La capitolul organizare, intr-adevar, poate austriecii stau ceva mai bine decat noi in Romanica, dar stati linistiti si ei sunt cateodata la fel de organizati ca niste furnici bete...si am destule exemple care arata ca nu-s mai breji ca noi.
Intr-o dimineata, pe la 10 fara 15 primim sms: "REPEDE LA 10 TREBUIE SA FITI IN CENTRU CA MERGEM LA nu stiu ce operatiune de tranchilizare si recoltare de probe la niste bizoni" undeva, la o rezervatie, in the middle of Austria, la o ora jumate de mers cu masina. Eu eram racita cobza, in pat de 2 zile, Ovidiu tocma se pregatea sa mearga la alt curs, dar nah...puteam noi sa ratam operatiunea monstru?!
Asa ca aruncam pe noi 2 haine, alergam ca disperatii 3 statii in fata tramvaiului, ajungem in metrou, ne legam la sireturi si ne inchidem la haine in timp ce eu ma indop cu Strepsils-uri; intr-un final ajungem la punctul de intalnire, ne suim cu totii in masina (5 oameni intr-un Mini Cooper) si pornim voiosi la drum, cu placutul sentiment ca vom infaptui lucruri marete in ziua aceea.
Inainte sa intram pe autostrada dam un telefon la rezervatie sa le zicem ca venim...stupoare!!!...incepusera de o ora, si intr-o ora urmau sa termine...
Foarte contrariata, una din colege se revolta: "Data trecuta au zis ca incep la 12 si au inceput la 3!! Azi ce le-a venit sa fie punctuali?!?!"
End of story
Showing posts with label cu bune si cu rele..... Show all posts
Showing posts with label cu bune si cu rele..... Show all posts
Monday, 12 January 2009
Thursday, 24 July 2008
Memories
Ioana's loss brought back memories. And they were not great memories.
Memories from University. The famous Uni from Bucharest, where our horse vet chief surgeon, still preached about the benefits of firing horse tendons, when the rest of Europe had already banished it by law and classified it as animal cruelty.
The time when we were sneaking in as students trying to give a very dehydrated horse, lodged in the large animal hospital, more then the prescribed 1 L of IV fluids. One whole litre!!!
I could dig back dozens of such memories. I could also dig back the endless amount of unnecessary information, from the 60's if not sooner, that we had to memorize as students.
I could remember the times when I watched in amazement how, in the small animal clinic surgery, the reputed ortho surgeon repairs a fracture without gloves. "I can't feel the structures just the same with gloves" was the running excuse. Hello??? This is not like wearing a condom, optional! Performing surgical acts with sterile gloves on is mandatory nowadays!
Or speaking on his mobile during surgery, closes the phone and then goes back into surgery. For the next surgery, the same instruments were sprayed with alchool a few times, and reused again without blinking. And all these in the main teaching institution, that should set a good example to everybody else.
I used to feel guilty for not spending time in the university's clinics and see "practice". Another "rebel" vet colleague, who is probably abroad as well now, told me once "I don't want to hang around, just in case I get some bad habits". Too right!
Still, while a student, I never really comprehend the full extend of the lack of professionalism and diagnostic errors that occur in veterinary practice in Romania. I had a vague idea, thinking that even for the most reputed clinician, lacking lab tests, X-rays, cages to keep animals hospitalized, etc., life would be pretty impossible.
And then I finally graduated, and found an opportunity to work abroad in a vet practice abroad. It was in Cyprus, the influence was very British in the practice...and that's when everything started for me personally; it wasn't anything by any stretch of imagination extraordinary, just a regular small animal practice at European standards. I learned in the first year there more about small animal practice then in the whole years spent in the university. It wasn't easy, but before every new surgery I would see the next day, I got books at home and red in advance. And by books, I mean updated, large, reputed small animal textbooks,....not the leaflet i received in university as my small animal surgery book.
After a year and a half spent abroad, I decided to return and practice in Romania. That's when it hit me, the huge gap between what could be and what really is happening.
I watched my colleagues doing surgeries on half awake animals (full deep anesthesia is very dangerous). I watched everybody taking surgical instruments off the shelf, rinsing them in alcohol, if that much, and getting to surgery. I watched very simple and basic ideas of surgery being slayed, just as plain skin closure techniques, that in view of most Romanian vets, need to be done with the thickest suture available and as tight as possible "to hold well".
I also saw the other side, of being employed in a small animal practice and getting a salary of 400$ monthly...and sometimes not getting that at all.
I saw, in 2007!, 2 great value products being used on animals...tarantula venom that is meant to help in localising the abscesses, and moth ball powder sticked onto fresh wounds to keep parasites away. I saw many medieval concepts. I also saw it's a battle to change the old ways, and certainly, should I ever feel like changing the ways and opening a practice in Romania, it would have to be either on my own, or together with some other open minded other vets with some years of experience of practising abroad.
Because a sad reality is...Ioana speaks about referring the cases. Well, my sad Romanian conclusion is ...apart from 2 places I could think of where I would refer my animal in Romania, (and both of them away from Bucharest), all else is silence. One is a vet that moved out from Israel, and has a practice in Arad. The other one is our very own Ricky, that despite just having started the practice 6 months ago, is growing it into a nicely equipped practice, and compensates with his solid theory knowledge all else. They both lack something essential thou...a serious Romanian lab for accurate hormone dosing, biopsies, cultures. I mean, seriously. Where would you sent a thyroid panel in Romania?? And mostly, how many Romanian vets would see the necessity of the exam?
Anyway, sad but true, the romanian reality in vet medicine is very sad. I think there are some very big hearted people out there. But the lack of proper training, the "books are written from books" concept and the complete lack of basic equipment leads to some serious errors.... and I hardly see things changing anytime soon.
Memories from University. The famous Uni from Bucharest, where our horse vet chief surgeon, still preached about the benefits of firing horse tendons, when the rest of Europe had already banished it by law and classified it as animal cruelty.
The time when we were sneaking in as students trying to give a very dehydrated horse, lodged in the large animal hospital, more then the prescribed 1 L of IV fluids. One whole litre!!!
I could dig back dozens of such memories. I could also dig back the endless amount of unnecessary information, from the 60's if not sooner, that we had to memorize as students.
I could remember the times when I watched in amazement how, in the small animal clinic surgery, the reputed ortho surgeon repairs a fracture without gloves. "I can't feel the structures just the same with gloves" was the running excuse. Hello??? This is not like wearing a condom, optional! Performing surgical acts with sterile gloves on is mandatory nowadays!
Or speaking on his mobile during surgery, closes the phone and then goes back into surgery. For the next surgery, the same instruments were sprayed with alchool a few times, and reused again without blinking. And all these in the main teaching institution, that should set a good example to everybody else.
I used to feel guilty for not spending time in the university's clinics and see "practice". Another "rebel" vet colleague, who is probably abroad as well now, told me once "I don't want to hang around, just in case I get some bad habits". Too right!
Still, while a student, I never really comprehend the full extend of the lack of professionalism and diagnostic errors that occur in veterinary practice in Romania. I had a vague idea, thinking that even for the most reputed clinician, lacking lab tests, X-rays, cages to keep animals hospitalized, etc., life would be pretty impossible.
And then I finally graduated, and found an opportunity to work abroad in a vet practice abroad. It was in Cyprus, the influence was very British in the practice...and that's when everything started for me personally; it wasn't anything by any stretch of imagination extraordinary, just a regular small animal practice at European standards. I learned in the first year there more about small animal practice then in the whole years spent in the university. It wasn't easy, but before every new surgery I would see the next day, I got books at home and red in advance. And by books, I mean updated, large, reputed small animal textbooks,....not the leaflet i received in university as my small animal surgery book.
After a year and a half spent abroad, I decided to return and practice in Romania. That's when it hit me, the huge gap between what could be and what really is happening.
I watched my colleagues doing surgeries on half awake animals (full deep anesthesia is very dangerous). I watched everybody taking surgical instruments off the shelf, rinsing them in alcohol, if that much, and getting to surgery. I watched very simple and basic ideas of surgery being slayed, just as plain skin closure techniques, that in view of most Romanian vets, need to be done with the thickest suture available and as tight as possible "to hold well".
I also saw the other side, of being employed in a small animal practice and getting a salary of 400$ monthly...and sometimes not getting that at all.
I saw, in 2007!, 2 great value products being used on animals...tarantula venom that is meant to help in localising the abscesses, and moth ball powder sticked onto fresh wounds to keep parasites away. I saw many medieval concepts. I also saw it's a battle to change the old ways, and certainly, should I ever feel like changing the ways and opening a practice in Romania, it would have to be either on my own, or together with some other open minded other vets with some years of experience of practising abroad.
Because a sad reality is...Ioana speaks about referring the cases. Well, my sad Romanian conclusion is ...apart from 2 places I could think of where I would refer my animal in Romania, (and both of them away from Bucharest), all else is silence. One is a vet that moved out from Israel, and has a practice in Arad. The other one is our very own Ricky, that despite just having started the practice 6 months ago, is growing it into a nicely equipped practice, and compensates with his solid theory knowledge all else. They both lack something essential thou...a serious Romanian lab for accurate hormone dosing, biopsies, cultures. I mean, seriously. Where would you sent a thyroid panel in Romania?? And mostly, how many Romanian vets would see the necessity of the exam?
Anyway, sad but true, the romanian reality in vet medicine is very sad. I think there are some very big hearted people out there. But the lack of proper training, the "books are written from books" concept and the complete lack of basic equipment leads to some serious errors.... and I hardly see things changing anytime soon.
Sunday, 20 July 2008
FOR ALL THE VET WANNABES OUT THERE!!
OK, so I have 2 things to write about, and I have no idea why the hell I am writing now, a bit more than 24 hours away from my private pilot exam, with about 1000 pg left to review. BUT I am in the same time excited and pissed off.
The single good thing that happened to me lately is that today I was accepted to the EAZWV Summer School. Ovidiu too. Of course the rest of the students accepted are either German, Swiss, or anyway German speaking. The courses will be in
Now for the pissed off part. I don’t know if I should write this in English or in Romanian, so that all the “language impaired” Romanian vets could read this.
My dog died last Sunday (Dona, for the ones who knew her), and it was mostly because of poor (or totally inexistent) medical training or professionalism. Partly because the owners (me included) reacted waaaaay to slow to the symptoms.
However, after a few more days, Dona’s state was getting worse. She stopped eating. No defecation, no drinking, no nothing. My mom tried to force feed her, but Dona vomited on the spot all that was given to her.
When I found out about this odyssey I literally rushed the 1100 km back to
I asked myself what may have caused this all? I reached absolutely no conclusion. Heart was of course weakened, but still ok, lungs were indeed mittelgradig verschärft vesiculär (raluri umede moderate?!-> edema?), but all the symptoms were consistent with her not having eaten for 3 weeks. And the neuro symptoms? She had 5 kg instead of 7-8kg. What the hell caused that in the first place?! Poisoning? A chronic condition? Both??! She was actually developing signs of shock. So I came up with a treatment plan for the next day until I could get her to a real doctor. This involved all sorts of IV fluids (from ringer and glucose to dextran and HES. Ovidiu helped me with the doses and combinations. I even started considering finding a blood donor dog) + electrolytes and vitamins; ranitidine; minimum dose of furosemid or spironolactone and even a urinal catheter, because she had no urine output in days & renal function must have been a mess; I also wanted to use a human urinal catheter as a naso-gastric tube, for artificial feeding. This was the “support” part of the treatment. On VIN I found that in the case of septic patients is safest to use a combination Ampicillin+2nd/3rd generation cephalosporine (they’re plenty for human use). I found cefoxitine. As for an antiinflamatory I couldn’t find anything injectable at the pharmacies around me. I started making a quick check up with a chart with vital parameters every hour. I tried my best to make out of my bedroom an improvised ICU. I know, basic treatment. Nothing fancy. I didn't want to risk making any more damage. But is guess it should have been enough for one day, until we had access to some blood/urine tests, ultrasound or eventually Rx, to find out more and set a diagnostic…
After 1.5h on the glucose she seemed to be a bit more energetic (but it can be of course my sick mind after 30h of not sleeping trying to convince itself that Dona was going to live). After I returned from the pharmacy ready to start with the aforementioned treatment, she became more and more agitated. She developed abdominal spasms and eliminated a dark reddish-brown, viscous paste (fecals, blood, intestinal mucosa?...), with a putrid smell, and in great quantities for such a small dog. She relaxed immediately. For one more hour she just stood still, probably tired from the spasms. But she started having them again, this time not eliminating anything, and she died in my arms, without being able to do anything.
So, for all the Romanian vet wannabes out there: YOU ARE NOT DOING MEDICINE!! YOU JUST ARE PLAYING DOCTOR! BADLY!!
The lack of knowledge is unacceptable, and nobody should blame that on the lack of money, the fucked up university, the lack of equipment, or the stars in the sky. Good books actually DO exist, information IS really there, if you can spare some time to find it and learn it. Lives can actually be saved, and you don’t need some fancy equipment to make an assessment. And when you’re over your head, don’t send the owner home with some pills and pray that everything will be all right. REFER! There are other doctors who know what they are doing!! And YES! Modern medical technologies REALLY DO EXIST FOR ANIMALS TOO!! Nobody will ask a neighborhood vet to perform a phacoemulsification or a TPLO, but taking a shitty blood sample won’t kill you! Might kill the patient if you don’t!
I am so sorry there is no malpraxis law in
Monday, 7 April 2008
Cind se duce lumea la culcareeee
Cele ce urmeaza merita scrise in romana, mama lor de clienti rasfatati...
Nu mi-am dorit de multe ori sa fiu propria mea sefa, sa am afacerea si unica responsabilitate. Si putere. Dar cu singuranta mi-am dorit mult, mult, mult de tot azi-noapte...
Sa fi fost vreo 12 jumate, in miezul noptii. Am muncit tot weekendu, si a fost foarte aglomerat. Dormeam linistita, visand la te miri ce. Dormeam si ma odihneam, cind deodata clasicul tiriit al telefonului de serviciu. Trr, trrrr. Buimaca, ingaim ceva si raspund....cind, ce sa auzi, o femeie...
care nu zice nici buna seara, nici nimic, si incepe sa imi reproseze in urechea adormita. Care era nemultumirea principala a clientei? Ciinele ei latra in continuu si ea nu putea sa doarma.
Eu incerc sa continui profesionist anamneza...vomita? Nu. Maninca si bea normal? Da. Alte semne de boala? Nu. SI CE VREI SA FAC EU FEMEIEEEEEE? Imi vine mie sa urlu. Nu se opreste aici. Sefa mea, un chirurg cu mare experienta, i-a sterilizat acest catel acum vreo saptamina (am vazut operatia, impecabila) si de atunci nimic nu a mai fost la fel. De ce nu mai e la fel? Incerc sa-i explic ca ce are Ana cu Caiafa, nu are nici o legatura. Deja incepe sa plinga isteric la telefon. O intreb de ce plinge. Zice ca nu poate sa doarma din cauza ciinelui si e obosita. Mie imi vine si mie sa pling. Sa pling sau sa injur, sau amindoua in acelasi timp.
Nu vrea sa vina la clinica sa vad ciinele.(Taxa de urgenta, eheee). Perfect, inchei eu amabil, vino miine dis de dimineata la clinica si colegii te vor ajuta. Imi vine sa ii zic "Noapte buna" dar mi-e teama sa nu sune prea sarcastic. Am inchis si dupa aceea mi-a luat cel putin juma de ora de frikinit in pat, sa imi aduc tensiunea in limitele fiziologice si sa revin la somn.
Mama voastra de clienti rasfatati! Sa va dea Dumnezeu cite un Tanase pe cap, ca asta meritati.
Nu mi-am dorit de multe ori sa fiu propria mea sefa, sa am afacerea si unica responsabilitate. Si putere. Dar cu singuranta mi-am dorit mult, mult, mult de tot azi-noapte...
Sa fi fost vreo 12 jumate, in miezul noptii. Am muncit tot weekendu, si a fost foarte aglomerat. Dormeam linistita, visand la te miri ce. Dormeam si ma odihneam, cind deodata clasicul tiriit al telefonului de serviciu. Trr, trrrr. Buimaca, ingaim ceva si raspund....cind, ce sa auzi, o femeie...
care nu zice nici buna seara, nici nimic, si incepe sa imi reproseze in urechea adormita. Care era nemultumirea principala a clientei? Ciinele ei latra in continuu si ea nu putea sa doarma.
Eu incerc sa continui profesionist anamneza...vomita? Nu. Maninca si bea normal? Da. Alte semne de boala? Nu. SI CE VREI SA FAC EU FEMEIEEEEEE? Imi vine mie sa urlu. Nu se opreste aici. Sefa mea, un chirurg cu mare experienta, i-a sterilizat acest catel acum vreo saptamina (am vazut operatia, impecabila) si de atunci nimic nu a mai fost la fel. De ce nu mai e la fel? Incerc sa-i explic ca ce are Ana cu Caiafa, nu are nici o legatura. Deja incepe sa plinga isteric la telefon. O intreb de ce plinge. Zice ca nu poate sa doarma din cauza ciinelui si e obosita. Mie imi vine si mie sa pling. Sa pling sau sa injur, sau amindoua in acelasi timp.
Nu vrea sa vina la clinica sa vad ciinele.(Taxa de urgenta, eheee). Perfect, inchei eu amabil, vino miine dis de dimineata la clinica si colegii te vor ajuta. Imi vine sa ii zic "Noapte buna" dar mi-e teama sa nu sune prea sarcastic. Am inchis si dupa aceea mi-a luat cel putin juma de ora de frikinit in pat, sa imi aduc tensiunea in limitele fiziologice si sa revin la somn.
Mama voastra de clienti rasfatati! Sa va dea Dumnezeu cite un Tanase pe cap, ca asta meritati.
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