventual domination of a small island by hordes of formerly extinct predators, there are a lot of things that can go sideways when we expect “routine” to yield a predictable outcome.

“Life will find a way,” says the Jeff Goldblum character in the first Jurassic Park.  Biology is a fascinating thing. Bodies, whether human, animal, or even microscopic, are amazingly complex machines. This complexity ensures that species survive against a universe that is trying to destroy them, but it also makes the veterinarian’s job tougher. While drug dosages, surgical procedures, and even basic anatomical references are based upon the average critter, some individuals just don’t read the text books.

This means that despite successful use of a particular anesthetic protocol in 999 previous patients, patient #1000 will stubbornly refuse to go nighty-night and stay there for the appropriate period of time. Or the dog who is the 30th spay of the week will decide to have one ovary hiding just north of the incision.

Forces outside of biological variation also conspire to make the routine more...interesting.

In 30-odd years of working around horses, my only significant injuries came about not during some heart-stopping, rodeo of a day, but during depressingly mundane – ROUTINE – procedures.

Case 1) I was finishing wound treatment on a sedated horse that had been hospitalized for a week. He was restrained by our rock-star-amazing technician. In other words, we were doing everything right. The horse happily imitated a statue through the wound debridement, but when I went to wash some blood off his leg, he leapt forward, kicked out, and I wound up in the hospital with two hoofprints over my sternum.

Case 2) I was performing a pre-purchase exam on a new horse. When I lifted the hind leg (something I’ve done literally thousands of times over the years), the horse began to act up, eventually jerking his leg out of my hand and breaking my hand along with it. I still have the scar and plated bone as souvenirs.

Sometimes human behavior can rival animal quirks for turning the routine into an adventure.

Grief, worry, and even simple ignorance do funny things to people. Otherwise sensible individuals lose their cool and ability to listen where their animals are concerned.

As a rule, to keep from contributing to the devolution of routine into mayhem, it’s good to avoid the following:

  • Flinging yourself across the head, neck, or body of an ill or injured animal. The larger the animal, the more this rule applies. Actually, covering a hamster or bird with a fully fledged human is also a bad idea, come to think of it.
  • Insisting on restraining your own animal for examination, vaccinations, etc.
  • Refusing to allow an anxious or aggressive animal to be muzzled or sedated.
  • Not having your animal properly leashed, haltered, crated, or otherwise restrained for the veterinary visit.
  • Ignoring post-surgical instructions for exercise restriction, medication, bandaging, etc.

And, not infrequently, “routine” is completely derailed by the combined laws of entropy and Murphy. For large animal veterinarians, weather alone can wreak all kinds of havoc with something as simple as a vaccination appointment. Horses, at the best of times, are large, fast-moving, and needle averse. Add a nice strong wind or thunderstorm, and it’s like trying to vaccinate a class of thousand-pound third graders on a cupcake high.

Even in the civilization of an indoor hospital with all of the bell, whistles, frills, and tassels, things can go sideways. The puppy that came in for the “routine” spay may turn out to have, as one of my parents’ poodles (aka vacuum cleaners) once did, secretly consumed a small garden-path full of rocks, turning the “routine” surgery into a spay and foreign body removal.

Previously unknown drug sensitivities, illnesses, or other conditions may lay hidden, just waiting to complicate the “routine” procedure.

It doesn’t take a meteor strike or alien invasion to turn routine into something far more interesting. (As explained in the movie Serenity: “How do you define interesting?” “God, oh God, we’re all going to die.”)

I’ve heard therapists refer to expectations as “pre-programmed disappointment.” When the expectation is one of predictability and assumed safety, disappointment wanders into the forests of danger and heartbreak.

It takes practice, attention, and no small amount of luck to keep the routine routine.


 
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