Vet Surgery Life Rules

You've heard of Halstead's first principles, no doubt. But these are, it turns out, incomplete. Here are some tough lessons—experienced, observed, or shared from the operating theatres of veterinary medicine - which ought to be included in the next edition of Fossum. Feel free to forward this to the editor.

1. Make big flaps. The little skinny things tend to go wrong. As a vet dentist, I was thinking of the oral cavity as I wrote this, but it’s a reasonable enough thing to say outside the mouth too.

2. If you name a "new" procedure because you made some freestyle shit up… it will probably go wrong. Just wait.

3. "Oops" is a horrible word to hear from a surgeon when monitoring an anaesthetic. Something bad has happened. The next thing the surgeon will be doing is naming their "recovery effort" something like the Nicol-modification. Refer yourself to point two immediately.

4. In all fairness to surgeons, "oops" is also a bad word to hear from your anaesthetic vet tech or nurse. The difference is one of perspective. A surgeon can still do their job if the patient collapses. In fact, they won’t even have heard you - because they’re not interested in anything other than what’s at the end of their scalpel. And frankly, a little less blood is helpful, right? The exception to this is when “oops” means: Oh shit, I didn’t turn on the isoflo and the patient is about to wake up. Then surgeons do tend to get upset. Nobody wants a moving target.

5. Avoid at all costs operating on any pet named Lucky. At the very least, double-check your PI insurance before you do. Complex surgeries and animals by this name are what specialists are for. (Yes, I know this is a soft repeat from the original Vet Life Rules—but it’s entirely necessary because you weren’t paying enough attention the first time. You really do need to bear this in mind.)

6. If you apply an external fixator array of any kind to a pet owned by a human medical professional, you will never see that equipment again. I mean literally—it’ll be inexplicably gone by your first recheck. Maybe even sooner. Do everyone a favour and choose a more secure method of stabilisation. These people cannot be trusted.

7. "Cage rest only" is a weirdly ambiguous notion rather than the clear, solid instruction you believe it to be. Sofas, for example, are cages. Short walks off-lead in the local park - just to see the pigeons, who your patient wants to eat - count as rest. Paddling with an open surgical drain in the local river is also, unbelievably, considered rest. You probably need to draw a picture of their pet in a tiny prison to illustrate the concept.

8. Closing skin wounds is, at times, utterly insane and grotesque—but hugely enjoyable. Making a hole is the easy bit. Getting it closed again takes some creative thinking. Refer yourself to points one, two, three, five, and seven as advisories before opening your surgical pack. If in doubt, proceed with a creative surgical friend scrubbed in. At least you will be have a modofication named after you. A problem shared…

Consider yourself warned. And the can opened. Now it’s your go... do you have any hard won Vet Surgery Life Rules?

You might find me currently a little preoccupied with the subject of mentoring and skill transfer. You acquire practical skills in the classroom, yes, but much of what this piece is based on are adaptations of realities witnessed or experienced directly, as we struggle to become competent in our work.

Supportive colleagues, and a commitment to being better next time, are what get us into and out of these moments. Skills (and scars) are acquired through the effort of trying and caring.

You may be writing a future bullet point for your memoir or blog right now. If so, it probably doesn’t seem at all funny. And that’s how it should be.

But trust me—one day, most of these moments will be the ones you look back on with humour, possibly even fondness.

Good luck. Learn from your errors. And go easy on yourself.

We’ve all been there.

Looking for more lessons they definitely didn’t teach you in vet school?

Grab a copy of So You’re A Vet... Now What?—a straight-talking guide to surviving and thriving in your early career. Packed with the kind of advice you wish someone had given you on day one.