HSVMA-RAVS: Valuable Lessons in Medicine and in Life

by Laura Nelson

October 8, 2012

Laura examines a dog
Fourth year veterinary student, Laura Nelson, examines a dog at an HSVMA-RAVS clinic at the Standing Rock Sioux Reservation in North Dakota earlier this year.
Lori Rohlfing

Sleeping on dusty gym floors, not knowing whether or not you will get lunch that day, to the ever-present question — will the showers have hot water? This is a normal day in the life of a student on a RAVS trip. While many would turn their nose up at this description, it actually made me more and more excited for the clinics as the meet day approached.

My name is Laura Nelson, and I am a fourth year veterinary student from the University of Wisconsin. For the past two years I have gone on the 10-day RAVS trip to the Standing Rock reservation in North Dakota. Immediately after my first trip ended last year, I was already dying to go back.

Before leaving for my first RAVS experience on the Standing Rock reservation, I was excited for my multi-faceted role as a vet student giving preventative care to the communities' dogs and cats, and as a teacher sharing animal husbandry techniques with the communities' families. It was eye-opening to me that, in many circumstances, the primary caregivers for the family animals were the children. The special bond between the children and their animals is undeniable; it is the children who know their animal best, and in return, the animals give them unconditional love and a friendship that is priceless. When I asked a family whether or not an animal would be spayed or neutered or asked for permission for treatment, it was often a child in the family that was looked to for an answer. For this reason, I felt that it was especially important to educate the children about proper animal healthcare; to my delight, they were always eager and excited to learn. I especially enjoyed the look of wonder on their faces when they heard their animal's heartbeat through a stethoscope. As much as I enjoyed teaching, what I actually found most fulfilling was how much the clients taught me.

Prior to my first RAVS clinics, I had never spent an extended period of time in an economically challenged community so I didn't really know what to expect. However, one thing resonated within me very quickly: Love for animals is ubiquitous. In these small communities I saw love between owner and animal as well as companionship between child and pet. I also saw the gratefulness behind the eyes of many of the community members for the services that RAVS was able to provide for their pets. The trip that I have attended for the past two years is the only access to veterinary care for some community members. It was great to see familiar faces from the first year to the second year. The presence of repeat clients showed me that the community members valued their pets' health because, in an area where daily life can be full of overwhelming family responsibilities and merely finding a ride to the clinic can be a challenge, they still found a way to come to our clinics to ensure their pets received proper preventative care.

I imagine that there are many misconceptions involving callous regard to animals on reservations amongst veterinary students before they embark on a RAVS trip. In my 10 days of RAVS clinics, I, as well as my fellow veterinary students, definitely learned that these misconceptions were not true. For instance, I witnessed a family that made a 20 mile-trip multiple times a day to visit their dog that was being given supportive care by the RAVS team for a spinal injury after being hit by a car. Each day they brought him home-cooked meals of rice and different meats to see if he would eat. The children brought along his favorite ball, and they never stopped petting him and whispering their affections for him during each hour-long visit. I also witnessed a stranger who brought in a stray, ailing dog with a collar embedded in his neck, who then offered to care for the animal and give him a forever home. And I witnessed a woman who sobbed at the loss of her cat that she unselfishly chose to have humanely euthanized for suspected malignant cancer. For each case of animal neglect or illness that I witnessed, I saw a multiplicity of happy, healthy animals with caring and loving owners. After seeing these emotional moments, it became crystal clear to me that animals are important to most everyone, no matter what their situation is in life. I have not had any other experience outside of RAVS that has made me prouder to become a veterinarian and be able to be the one that provides the care for owned and shelter animals.

Laura Nelson preps a dog for surgery.
Laura performs a pre-anesthetic physical exam and administers wellness treatments, including vaccinations, deworming medications, and flea/tick preventative.
Lori Rohlfing

I have also learned that "proper care" has different meanings to different people. In veterinary school we are taught "ivory tower" medicine — medicine where every differential can be investigated and any treatment protocol can be initiated if the client is able to afford the expense. On the other hand, in field medicine where practitioners are still capable of a surprisingly large array of high quality diagnostic and treatment options, most of the options aren't options at all because the practitioner must factor in the reality of the client's limitations due to their geographic location, economic standing and/or complicated life logistics. While some practitioners may be frustrated that everything can't be done, I on the other hand, grew to embrace what could be done. The truth is that fieldwork reduces veterinary medicine to its simplest form, to the backbone of the oath we take when we swear, "to use my scientific knowledge and skills for the benefit of society through the protection of animal health, the relief of animal suffering…" Field practitioners are able to help clients and their animals by re-framing the prognoses for each treatment option within reality so that choices can be made based on realistic outcomes and an animal's quality of life. For example, a practitioner might offer a limb amputation rather than casting for a broken limb because the follow-up care can be done by a dedicated owner in one instance and not in the other. Along similar lines, when an owner does not have the resources to provide the necessary care for an ailing animal, a practitioner may offer humane euthanasia as a kinder choice than a longer painful life and a slower natural death. RAVS not only improves the quality of life of community animals through emergency services, but also through veterinary preventative care services. RAVS' physical exam, vaccination, de-worming, flea/tick medication, and spay/neuter services provide communities with a portion of the answer to creating a healthy, manageable population of community animals.

Since my career goal is to practice in shelter medicine, the hands-on experience that RAVS provides is invaluable to me. I have learned that teaching my hands to perform a good physical exam is one of the most valuable tools that a veterinarian can possess. I have become more comfortable with my physical exam techniques as well as determining anesthetic protocols and monitoring patients under anesthesia. I have also gained more experience in surgical techniques. On RAVS trips, veterinary students perform spay and neuter surgeries one-on-one with a veterinarian. Being a proficient surgeon will allow me to help prevent countless more stray animals from entering shelters every day. In veterinary school, students perform a minimal number of surgeries. RAVS clinics allow veterinary students to be mentored by a variety of volunteer and staff veterinary professionals in a variety of hands on experiences. As a result of this close mentorship, I feel that I will develop -into a more well-rounded veterinarian with an open mind for continued intellectual and technical advancement.

My time on the Standing Rock reservation with RAVS taught me many lessons. Most importantly, I learned that nobody should be judged unless we have walked in his or her shoes. I also learned that field medicine is realistic, can be practiced in a high quality manner, and provides a wellness plan for bettering the lives of animals on the reservation. Through all the medical knowledge I have come to possess in my years of school, it is the fundamentals that are most important: Sometimes love, compassion, and doing what you can with the resources available is truly the best medicine.

Laura Nelson and her dog, Zoey

Laura Nelson is in the class of 2013 at the University of Wisconsin-Madison School of Veterinary Medicine. Her career goal is to go into shelter medicine after graduation. Her passion for Shelter Medicine began after adopting her dog, a pit-bull mix named Zoey (pictured), during her first year of veterinary school. Laura says watching Zoey blossom from a quiet, shy and reserved dog to the bright, happy and loving dog that she is today showed her how much a little love and care can bring out an animal's true personality. "Shelter animals are the underdogs; they need someone to be their advocate and give them the best chance possible. I want to be that person, and help give them a better chance at adoption and finding the love they deserve. Zoey is truly my best friend and I will always have her to thank for opening my eyes to the wonderful world of Shelter Medicine."