Animals and people dictate what happens every day for me. Simple routine appointments can turn out to be complex once the unpredictable yet potent potion of human personality is added to the mix.

A few months back an elderly woman came in to the clinic. Her cat had been suffering for weeks with non-stop itching. As I examined the cat I noticed that this itch was insatiable. The poor cat had scratched and irritated nearly every inch of its body in an effort to satisfy the intense itch. The scratching was so intense, that nearly her entire body was covered with bleeding sores.

A diagnosis of mites was made after taking a skin scrape and looking at it under a microscope. This particular mite is elusive and difficult to find even for the most experienced veterinary dermatologists. However, it is highly contagious.

As I began speaking with the owner about the severity of the diagnosis and the need for immediate treatment, I could tell that her mind was wandering. She was clearly not focusing on what I was saying. I politely asked if I had said something that did not make sense or if she had any questions. Often, the open ended questions will allow a client to discuss their concerns, however, I was not prepared for what happened next.

“Doc, do you think I have what she has?”, her voice was inquisitive. “Excuse me?”, I replied, “What do you mean?” Before I could say another word, this elderly woman dropped her pants. Literally right to the floor. Her legs were covered in large red lesions. They actually looked like checker boards. I learned that day, albeit involuntarily, what “granny panties” look like.

I am easily embarrassed, and when this happens my face turns a deep red. I stammered, “I…. I’m… a… I am sorry ma’am, you will have to go to your doctor for that”. The beet-red shade on my face persisted even after I exited the room.

As crazy as this may seem, I have had worse things happen while going about my daily appointments. However, those are saved for another My Take Tuesday.

My job is never boring. The two legged creatures that come in keep it from ever being so.

And that is my take.

N. Isaac Bott, DVM

The sun reflected off of the windows of the busses as I stepped out of Bustad Hall. I could feel the sweat drip off the palms of my hands. As I walked across the parking lot, I lugged my suitcase behind. I was surrounded by unfamiliar faces. As I boarded the bus, I peered out the window at the long line of strangers. I nervously realized that I didn’t know a single person. As we headed north through the rolling wheat fields of the Palouse, I thought about the upcoming days. The destination was Ross Point, a beautiful camp nestled along the scenic Spokane River. The next several days were to be spent with my 100+ of my veterinary school classmates at an event called the Cougar Orientation Leadership Experience (COLE).  
This program challenges incoming students to define their personal strengths and goals, build community with fellow students and faculty and consider their evolution from students to outstanding professionals. Veterinary schools across the world have modeled their orientation programs after this unique visionary experience first conceived at Washington State University. 
The next several days were filled with challenge by choice activities. I remember getting to know the people that I would spend the next 4 years with. It was a pleasant experience and a time of preparation and reflection. It was so helpful to have this experience prior to beginning a rigorous four-year program of veterinary education. This camp helped acclimate me to professional school, and set the foundation for cooperation and teamwork over the next four years. 
This past week, I returned to the Cougar Orientation Leadership Experience at Ross Point. I joined the class of 2021 as they kicked off their 4 years of veterinary school. I gave talks about the ups and downs of veterinary school and the opportunities that lie ahead following their graduation. 
The experience was surreal. 12 years have flow by so quickly! In so many ways, it seems like just a few months ago, that I sat in the very seats the new students now occupied. 
I saw the excitement in their eyes. I caught a glimpse of the dreams they have. I interacted with them late into the evening each night. It was a treasured experience and a true honor for me to be able to spend time with such a tremendous group of students. 
Time moves so quickly. As I look back on the last 12 years, I see the tremendous growth that I have experienced. The thousands of long arduous hours spent studying while in school are now just a fleeting memory. The classmates who became some of my dearest friends, are now practicing all over the world. 
I have been very fortunate. I have had many opportunities to learn and grow. I have had successes and failures, triumphs and defeats. It has been wonderful! I wouldn’t do anything different, as each experience has helped me become who I am. 
 I love what I do. I have been extremely blessed. The past 12 years have been full of adventures all over the world with animals of all types. I have followed my heart and intuition. It has been an exhilarating ride. I am excited for what the future holds.
And that is my take!
N. Isaac Bott, DVM

It was a busy morning at the clinic. Mrs. Robins arrived right on time for her scheduled appointment. She was a long time client at the clinic and was always pleasant during my interactions with her. Her hair was white, and always perfectly styled. She greeted us warmly as she came through the front door. She carried a white fluffy cat inside a pink pet carrier.
Snowball was her name. Such a name is suggestive of a soft white fluff-ball, a sweet angelic and innocent kitten. She was due for her annual vaccinations and a wellness checkup.
However, this kitty’s name is what I would call a major misnomer. Clearly, this kitty received its name long before its true nature was known.
All too often, I hear the phrase, “Doc she is an angel at home. She is just the sweetest thing.” Mrs. Robins repeated the phrase verbatim as we entered the exam room.
Snowball was sitting peaceful in her carrier. As I peered through the door of her carrier, I noticed a couple of warning signs.
When a cat is distressed, it will crouch in a unique form with the legs and tail pulled in under the body. They will extend their neck, flattening the ears against the head.
Cat bites and scratches are painful and notoriously prone to infection. As a veterinarian, I have to be very careful and observant. A cat bite on my hand could literally make me useless – everything I do on a daily basis, from surgeries to physical examinations, requires extreme dexterity and use of my hands.
“Snowball doesn’t seem very happy today,” I observed, “We need to be careful taking her out of her carrier.”
“Don’t worry doctor,” Mrs. Robins replied, as she swung open the carrier door, “She will come right out.”
Snowballs exit from the carrier was reminiscent of a rodeo bull exiting the chute during the NFR. She came flying out, hissing and swiping at everything in her path.
She leaped from the table and landed directly on Mrs. Robin’s head. She immediately extended her claws on all four feet simultaneously and plunged them into poor Mrs. Robin’s scalp.
Almost in an instant, snowball fell from atop the terrified woman’s head. Clinging desperately to a white wig. As she hit the floor, she released the hair piece and hissed. Mrs. Robins reached down and grabbed the wig and placed it back on her head.
“Wow!” she exclaimed, “She is sure mad at you!”
Dealing with a spitting and hissing feline in a demonic rage is a dangerous predicament, and can present a formidable challenge to any individual, let alone one smelling of vet.
Snowball then looked at me, hunching her back, while aggressively growling and spitting. She leaped towards me, as I jumped back. Her trajectory was clearly aimed at my upper body, and as I moved, she adjusted her posture mid-air and redirected. Her extended claws sank into my pants. I felt her claws sink into my skin and she climbed upward and onto my lab coat. She came to a stop on top of my right shoulder. Ironically, a moment of tranquility ensued. The hissing stopped and she retracted her sharp claws.
Seeing this an an opportune time, I grabbed the rabies vaccine and removed the syringe cap. I had to be supremely careful that I wouldn’t be knocked or in some other way accidentally discharge the injection into Mrs Robins or myself. At last, I found a piece of leg and carefully thrust the needle through a felted mat of fluffy white hair and into the muscle beneath.
Snowball’s reaction was unremarkable. She did not hiss or spit. She didn’t even growl.
I gently placed her back on the examination table and finished the remainder of the vaccinations and the examination.
She purred as I looked into her eyes and examined her mouth.
She entered the carrier without any hesitation upon completion of the appointment. I stood dumbfounded, what I had just witnessed made little rational sense on any level. Aggression like this that is episodic and transient, is something even animal behavior experts don’t fully understand.
“Wow, Doc, she must have just had a little rage she needed to get out of her system,” Mrs Robins stated, “She really is such a sweet little thing.”
I smiled as I glanced at the content Snowball, as she sat purring and comfortable inside her carrier.
My legs began to sting, as I felt a trickle of blood run down the front of my knee.
As Mrs Robins left, I noticed her white hair remained immaculate, and despite having been tossed around and trampled by a wild feline, not a single piece of hair was out of place.
And that is my take!
N. Isaac Bott, DVM

Black Friday:

It was a beautiful Friday in late November. The animals were standing, by the thousands, crowded in the isle. The primitive fight or flight instinct had clearly pushed towards the fight response on this particular day. This mammal known as man is best avoided on the day after Thanksgiving. In years past, I stood in these massive lines just to get a good deal, after all, nothing says “America” like fighting over a TV at Walmart.

This particular Black Friday, however, was spent driving to and from farms in Utah County tending to a variety of sick animals. What began as a perfect day, quickly took a turn for the worst.

The Mare’s name was Dollar. She was a beautiful sorrel. She had recently given birth to a healthy young filly. Shortly after foaling, she developed severe lameness in all four of her feet. Her condition quickly deteriorated and she was barely able to walk when I arrived. To make matters worse, Dollar had developed severe colic, a term referring to abdominal pain in horses. Her intense pain was caused by gut spasms and every few minutes she would suddenly drop to the ground and roll.

Upon arrival, I performed a thorough physical examination. I then administered a mild intravenous sedative and passed a tube through her nose and into her stomach. I then pumped in a half-gallon of mineral oil.

The next treatment in a case like this is to administer a non-steroidal anti-inflammatory to help with the pain. The two most common drugs that veterinarians use in this case are Phenylbutazone (commonly called Bute) and Banamine.

For me on this particular day, I reached for a bottle of Banamine.

With the needle in my right hand and the syringe in my shirt pocket, I held off the jugular vein with my left hand. Dollar didn’t flinch as I quickly slipped the needle into her vein. With dark blood slowly dripping out the needle hub, I reattached the syringe and steadied my hand against her neck. Just then, a gut spasm hit, Dollar jumped up and staggered sideways. I quickly sidestepped in an effort to remain in a position where I could inject the medicine.

Without warning, and before I had injected any appreciable amount of Banamine, she reared up on her back legs. I retracted the needle immediately and instinctively stepped backwards. The momentum of her rearing up and me pulling back made me momentarily lose my balance. I pulled my right arm abruptly to the side of my body to avoid falling over. As I did so, the large bore 18 gauge needle plunged over an inch and a half straight into the right side of my abdomen. The needle entered about 6” to the right of my navel and 3” below my last rib. I felt intense pain as the needle cut through my skin, subcutaneous fat, and abdominal muscle. The hub of the needle was nestled flush against my brown Carhartt Jacket. During my split-second of inattentiveness approximately 2 mls of Banamine was injected directly into my abdominal cavity.

Immediately, I grimaced in pain. The owner of the mare looked at me as I pulled the bloody needle from my abdomen. “Are you ok?,” he inquired, “Did you just stab yourself?”

“I sure did,” I groaned.

The pain was incredible. It was so severe, that I actually laid right down in the stall and waited for the stinging to subside. It felt as though some one was burning with a branding iron.

After nearly a half an hour, I was able to stand up and walk back over to the mare and administer the Banamine properly. I then climbed in my truck and immediately headed to the doctor’s office.

There are some veterinary drugs which are fatal when injected into humans; fortunately for me Banamine isn’t one of them. Although it relieves pain when administered intravenously in horses, I learned that day that when administered outside a vein, the effects are the total opposite.

It stung far worse than any insect sting or abdominal pain I have experienced.

“You what?”, The doctor blurted out, “How much did you inject?”

My physician is unique. His father is a veterinarian. He was raised at a veterinary clinic and spend his youth helping his father in a general mixed-animal practice.  Fortunately, he knew exactly what Banamine was and what he needed to do to treat me.

Afterwards, he laughed as he reminded me, “Hey Doc, keep that needle pointed away from you next time!”

I most certainly learned a painful lesson that Back Friday.

And that is my take.

N. Isaac Bott, DVM

My Take Tuesday: DocBott

I have never been one to shy away from an adventure. I enjoy a good challenge. The result is an opportunity to grow, a chance to try something new and a moment to stretch the boundaries of my comfort zone.

For years, I have been approached by many media groups about putting together a television show based on my daily work as a veterinarian. I have always politely declined these offers.

My Take Tuesday: The Late Night Call

The phone rang at exactly 2:03 AM. I jumped out of bed and sleepily answered, “Hello?”.

Calls like this often come in the early morning hours. Animals, it seems, have the worst troubles while we are sleeping.

“Hey Doc, can you come out to my place?”

“What’s going on?”, I responded, wiping the sleep from my eyes.

“It is one of my ewes, Doc, she has 5 hooves sticking out of her backside!”, he explained with a dramatic tone.

“Alright, I will be right there”, I replied, as I quickly changed my clothes and dressed for the outside temperatures. Situations like this seem to always occur in January, when the temperature is below zero.

I fired up my pickup truck and headed down the road.

Mr. Johnson was a long time client and a good sheep man. He knows enough to get through most situations and is good about calling me before all hope is lost.

Farmers like Mr. Johnson are becoming more and more rare. Large corporate companies have taken over so much of the agriculture industry and have forced the small guys out, sending along the notion that each individual animal has value simply because it lives. The loss of both equates to a disappearance of my favorite part of being a mixed animal veterinarian – the interactions I have with people. The ability to help individual people through service for their animals is the hallmark and joy of being a successful veterinarian.

Bravery and survival are sojourners, and Mr Johnson still fights daily to stay afloat and continue his 100+ year family legacy of sheep farming.

As I pulled into the Johnson ranch, my headlights hit the west side of the weathered old barn. Missing slats checkered the barn wood walls and added variety to the relic that can be seen during the day from the busy interstate, I-15.

As I stepped into the barn, Mr. Johnson greeted me warmly. “Hazel is making some hot chocolate for you Doc, we sure do appreciate you coming out in the middle of the night like this.”

He pointed me to the Suffolk ewe. She was indeed in distress, and sure enough, 5 legs and small hooves were protruding from her back side.

I calmly knelt down behind her and began my work. A recent trip to Auburn University provided me with a valuable trick in a situation like this. A small dose of Epinepherine was administered intramuscularly, and almost instantaneously, her uterus relaxed.

I gently pushed each of the legs back in and blindly felt around with my hand. A head was readily palpable, as was a tail, and a second head.

“Well, we at least have three!”, I exclaimed as Mr. Johnson anxiously looked on.

I continued to palpate until I was certain that I had two front feet from the same lamb and began the delivery. The first lamb was a large buck, nearly 18 pounds and jet black. The second and third were both ewes and were smaller and lighter in color. I then reached back in, and to my amazement, pulled out a 4th lamb. The last one was a buck and was much smaller in size compared to its birthmates.

All four lambs immediately began moving after being delivered. Mr. Johnson and Hazel gently rubbed each of them with warm towels as they coaxed them to breath.

After the delivery, mother and each of the quadruplets were doing remarkable well.

“We have never had 4 babies at once!”, Hazel exclaimed, “It looks like we will be busy bottle feeding!”

I sipped on my hot chocolate as I watched the newly born lambs stand for the first time.

I thanked the Johnsons as I pulled away.

As my headlights again hit the barn wall and then the straight long driveway of the Johnson ranch, the lights hit a barren tree along the fence line. The branches were covered in small ice and snow fragments that sparkled in the headlights. As I peered out my window, the barb wire strands seemed to glisten and sparkle as I traveled down the roadway.

I sat in amazement. Here is a simple ranch with a barn that is falling apart, yet on this cold winter night, it was a quiet serene paradise.

I pondered how fortunate I am. While the rest of the world is in bed, I have the privilege of bringing life into the world and seeing the majesty of God’s creation.

In this acquisitive world we must learn that in our lives we can’t have everything. But if we have freedom of spirit: to imagine, to question, to explore; then we have everything we need. To travel hopefully is a better thing than to arrive. The journey is the reward. I love being a veterinarian!

And that is my Take!

N. Isaac Bott, DVM

 

My Take Tuesday: My First Surgery

I was raised on a small farm in Castle Dale, UT. We raised Guernsey milk cows, Suffolk sheep and many varieties of chickens and pheasants. My daily chores included feeding the chickens and gathering the eggs.

My Take Tuesday: Dr. Ruby
My stomach ached. The warm May weather and the beautiful rolling hills of the Palouse were not able to distract me as I nervously opened the letter. As I read the first paragraph, my heart sank. 
“You are ranked in the bottom 10% of your class. Statistically, your chances of passing national boards are reduced.” 
Tears streamed down my checks as I read each sentence. 
It seemed each word stabbed deeper. Each blow, injuring me mortally. Failure. Disappointment. Shame. 
Veterinary school was proving to be much more difficult than I had ever anticipated. Many of my classmates had spent years working at veterinary clinics before entering veterinary school. I had spent less than 50 hours shadowing in a veterinary clinic prior to starting veterinary school. Everything I learned during my first year was new to me. It seemed as though I has so much catching up to do. 
I knew that I had struggled in a couple of classes, but I did not realize that my ranking fell at the very bottom of the class. The hours and hours of arduous study led to my passing, albeit just barely, of each of my final examinations. 
“How could they be so skeptical?,” I silently asked myself as I reread the letter. “Why don’t they believe in me?”
I felt dejected. I felt abandoned. I felt shamed. 
“How am I going to recover from this?,” I wondered as I climbed the steps to my second floor apartment. 
Fortunately for me, there was someone to meet with. There was someone to talk to. 
Dr. Ruby was a pioneer in Veterinary Medicine. Her visionary approach to veterinary medicine education and its inherent professional maladies were years ahead of the rest of the country. She understood the stress that veterinary students faced, and she confronted these difficult situations head-on. 
I remember our first meeting as if it were yesterday. I sat on the couch in her office, trembling, as tears poured down my checks. I described how difficult it was for me to prepare for tests. I discussed the issues I faced with each question on multiple choice examinations. 
She patiently listened. And then she listened some more. 
And then she guided me through some techniques to help with my anxiety. She identified some patterns that prevented me from thinking through the test questions. She provided resources for me to read. She helped me understand that the issues that I faced were normal. She made me feel that I could do better. She believed in me; I could feel it with each appointment. 
Miraculously, as the second year of veterinary school started and the examinations started to dot my schedule, my test scores began to rise. With each passing semester, my performance continued to improve. 
My confidence increased as I mastered the material in each class. 
By the time graduation came, I felt prepared to enter practice. I hit the ground running and have literally not looked back. 
Not only did Dr. Ruby believe in me, but she helped me overcome the serious anxieties that come with the rigorous schedule of professional school. 
I look back and wonder why that letter was sent to me. Was it meant to inspire? Was it meant to shame? Was it intended to discourage me? What would have happened if I didn’t have anyone like Dr. Ruby to help me through the darkest times? Would I be where I am today?
Failure is inevitable. It creeps up and stumbles even the most skilled on their path to victory. Our response to it’s overreaching nature is largely what determines our potential. As Alexandre Dumas observed, “There is neither happiness nor misery in the world; there is only the comparison of one state with another, nothing more. He who has felt the deepest grief is best able to experience supreme happiness. We must have felt what it is to die… that we may appreciate the enjoyments of life.”
Dr. Ruby has been there for over 2,000 students at WSU over the years. As each class graduates at Washington State University, her influence and vision is passed on to another generation of veterinarians. Her impact is immeasurable. Her legacy is sure. Her vision is cemented in the hearts of those lucky enough to have sat on the couch in her office. 
Dr. Ruby is a pioneer. She was one of the first mental health professionals to commit her career to developing wellness programs for the veterinary profession. She has taken on the most difficult challenges facing the veterinary industry. She has educated and counseled thousands of veterinarians about communication skills, stress management, life balance and suicide prevention. She co-founded the Veterinary Leadership Experience, a program that has become the model for veterinary schools around the world. In addition to this, she was also the founding Editor-in-chief of the Veterinary Team Brief, a peer reviewed journal devoted to professional skills. I am not aware of anyone who has given more to the veterinary profession in terms of professional life development, stress management and personal success. 
At the end of this month, Dr. Ruby will be retiring. Tears fill my eyes, flowing just as they did on the day I read the letter. I feel so fortunate as I ponder the influence she has had on me. She believed in me when others didn’t. She encouraged me when I felt like a failure. 
How much better would we all be if we had a Dr. Ruby to turn to when adversity and failure creep into our lives? 
Dr. Ruby inspired me. She encouraged me to rise to my potential. She helped me increase my capacity and helped me be the best I could be. She taught me that I could make a positive contribution to the profession. She helped me believe in myself. 
Thank you Dr Ruby. Thank you for believing in me. Thank you for encouraging me when others didn’t. Thank you for your kind and caring counsel. Your influence will forever remain in my heart. 
And that is my take. 
N. Isaac Bott, DVM

My Take Tuesday: Human Blood

Times of severe stress, injury or fear can trigger the reflex: your blood pressure drops, your heart rate slows. This reaction is primeval stuff, buried deep within our brains. Medically, it goes by the name “vasovagal syncope.” Common folk like me simply call it fainting.

Being a veterinarian is not for the faint of heart. On any given day, I will treat a myriad of infirmities. The sight of blood, pus, maggots and trauma are part of a normal day at the clinic. I, fortunately, am not affected by this. I am able to reason and think clearly in situations like this and am able to immediately go about trying to fix the problem. I’ve seen some nasty stuff, but not once have I ever felt light headed with animal blood.

Human blood is a different story. Ironically, I cannot deal with human blood. The sight of it makes me queasy. I have fainted on a couple of occasions at the sight of my own blood. I find it strange that I am fine with animal blood but so unstable when it comes to people.

As luck would have it, on a number of occasions, clients have experienced medical emergencies as I worked on their pets. During one of these situations, I overheard a radio exchange between emergency responders and dispatch.

“He is with a veterinarian,” the dispatcher said.

“Oh good,” the emergency responder replied.

Upon hearing this, I exclaimed, “No, it’s not good! I don’t do human blood! You had better hurry up and get here!”

Keeping it together in such situations is difficult for me. Luckily, no one has died in these situations. However, I did experience a very close call a few years back.

Sheldon was a nice man. His gentle smile and blue eyes were reflective of his kind nature. He raised beautiful Charolais cattle. The pure white bulls he hauled into the clinic on this particular day were no exception. The massive 2000+ pound animals were there to be semen tested before the breeding season.

Sheldon walked with his cane along the side of the alley that led to the squeeze chute. He gently nudged the first bull as I closed the hydronic chute. He opened the side gate and stood directly behind the bull.

I asked about his farm and about the drive down to the clinic. He seemed happy and excited about the coming spring.

As I proceeded to work on the bull, I turned my back to reach for some supplies.

I then asked, “Sheldon, can you help me hold this?”

There was no reply.

“Sheldon,” I continued.

Still no response. I peered into the chute where he was standing just moments before and he was nowhere to be found. As I stood up and entered the side gate, I found Sheldon lying in the alley. His head was lying just inches from the back feet of a bull. Any sudden movements and the bull could easily crush his skull. My blood pressure skyrocketed!

Instinctively, I picked him up and carried him out the side gate. He was non-responsive. I grabbed my stethoscope and listened to his heart. The rate and rhythm were irregular. He was clearly having a heart attack. I shouted for an assistant in the clinic. I asked her to dial 911 and get an ambulance there as soon as possible. I elevated his head and began the first aid I had been taught many times.

I sat with Sheldon until the ambulance arrived. His vitals continued to be irregular, but he continued to breath. As the EMTs arrived, they loaded him in the ambulance. As they pulled out of the clinic, despite having the light on and the sirens blaring, a car nearly side swiped the ambulance.

I stood there in awe. My body trembled as the stress finally caught up. I paced around the parking lot for nearly a half an hour until my nerves were under control and I was able to return to work.

Somehow Sheldon survived the ordeal. I visited him that night in the Payson hospital. He was his normal self as we joked about how bad he had scared me.

He thanked me for helping him.

“It is a good thing you knew what to do,” he continued, “I am lucky you were there.”

If he only knew how uncomfortable I am in situations like this. It took several days for me to be able to return to normal life. The thought of seeing him in the alley with such large animals on either side of him still haunts me to this day.

Fortunately, no other heart attacks have occurred on my watch since that day.

I can quickly fix even the most gruesome lacerations on an animal without a second thought, but when it comes to people, Doc Bott is not the person you want at your side.

And that is my take!

N. Isaac Bott, DVM

My Take Tuesday: The Disgruntled Veterinarian

Veterinarians are some of the most kind and compassionate people on the planet. They are hard workers, and are some of the best people I have ever met.

As with any profession, there are occasional outliers.