June 22, 2020

My arms felt like heavy weights resting on the desk in front of the computer. It was 10 minutes until the lobby closed.  Everything seemed slower than normal.  I gave a sideways glance to the bags of bodies piled up; clear plastic totes filled with the recently dead filled the floor in front of my exam table. I sighed. At least 10 more patients to admit and then hours of records to write.  I had already admitted over 150 new patients in the last 9 hours—almost all of them sick or injured, brought in by a predatory human filled with a rescuer complex, praising themselves for their selfless act while they petted the terrified bunny, took selfies with the injured duckling, or showed the off the ill crane who had been forced into fight-or-flight for hours, causing its muscles to digest themselves [capture myopathy].  But only 10 minutes and I would be one step closer to leaving.  There was an invisible force keeping me from leaving my counter-height chair.  I forced myself to push the force aside, grabbed the 8 boxes containing 10 injured or orphaned wildlife and stacked them next to my exam table.

This part was usually rote, like highway hypnosis, until an injury or lesion was found: Write down the case number, do an in-the-box visual exam, put the animal in the weight bucket, finish the hands-on exam, make a decision and put the animal in the appropriate box.

20-8763 unidentified 1 animal. I opened the box, it was an American robin, juvenile based on plumage, he clacked at me to scare me away and at the same time left his mouth open, begging for food. This age was just starting to learn who was a predator and but would still take handouts from whoever offered (reminded me of human teenagers). Realizing I wasn’t going to feed him, he clumsily tried to jump out of the box-I caught him mid jump and noted the off-balance way he was using his legs.  Even for a clumsy teenager it was off.  I started by palpating the wings. Grabbing the bird with my left hand I extended the right wing with my right hand: right humerus, radius, ulna, metacarpals = normal.  Shoulders—no laxity (normal).  Elbow, wrist-normal range of motion. I tucked the the right wing back into the body and  continued onto the right leg. Right femur, tibiotarus, metatarsus, and foot all palpated normal.  The hip, stifle, hock and foot joint all had normal range of motion.  The problem was in the left side of the body.  I switched the bird to my right hand and repeated the palpation on the left wing and leg.  The wing was normal.  Femur-normal, tibiotarsus—crepitus (=grinding of broken bones).  There was a fracture in the distal tibiotarsus.  Gently, I repositioned the leg so I could better see and feel the fracture; the fracture was in the distal leg, near the hock joint, but far enough away I could likely get an intramedullary pin and realign the bone with surgery.  Luckily, the fracture was closed and had not broken the skin.  I placed the animal in the scale, wrote down the weight, and gathered the supplies I needed for a temporary splint—makeup sponge, ½” paper tape.  I started trimming the sponge—I saw the totes filled with bodies out of the corner of eyes and remembered the procedure lists for the next two days—several turtles needed their shells fixed, and had already waited several days for their turns in the surgery ward; dozens of juvenile mallards needed a feather procedure due to a mistake that another staff member made.  The organization had grown so fast, our facilities and resources couldn’t—we were out of space and people—any tiny mistake in management of the 1200 ducklings we admitted every summer resulted in dozens of health complications—everything was stretched to the max.  Any problem in the complex, well-oiled machine that was WRC snowballed into a huge complex knot that would need to be unraveled by me.  That’s why the ducks were here.  We also had 70+ recheck exams, an unpredictable number exams on whoever of the 1500 current animals in care spontaneously developed medical problems, and the 100 plus new patients that were due to show up in the lobby tomorrow—putting one more surgery on this already full schedule might break our already extended resources. Staff and volunteers were already pushed to their brink—COVID, the riots, 2000 more admits to date than last year—we couldn’t afford to lose anyone.  Any loss of staff in this well-oiled machine  would snowball into no more bandaids-we had used them all. The next step was mass euthanasia of groups of animals.

This one baby robin represented all of the problems of WRC, exacerbated by COVID and the riots.  How could one tiny bird carry such a heavy weight? I could barely move my hands off the desk 3 minutes ago, and somehow this 50 gram floof ball, gaping it’s wide yellow mouth at me, seemed to be able to carry that same weight, while it tried to hop around on a broken leg. He was so oblivious to the problems of the world, of humans. And yet I would put so much emotional burden into this little being, and lament his death.  If only I had more time, more resources, more skills—if only I could be faster, more efficient, a larger facility. If only. 

I gently wrapped the robin up in small piece of fleece, and gently placed him into the clear plastic tote already filled with gas anesthesia vapors.  He was placed onto a stack of at least another 20+ fabric rolls containing that many animals already deceased in the last few hours.

He would inhale his first breath in the box, be upset that it smells funny and stung his throat.  He would exhale and then inhale again, shaking his head.  He would then pass out, fully anesthetized before his next breath.  It was the most humane way we could think to euthanize most of our patients. Most.

“Dr Renee,” said an Intake Staff member coming from the direction of the front desk, holding a closed shoe box, “I have 5 bunnies that need a health check.”

“What’s the story?” I said as I stood up, grabbed my notes, and simultaneously wrote down my findings from the robin as I listened (Juvenile, 50 grams, left TT fracture, distal closed, thin, EOA [euthanized on admission[).

“Dog found the nest this evening, they immediately brought the bunnies in.  They aren’t sounding too keen on reuniting but I think I can get them to come around.”

I looked at the baby bunnies in the box.  They were pink, only a few days old, with dried umbilical cord remnants. Their bellies were full of milk; they had just been fed. 

“yes, they look really healthy.  They are too small to survive with us, so hopefully you can get them to take them back.  I’ll take a look and put them back up front when done”.

“thank you” the staff member left to try to go convince the finder to leash their dog for 2 weeks.

I gently placed each bunny into the scale one-by-one, at the same time doing a physical exam.  I wrote down the weights and double checked my palpation of their long bones as I put them back into the box.  One had a broken femur from the dog, I wrapped him up and put it into the plastic tote on top of the now deceased robin.  The rest were healthy, hydrated and full.  Their mom would come back some time around dawn to feed them again. She wouldn’t care about the dog smell or human smell or that they were gone for several hours—she would feed whoever was in the nest when she returned.

I placed the box of bunnies into the holding room with a note that told the volunteer we’d keep one for a femur fracture but the rest were healthy enough to go back. 

I returned to my pile of boxes left on my exam table and opened the next one.

20-8764 American Crow. I peeked into the box—it was an adult by eye color (brown) and mouth color( black). I groaned internally.  Adult crows almost never came in with an injury that was fixable.  They were an incredibly smart bird with highly advanced social structure.  They could scavenge and help each other when in need. I prepared my self for another euthanasia.  I peeked in the box again and noted a right wing droop.  I grabbed a towel and quickly threw it over the bird, scooped the bird up, bringing the left wing into the body with my left hand, and leaving the right hand a little more loose on the right side of the body.  I set the crow-burrito on the exam table and carefully revealed the right wing, leaving the rest of the crow wrapped up.  Gently, oh so gently, I palpated the metarcarpals—ok; wrist--ok, radius/ulna—ok; elbow—weird; and then humerus—I felt moist feathers ventrally and a dry crusty bone sticking out.  I glanced and saw ~1cm of necrotic bone poking out from beneath the wing. The degree of bruising, swelling and necrosis indicated this fracture was well over 2 weeks old.  There was way too much necrotic bone and soft tissue damage to repair.  I placed the crow-burrito on top of the now decreased bunny-burrito and closed the tote.  Adult, 420 grams, very thin, right open humeral fracture mid shaft 1cm necrotic bone EOA.

I worked through the rest of the boxes in this manner.  I was able to try and treat 3/10: a nestling Baltimore oriole who was thin and dehydrated but otherwise pretty perky, a hairy woodpecker who hit a window and would likely have a shoulder fracture (we would get radiographs tomorrow), and a lone mallard duckling found orphaned but otherwise seemed healthy.

It was closing time now, so I took one more look in holding room—my heart sank. The box of bunnies was still there. My note had another jotted on it, “finder refused to take back”.  I swore profusely out loud.  Fucking entitled dog-owners who can’t seem to leash their dog for two weeks.  Our intake staff is really good about playing the guilt card at the end so I’m sure the convo went something like “bunnies this age don’t do well here, if you could just leash your dog for 2 weeks, they would have a great chance with mom! Unfortunately they are too small to survive here-they really need their mother”.  So the finder knew what they were doing.

I should make the finder physically put these perfect, plump newborn neonates into the plastic tote of death. Maybe then they’d get off their lazy asses and leash their GD dog.

It’s a good thing I don’t often have to talk to finders.

I gently wrapped up the bunnies into a group burrito and placed them on top of the crow.  I whispered ‘I’m sorry’ as I clasped the lid shut.

Grabbing all my notes, I plopped back down into my chair and began entering all the information into our electronic medical records.  Each patient needs a minimum of 10-15 data points entered but many have more.  I start with the 3 patients that I did not euthanize. Mallard duckling, healthy to the nursery; oriole appeared healthy, but upon reading the history, I find he was caught by a cat. More swear word exited my mouth. Cats belong indoors and only allowed outdoors under supervision.  They cause so much destruction of wildlife, and owners are allowed to simply let them wander the neighborhood?  that wouldn’t be allowed with dogs but yet it’s acceptable for cats?  My 3 cats stay inside b/c it’s better for them and for the wildlife.  I write something snarky on the cage label about “another $*#$ cat”, prescribe antibitiocis, pain medication and a recheck exam.  The hairy woodpecker likely has a shoulder fracture, painful! So I prescribe a slew of pain medications, schedule radiographs for tomorrow and prescribe the anesthetic drugs needed for the anesthetized radiographs (we can’t simply ask the bird to lie still hahhaa).  I grab all the cage labels, med sheets, food sheets and distribute them to the appropriate boxes and locations for the appropriate staff and volunteers to put them away.

On the way back I check on my juvenile emaciated mange fox who is on IV fluids and a blood transfusion (from my own dog).  He’s alive. I count his respirations and HR—good.  I bolus another 2 ml of blood and return to the computer.

Taking a deep breath, I gather my notes.  It has been such a busy day, that I have barely entered any of the EOA or DOA animals I admitted from the day.  So I begin.  10-15 data points per patient are entered into the system, all ending in mostly EOA but a few DOA.  One by one, I cross them all off my scraps of paper.  Each line brings back the memory of the patient in a sudden “POP” manner in my brain.

20-8540 unidentified juvenile 25 g lethargic thin dying feathers EOA  .  Who was this? I furrow my forehead, trying to think—I forgot to write a species down—25 gram juvenile is likely a songbird…feathers? POP! I see the image in my head of a juvenile sparrow rushed to me by the intake staff member, caught by a cat, laying on its side, barely breathing.  I put it on the scale, noted it’s white feathers (a nutritional thing likely from being a runt or the parents feeding it fast food), and then set it into the euthanasia tote.  I enter my notes.

I repeat this process for the remaining 70 animals I have left to enter, taking a break every 10 minutes to check on my fox and bolus more blood. 

I feel very conflicted about the fox.  Having reviewed his initial bloodwork showing he was severely anemic, emaciated and dehydrated, we realized he either needed to be euthanized or put on IVF and a blood transfusion.  We don’t do these often due to volume of patients. But the day had been grueling, my intern was working with me, and we made the decision together to attempt.  So I took the time to draw blood from my dog, place an IVC in the fox, set up the IV pump and fluids, prepare the blood and give it.  The time investment in this fox went from 2 minutes (exam and euthanasia) to 1.5 hours.  I could have pinned that robin’s leg in less than 1. 5 hours.  Who am I to say the fox is more worthy of my time and medical care than the baby robin?

I pushed the last of the blood into the fox and flushed the line.  I replaced the IVF and reset the fluid pump.  I gave one last dose of diphenhydramine (to ward off any anaphylactic reaction as we decided not to cross-match), checked his temperature (normal, good), gave him a VERY small amount of VERY few calories (do not want him to die of re-feeding syndrome), wrapped his catheter and leg to prevent swelling, and left him for the night.

As I was walking back to my computer, a nursery intern came rushing into the room with a nestling house finch.

“he was doing ok last feeding but I found him like this just now”

I take the finch’s limp body, still breathing, but not able to gape or move much.

“I am going to euthanize him,” I tell the intern.

“ok” they say with a sign of relief.  This intern has been here several weeks. The first week or so, they appear upset when you tell them you with euthanize.  But after some time, they’ve been sent back with birds not doing well and have had the unfortunate opportunity to watch them deteriorate over the next few hours.  The sigh of relief tells me this intern is glad they won’t have to watch the bird die.  I am glad to take the burden off them. But independently, my burden is growing.

I return to my station and double checked the admit log for the day—filling in any data points I missed.  I finished reviewing the rest of the diagnostics my technicians completed throughout the day and adjusted treatment plans accordingly. Blood lead level was high on this squirrel, prescribed the 10 different drugs we prescribe for chelation.  This pigeon’s white blood cell count came down to a normal level, stop antibiotics.  New turtle radiograph shows she is gravid but has suspicious shoulder fractures—more radiographs needed when we sedate for fracture repair. And on and on.

I look around.  Luckily, my students have removed all the bodies from the treatment room.  When I don’t have students, I have to physically take them downstairs to the freezer myself; I do not think I could have handled that tonight without breaking down. I am thankful for all the support I have, especially on these tough days. I remember the conversation I had this morning with the staff member who takes our bodies for disposal. He was frustrated at the bloody bags, how his car stinks, how he’s asked for us to double bag them so he will no long take single bagged bodies; I have never heard him this frustrated (he is one of the nicest people I know). I apologize as I had not heard this before and reassure him we will double bag everything from now on—it’s not fair for him to have to endure that.  I put up signs and wrote communications, apologized to him again, he explained he’s been stressed because of planning his grandfather’s funeral which is this week.  I’ve been asking a lot of him lately because we are so busy—I feel guilt and sympathy for him, wish I could lighten his load, but I have no more left to give either.

I ask the closing technician if they need any help; they are good so I can leave. I say pleasant goodbyes to the volunteers and interns I pass on my way out, keeping that invisible barrier up to shield them from my pain.

On my way home I think about the day.  I don’t like feeling like god, choosing the fox over the robin. Did I really make that choice? Does it matter? It does if the fox is dead in the morning, when I could have chosen the robin. But I guess the robin could have died overnight as well. I have to remind myself over and over, that both would have died if we weren’t there. So isn’t some chance better than none?

I am both grateful and full of pain.  I love my job. But I wish I could do more because it doesn’t feel like enough…