Veterinarians, like many professionals, are required to attend continuing education meetings on an annual basis. To help our local colleagues with this requirement, Dr. Bianucci and I (Perry Jameson) sponsor a daylong event on a Sunday every February to give them eight of these needed hours.
After 28 years of practicing medicine you would think there is little left to learn, but I always come away with at least one new pearl of wisdom. This event always makes me reflect on how my profession has changed over my nearly 30 years of practice.
One of the biggest changes is the building in which our hospital operates. When I moved to Charleston in 1995, our facility was on Remount Road near Hanahan in a small strip mall, which is now a Walgreen’s pharmacy. A Little Caesars Pizza shop was the tenant next door. In this small, less than 3,000-square-foot space, we operated an emergency clinic that was open evenings from 6 p.m. until 8 a.m. and weekends from noon Saturday to 8 a.m. Monday. During the week there was a surgeon and internist on duty.
We now have a close to 10,000-square-foot hospital in North Charleston and a 16,000-square-foot facility in Mount Pleasant. The Mount Pleasant building in many ways is similar to a human medical facility in appearance. Even with these two large hospitals we could use more space to treat all of the animals needing care. The emergency services now never close and are constantly busy.
In my early days of practice, we had machines in-house that could run minimal blood tests on patients where we needed some information after-hours. For more detailed analysis we used the local human blood laboratory services. With every test we had to take into account that since their machines were set to analyze human blood, not dog and cat blood, this could create some false results.
Now we have in-house machines that rival what any laboratory can perform. Within minutes I can have a complete blood count (CBC) and profile in my hands. For more detailed tests, we no longer depend on the human laboratory but have several that only analyze the blood of veterinary patients.
When I was in veterinary school at North Carolina State University in the late 1980s, we did not have an MRI at the teaching hospital. For many neurological diseases, this is the best and potentially only way to get an answer. So if a patient needed an MRI, we would have to head over to Durham and the hospital at Duke. The problem was this had to be done before the human patients arrived. As the senior student, this meant I had to be at the hospital at 4 a.m. to get everything prepared so that when the neurologist arrived an hour later we were ready to leave and head to Duke.
At our first facility on Remount Road, the only diagnostic equipment we had were an X-ray machine and ultrasound. The ultrasound produced such grainy, gray images I am sure many abnormalities were not visible.
Now at all veterinary hospitals of our size (and every teaching hospital) there are MRIs, CT scanners and advanced ultrasound machines. These allow us to see internal images of almost every organ and body system.
My residency in internal medicine trained me in not only internal medicine but medical neurology, oncology and cardiology. So when I arrived in Charleston, I treated patients for problems of all of these areas. My appointments often went from administering chemotherapy to a dog with lymphoma to performing an echocardiogram on a cat in heart failure to performing a colonoscopy on a dog with chronic diarrhea. The day might end with me trying to get a dog to stop having seizures.
As the years have gone by, veterinary medicine has gradually subspecialized, as in human medicine. There is just too much new information to be a Jack of all trades. There are oncologists who treat the cancer patients, cardiologists who deal with heart failure and neurologists to stop that dog from having seizures.
Now I can just focus on internal medicine that, for now, deals with GI, blood, lung, liver, kidney, pancreatic and hormonal issues. Recently there has been a proposal to make nephrology (a focus on the kidneys) its own specialty, so this will continue to change as the amount of information continues to grow.
When I step back and look at where veterinary medicine has gone in the past 30 years, I am amazed and excited to see what we will be able to do for our patients next.