"Paging Dr. Embertson ..." Unexpected emergencies, veterinary interns high on sugar, and more from our chronicle of 24 hours during foaling season at one of the country's top equine hospitals, in this excerpt from the Eclipse Press book Equine ER by Leslie Guttman.
No matter what time of day, the hospital is full of sounds: scrubbing, scrubbing, and more scrubbing … workers clean operating rooms, barns, stalls, entryways, and examining rooms. Hay rustles as horses feed, water drips from hoses and faucets, hooves clip across asphalt as clinicians conduct lameness exams. You hear the crinkly sound of granola bars being unwrapped by famished interns and externs (staff veterinarians never eat, as far as I can tell), the gabbing of a flock of birds that nests in the three evergreen trees by Barn 7.
Dr. Rolf Embertson, right, at work.
The P.A. system constantly interrupts conversations, as it did after Saturday morning melted into lunchtime during these twenty-four hours: Dr. Rolf Embertson was being paged. A 1,400-pound warmblood had arrived from Indiana. He had gotten a leg caught in a gate. The laceration wasn’t serious, but it needed to be stitched up. In the admissions office, his owner, bossy in her worry, wanted an MRI. The admissions staff told her regular X-rays would probably suffice, and they did.
In the surgery area, interns readied the horse for Embertson. On the gurney, the warmblood looked even bigger than he did when standing.
“The table needs to be brought up,” said Dr. Leslie Christnagel, who was running the anesthesia, to Dr. Alexandra Tracey.
Tracey bent down and pressed the button that raised it electronically. The table jerked, rose, and then came off its hydraulic wheels a bit, as occasionally happened, tilting the table slightly and putting the horse on an angle that didn’t look right for surgery. Everyone jumped.
Embertson walked up.
“It looks like that horse is going off the table. We need to drop him down,” Embertson said. (An intern from a previous year told me Embertson often pointed out to interns what they felt they already knew, and they loved to tease him for it. This intern’s nickname for the chief surgeon is Captain Obvious.)
The interns fixed the table, and Embertson put on his headlamp and sat down on a chair in front of the horse’s injured leg. With a scalpel he peeled back the skin of the laceration, and then with surgical scissors, he started removing any tissue that was dead, contaminated, or traumatized. Tracey and Dr. Milosz Grabski assisted him.
The interns were high on sugar. The hospital’s weight-loss contest had ended the night before, and they had spent the last fourteen hours or so eating as much chocolate as possible. As they all worked, the giddy intern threesome speed-talked to Embertson about everything from Dr. Alan Ruggles’ self-confidence (“His favorite phrase: ‘One time I was wrong, but it was a mistake.’) to Christnagel’s engineer boyfriend texting her about his breakfast getting ruined in the toaster (“The biojelly Pop Tarts have a thermal expansion issue.”).
Embertson finished up and anchored in a drain to draw off excess fluid. Then he pulled the two biggest edges of the skin toward each other over the open wound and the drain. A gap existed in the middle. “It’s going to be a little tight,” the vet said. Then, slowly and carefully, he sutured the wound, solving the puzzle of how to close the gap with the existing skin step-by-step. He did so by looking for different angles to align and by finding which parts of the skin stretched and which did not. In the end, the wound was almost completely sewn up. Only a tiny gap, less than an eighth of an inch, remained on one corner.
Now it was time for the horse to go into a recovery room. Although the interns didn't know it yet, trouble awaited them ... sometimes, a horse coming out of anesthesia can be dangerous, and this horse was one of them.
Next: An intern yells for her colleagues for help. And over in ICU, did the struggling foal survive?
Note: If you're coming to Lexington for the World Equestrian Games,
author Leslie Guttman will be signing copies of Equine ER throughout
More details to come. If you want to reach Leslie in regard to Equine
ER, now in a second printing, email email@example.com.
Thanks for reading this blog.