Y2S2 Week 4: Healer's Art, more Parasites, and Medical Errors!
This week began with a quick whirl around the neighborhood followed by our first quiz of the block. We then dove into two lectures on trematodes (flukes) and cestodes (tapeworms). We then had a little break and so I was able to get in a nice swim at the rec pool. That afternoon we had a parasitology lab which helped emphasize the earlier lectures and review the past week’s material. I then took Churro on a quick walk before heading back to campus to teach the undergraduate KLOHC course. This week’s topic was on animal welfare and how access to veterinary care can be an important factor in the welfare of an animal.

We broke this topic into two main categories, the first was a lack of client education and the other was an inability to obtain care due to physical and financial constraints. These two factors feed into each other, and it becomes a vicious cycle that ultimately results in decreased welfare for the animal. If people do not have the ability to see a veterinarian, they will not have the ability to become educated and understand how to properly provide for their pet. Without this knowledge, they may not easily recognize signs that their animal needs help or is in pain.
Veterinarians have a key role as an educator in the community and if people are unable to access this care, and knowledge, their animals will not be able to receive the care they need to thrive. A person’s proximity, as well as their physical ability to get to the clinic whether that is due to a lack of transportation or physical disability can directly impact the welfare of their pet. This is an important topic to discuss because the pendulum can also swing the other way, there may be an owner with all the money in the world but without proper education from their veterinarian, they may not know that their animal needs help. Subtle signs such as paw licking, scratching, panting, “walking weird”, may seem like obvious issues if you are familiar with animal behavior, but if you aren’t exposed to this information, it is easy to miss these little signs.
It’s a privilege to have the opportunity to talk to undergraduates about this important topic and it is also fun to hear their perspectives on these ideas. The rest of the night was spent studying with Churro.
Tuesday morning started off with a quick run with Churro followed by a hot yoga session. We then had a lecture on diagnostic test selection followed by a lecture on bacterial mechanisms and intracellular bacterial infections. The last lecture of the morning was about the immune system and how it responds to bacterial infections.
During lunch I attended a VBMA meeting where we had a nice talk from Dr. Conn who owns two practices (one general practice and one emergency clinic) on the central coast. It was interesting to hear his perspectives on practice ownership considering that one of the practices was an acquisition and the other he started from scratch. There are multiple pros and cons to each situation and sometimes you must be flexible and jump on an opportunity when it presents itself and just “be lucky.” We then transitioned into a two-hour session on the “money talk.” This session explained how to talk to clients about the cost of services and how to make sure that you are charging adequately. Dr. Clark presented some interesting information comparing veterinary medicine to human medicine and one of the biggest differences is the availability of insurance. Most people have insurance, or access to insurance whereas pet owners are often left in the dark and unsure how to decipher the different pet insurance companies.
Vet school does not inform veterinarians on these options and when it comes down to it, the blind are leading the blind which leaves people feeling lost and unlikely to purchase insurance that may save them a lot over the course of their pet’s lifetime. We also discussed payment options and dove into CareCredit, a common option for pet owners when they are in a pinch.
Initially, CareCredit may seem like a fantastic option, and it can be if you read the fine print. CareCredit will loan the owners a certain amount of money and interest is deferred during the repayment period but is accruing. If the owner pays in full by the end of the term, they do not pay any interest. However, if they fail to pay in full, they owe 26.99%-29.99% interest on the entire borrowed amount, not just the remaining balance. In all honestly, I had not fully understood CareCredit until this discussion and I think that it is extremely important to be educated on these options, or have staff that are knowledgeable about these options so that owners are not left in the dark or get into a situation that they won’t be able to recover from.
The afternoon ended with a two-hour discussion on diagnostic test selection. We were presented with ten different cases and worked as a team to figure out if we would use a direct pathogen detection test or a host-response test. This was a great way to help sift through the earlier lecture material and understand when each type of test would be relevant.
After that session, Morgan and I took a quick walk around the Arboretum before heading back for the first session of the “Healer’s Art” course. Although the name may be a little misleading, this course is NOT an art class. This course was initially intended for medical students and was brought to UC Davis about five years ago with the “hope of offering a safe learning environment for personal in-depth exploration of the time-honored values of service, healing relationship, reverence for life and compassionate care. The Healer’s Art course utilizes principles of adult education, contemplative studies, humanistic and transpersonal psychology, cognitive psychology, formation education, creative arts, and storytelling to present and explore human dimensions of medicine rarely discussed in medical training. Topics covered include deep listening, presence, acceptance, loss, grief, healing, relationship, encounters with awe and mystery and self-care practices. The curriculum enables students to uncover and strengthen the altruistic values, sense of calling and intention to serve that have led them to medicine, creating a firm foundation for meeting the challenging demands of contemporary medical training and practice.” For more information on the course you can check out this link: https://rishiprograms.org/healers-art/
After an initial group introduction and course overview, we were split up into small groups and assigned to a facilitator. There were only six second-year vet students in the course, so we were grouped together and assigned to the wonderful Dr. Serena Brenner. The first session was centered around “wholeness” and things that make us feel alive/excited. A lot of the time vet school can seem like a vacuum and suck up a lot of time and with that some hobbies also seem to evaporate. We discussed things that are important parts of our lives and how we can continue to incorporate them into our busy schedules. I thought that this was a great reminder to be a human first and a vet student second. While this was not novel news to me, it is an important reminder. I know that if I do not prioritize my workout, I am not able to show up as the best version of myself and that is not good for anyone, especially myself. I will not negotiate on the time that I use to train as well as the time I spend with Churro, an A in a class is NEVER that important. At the end of the day, we are all going to graduate and the last thing that a client is going to care about is a gpa. They want a real person talking to them about their pet, not a perfect robot.
Wednesday morning started out with a quick run with Churro followed by Steve’s hot Pilates class! As always, this class was a humbling experience and a fantastic way to start the day! We then transitioned into a mentor meeting and Dr. Macia-Rioseco lead us through a few pathology case studies specifically emphasizing HPAI (highly pathogenic avian influenza). This was a great way to learn more about the current disease outbreak and practice describing pathological lesions. The rest of the morning was spent working on some Symposium activities. I then took Churro for a quick walk before jumping into some parasitology studying. That evening, I spent some time hanging out with Madeline and then studied for the rest of the night with Churro.

Thursday morning started with a nice run with Churro followed by some playtime with his friends on the field. We then transitioned into an immunology lecture followed by two lectures on bacteriology and clostridial diseases. After a quick lunch meeting with our Symposium facility team, we had two lectures discussing medical errors in a veterinary setting. While talking about medical errors is not the most fun thing to discuss, it is important to understand that mistakes happen and at some point, in our careers we are going to have to navigate through an error. Having clear communication and being honest with clients is crucial and studies have shown that having an open and honest approach when addressing an error can decrease the likelihood of receiving a board complaint.
During our discussion, the topic of errors made by technicians and paraprofessionals was frequently discussed. As a veterinarian, technicians and other support staff are working under your license so you are responsible for things that happen even if you are not the one that was directly involved. It was mentioned that veterinarians “consume lot of things they didn’t prepare” meaning that they often take the blame for things that were not directly their fault. This highlights the importance of having a team that you trust and making sure that there are protocols in place to help decrease the likelihood of mistakes.The rest of the afternoon included a nice walk with Churro and some studying. I also had the opportunity to stop by Madeline's clinic and help with some blood pressure recording. It is always a privilege to be in her clinic and meet her wonderful clients!
Friday morning started off with a hot yoga session followed by a parasitology lecture and two lectures on enterobacteria. We learned more about the gut microbiome and how commensal and pathogenic bacteria can cause disease when things become unbalanced. That afternoon, we had time to work in groups and deconstruct some of the immunology concepts discussed earlier in the week. This was a nice way to work through some of the confusing aspects of the lectures and prepare for the upcoming quiz and exam. The rest of the afternoon was spent with Churro while working on some symposium things.
Saturday morning started off with a 6 mile run with Churro followed by a hot yoga session. I then spent most of the day reviewing for the upcoming exam and getting some things done around the house. After church and a 5 miler with Churro, the rest of Sunday was spent studying and preparing for the upcoming client simulation. There was also a hint of acupuncture studying because those exams are only 6 short weeks away!
Quote of the week: “I’m a pathologist so all my patients are dead” -Dr. Uzal

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