Occasionally when I work overnight, I have the pleasure of working with one of my close friends (Dr. Z) on swing shift. This particular individual is a wonderfully chill, smart, funny veterinarian who just so happens to be a shit magnet. We all moan and groan when she says she’s stopping by the hospital because we know the minute she walks in all hell will break loose. The story I have for you today entails one such evening when I worked a shift with Dr. Z.
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I walk in and mayhem is immediately evident. There are about 20 hospitalized patients and already 6 triages waiting to be seen. We quickly round then immediately dive into the triages. After working for several hours, it is nearly time for Dr. Z to take off for the evening and leave me to work the overnight shift alone. Surprising no one, a STAT triage is called. I am already working to get an intravenous catheter and sedation into a dog with respiratory difficulty due to congestive heart failure. Dr. Z cordially agrees to stay a bit late to take this last case. The technician comes running back with a cat (Muffin) that is yowling at the top of her lungs. Muffin is tilting her head to the right, her eyes are jumping back and forth (nystagmus), and she is drooling profusely. There is a terrible malodor to Muffin that can’t be ignored, and a severe ear infection is quickly suspected.
Dr. Z goes to meet the owner and obtain a full history. The owner is a paramedic who has driven his cat to the hospital this evening in an ambulance… Because this is a normal scenario… (Insert here: Emoji with the hands on his cheeks and the white eyes of awe). Also, the owner is high. Naturally.
The history is as follows (sarcastic mental comments noted in italicized script): Muffin spends a significant amount of time outside (oh, lucky girl) and is not currently on any flea, tick, heartworm prevent (why would she be?), and she was totally fine until just now (of course she was).
Please note: It is hard not to get jaded when working emergency. I recommend dry sarcasm, a sense of humor, and wine after work, but that’s just me.
Dr. Z takes it all in stride – she doesn’t skip a beat. She obtains a swab of the ear and looks at the material under the microscope.
All of a sudden, one of the technicians hollers my least favorite phrase: “Can I get a little HELP OVER HERE?!”
This particular phrase always sends chills down my spine because it means something terrible is afoot. There is an incline in the volume and terror in the voice that always accompanies this series of words. It screams: impending doom!!
Dr. Z runs over to Muffin, who has promptly decided to try to die. Her pupils are dilated and she is stretching out and paddling with her front legs. The technicians quickly get an intravenous catheter into the cat and provide flow-by oxygen while Dr. Z runs up to reception to speak with the owner.
Dr. Z explains that Muffin has declined rather quickly and she is about to arrest. She explains that, unfortunately, it is not clear at this time what is causing Muffin to be sick. She has an obvious ear infection, but that finding does not explain her decompensation. Dr. Z asks if the owner would like CPR performed, and the owner says “YES, of course!”
Dr. Z returns to the back/treatment area and starts to work on Muffin. She places a tube into the trachea to ensure a patent airway and provides oxygen. Muffin’s heart is beating, but she is no longer conscious.
Another triage is called, and I head over to perform a physical exam. In the background, I hear Dr. Z say: “What the fuck?!”
At this, I turn around and see the cat spewing a dark liquid substance that I can only equate to black ichor – something straight out of Lord of the Rings, this I know. The volume and force of the vomitus is like a scene from a horror film. I tell my technician to take the most recent triage to an exam room. I then start to head over to assist Dr. Z when a blur runs past my peripheral vision, and I hear a stranger shout:
“IT’S OK, I’M AN EMT!”
Muffin’s owner has snuck back to the treatment area (shoving past my poor technician who was returning to reception with the next patient) and is running to his cat who is in the process of respiratory arrest (and quite possibly some kind of exorcism). He scoops up Muffin and turns around to make a break for it. Dr. Z, being the magician she is, manages to nimbly grab the end of the endotracheal tube between her pointer and middle fingers and pulls it from the cat as the owner starts to run away. Dr. Z and I lock eyes in a moment of shear amazement. The owner doesn’t hesitate – he sprints out of the hospital with his cat, hops in the ambulance, and drives away.
IV catheter in place.
No Against Medical Advice (AMA) form.
A thousand thoughts run through my mind. Begin internal monologue: Did that seriously just happen? … Whelp, that cat is toast… Why does this shit always happen when I’m here?… My family is never going to believe this one… I swear, I need to write a book about this shit (Insert here: Emoji wink face).
After blacking out for an unknown amount of time, I look at Dr. Z. I half expect her to start crying or stressing about the obvious liability with regard to this case. Instead, I see her nonchalantly type a brief medical note detailing the events of the appointment. She looks up, calmly collects her things, and says: “Ok guys! It’s been a good night. See you next time.”