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A Fine Balance
Submitted by ucedas on Sun, 03/18/2012 - 11:23pm
Some of the most humbling experiences for Ron Mandsager have come with the strongest animals. Intubating a polar bear, for example, came with the task of holding the animal’s mouth open and placing a tube in its trachea. Watching a gorilla yawn on the operating table revealed canines the size of Mandsager’s thumb. Once, while holding an orangutan’s hand as the animal woke up from anesthesia, Mandsager felt the creature’s strength when it began to squeeze his hand – hard.
“It’s pretty intimidating, sometimes, seeing what these animals are capable of doing,” he says.
In a way, it’s Mandsager’s job to soothe them – he’s a veterinary anesthesiologist, and making sure animals from dogs to cats to gorillas to giraffes go down for surgery and then wake up is his job.
“One of the things I talk about with my students is that putting a patient to sleep is not hard, “ he says. “It’s the waking up part that takes skill. I remember seeing that early on a few times, and thinking, ‘This is pretty neat that you can accomplish that.”
For the past 3 years, Mandsager has been working at Oregon State’s College of Veterinary Medicine and in the Lois Bates Acheson Veterinary Teaching Hospital. He and Dr. Thomas Riebold, a 30-year veteran at Oregon State, make up the college and hospital’s anesthesia team. Assisting them are three certified veterinary anesthesia technicians, a resident, and anywhere from 3 to 5 senior veterinary students on a three-week rotation.
“One of the things I enjoy about working with students is watching them often come into the anesthesia experience quite nervous and scared, but watching them figure it out. They think, ‘Hey, I can do this,’ and at the end of three weeks they’re not as scared,” he says.
Mandsager and Riebold are two of only a few board-certified veterinary anesthesiologists in Oregon. Acheson is also the only clinic in the state with two full-time anesthesists on staff. It makes Mandsager and Riebold unique. The fact that the hospital offers sophisticated diagnostic and specialty services, like cardiology, is a draw for animal owners throughout Oregon.
Mandsager comes from a medical family. His father was a general surgeon, and two of his older brothers are physicians. But he always loved animals, so much so that when he flips through the drawings his mother saved from his childhood, every single one of them features an animal, whether it’s a dog, cat, or something more exotic – a giraffe, maybe, or a lion.
It was natural fit for him to go into veterinary medicine. But he got hooked on anesthesia when he started to see how pharmacology and physiology mesh together. The transformations patients undergo with the anesthesia experience fascinated Mandsager. “They go from awake to unconscious, painful to pain free,” he says. “We create a lot of changes in physiology – cardiovascular changes, respiratory changes, and so we’re monitoring things and adjusting them constantly.”
It’s a puzzle, even in straightforward cases in which the patient is healthy. It’s even more so when a patient comes in with complications. A horse with severe colic, for example, may come in having needed surgery for a long time – the patient could present with metabolic issues, or electrolyte or fluid balance abnormalities, the result of which is an unstable cardiovascular performance. It makes it harder for Mandsager and the team to keep things stable for the patient during surgery.
Mandsager considers it his job to keep a cool head in potentially tense situations. It helps keep the students calm, and it helps them see that it’s possible to solve complicated problems when a lot is at stake. Mandsager loves watching his students progress as they move through the college’s curriculum, from lectures and labs in the second year, to their hands-on rotation in their senior year. The fact that rotation sizes are small, as well, means that students get even more guidance from professors like Mandsager.
“It takes time to feel comfortable in a more challenging case, but that’s what we’re here for,” he says. “But they feel comfortable that they can do the basics. It’s fun to watch. It’s satisfying.”
According to Mandsager, veterinary medicine has evolved as human medicine has evolved. The ability to do more complicated procedures has ratcheted up people’s expectations. But he feels Oregon State has the ability to meet them. “I think clients can be very comfortable having their patients anesthetized. They know they’ll get good care and it’s not one of the things they have to worry about.”