Writing is ImPAWsible

[Monday 11:30AM]

            After my morning appointments, I walk into my shared office to grab some lunch. I just got out of an appointment with four-year-old Bagel the Beagle. I love saying that because it’s so cute. I had to diagnose the poor thing with pyometra[1] and schedule for surgery.

            “Hey, Dr. Earhart,” I greet as I sit down at my desk adjacent to his. Dr. Earhart opened Four Paws Veterinary Clinic and took me on as an intern when I was in Grad school, and I interned for a total of three years. Upon my graduation, I asked him if he was hiring any new veterinarians, to which he responded that the job was already mine. There are three certified veterinarians that I work with: Dr. Ron Earhart, Dr. Jess Miller, and Dr. Bonnie Jameel. Dr. Earhart is very intimidating as he is the owner of the practice.[2] Meanwhile, Jess and Bonnie are the best and I love working with them (and you can tell because I refer to them as their first names, not Dr. Miller or Dr. Jameel). “I diagnosed Bagel with pyometra and need to schedule her for surgery. Who should do it?”[3]

            “You should do it!” he cheered.

            I feel my cheeks getting hot. “W-what do you mean? Jess is away on vacation.”[4]

            “So?” he asked. “She’s been praising you for weeks, she recommends that you are ready to perform surgeries on your own. Completely independent.”

            I smiled. I was nervous, of course, but excited. This is my first independent surgery and I couldn’t be happier that I’m officially a veterinarian. “Really? That’s amazing. I’ll schedule her for this Friday, then.” Before I can walk out of the room to tell the receptionist to schedule the surgery, what he says stops me dead in my tracks.

            “You’re going to have to write up a protocol[5] for pyometra. We don’t have one yet.”

[Monday 1:30PM]

            I sit munching on my carrots as I start doing some research about pyometra and veterinary protocol. I know absolutely nothing.[6] I’ve never had to write a protocol before, and embarrassingly enough, not even discharge statements either. Jess, who observed my surgeries, wrote them for me. Discharge statements and protocols are very similar to each other.[7] They provide the same information about what was treated, how it was treated, results of the surgery and the follow-up care, including any medications and doses, and diet or exercise changes. What discharge statements do not have are explanations of the emergency, in this case pyometra, and how to test for it. Obviously, I know what pyometra is and how to test for it because I diagnosed Bagel. But this is basically like writing a research paper! I need to remember to stay calm.[8] I absolutely hate research papers. I had a very bad experience in veterinary school.

[April 2024 at Tufts University’s Cummings School of Veterinary Medicine][9]

            Professor Cowell is literally the worst. He tells me to write this research paper on three domesticated animals of my choice, including history of domestication, mating, feeding habits, hunting behavior, social behavior, health history, how well they interact with humans, and a comparison of the three animals I chose—cats, cows, and elephants. The research paper ended up being 40 pages, with over 30 sources to support my research, all academic as in grad school websites and popular sources are not ideal. I slaved over it, went above and beyond his expectations, and then he has the nerve to tell me that I need to WRITE MORE? The worst part is he doesn’t even tell me what I need to add.

            “I think there’s something missing,” he told me ten minutes ago in his office. I went to his office hours for him to read over it and give me advice—although, I wasn’t expecting any since I and everyone who read it thought it was perfect. “I don’t know what it is, but I don’t love it.”

            My jaw dropped to the floor. “I’ve spent literally all semester on this. I’ve used every technique any writing and science class has taught me. You asked for a minimum of 21 sources, and I find 32,” I stumble with my words.

            “I know, and your research is amazing. Maybe that’s the problem. You need to rely less on research, and more on memorization of these kinds of facts.”

            “Do I really need to memorize everything little minuscule fact about the animals I’m working with?[10]”

            “I believe you should.”

            It’s no wonder I now dread research.

[Monday 1:35PM]

            I know that the research project I wrote in graduate school is not the same thing as this protocol, but it makes me feel the same thing. The amount of research going into this and the fact that so many people could be depending on my writing is just so daunting. It doesn’t make it better that I was trained wrongfully to memorize everything that I feel useless that I have to look things up.

I am knocked back into my senses when Julia knocks on my door. Julia is one of our veterinary technicians[11] and has become one of my best friends. She’s a year younger than me and started working there around the same time I started interning. She had just graduated from a four-year college with a degree in biology and decided to do training to be a vet tech while she decided if she wanted to go to vet school and earn some money while she decides.

            “What’s got you so stressed?” She could sense my anxiety from across the room.

            “This protocol. It’s so daunting. There’s so much to write.”[12]

            “Look at examples that we have. It’s basically everything that you already know. You might have to do some research in our books to get the prescription names and dose numerology.”[13]

            “I am freaking out about writing this protocol. I am honestly freaking about this protocol more than I am about performing this surgery.”

            “You’ve done surgeries before; you haven’t written a protocol before.”[14]

            “What if I write the wrong after-care and it causes poor suffering for Bagel?”[15]

            “You’re writing a protocol, not a discharge statement.”

            “Yes, but the protocol is the basis for discharge statements! Bagel’s owners are not the sharpest tools in the shed[16], I have to write simply for them, so they understand.[17]”

            “You have to write clear and concise, anyway,” Julia pointed out.[18]

            I nodded. “True.” I sighed. “I just got a lot to do.”

[Monday 7:30PM]

            I come home to read a note on the table saying that my husband, Jonathan, is on the night shift at the station. I greeted my two cats, Muffin and Pancake. Muffin is almost 11 years old and the reason I decided to become a veterinarian. She has been with me on this journey since the beginning. And then there’s Pancake.

            I walk towards our library and pull out my veterinary textbooks that I kept. I usually use the ones that the clinic has since I only write when I am there, but I kept these partially for sentimentality and because they’re interesting to reread. I never thought I’d have to use them to write a research paper.[19]

            I turn to the S.O.A.P chapters in Ryane Englar’s Writing Skills for Veterinarians.[20] If I remember correctly, variations of S.O.A.P include protocols. S.O.A.P stands for Subjective, Objective, Assessment and Plan—in simpler words, what is the emergency, what the treatment is, how to enact the treatment, and the plan for after-care.[21] So, I use that mentality as I break open the Handbook of Canine and Feline Emergency Protocol, Second Edition by Maureen McMichael.[22] This book literally has every single emergency that could ever happen to a dog or a cat, from endocrine emergencies to gastrointestinal emergencies and infectious diseases to reproduction emergencies. I flip to the reproduction chapter and find pyometra. Although in bullet point notes, this section on pyometra tells me everything I need to know, including the history of pyometra, the clinical signs, diagnostics, treatments with numbers and medications specific to the species, and the prognosis.

            As I already knew, pyometra is a life-threatening infection in the uterus. The infection results from hormonal changes in the female’s reproductive tract because during estrus[23], white blood cells[24] are inhibited[25] from entering the uterus. This allows sperm to enter the uterus safely—however, if pregnancy does not occur for several consecutive estrus cycles, the uterine lining continues to increase in thickness until cysts[26] often form within the tissues, which creates an ideal environment for bacteria to grow in. Bacteria leads to infection[27]. When examining Bagel, I was informed that she was lethargic, stopped eating, and seemed depressed all the time.[28] While, these symptoms could mean a lot of things, I began the exam and found pus underneath her tail. The preferred treatment is to remove the uterus and the ovaries, which is why I scheduled Bagel for surgery. This surgery is exactly like a spay; however, the surgery is done on older females who were not spayed, thus their reproductive tract causing them pain and depression.[29]

            MEOW. The two little kitties (no, they are not kittens, but they are to me), rub up against my legs telling me they want dinner. That’s right! It is now 8:30 and I’ve been so intrigued by reading these books I forgot to feed them. I stand up off my bed and walk towards the kitchen. Although the cats have kibble out all day, I still like to give them a little treat at night.

            I sit down at the dining room table with my computer. I open a Microsoft word document and begin my protocol.

            The first step was to title the protocol procedure. PATIENT CARE: PYOMETRA[30]. Also, when I get to the surgery, I need to title it SURGERY: PREPARATION OF PATIENT so I inserted a page break to indicate the second section of the protocol. How I am going to set it up is in the patient care section I will include what pyometra is, how to test for it, a brief section on how to treat it, and then the after-care instructions. In the surgery section, I will do a step by step protocol of the surgery, including a protocol for the team members and for sterilization of equipment. Oh, I should insert two more page breaks titled SURGERY: PREPARATION OF TEAM MEMBERS and SURGERY: STERILIZATION OF EQUIPMENT, respectively.

            I begin writing that pyometra is a life-threating disease and how to test for it.

PATIENT CARE: PYOMETRA[31]

HOSPITAL NAME: Four Paws Veterinary Clinic[32]

Date created or updated: 17 June 2029

PC55[33]: The practice utilizes a written protocol and training program that addresses how to identify and report pyometra in female dogs. This includes concerns such as lethargy, depression, unprovoked weight loss, and pus forming around the vaginal area.

Purpose[34]:

Symptoms[35]:

Treatment[36]:

After-care[37]:

SURGERY: PREPARATION OF PATIENT[38]

HOSPITAL NAME: Four Paws Veterinary Clinic

Date created or updated: 17 June 2029

SX11[39].  The practice utilizes a written protocol for the preparation of surgical patients, addressing: 

Appropriate order, duration and timeliness of preparation
Preparation of specific body areas
Methods of antisepsis
Antiseptic products
 

Purpose:[40]

Procedure:[41]

SURGERY: PREPARATION OF TEAM MEMBERS[42]

HOSPITAL NAME: Four Paws Veterinary Clinic

Date created or updated: 17 June 2029

SX19.  The practice utilizes a protocol to ensure proper preparation of surgeons and surgical assistants.

Purpose:[43]

SURGERY: STERILIZATION OF EQUIPMENT[44]

HOSPITAL NAME: Four Paws Veterinary Clinic

Date created or updated: 17 June 2029

SX34.  The practice follows a written sterilization protocol that provides for appropriate sterile equipment and supplies.

Purpose[45]:

            Okay, now that I’ve set up the template, I just need to fill in the blanks. Thump. I look on the table and see that my cat Muffin has jumped up on the table. She navigates herself around my computer and proceeds to step down onto my lap. She cuddles herself into a ball and falls asleep. I left my books with all the information about pyometra on the floor in the guest room, where our mini library is located. Well, I cannot disturb the sleeping kitty cat.[46]

            Content with what I’ve accomplished tonight, I close out of Microsoft word and open Netflix. The Vampire Diaries’ fifth spin-off just uploaded their most recent season. I cuddle with my cat and watch the show—my protocol isn’t due until Friday, anyway.

[Tuesday 7:30PM]

I walk through the doors of my home after a long day of work. I’ve been so eager to come home to work on and finish my protocol. However, I walk through the doors to see rose petals and a candle light dinner prepared before me. The dinner was pizza, but it was still romantic.

Oh shit. It’s June 18th! It’s Jonathan and my anniversary! I bought his gift and wrapped it weeks ago, but I completely forgot!

He’s smiling across the room at me and says, “Happy Anniversary.” It’s the 12-year anniversary of us being together, but the 7-year anniversary of us being married. Yes, I wanted to keep the same anniversary.

“I’m so sorry, I completely forgot!”

“You?” he laughed. “The girl who wanted to celebrate every single month the first year we dated, and the girl who remembers the dates of the first time we kissed, said I love you, got engaged, met the parents—”

“I know. I’ve just been preoccupied at work.” He smiles and grabs my hand, pulling me towards our dinner table. He kisses my forehead and pulls out my chair and motions for me to sit down.

I sit down at the table and decide what’s one more day?[47]

[Wednesday 11:30PM]

            I cannot believe this took me almost four hours. I thought it would be much quicker than that! But, whatever. Time flies when you’re having fun—although, I wasn’t really having fun.

            I decide to reread what I have.[48]

PATIENT CARE: PYOMETRA

HOSPITAL NAME: Four Paws Veterinary Clinic

Date created or updated: 17 June 2029

PC55: The practice utilizes a written protocol and training program that addresses how to identify and report pyometra in female dogs. This includes concerns such as lethargy, depression, unprovoked weight loss, and pus forming around the vaginal area.

Purpose:  Pyometra is a life-threatening disease appearing in the uterus of female dogs and cats who were not spayed. Pyometra is a secondary infection in the female’s reproductive tracts. It must be treated quickly and aggressively.[49] The infection results from hormonal changes in the female’s reproductive tract because during estrus, or heat[50], white blood cells, which usually protect against infection[51], are inhibited from entering the uterus. This allows sperm to enter the uterus safely—however, if pregnancy does not occur for several consecutive estrus cycles, the uterine lining continues to increase in thickness until cysts often form within the tissues, which creates an ideal environment for bacteria to grow in and leads to infection.

Symptoms: Symptoms would include vomiting, refusal to eat, fever, lethargy, increased thirst and frequent urination. Uncomfort and depression will be present. The major indication of pyometra is when pus forms around the vaginal area and when it is present on the surface the animal was residing on.[52]

…

I feel like I’ve written too much, that I have information that is not really needed.[53] Do I need to write the preparation of the veterinarian and the vet techs?[54] Do I really need to write instructions on how to sterilize the tools?[55]

            I decide that I should peek into the drawer at work tomorrow and compare my protocol to the ones my colleagues have already written. Why I waited until the last day to do that is beyond me.

 [Thursday 1:00PM]

After looking at the examples we have in the cabinet, I feel hopeless. All my information is right, and I included everything I had to—but my protocol is so much longer than theirs!

Julia comes into the office to ask me a question and sees me staring at the wall. She knocks on the door to snap me out of my gaze. “Hey, Bry, what’s up?”

“Oh, nothing much,” I lie. “Just struggling to think of something.”

“Are you writing your protocol?”

I groan and hang my head. “I might as well just give up I cannot do this.”

“Woah woah woah,” she sits down beside me. “Can I look?”

At first, I don’t say yes right away. I am a little bit wary about getting feedback from other people since my professor at Tuft’s gave me completely wrong advice. I then remember that everyone in this clinic understands the clear and concise method, and with all the formularies we have lying around I doubt my colleagues have everything memorized. I nod in defeat and let her look at what I’ve. “This is really good, what’s got you stuck?”

“Everything! I’ve been researching protocols all week, but I still feel stuck.”

“Oh, shit.” Julia shook her head and laughed. “It’s okay to ask for help. Bonnie will be completely understanding.”

“I can’t go see Bonnie. She’ll think I’m helpless.”

“Now, why would I think that?” Bonnie grinned as she walked into the office.

“Bryana’s stuck on her protocol!” Julia blurted.

Bonnie smiled at me. “Why would that make me think you’re helpless? This is your very first protocol, not to mention first standalone surgery—with the exception of the techs,” she laughed. “I don’t doubt that the stress of performing this surgery is interfering with your ability to write, or even comprehend research. There’s no harm in asking for help.”

I laughed, feeling a little relieved. “Thank you, Bonnie! I realize that now.” She sat down beside me and asked to see what I wrote so far. “I looked at the ones you and Jess have wrote, and mine is so much longer.”

She nodded. “You do not need to write more than you have to get your point across[56]. Be clear and concise, and do not explain every little thing. These protocols are for you and other veterinarians. You do not need to subsidize the veterinary terms, because we all know them. When shrinking this information into a discharge statement, then you use simple, non-medical terms. Also, protocols, while they are supposed to share a ton of information, it needs to be concise because before going into a surgery you don’t want to read 12 pages of the surgery and aftercare. 4-5 pages is plenty to get your point across. Does this help?”

I nodded and smiled. “A lot of revising[57] I have to do tonight!”

[Friday 11:45AM]

Currently, I am in my office finishing up the discharge statement so I can call Bagel’s owners and let them know it is time to pick up their beloved dog. I finished the protocol last night and I am pretty darn proud of it! I showed it to Bonnie and Jess this morning and they were impressed. We added it to the protocol file, so now when any of us must perform this surgery/treat this disease again, my work is on display to help my fellow veterinarians! I competed the surgery itself of removing the uterus and ovaries just an hour ago and have been writing the discharge paper since we settled Bagel in her little bed to rest. Typically, veterinarians can have hours to write the discharge statements as owners won’t be able to pick up their animal until after work or until the animal has fully awoken from the anesthesia[58], which can take a couple of hours based on the size of the animal. However, we do like to get these done sooner rather than later so that our furry friends can go home and rest. It took me about ten minutes to write this discharge statement. Now all I must do is sign off on the bottom and call Bagel’s owners. Oh, I also must send a copy to the receptionist so she can get the medications together and make labels on the prescriptions.

FOUR PAWS VETERINARY CLINIC DISCHARGE SUMMARY[59]

Client: Bagel Dayton[60]                                          Animal ID: FPVC1145
Diagnosis: Abnormal discharge from the vagina, known as pyometra[61]
Treatment / Tests: Surgery removing her uterus. She was put under animal anesthesia. An incision was made to remove the uterus and then the skin was stitched back together. [62]
Medications: Oral antibiotics should be taken one tablet a day daily for 2 weeks.[63]
Exercise: Very little exercise to allow for healing. [64] [65]
Dietary Restrictions: There are none.[66]
Recheck Date: 07/04/29 [67]
Addition Instructions: Patient remained calm before and after surgery. She was very cooperative. Surgery went smoothly. Full recovery is expected. [68]
Veterinary Signature[69]:                                            Date: 06/20/29
If you have any questions call 508-902-6781 [70]
 

Bagel is around the corner and I can hear her barking as she comes out of her loopy state from the amnesia. She sounds happy. I send the discharge paper to the printer and walk over to see Bagel.

“Hi Bagel!” I greeted and lean down to the cage. I beam with pride that this dog is now waving her tail and already appears to feel much better after getting her problematic uterus removed! And I did it! And not only did I do it, but I wrote the perfect instructions to give to her owners.

“Dr. Wanko,” our receptionist Hannah calls. “Bagel’s owners just arrived,” she tells me.

“Oh wow, they beat me to the punch,” I mutter. I hadn’t even called them yet.

I shrug and open Bagel’s cage and the little dog crashes into me almost like a bear hug. She’s wagging her tail, even more thrilled to be free from the tiny cage.

“Let’s go, Bagel!” I cheer as I hook her on her leash and lead her to the front of the clinic, making sure to grab my discharge paper.

“Bagel!” Mrs. Dayton exclaimed as she saw her beloved pet galloping towards her. It was quite a sight to see.

After Bagel and her owner had a beautiful reunion, I briefly explain everything that was on the discharge paper to Mrs. Dayton. She nodded as I spoke, so hopefully she understood what I was saying. “Everything is written down on this sheet of paper. Call us if you have any questions, our number is at the bottom of the sheet.”

“Thank you, so much!” She beamed. I leaned down to scruff Bagel’s chin one more time and then they were gone.

“Nice work today!” Dani said.

“Yes, congratulations!” Bonnie smiled from behind the desk where she was helping Hannah with something. “I know it can be overwhelming doing something for yourself for the first time, but you did great. Remember, do not overthink it. You will never be taking an exam here. Those times are long over,” she chuckled.

I laughed, too. I made my way to the break room where I saw Julia. “Hey Jules, wanna go get lunch?”

[1] Jargon: Pyometra is a disease in the uterus.
[2] Audience: She doesn’t know it yet, but Dr. Earhart being very intimidating and the hand who holds her career, she will be scared to write her protocol in fear of what he thinks.
[3] Ethos: I am asking Dr. Earhart since he is my superior.
[4] Ethos: Jess is another one of my superiors. She has been shadowing me for the past eight surgeries I have done by myself. When becoming a veterinarian, you observe some surgeries before you can do it on your own, and then when you are doing them by yourself you have an experienced veterinarian observe you to make sure nothing goes wrong.
[5] Genre: The assignment my character is given is to write a protocol on pyometra. A protocol is an explanation of what the disease is, how to test for it, how to treat it, and how to recover from it.
[6] Assumption: My character assumes she knows absolutely nothing, which is not true. She knows what to do and how to do it, but everything is scattered in her brain. She needs to organize it and put it together.
[7] Primary source: Jessica Willet, the veterinarian I interview, explained this to me.
[8] Writing Process: My character needs to stay calm. Stressing about the protocol will just taunt her to procrastinate.
[9] Flashback
[10] Genre Awareness: Although research papers are not very common in the field, he is implying that you have to memorize everything about the animals you are working with, including medications and doses. This is far from the truth. There are books available to help you, although the longer you work as a veterinarian, the more you’ve become aware of the genre. The veterinarians I’ve worked with know so many facts when they’re in the appointments and when I asked how they remember all of this information, they responded that they’ve explained it to clients so many times over the years and they just got used to saying it.
[11] Jargon: Veterinary Technicians are the nurses in the veterinary world
[12] Assumption: She assumes that this will be time consuming.
[13] Secondary Sources: Extremely helpful books such as the Dictionary of Veterinary Terms: Vet-speak Deciphered for the Non-Veterinarian by Jennifer Coates, Writing Skills for Veterinarians by Ryane Englar, and Handbook of Canine and Feline Emergency Protocol by Maureen McMichael will provide all the information she will need to write this protocol.
[14] Logos: Julia makes a logical conclusion to my character’s nerves.
[15] Consequences: If she writes the wrong after-care instructions or prescribes the wrong medications, then Bagel will suffer the consequences.
[16] Assumption: She assumes that Bagel’s owners are dumb.
[17] Audience: Mr. and Mrs. Dayton are Bagel’s owners and the primary audience for the discharge statement. Discharge statements are supposed to be written clearly and simple so that non medically trained people can understand. In addition to that, the discharge statement must be even more facile to comprehend because the primary audience is not that smart, so her word choices will be over simple.
[18] Genre Awareness: When discussing surgeries and medicines, there are words that not everyone understands. Not everyone is medically trained, so when speaking to owners or writing discharge statements, you must write in a way that those not medically trained can understand.
[19] Preconception: She didn’t think she’d have to use the books again but kept them for other reasons.
[20] Secondary Source.
[21] Jargon: Even in her head, my character is already taking out the medical terms and using well known ones.
[22] Secondary Source.
[23] Jargon: Estrus means when a female mammal is in heat. All mammals, with the exception of higher primates, go through heat. This is the stage in the cycle where they are most fertile and sexually active.
[24] Jargon: White blood cells protect against infection.
[25] Jargon: Prevented
[26] Jargon: In the body, a cyst is a membranous sac or cavity of abnormal containments of fluid.
[27] Secondary Source: I found this information on the Veterinary Centers of America website.
[28] Genre Awareness: These are clinical signs, or symptoms, of pyometra.
[29] Secondary Source. Information found on the VCA website.
[30] Writing Process: My first step was to title what I was writing. This isn’t the type of title where you should wait until the end to come up with a create title—this was a scientific report; it needs to be straightforward.
[31] Genre Awareness: When writing out surgical procedures, the title is addressed as PATIENT CARE: *name of procedure*
[32] Genre Awareness: Templates I found online included the name of the hospital and the date the protocol was created/updated.
[33] Genre Awareness: This abstract section is given a symbol PC for Patient Care.
[34] Genre Awareness: This is where the explanation of the disease is written.
[35] Genre Awareness: This is where a detailed description of the symptoms of said disease is written.
[36] Genre Awareness: This is the part in the procedure where a brief overview of the surgery is indicated.
[37] Genre Awareness: This is where the instructions of the after-care is written, which is also the basis for a discharge statement.
[38] Genre Awareness: While finding protocol templates, I also found templates on how to prep for surgery which could possibly be included in the overall protocol packet. How to prep the patient is an important part in surgery as you would want a patient under anesthetic, for a blanket making them comfortable, and cloths covering their body so when you do incisions the blood does not make a mess on their body or fur. This section will also include the step by step instructions for the surgery.
[39] Genre Awareness: The symbols SX stand for Surgery.
[40] Genre Awareness: This is where the instructions for making the patient comfortable is written.
[41] Genre Awareness: This is the step by step surgical procedure.
[42] Genre Awareness: The preparation of team members would include putting on masks and gloves, which is important to not forget as the anesthetic in the room could be inhaled or blood could stain the hands.
[43] Genre Awareness: This is where the instructions for putting on masks and gloves would be.
[44] Genre Awareness: Although obvious, having instructions on how to sterilize equipment can never be overdone.
[45] Genre Awareness: This is where the instructions on sterilizing equipment would be.
[46] Constraint: I cannot work on my protocol as I left my books in a different room and am trapped by the cuteness of my cat sleeping on my lap.
[47] Constraint: Another day has passed, and I have still not continued working on my protocol.
[48] Writing Process: After spending hours writing her protocol, she decides to read it over again.
[49] Genre Awareness: While this introduction is accurate, it’s a little too lengthy. When she has to revise this later in the story she would only need “Pyometra is a life-threatening disease appearing in the uterus of female dogs and cats who were not spayed. It must be treated quickly and aggressively.”
[50] Genre Awareness: When revising later, she can delete the phrase “or heat” because all trained veterinarians and vet techs know that estrus means heat in certain mammals.
[51] Genre Awareness: Most people who took biology will comprehend what white blood cells do and this does not need to be written when the audience are all trained medical professionals, so when she is revising, she can remove this phrase.
[52] Genre Awareness: While all the information is correct, there are three unneeded sentences. When she revises later in the story, she will only need to write “Clinical signs to look out for include vomiting, anorexia, refusal to eat, fever, lethargy, increased thirst, frequent urination, depression, and pus forming on the skin or hair under the tail or on the surface where the animal has recently laid.
[53] Genre Awareness: She understands that she has written more than the genre requires, but her training in grad school taught her to write every little thing and that training is engraved in her head.
[54] Audience: My character is pondering whether she needs to take into consideration the vets and vet techs performing this surgery in the future. Do they need these preparation steps? Or is it automatically assumed as they have to do this all the time.
[55] Audience: Will the vets and vet techs need these instructions about sterilization, despite doing this every day, sometimes up to five times a day?
[56] Primary source: This advice was given to me by Jessica Willet, the veterinarian I interviewed.
[57] Writing Process: All steps of the writing process follow you no matter what career you go into.
[58] Time Constraint: Although, not a constraint, veterinarians can have hours to fill in a document that takes less than ten minutes.
[59] Genre Awareness: This is the discharge statement, now meant to follow up the information from the protocol to give to the owner.
[60] Genre Awareness: Name and ID of the patient is required.
[61] Genre Awareness: The diagnosis only requires the cause for surgery. There should be no medical explanation of the disease itself.
[62] Genre Awareness: The explanation of the surgery is kept simple and short. Just a quick explanation of what was done.
[63] Genre Awareness: The amount of medication dose is based on the weight of the dog. Bagel is a medium size dog, so she requires one table daily for two weeks.
[64] Genre Awareness: Limited exercise is recommended to promote optimal healing in the wounds.
[65] Audience: She also used simple words instead of limited and optimal so that the owners can understand that very little exercise is the quickest way to recovery.
[66] Genre Awareness: There are no dietary restrictions.
[67] Genre Awareness: Surgeries require a post-operative check approximately 14 days after surgery to check for adequate recovery and healing of the wound site. Also, the removal of stitches will occur during the recheck date.
[68] Genre Awareness: As I observed when I was shadowing Dr. Freedman, in the additional notes section he likes to provide positive feedback on the patient’s behavior before and after surgery.
[69] Genre Awareness: Without the veterinary signature, the patient would not be allowed to leave the premises.
[70] Genre Awareness: At the bottom of discharge papers is the number to call if something is wrong with the animal at home. My character shows that she understands what the genre of discharge paper entails.