Thoughts on Thanksgiving

Tonight, my emergency room is near empty.  My only patient is a blind and stuporous head trauma victim with a broken jaw.  My stomach if full.  My heart is swollen with gratitude.  My mind is wrapped in reflection.  It is Thanksgiving.

Watch where you're going...but not this close!

This young healthy boxer walked into our exam room wagging his tail.  He was actually so hyper that we were unable to examine his injury without sedation.  The owner explained to us that the dog had been outside playing and when he returned to them, he noticed he was having an eye problem.  It appeared that his pet had ran into a stick. 

I examined the pet as best I could and explained to the owner that I was unsure what to expect until I could open the lids, pull down the third eyelid, and examine the globe.  I suggested that he prepare himself to hear that the eye would need to be removed, judging from the size of the stick. 

We anesthetized the boxer and began a thorough exam.  To our surprise, we found an intact globe that was very inflamed.  The stick was positioned directly under and to the left of the globe.  The iris still had tone and there was no blood in the interior eye chambers.   Could this be as simple as just needing to pull out this small stick.

We flushed the wounds with antibiotic solution and began the extraction.  I pulled slowly and gently....and the stick just kept coming!  Amazingly, this stick was at least five inches long!  Again we flushed to remove as much remaining bark, splinter, and debris as possible.  We reexamined the eye.  Aside from the deep wound, there was only a small wound to the globe from having rubbed against the stick during eye movements.  We dispensed an eye ointment, some antibiotics, and some antiinflammatories and asked the owner to see his regular veterinarian to check this eye as soon as possible.  Since I saw this pet at the emergency clinic, I was afraid we would not get to hear or see from these two again and be left wondering whatever had become of this eye injury.  

The owner did stop by two weeks later just to say thank you.  He told us the dog did excellent after the foreign body removal and appears to have no problems with the eye at all.  His veterinarian reports no complication, good healing, and excellent vision.  Had we not had these pictures, you would never know that this pet has been injured!

A Chance to Bite Back

The 16 week old pit bull puppy sat cowering on the table.  Its right front leg a swollen and mangled mess.  "How did this happen, " I asked again.  She had already told me once about the accident, but she had yet to look me in the eye.  In order to help all involved, I needed the truth.  The owner, an attractive young blond stood by the exam table with no shoes on her feet.  Her beautiful but swollen facial features were coated in a thick layer of make-up.  It was a valiant but failed attempt at hiding her black eye and the bruises on her cheeks.  "My boyfriend shut it in the door.  He didn't mean to.  He was in a hurry to leave and slammed the door on his leg."  I moved to touch her cowering puppy and it screamed in anticipation of pain.  Tears welled up and spilled down her face.  This was not the first time in its young life it had experienced pain from the hands of a man. 


The faces and injuries change, but the scenarios are always similar.  The pet, a frightened or aggressive nightmare.  The owner, a timid woman, enveloping the pet in a protective and comforting embrace.  The tale of the injury always told to the floor,to the pet, to the wall, but never to my face.  The man in the picture is almost always absent from my exam room, but will receive a tearful phone call to beg permission to spend their money for the animal's care. 

East Tennessee Lead Poisoning

About once every two weeks I am presented with a familiar scenario.  An angry owner, frantic and covered in blood, carries in a pet.  I end up asking the client to quieten down their livid threads of death or injury to the neighbor who shot their dog so that I can auscult the chest.  I end up taking x-rays that show trails of bullet fragment through legs, chests, and abdomens.  Often I find that there are old bullets and pellets in the pet from previous incidents.  Almost always these pets are sexually intact and free to roam.  We call this east Tennessee lead poisoning.  It is one hundred percent preventable.

Curly, A Love Story

As a young unmarried professional who had just moved to a small town, I found dating awkward.  I was suddenly thrust out of the familiar circles where everyone was my age, single, and looking.  I caught myself lingering a bit long in the produce section.  I admit to sitting in bookstores pretending to read books, when I was really scanning the room.  I believed that she was out there....but how would I find her in this small town?

The town to which I had moved for my new job was Cleveland, Tennessee.  I had never heard of it before moving there.  It took me only a short time to realize that I had moved to the town of the international headquarters of the church of God and Lee University, a private church of God university.  I was a young single doctor in a pentecostal town.  God help me.

I didn't get it at first.  Overly friendly mature women with big hair would bring in their pets to see me.  They'd complain of a vague problem their dog was having.  I would examine their pet and find nothing wrong.

"Am I this bad of a doctor," I would think, "I can't find any reason that this dog is doing what she claims." 

I would offer tests to rule in and out possible causes of the vague illnesses.  The mature women would politely decline and elect to "just watch it."  Then, before I could excuse myself from the room, they would pull a red-faced youth up from her seat and push her forward. 

"Dr. Dolen," they would say, "have you met my daughter?"