Anyway, the alarm went off and I stumbled to the bathroom for a cold sponge bath in the sink. That would become my morning routine - both to get sort of clean and to wake myself up. I think that there were hot showers through some tunnel in the dormitory building but that seemed to require too much effort. Still no working toilet.
Breakfast was left for us in the kitchen. No complaint on that - bagels, cereal, toast, and Sunny D. Between that and the bologna sandwiches we got for lunch, I felt like I was time-warped back to the 70s.
We left the dorms at 6:30 and drove 30 miles back to the garage, which was set up for the day. The clinic started at 8, but there was already a line of patients at 7 am. The group was divided as follows: receiving (meeting the clients, examining the pets, vaccinating, treating, admitting if surgery was needed), anesthesia (they were with the pet from the time the pet was given pre-anesthetic medication until the time it was up and walking after surgery), and surgery. There were two receiving vets, three full-time surgery vets, and two vet employees, who did surgery and also dealt with logistical issues. I was in surgery the first four days.
As patients were admitted, their information was placed on the surgery boards, which looked like this:
Each patient was then assigned both a surgery and anesthesia student, and a surgeon. Doctor Paul (one of the in-charge vets) was nice enough to start me off easy, with a dog neuter. I was still nervous!!! In fact, I think my hands shook through that surgery. I had a student scrub in with me and let her do as much as she could with the time we had. Most of the students were between their 2nd and 3rd years of vet school and had some, but not much, surgical experience. They also had to pass a practical exam before they were allowed to scrub in. We were allowed 60 minutes for anesthesia or 20 minutes for a dog neuter/45 for a spay (dog or cat), whichever was less. So if an animal took a long time to prep for surgery, that cut into our surgery time. Often we would ask the surgery student what part of the surgery (incision, tying ligatures, closing the skin, etc.) they wanted to do for sure, and then the surgeon would do the rest. I was a little lax and sometimes went over a minute or two in order to let the student do a little more.
That first day, our team performed around 35 surgeries. My most memorable was a little pile of matted fur named "Princess". It took over 30 minutes to shave all of the mats off of her! She must have had 100 ticks on her, too. In fact, she had one engorged tick and at least 6 smaller ticks trying to eat out of the same hole! Gross! And she was in heat and I had only 30 minutes to spay her. It was a bit of a bloody mess, but my confidence was up. I had begun to use a new knot technique, which is sort of a game changer for me.
Princess Before
And after
Even though it was in a garage, the clinic was impressive! Here is the line of 4 surgery tables. The anesthesia students have fancy orange duct tape badges and the surgery students have an individually color-coded duct tape badge. The vets only got plain grey duct tape.
The surgery packs. There were two large autoclaves going pretty much all the time to keep up with sterilizing the instruments.
Recovery. Note the screen tent in the background. Cats recovered in the tent so they could not escape!
Even though it was a no-cost clinic, no corners were cut. All surgical patients had an IV catheter and IV fluids, sterile packs, local anesthetic block when indicated, gas anesthesia (even cat neuters!), and pretty good monitoring. It was a great learning experience for the students.
It was a long day. I think we got lunch at about 3 pm (it came pretty erratically the entire week). Bologna sandwiches, watermelon, cold water. I will admit that week I fell off of my Pepsi wagon. Even on the first clinical day I was tired and needed caffeine. There was a grocery store 1/2 mile from the dorms but we never ever had time to even go there. So between the meals, I kept myself nourished with Pepsi from the vending machine and snacks that I had bought in Bismarck.
The surgeries were done at about 7 that night, but Princess was not waking up as fast as she should. Actually, she was awake but her body temp did not rise over 99. So one of the staff vets pulled out the ultrasound to make sure she wasn't bleeding internally from her spay (you know, the one I did). She was fine, but her recovery delayed the entire system. We could not break down all of the clinic until we were certain that we would not need to do anesthesia or surgery on any patients at all.
So after over 12 hours of clinics and surgery, we then got to take the entire clinic down and pack it back into the trailer. And drive 30 minutes to another town in the reservation, where we unloaded the trailer into a clean and spacious gymnasium.
Back to the dorms. We were so late that we almost didn't get dinner. Still no hot water. Still no working toilets. But I was too damned tired to even care.
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