Every Wednesday morning at 7:30, the large animal medicine department presents a case or two. It happens that Wednesdays are the only day of the week I don't have to be at school by 8 am, but medicine rounds are my favorite, and I needed a better reason than my impending mid-term to get up and at 'em this morning, so there I was. The student on the rotation began presenting the case, a horse with chronic eye problems. This is where it gets good--just last night, we had a dinner lecture about large animal ophthomology cases, so I was hopeful I might have picked up a relevant tidbit or two. I'm going to skip the boring part where I knew the answers to some of the questions the student asked and get to the career-affirming part. (Which is not to say that knowing the answers to questions isn't career-affirming...)
Not only are dry eyes not very functional, but they can also be extremely uncomfortable, so it is imperative that that their normal hydration be restored. If a medical treatment is unavailable, the treatment of choice is a surgery called parotid duct transposition. The parotid gland is one of several salivary glands, and its duct takes a superficial course from the angle of the mandible (corner of the jaw) along the ventral border of the mandible (the lower edge) and then up, to open inside the mouth on the cheek next to the first upper pre-molar. The surgery moves the parotid duct opening from inside the mouth to the outer corner of the eye, replacing the normal tears with saliva. Parotid duct transpositions are actually performed quite frequently in dogs, but the large animal hospital here had only performed two of them on horses, and our case at rounds this morning was the third.
Now, here comes the career-affirming moment: while she was talking to us about possible post-surgical complications, the student fed the horse a carrots. Chomp, chomp, chomp, chomp...another carrot....chomp, chomp, chomp.... And then, a tear welled in the corner of the horse's eye and rolled down his face, followed by another, and another. Of course, the tears we saw were not tears at all, but saliva, showing that, at least initially, the surgery was successful!
As amazing as it was to witness that success as a knowledge-thirsty student, I can only imagine what it must feel like when you know it was your hands that performed that little switcheroo.
Friday, February 19, 2010
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