Sunday, August 31, 2014

The joy of suturing

sutures in hand
Beautiful, simple sutures.
Last week we posted on what it takes to become an expert and just how much time experts put into developing skills (read the full post here). Coincidentally, Dr Ilana Mendels – so much a fan of veterinary continuing education that she became an official provider of it through VetPrac – emailed about an upcoming suture workshop.

Suturing? Isn’t that a basic skill and shouldn’t all vets be highly skilled at it? Well, yes and no. We learned those skills back at uni under guidance of specialists, then went out into the world and did our best. We practiced and practice, but as I learned last week pure practice doesn’t equal perfection.

Practice needs to be purposeful.

And then, when we DO become skilled, the action follows as second nature. We develop expert induced amnesia. When that happens, it can be hard to recognise problems and break bad habits.

As the ever-enthusiastic Dr Mendels says,

When we use our skills every day, we rarely remember action for action, how we came to develop the skill. We usually remember a frustration in learning, the awe towards our mentors and peers and then, through fumbling and practice over time - it one day clicks. 

So spending a day focusing on suturing, now that one has the benefit of experience under one’s belt, could be quite enlightening.
The suture is the central locus for a surgeon. It is the known thing, around which all the other things we know about surgery become significant and depend of each other.  The suturing workshop will be fun. We'll be doing some basic ties, and some fancy ones. We'll show you some specialist tips and share stories of "man vs tissue".

We will also go over some important points to remember about types of suture and needles, which is a funny thing that most of us ignore... If you're anything like ANY of the vets I've worked with you'll be familiar with "absorbable 3-0" as the regular request. But if you consider your skill as a craft, then the type of needles and materials become increasingly more important. And we will discuss this, because good surgeons, like good artists, know their materials as well as their canvas. 

There is a tendency for people to think they have learned one thing, ticked it off and can now move on. On the contrary. When its a skill you use every day, there's always something new, always something you can improve. (Of course, its always a little challenging when you do the best sutures in the universe and your patient goes home for "bed rest", gets a touch of ye olde cabin fever and jumps over the fence to hang out with next door's poodle...or lets their housemate nibble the sutures out prematurely). 

But seriously, I love the teaching philosophy behind this workshop, the palpable enthusiasm and the concept that we can always work harder at mastering (or tweaking) the so-called simple things we take for granted. It makes me wonder what other skills veterinarians and nurses use that are second nature, and whether we could benefit from revisiting some of those.

Friday, August 29, 2014

Update on Sutcliffe, the baby bearded dragon

Baby central bearded dragon
Sutcliffe chills on an ornament while his enclosure is cleaned.

For those SAT readers dying to know, little Sutcliffe the Central Bearded Dragon is chugging along very nicely, although he would prefer to see the end of these grey skies and accompanying torrential rain (wouldn't we all??? - I've seen so many miserable dogs in the last week who aren't getting their daily walks and don't like peeing if it means getting their feet wet. Can't say I blame them). He hasn’t grown visibly but is happily eating the Hills a/d and taking his calcium Sandoz without much fuss.

Central bearded dragon on finger
Sutcliffe meets world renowned herpetologist Dr Glenn Shea.
When he does catch a moment in natural sunshine (as opposed to the artificial UV light he is exposed to) he comes alive. Otherwise he mostly sleeps.

Close up baby bearded dragon
Close up of Sutcliffe catching a nap on the hand of Dr Glenn Shea.
If you’re looking for tips on reptile husbandry check here or grab this awesome book.

Meanwhile the Australian Veterinary Journal will this month publish case reports of horses contracting Australian Bat Lyssavirus, a very concerning development. Read more here.

Finally, don't forget to enter our giveaway to win a doublepass to a nighttalk at the Australian Museum. Details here.

Thursday, August 28, 2014

Animals and the law

Cow sculpture in the garden at Bear Cottage.

Later this year Voiceless will be hosting the Australian-New Zealand Intervarsity Moot on Animal Law (cleverly named so it can be abbreviated thus: ANIMAL).
The aim is to provide law students with the chance to develop knowledge in animal law while honing their written oral and advocacy skills.

ANIMAL is open to all Australian and New Zealand law students. It will be held at Bond University over the weekend of 18-19 October. Individuals and teams are invited to register. Questions and facts will be released one month before, at 9am on 15 September. Written submissions must be emailed on October 17.

You can view the draft program here.

The program includes optional question and answer forums with senior animal law academics and panel discussions with legal experts in the field.

If you aren’t a law student you can still attend as a spectator. Contact the organisers for more information.

Speaking of the law

Newspapers have seized onthe story that a vomiting cat was the reason a footballer got off lighter thanhe could have for a speeding charge. There’s a lot of speculation as to whether this was a legit or “dog-ate-my-homework” kind of excuse (though I am here to tell you that dogs DO, occasionally, eat homework – as well as the odd mobile phone)(and if you’ve not experienced a vomiting cat before, feline emesis can be dramatic and terrifying).

But before you think that the animal-in-distress excuse works, one of my clients had a French bulldog who actually went into anaphylaxis on a freeway and the judge wasn’t lenient at all.

Do professional associations matter?

Professional associations, those organisations we pay fees to, play different roles. This month the Australian Veterinary Association is one professional organisation participating in the “Associations Matter” study.

It’s a chance to provide feedback about what the organisation is doing well and what could be done better. We’re a big fan of professional associations here for a range of reasons including advocacy and ethics, but an association is only as strong as its membership and can really only help if we provide specific feedback.

Tuesday, August 26, 2014

Meeting Frankie from Bear Cottage

Frankie the assistance dog
Frankie from Bear Cottage shakes paws.

SAT readers may be aware that SAT has been behind a fundraiser for Bear Cottage, a children’s hospice based in Manly. We learned about Bear Cottage when we read about the residentassistance canine, Frankie, who among other things can operate the electric train set and use the lifts to get herself around the place. Frankie is the non-human member of an incredible team who care not only for sick kids but their entire families.

We were fortunate enough to be invited to Bear Cottage to meet the team (although Phil sat this one out in front of the heater).

It was a pretty miserable Sydney morning, the traffic resembled a scene from Ben Elton’s Gridlock and it the rain poured down. The moment I arrived Frankie greeted me at the door, gave me an enthusiastic sniffing-over then laid down on the couch with her head in my lap.  

Frankie lies down
Frankie lies down on command.
As I toured the Cottage I could see first-hand just how important this kind of place is, providing comfortable accommodation, art, music and play therapy, a homely environment and total care so families can spend precious time together. And Frankie’s presence just adds to the warmth of the place.

Bear Cottage is a resource in demand – it operates at 100 per cent capacity and staff try to accommodate the needs of visitors as very best they can.

Frankie contemplates her next trick...and a treat.
Frankie agreed to demonstrate a couple of tricks for me (for a small price of course, she is a Labrador). When I returned from the car with a basket of presents for her she knew that she was the intended recipient and started to unwrap them immediately. She received a new bed, a food hopper, a bag of toys, some Greenies and potato ears (like pig’s ears but made of potato instead of pork).

Frankie the labrador with toys
Frankie embraces one of her new toys on her new bed.
I wish everyone I gave gifts to responded with such enthusiasm! It was a fantastic morning and a real honour to be able to visit the team. Frankie was still on her new bed when I left.

Frankie wears potato ears.
Frankie rapidly established that potato ears are better eaten than worn.
I have one more superdeed to perform as part of my fundraising commitments before hanging up the cloak til next year. That involves giving a lecture at the University of New South Wales next week. You can donate to this effort here, or find out more about Bear Cottage here

Monday, August 25, 2014

Win a double pass to the Australian Museum night talk and a TED talk about mental illness in animals

After reading our post mentioning their night talks, the Australian Museum have generously offered SAT readers TWO double passes to their night talk on the White-fronted Chat (a chat about a chat – but you can’t take your cat!)(okay, I will stop now).

The White-fronted Chat, Epthianura albifrons, is a small honeyeater. It used to be found all across Sydney but is now isolated to two patches of saltmarsh which are surrounded by urban development.

Ecologist Richard Major has been undertaking research to look at the decline of the endangered Sydney population. Using genetic techniques, he and his team have set out to determine whether urbanisation is the problem and has also trialled cages to help protect nests from predators.

Dr Major is the Principal Research Scientist in Terrestrial Research at the Australian Museum. His other research interests include birds in backyards and historical changes in the birds of Sydney.

If you’ve not been to a talk at the Australian Museum it is well worth the experience. There’s something cool about popping into the Museum after hours and hearing from experts in their field. The talk is will be held on October 30. Tickets are normally $30 each (or $20 if you are a member of the Australian Museum). For more info, hit this link.

To WIN a double pass, simply tell us in 30 words or less why you’re keen to go, and don’t forget to include your name and contact details. Entries must be received by 9am on September 30.

In other companion animal news, Jess sent this link to a fascinating TED talk by Laurel Braitman about the mental health of animals, and what it means for humans. I found this take very interesting, particularly the discussion of humans acting as assistance companions for animals, growth of the pet psychopharmaceutical market and the difference between history taking when discussing human vs animal anxiety, depression and mental health (its about twenty minutes but quite interesting - definitely worth making a cuppa for this one).

The late actress Lauren Bacall has left about $AUD10K to ensure the ongoing care of her dog Sophie, a Papillion. Bacall once described herself as a dog yearner.

“I didn’t have a dog growing up in the city with a working mother. As an only child, I yearned for someone to talk to.”
Sophie accompanied Bacall on set. Good for her – taking your dog to work is fantastic if you can do it, and if you can afford to put money aside for your pet’s care in your will it can help avoid family dramas.

Saturday, August 23, 2014

How to become an expert

they soon master it!
What are you up to this weekend? I know SAT reader Jenna is going to be spending most of it with her new puppy!

What are you up to this weekend? Will you be devoting any time to practising a particular skill? Here at SAT we rarely find ourselves reading books about sport, but we were persuaded by some friends and teachers to read Bounce: the Myth of Talent and the Power of Practice.

Bounce was written by journalist and international table-tennis champion Matthew Syed. The central thesis is that supposedly talented individuals practice HARD. We see the fruits of that practice but feel compelled to turn a blind eye to the evidence of the blood, sweat and tears behind it. It’s easier sometimes to judge that someone is incredibly talented instead of considering that if we were to put in the hours, we could be that good too.

She is a Jack Russell terrier, just over 1kg.
So one point Syed makes very convincingly is that it takes a good TEN YEARS or TEN THOUSAND HOURS to make an expert. Even 2 or 3 thousand hours can make you very good at something.

“…from art to science and from board games to tennis, it has been found that a minimum of ten years is required to reach world-class status in any complex task….In Outliers, Malcolm Gladwell points out that most top performers practice for around one thousand hours per year (it is difficult to sustain the quality of practice if you go beyond this), so he re-describes the ten-year rule as the ten thousand hour rule”p15.
This is fascinating in the light of a study I read a few years ago suggesting that the average career in veterinary practice in Australia was five years.  Think how often people in general change careers these days. Are we giving up when we’re good enough? The talent myth, he says, is disempowering because when we praise someone for being blessed with talent we a) ignore their hard work and praise them for something they feel they have no control over; b) fail to recognise the need for hard work to get there and perpetuate the talent myth.
Another point Syed makes is that experts just LOOK as if they have more time because with practice many moves and steps become automatic. And they’re not great at telling us HOW they do it because they develop “expert induced amnesia”.

“Federer has practised for so long that the movement has been encoded in implicit rather than explicit memory. This is what psychologists call expert-induced amnesia”p34.

But JUST DOING IT for 10K hours won’t get you there exactly. It might get you close, but the difference between so-called talented performers and the rest is purposeful practice. Top skaters, Syed argues, fall MORE during their training sessions.

“Purposeful practice is about striving for what is just out of reach and not quite making it; it is about grappling with tasks beyond current limitations and falling short again and again. Excellence is about stepping outside the comfort zone, training with a spirit of endeavour, and accepting the inevitability of trials and tribulations. Progress is built, in effect, upon the foundations of necessary failure. That is the essential paradox of expert performance,”79.

The argument is very persuasive, although when I think of the development of surgical and medical expertise such falls are unsustainable. So I would love to hear a surgeon’s take on this (Dr Charles Kuntz discussed being a surgeon in this previous post and has done some reading about expertise and the ten-year/ten-thousand-hour rule).

Contemplating becoming an expert: its hard, hard, hard, hard work!
Syed’s discussion about the mindset of different people, taken based on Dr Carol Dweck’s work, is fascinating. People who think intelligence/talent/whatever desirable property are set in stone have a fixed mindset. Those who think these things can be gained and transformed with effort have a growth mindset. We often making the mistake of praising one another, and students, in a way that promotes the former which can be dangerous.

“…we should praise effort, not talent; that we should emphasise how abilities can be transformed through application; that we should teach others and ourselves to see challenges as learning opportunities rather than threats; that we should interpret failure not as an indictment but an opportunity,”p123.

How long does it take you to develop a new skill? How long are you prepared to work at it? Do you do things the same way or a little bit differently each time?

Being able to deliver praise in a way that promotes a growth rather than fixed mindset can be very helpful. Next on the reading list: Mindset by Dr Carol Dweck.

Friday, August 22, 2014

The best job in the world?

Tiquie the tapir feels good.

Have you moisturised today? Yes, it’s true that SAT has included a few zoo posts this week but when we found out that Taronga Zoo’s Brazilian Tapir, ‘Tiquie’, has a regular moisturising session we could not resist. People think companion animal vets have an awesome job, and I'm not going to lie, it has its moments. But never in my career have I been required to moisturise a tapir.

That's a happy tapir.
Keepers gave Tiquie a hands-on health check and grooming session this week, rubbing diluted QV oil into her skin to prevent it drying out and brushing her wiry brown mane. (What a PR coup for QV – everyone with dry skin and a wiry mane will be rushing out to buy this stuff now!).

“Although Tapirs are normally solitary and quite elusive in the wild, Tiquie loves the interaction of the grooming sessions. She’ll close her eyes and tilt her head back when we’re rubbing the oil onto her skin and often roll onto her back for a tummy tickle,” said Keeper, Nat Dunn. Tiquie’s daily grooming sessions are also an opportunity for keepers to educate zoo visitors about Tapirs and their challenges in the wild. Although Tapirs have survived for millions of years, their future is under threat. They are hunted extensively for food, sport and for their thick skins and their jungle and forest habitat is disappearing due to destruction caused by logging and clearing of land for agriculture.

Of course, in the wild Tapirs don’t have access to QV oil either…but it is good to see this focus on enrichment.

Taronga is helping to protect Tapirs in the wild through its support of the LowlandTapir Conservation Initiative, which is promoting research and conservation of Lowland Tapirs and their remaining habitats in Brazil.

The beautiful photos were taken by Paul Fahy.