And My Family Still Doesn’t Know What I Do!
by Karin L. Cannizzo, D.V.M., MS, Diplomate, American College of Veterinary Internal Medicine
Veterinary Specialty Center
Let me start by saying that I have a very close-knit family and that they have always supported me and my career choice. But the truth be told, I still don’t think my family knows what I do. I can’t really blame them for this. Most people don’t even know that there are internal medicine specialists for animals, let alone what one actually does.
You could definitely say that my mom started it all. As a child, I, as many kids do, gave the answer of wanting to be a veterinarian when I grew up. When I was thirteen years old, she arranged for me to spend a day with our small animal vet and with our horse vet. This led to me working for the horse vet throughout middle school and high school. This was the kind of veterinary work my family understood. It was mostly preventive medicine (vaccinations and de-worming), lameness and colic. This was the kind of care they could see performed on our horses. Simple and straightforward- the family was with me!
I went to college (Colorado State University- Go Rams!) for my undergraduate degree. I completed my Bachelors in microbiology with four years of work. After this, longer explanations at family reunions started: “Yes, I have finished college and am going to vet school.” Interestingly, most folks seem to know that vet school was considered “harder” to get into than many medical schools. About 2 years later, with 2 years to go, the “glow” of vet school had worn off and I was explaining to my second cousins and family friends that “yes, I was still in school.” Vet school is so unlike college that it was hard for me to explain what I was learning. Now I say that vet school is like learning a foreign language. Certainly, our patients didn’t speak English and the doctors barely seemed to. Literally there is new medical vocabulary and techniques to learn. When my parents toured the vet hospital at CSU, my dad said incredulously, “It’s like a real hospital.” This was my first hint that they didn’t really understand today’s veterinary medicine. Where did he think they did those total hip replacements for dogs that I had been telling them about?
By vet school graduation, I thought that I had learned every possible medical condition and presentation. Two days out of vet school, I wasn’t sure that I learned anything. If vet school was teaching me a foreign language, being a veterinarian was living in a foreign country! My first job as a veterinarian was an internship at Alameda East Veterinary Hospital in Denver. An internship is basically a year position designed to provide a more intensive work environment to accelerate learning and experience. As I tried to explain this concept to my family, you could see that they couldn’t quite place the concept: “How is it a job if it is only for a year? What does she mean by “internship”, she is a doctor finally, isn’t she?” I lived with my sister and brother-in-law during this year, and again I understood that they didn’t understand. About 4 months into the year, I was telling my brother-in-law about a very difficult case that I had to euthanize that day. My brother-in-law asked who advised the owners about this and who performed the euthanasia. I could see that he didn’t understand my job as I responded, “I do”.
Today, people have more exposure to some of the behind the scene work in veterinary clinics thanks to shows like “Emergency Vets (on Animal Planet).” At the time of my internship the show was in its early time, I know because we were in the second season. This causes quite the giggle in the family because I never wanted to be photographed, let alone videotaped. I was known for the bob-and-weave at Alameda, but the filming was a mild inconvenience at most. People always ask if it was intimidating to be on the show and the answer is no. I would have been more nervous about the cameras on a game show, because in real life, the highest concern is about the patient and owner, causing the cameras to fade into the background. These shows helped my family understand a little more about the world I had entered, but these glimpses were edited for television. Things are shorter and less complicated on television than in real life.
In real life, my internship ended and I was moving to Ohio for my residency in internal medicine. If vet school is hard to get into, an internal medicine residency is almost impossible with only about 40 positions available each year. But in family speak: “residency” means another not-quite-real job. During a residency, a veterinarian specializes in a very specific field, such as internal medicine or surgery. During a residency, veterinarians work only with patients in their area of specialty, under the guidance of established specialists in this area. My residency was at The Ohio State University and this clinical work was combined with teaching vet students’ their “new language” and completing a Masters degree. After three years of work, I completed my qualifications and succeeded in becoming board-certified with the American College of Veterinary Internal Medicine. The pride in this accomplishment is as hard to contain, as the distinction is hard to explain. For me to complete a residency without achieving board certification would be like attending high school but not being able to complete the requirements for graduation. Board certification validates the clinical skills within the specialty.
The internal medicine part of this is hard for people to grasp because it encompasses so much: cancer diagnosis and treatment, gastrointestinal disease, diabetes, kidney and liver failure. Internal medicine is hard for people to understand because it can sound so simple: you do some tests and then you give some medicine. People can imagine board-certified surgeons doing complex surgery, it is harder for people to imagine internal medicine specialists thinking about a pet’s condition- but that’s really a lot of what we do, we are problem solvers and detectives. We know the details of physiology, disease, diagnostic tests, medicine and treatments that make the difference for our patients. Internal medicine is what I have been doing for the past 4 years here in Colorado Springs and I had all but given up sharing my passion for my work with my family. I had become frustrated with my own ability to communicate my work: I would end up saying things like, “My patient who got hit by the train is doing great and went home yesterday.” It would be the same as my brother-in-law, a corporate accountant saying, “It’s tax season, so I have been doing a lot of math.” Neither of us really understands that depth of the other’s work. The simplifications belittle the passion and complexity of the job.
I thought this would all change when my mom’s Bassett hound Lucy recently needed my help. Lucy is about 8 years old and had begun to gulp. My mom called and I offered her some preliminary advice. I consulted with her family veterinarians by phone. Our medication trial didn’t change Lucy’s gulping and their radiographs and blood tests didn’t reveal any concerns. During my next visit, my mom intermittently exclaimed, “There, did you hear her?” as Lucy gulped randomly. Needing more extensive evaluation, I brought Lucy to Colorado Springs with me. I performed special blood tests; I performed abdominal ultrasound; I performed endoscopy and most importantly, I thought about her a lot! I thought this might really be the time for the family to understand what I did. It was good news for Lucy, nothing significant was found. Of course, since my mom didn’t come down with us, Lucy is the only one in the family who really understands what I do. Well, I guess that’s a start!