My days off

Well, it is back to work for me today...at least I am off the floor though and in ICU 4p-4a--well I am on the floor from 1a-4a but I can handle that. So my days off, what did I do...I slept half of Sunday away, then woke up and went to the Mayfair mall...it is this huge, 2-layer mall, definitely not as good as the Mall of American in Minneapolis, but the best around here...although it does not have a Nordstrom's..which may be a good thing after all but I am still disappointed. So then I came home and went for a run and ate some Sushi I had picked up...didn't even know I really liked it until I ate it with a friend in Madison one night and turns out I absolutely love it!! Now I eat it all the time...there is a very good little restaurant around here where you can get it! Then I sat around and didn't do much. Should have studied but just couldn't bear to think about work yet. I started my on-call at midnight on Sunday (until Midnight on Monday)...never got called in thank-god. But it kinda prevents you from doing things. Although I still did. Let's see, my day started out and I was awoken by my doorbell ringing, confused, I wasn't going to answer but then did and it was delivery man with roses, chocolates, and a teddy bear for me!! Awww...Roses went up on top of the bookshelf because cats immediately started to devour them. I like getting flowers, makes me feel like someone likes me!! Makes me smile! So anyhow, then I got dressed and went to this little cafe by my house - 'Cosi' - Kevin and I had first went to one in Columbus Ohio when I was there on externship and it has awesome sandwiches. So I got a sandwich and vanilla latte and sat outside by myself, it was very relaxing. I am learning to go places by myself and sit and eat and not feel so stupid. It's fun. I walked around the shops a bit by the cafe and then came home with the intention of studying but of course fell asleep instead. Woke up in time for dinner over at my ternmate Jason's house. His wife made spaghetti and brownies...it was very good...Katie our other ternmate came to...was over there until around 9:15pm then came back home and tried to study but ended up putting myself to sleep! So I gave up and went to sleep, but woke up at 3am wide awake so I read again for an hour and then tried to fall back asleep. I have so much trouble sleeping now. I hate it. So I had my alarm set for 7am, was going to get up, go for a run and work out, and then study....got up, looked at clock and it was already 12p!!! I hate this schedule, I loved being a morning person, up before anyone else, getting to see the sunrise...hell I don't even see the sun set anymore...it's only for a year- have to keep telling myself that. So now I have about an hour to read through some stuff before heading in to work...is it July 8th 2008 yet??? Anyone have a time machine?

My busiest days yet

Finally a day off!! I just came off of two of the busiest days ever. I was the 2p-2a Fri and Sat….me and Jason my ternmate got absolutely plowed over!!! I walked out the door of the clinic at 9am on Saturday and came back at 1p…2 hours of sleep…I was dragging on my Saturday shift, and of course we were busy-from 5p to 2a there was always at least 5 waiting to be seen!! On Fri I admitted 5 patients, euthanized 4, had one DOA (dead on arrival), and saw millions of outpatients. Sat I admitted only one, had 2 DOA’s, euthanized 3, saw millions of outpatients. So what did I see…had a hit by car-head trauma-not walking-anisocoria (uneven pupil size)-swollen head-not walking, took abdominal and chest survey films—no damage seen yet, but can take 24-48 hrs to see any changes, placed on fluids, gave dose of mannitol and lasix (for brain swelling), placed on a fentanyl CRI (for pain control), elevated head 15-20%...so how did she do? Well, looked like death on Sat then all of a sudden shook her head, got up, and went for a jaunt around the CCU—still hooked to her fluid lines!!!! Yay!! Admitted a patient with pancreatitis (inflammation of pancreas) causing post hepatic biliary obstruction because of all the inflammation. Placed on fluids, antibiotics, placed nasogastric tube for feeding. Dog doing ok, its an old dog so that doesn’t help it any. Saw a kitty who had onychectomy (declaw) performed a few days before and was still bleeding, so had to rebandage the paws and send him home with a cone on his head! Poor kitty! Did a laceration repair all alone—at 6am in the morning after my shift,,,it was cool but I am sure that the owners wouldn’t want to hear that I was half asleep while doing it!!! Incision looked good though if I do say so myself. Dog will be fine. Admitted two baby birds again….why can people not leave nature outside,,,,I am too busy, please do not bring it in to the ER on a Fri or Sat night when there are dying animals waiting to be seen…that is not the time for me to be wasting my time seeing a baby bird that fell out of a tree! Sorry but there are dying pets waiting for my time and it’s already past my shift. Saw lots of vomiting and diarrhea of course…always see that…saw some respiratory cases…did a necropsy on one of my DOA patients. Had a dog with a rawhide stuck in its esophagus, did endoscopy to push it into stomach, it will likely dissolve there..bad thing? Dog now has aspiration pneumonia (aspirated his vomit while choking on the rawhide at home)…not good…especially since it was a 14 year old Husky…old pets don’t always do as good. But for the owners bank accounts sake ($1200), hope that he does ok. Placed him on sucralfate (antacid, coats stomach), famotidine (antacid), unasyn (IV antibiotic for the aspiration pneumonia), and nebulization/coupage. He was doing ok when I left, lots of inspiratory effort (could be tracheitis) and occasional expiratory grunt. Hopefully owners will let us re-take radiographs in the morning of the chest, because I took them right after the procedure so some of the lung artifact could be positional due to anesthesia (atelectasis-lung collapse-can occur during surgery) so want to see what they look like this morning, maybe aspiration isn’t as bad as it originally thought. Although, when pulled out endotracheal tube (breathing tube) after surgery, there was a thick, green mucous inside the tube, smeared on slide and tons of degenerative neutrophils!!! Not a good sign—usually means severe inflammation. It’s so sad, it is so busy there and I see so much but then I come here to try to write about it and cant remember. Lots of DOAs in the past two days…always sad because the owners are so confused about what happened, you always have to make them feel like it was not their fault, even if sometimes it might be. One sad one was a 2 year old cat that the owners found dead in the bathroom on the rug. My thought was probably seizure or vascular event (stroke), but could also be poisoning or other disease. Who knows. Well, I guess I will get going. It is about 8pm and I am getting tired again but should study some. Went to mall today, finally got groceries, went for a run…relaxed, it was nice!

Another year older

First off..happy birthday to me…27!!!! Well, I have had two extremely busy days at the clinic. I have gotten swamped!! Have been working the 2a-2p (2p-8a is actually the shift!!) which means as you all know that I am on the receiving floor. Tuesday night I saw almost all the cases that came in…I have been working with the new intern so I feel for her…know I know how hard it was for the others to work with me when I first started. The one good thing? The Wrath has turned its fire on her, so working, although busy as heck, has been more pleasant the past two days…amazing how that works….job can actually be quite enjoyable and fun when someone is not degrading you the whole time…THIS is why I am here. So yes, spirits are a little better…have been seeing so many cases it’s amazing…I get excited thinking about how much I am going to know at the end of this internship…and darnit all…you knew it would happen.,…you start to enjoy it, get the hang of things and what happens….hmmm….the word Residency once again starts to take on meaning in your mind. Still a no, but if I enjoy this anymore I’m afraid I might be applying for another 3 years of slavery!! Stay tuned…! Ok, so what have I seen the past two days? Another wildlife bird with an open wound on its back-did I humanely euthanize-nope, you guessed it-pain meds and supportive care overnight and wait for wildlife to pick it up in the morning…I do have to say though, this one was not an ugly sparrow, it was a pretty gray with a spike that was black and red and white on the wings, not sure what kind (I know Kevin is cringing right now because he probably knows the species!!!)…in my defense, I did not have time to eat dinner let alone try to figure out what kind of bird it was—doesn’t change my treatment plan—doesn’t really matter then. Saw a cat with a large ventral cervical (neck) mass that came in as a Triage stat..vomiting up foam/food, gasping for air…intubated (with difficulty), suctioned the airway—got a lot of vomit—not good for the lungs—then found the large mass—highly likely malignant neoplasia that is already compressing esophagus and trachea (thus the vomiting and gasping)—poor prognosis—unfortunately humanely euthanized, but probably best choice, cat was suffering and suffocating in its own vomit—sad though—kitties are hard for me—I get too attached—and I see Webbie and Patchie each time I see a kittie. Another kitty comes in, open-mouth breathing, salivating, exaggerated swallowing. On PE, lungs sound harsh and there is a severe expiratory effort (this means lung parenchyma involvement…likely pneumonia or some other process). Also upper respiratory congestion (this explains the exaggerated swallowing—post nasal drip=he is swallowing his snot down the throat because of the extreme congestion . My plan: thoracic radiographs to include cervical region, sedated oral exam (in case of laryngeal mass that I am missing), hospitalization on fluids in oxygen cage overnight..$700-900. What I did? Sent the cat home on oral antibiotics in case of URI (upper respiratory infection—usually viral in kitties, but they usually get secondary bacterial infections so that’s why the antibiotics) and pneumonia…and explained to the owners that their cat may die in the car ride home…he needs oxygen and supportive care…he is working very hard to breath…but I think they may take to rDVM tomorrow, I hope. Wife would have done everything, darn hubbie said not spending that much on a cat!!! Men!!! Saw a vomiting cat, placed a nasogastric tube to suction the stomach, set up to get endoscopy today. Saw a collapsing Golden Retriever…remember what disease this is? Hemangiosarcoma, that’s right, big abdominal mass, anemia…but owners want to talk with their vet prior to making any decision so I actually did a blood transfusion on this one and supportive care overnight…final decision was to be made this morning…Poor prognosis..absolutely no treatment, only prolonging life so owners can have more time…sometimes I am not ok with that..sometimes it is time to say goodbye…and sometimes your animals are telling you that…you gotta listen and let them go play in that big dog park in the sky! Saw a Persian who was run over by her owner (yes I don’t know either why you are letting you Persian walk around outside!!)..ran over tail, large degloving laceration (skin pulled away from tail down to vertebral column)…extremely painful in tail and hip region (uh oh…fractures?)…well I don’t know because owners didn’t want to spend the money on radiographs and wanted to discuss with their vet in the morning and transfer there for care. Ok, but then night goes on and bloodwork: anemia (bleeding somewhere? Who knows don’t have money to check), elevated renal values and no urine produced despite being on fluids…very tiny palpable bladder (Big Uh OH…ruptured bladder, damaged kidney?..Ruptured ureter? Once again I don’t know…but this will kill the cat first…hope they made a quick decision this morning)…my best guess? The cat needs surgery…STAT. Saw a couple suture removals, those are quick and easy. Saw a dog with acutely painful abdomen…bloodwork absolutely normal, radiographs normal, send home to monitor. Could be gastritis or early foreign body…recommended taking to rDVM this morning for repeat radiographs and possible ultrasound if continues. Other thing I worry about,,,they fed him some hot dogs…pancreatitis? Don’t know…we’ll see. Another dog…painful abdomen, trying to bite my hand off. Once again normal radiographs…didn’t do bloodwork because too expensive…owners will watch and take to rDVM if continues…sent home with NSAIDS for pain (yes checked renal values…they were ok). Allergic reaction dog—swollen muzzle, swallowing exaggerated (likely swollen throat), hives…gave injection of diphenhydramine (benadryl), sent home with benadryl. I can’t even remember what else I saw…there were a bunch more, lots of vomiting animals—some people go for the whole shebang (bloodwork, metabolic work-up, radiographs, hospitalization) other choose radiographs and at home supportive care, others choose to withhold food and try bland diet…saw some diarrhea cases—same treatment as vomiting (plus fecal and can send home on Metronidazole and dewormer). See lots of animals in respiratory distress…once again some owner go for full work-up and others choose to watch and wait. I am learning fast that you can’t save them all, can’t do everything you would like to do for every animal, but that is when it gets interesting and you have to use your brain to come up with a good plan for that animal that fits with the owners budget…what is going to kill them first…treat that and then go from there… I enjoy what I am doing….I just don’t like the hours but they don’t call it an internship for nothing…Gotta head out to rounds now…then probably back home to study.

Day Off

My day off is almost over. Slept most of it away...was on 4p-4a last night, walked out of the clinic this morning at 8am...long night..started out with a respiratory arrest that needed CPR and unfortunately did not make it. I had 8 patients in ICU...started out with my most critical patient, a dog with Bradycardia (heartrate was 30, normal is 100-120) Yikes!!! Hooked him up to ECG, sinus bradycardia...what causes this? heart electrical problem (sick sinus syndrome), other primary heart disease (valve or myocardial), increased intracranial pressure, systemic illness, vagal influence, electrolyte abnormalities...start the work-up...ok maybe not, too expensive for owner so we will just do an atropine response test to see if the heart responds, if it does then systemic illness and vagal disease is most likely although still could be an electrical abnormality in the heart...so what happened? Administered atropine Iv, heart rate increases to 130-140, dogs walks around feeling great because he is finally getting blood pumped throughout his body...next up, complete work-up to search for systemic/metabolic disease...if that is normal then its off to the old stompin' ground UW-Madison for a cardiology consult and likely pacemaker implantation...owner still deciding when I left. By this time it is 10pm and the doctors on the floor are getting swamped so I am pulled onto the floor to see a nice friendly gray cat who has been straining to urinate...I palpate bladder and sure enough feel distended, rock-hard bladder...yup he's blocked....then it's into the room to discuss FLUTD (feline lower urinary tract disease) with the owners, treatment options...oh and by the way it is $900-1100 for the first 12 hours..he will likely spend at least 2 days with us if not longer...amazingly owners always go for it...(this is because kitties have a special place in your heart!!)...so it is in to procedures to unblock him and then he's off to ICU on fluids and indwelling urinary catheter and pain meds..ok that's 9 I have now. Next up is a 2 pound Min. Pinchser (yes she was adorable),..unfortunately she got under foot and now has a crooked front leg and is mad painful....i do radiographs...diagnosis: simple complete transverse fracture of the radius/ulna, I place a Robert-Jones bandage and splint and send her home (after a pain injection) so that she can go to her vet tomorrow for cast placement...ideally I would have placed an IM pin and external coaptation or a bone plate...too expensive for this owner. It is small dog night because I then see a baby Chihauhau who awas bitten in the elbow by her sister and is now limping...I feel no broken bones and she doesn't seem painful over the bones, however I am worried about the joint space...owner does not want to pay for radiographs though so I clip and clean the wound and send her home with NSAIDS (of course I did an AZOstick first, Duh) and Clavamox (antibiotics) and instruct them to monitor her closely because I tell them I am concerned about joint involvement...they love this little dog and I am confident if she worsens they will bring her back so I feel a little better about no rads. Lastly I see a wildilfe sparrow that someone has found in the street and brought in...I suspect fractured tibiotarsus (its shin bone) and dislocation of the shoulder joint...cant do much becuase it is wildlife so I place in in a warm cage with food and water and IM (intramuscular) pain medications..wildlife officer will pick it up in the morning and it will either get rehabilitated or euthanized...sad but at least I have done my part to stabilize it and make it comfortable in the meantime. It is now 3am and I have got 7 ICU patients to examine yet as well as I am now the primary doctor on the floor since 1am...so I head into ICU at 3am and pray for no more triages... I examine the police dog who is just here for boarding, the dog with the allergic reaction and swollen eye, 2 more urinary blockage cats who I had unblocked the other night, a cat with URI (upper respiratory infection), my puppy from last night with pneumonia, and I check in on my heart dog....oh great his heartrate is back to its old 30bpm and he is laying there like he has no energy to move...well, I have done what I can now we just wait for the owner to decide what he would like to do...so I visit with him even though I have no time and jostle him around a bit so that his heart rate at least increases to 50bpm. I also start Theophylline to try to see if it works to increase the heartrate...there is a paper out there showing it's efficacy so we are trying it to see...It is now 4:01am and they call a triage...thank-you I am off the floor...I let the floor nurse triage it to me though because at the moment the 4a DR is not in the room...It is a dog that ate a whole bag of macadamia nuts overnight...these are toxic to dogs (cause v/d and also hindlimb weakness by a yet unknown mechanism)..dog vomited up a lot of the nuts at home and was very lethargic but is now doing good out in the lobby...i ask nures TPR (temp,pulse,respiration)...dog has tachycardia at 210 so I am a little concerned and about to go take the case when the other 4a dr walks in...thank-god...so I triage to her and the last I heard she is talking on phone to poison control because the dog is weak in hindlimbs...do we make it vomit? I am not sure what happened....I round my cases to the 4am ICU docs and then sit down for 4 hours of paperwork then it is home to my own negleted kitties who sit and watch me shower and then crawal under the covers and sleep away the morning with me. I only got 4 hours of sleep because at noon Kevin called and then AT&T called and so I gave up on sleep and instead got up and went for a run. I then showered and went to get a haircut...yes they cut it too short but I have not enough energy to even worry about that at this time. I am learning to live with no sleep and tiredness. Tomorrow I am back on the floor 2p-2a as well as Wednesday...then I have Thursday off...I have found that I take it one day at a time now...getting through one day to the next...until finally it will be July 8, 2008 and I will be able to walk out of the clinic for the last time!!! Then where do I go? I have got to start thinking of that and looking at clinics....I want a big city somewhere....I like having things to do and I want a large clinic with capabilities to perform diagnostics and treat so that I do not have to refer all my cases out to another clinic...maybe Minneapolis...maybe the west coast...maybe Boston...likely not WI...have to look around to see where clinics are...unless I try for internal med residency...in which case I would want either UofMN, UW, Iowa, or MI state...somewhere in the midwest near family and friends...because 3 years is a long time....i want to be able to see them every once in a while.

Longest Shift Yet

Ok, where to start. I just did my first 19 hour shift last night. I was the noon-midnight person and I walked out the door at 7am!!! Me and my ternmate Jason got slammed last night. Triage stat after Triage stat...for those who don't know what Triage stat means, it is this...you drop whatever you are in the middle of and run to the front of the receiving floor to perform the ABC-loc's on this pet (airway, breathing, circulation, level of consciousness). It does not matter how many other patients you are dealing with at that time. Do, we were there, side by side with our triage stats the entire night...in addition to 5-7 regular appointments in the waits at all times. What does this mean? This makes for a long night...because you know you are going to be catching up on paperwork at the end. I admitted 3 patients into ICU, 2 of those I had to do procedures on...I euthanized 3 pets...and saw many outpatients. Saw my first pet covered in maggots from head to toe...have you ever seen them? They look like little moving rice grains...and if you are quiet...they sound like rice being shook in a bag...or kinda like rice krispies with milk...snap,crackle, pop...unfortunately that old girl will now be playing in the big yard in the sky. Unblocked a urinary obstructed cat last night all by myself and explored some bite wounds and sutured them up...all of this occurred between the hours of 2-4am (keep in mind this is already 2-4hrs after my shift is up!!) But, that is what happens when you are busy..all your surgeries get pushed back to when your shift is up...so that means you are in for a long night...as I experienced last night. I absolutely love the medical aspect of the job, caring for the pets...I just hate that you are over-worked here with not enough help...more doctors are needed at night on certain shifts...I feel like people come in and wait hours for their pets because sometimes when its busy and there are Triage stats coming all the time it is like 2 hours until you can get back to the first patient you were dealing with... What else did I see...ear infection, tiny kitty with URI (upper respiratory infection)...there were many more, cant remember them all at this moment...still a little tired. ...that said, one thing I am learning is that I have gotten a ton of compliments on my personality...may people thanking me for being so kind and so thorough...I have gotten numerous hugs...numerous thank-you's...people who say that if they come back they will ask for me....that makes all this worth it, makes me feel like at least I am doing a good job in the clients eye, and afterall, it is their pet I am taking care of and they should be satisfied first. ...So I go back and forth on the Residency thing...do I want to put myself through another 3 years of this?...no way...I think I will look for a job after this...sitting here in this city with no one else I realize how utterly alone I feel...and already after 3-4 weeks I can see that I am starting to lose contact with people I care about...I can't imagine who I would have left after 3 years!!! Besides, and I NEVER thought I would say this...but I want a family and kids...somewhere between my life almost completely falling apart in vet school and being completely alone here I realize that I want my life to come first, not my career...I am realizing how career can satisfy you only to a point, but you still have to come home to a lonely house at night....who wants that? Not me...I want family, vacations, kids...so that when I look back at my life when I am 80 I have something to show for it...not just an old used stethoscope and a bunch of used medical books. Hope things are going good for all of you. Kevin, hope you and Cosmo had a great time camping this weekend...wish I coulda stopped down at least to visit...sit around the campfire abit...Mom & Dad hope you got the upstairs bathroom all refurbished--the house is looking amazing. Jen & Nick--hope you are not frying to death down there in the desert--Jen not too long until you come back home for a little break and to look for permanent residency back in the great midwest!!--I am excited about that--means I will actually get to see my sister more than once a year!!--then we can go out and have some more good times and find some one ways to drive down the wrong way!!! Gram & Gramp--hope things are going good--hows softball---keep fishin' on the lake--wish I could come and spend summers on the lake like we used to growing up! Ok, I should go for a run and read a little in my few hours before I head back to that place. I work 4p-4a today. Then I have Monday off...which I will sleep away most of but oh well just knowing I don't have to go in to the clinic is a great feeling, even if it is short-lived. Till later...

My Days Off

Well, this is the last of my days off...didn't do a whole lot...was hoping to have headed out of town but that didn't work out so much...not a surprise. Haven't gotten called in....that's lucky. Been studying, I'm getting too smart...can't stand myself....yeah right I wish. Back to work tomorrow, not looking forward to it, but at least it is the noon-midnight shift so I won't be there as late. Then I start some ICU shifts which I am looking forward to...a little time off the floor every now and then is nice.

There has been an Itatlian festival going on in Milwaukee this weekend...which has been cool because they set off fireworks each night so I got to see my fireworks finally,....since I was stuck inside the clinic on the 4th of July and missed the whole celebration. I miss Lake Florence in Stewie...bringing a blanket and bug spray...camping out on the shore and watching the fireworks fall over the lake...its weird the little things that end up being some of your best memories.... but I digress...

Oh yeah...got paid for the first time too...although it isn't a lot, it is at least some income that I have not had for the past 4 years.

What else, I bought a new car. Traded in Lila the Tracker for a new 2007 Nissan Sentra...I missed the Tracker and felt bad trading it in (like it was a pet) but got over it very quickly...I love the new car. So no more cotton ball blowing around in the wind...

Kitties are adjusting. Webster looks great, he is eating and filling out again. Apache of course is eating...I don't think she has ever stopped. They both wait for me to get home in the morning and then we all crawl into bed and fall asleep...me in the middle and a cat on each arm...Missing Cosmo like crazy, but at least Kevin keeps me up to date with email photos of him...I also get pictures of the fish too!!! Funny boy!

Ok, well I am going to get back to studying...learning about shock, DIC, SIRS, and heart failure...why? Because those are the stat traiges that come in that I am scared to death of because I don't quite feel comfortable treating yet....I am getting there....Each day I see something new...which is great...I will definitely learn a lot this year...

"It's not what you are that holds you back, it is what you think you are not"

Welcome..Let's see how this works

So here I find myself still stuck in Wisconsin...not at all where I pictured I would be but I am going to make the most of it. I am starting a new career, just moved to a new city, have a new apartment, meeting new friends...not really as scarey as I thought it would be...it's a chance to start all over...re-invent myself...learn who I really am...find happiness and peace again...calm down...stop worrying so much...and just have a good time. So I am ready for this thing they call real life...ready to become a slave to my work for the next year (god bless my family and friends for sticking behind me in my decision to disappear from their lives for the next year...and thank-you from the bottom of my heart to those who vow to still be around when it's done, you are my true friends...my heart goes out to all of you...I would not be able to do this if you weren't there by my side the whole time)...and finally....ready to figure out who I am...wonder who I'll become...hmmm, interesting. Below you will find my life put into words...a sinkhole into what is now my life...I will try to explain things...I'll include pictures as I get them in my Photos section...enjoy...dont judge, just listen...I may be down at times, but if you all stand by me I will keep smiling... Well, I am sitting here in my apartment actually starting up this website...I have had a few days off...Wed, Thurs...and now I am on call as of midnight until 12am Saturday. I was hoping to leave town on my days off...but no, they schedule rounds for us right in the middle of the day, so no, I am stuck sitting here by myself on days off. This internship is very hard...12 hour shifts are actually 18-20hr shifts. I have been working 2p-2a but not getting out until 6-7am. Then its home to shower and hop into bed for a few hours before getting up and repeating everything again. I usually work 3-4 days in a row...and that is enough...any more than that and you are dragging...this clinic is very busy and so 18 hrs goes by very fast. I have so far been on the floor which means I am receiving cases my entire shift. I have to say it is cool to finally be a doctor and to be able to perform the diagnostics, figure out what is going on, and cure the patient...I really enjoy that part. The bad thing is that we are so busy that you don't always have time to think about the case or read like you would like to and figure out more...I guess that is ER for you though. I am learning to juggle the huge number of cases...learning that I am only one person and that if the case has to wait then it has to wait because I simply cannot be in two places at once. I have unfortunately gotten very comfortable performing euthanasias. Not a night goes by that I don't perform at least one...and I don't like to say I am getting hard, but I at least do not always feel like crying anymore...although I will admit I have shared a tear with one or two clients...and I probably always will because no matter how much you know it is time to let go...actually letting go of that special friend is completely devastating... I am a cat person...I love Cosmo to death, but only him...however, in the clinic...cats are NOT NICE!!! They bite and claw and make physical examination impossible. A lot of times I find myself doing my physical exam on a sleeping cat....after I have knocked it out with a heavy dose of sedative!!! This is so that I can actually open the cage door and look in see that..yes, indeed that is a cat in the carrier. I read a saying the other day that went like this: "if you are unmotivated, lethargic, listless, prone to wild mood swings, and have a sporadic appetite...you are either a very depressed person or a cat." Hmmm, maybe I am part cat? I do not know what I am going to do tomorrow. I am on call so I have to sit in my apartment and stare at my phone for 24 hours...and hope like hell it doesn't start ringing...that is bad to say, but come on, I need time away from that place. I should be sleeping now in case I get called in but I have found that I cannot sleep now because I am used to staying up until 6am and then sleeping....it messes me up. Days off make me realize how alone I am here...but life goes on... Well, I am going to head out...to bed that is..try to sleep...might open up one of my text books...that puts me right to sleep!!! This is my favorite time of day...because I get to cross off another day on the calendar...and I get to sleep so that I am not thinking of how much I am not enjoying myself and how much I miss certain people in my life...(and one small black and white bug-eyed boston terrier!)