Scribbles in the Potions Textbook

​Written by Michael W. Miller, DVM
 
Certain memories from vet school stick with you forever.  Some are worth forgetting, but others are useful to reminisce about.  One of my memorable vet school moments came from my first rotation of my clinical year. 
 
One of my closest friends and I started on the small animal surgery rotation.  She was really anxious because her goal was to go on to do a surgery residency, so she really wanted to impress the clinicians.  On the first day, we were all assigned a patient for the following day.  We were expected to research the surgery techniques and present a plan for the procedure at morning rounds.
 
My friend went first.  She had pages and pages of notes.  Her presentation was thorough and detailed and right out of the surgery book.  When she ended, the attending surgeon thanked her for her presentation… and then told her that he did NOT agree with that approach to that surgery.  His technique would be completely different.
 
My friend was crushed.
 
She asked what book she should have used to research the surgery, and the surgeon didn’t have an answer.  His technique wasn’t published in a book.  It was what his mentor had taught him.
 
It was a powerful lesson.  Not everything in vet med is published in the textbook.  And, just because it’s not in a reference book doesn’t mean it’s not an appropriate version of treatment.
 
Looking back at that situation, I’m reminded of Harry, Ron, and Hermione’s sixth year of potions at Hogwarts.  Harry had stumbled upon the Half-blood Prince’s annotated version of the book Advanced Potion Making.  Many veterinary hospitals have similar books on their shelves with handwritten notes about drug dosages or treatment plans in the margins.
 
Harry was successfully making complicated potions using the unofficial, scribbled recommendations in the book.  Hermione was horrified that he wasn’t following the book, and Ron was upset that Harry wouldn’t share the book with him.
 
Those three personalities also happen in vet med.  Some are like Harry, willing to try any recommendations they come across.  Some people are like Hermione and reluctant to try anything not published in a reference textbook.  Others are like Ron, feeling left out as their peers appear to succeed using resources unavailable to them.
 
The cautionary tale of Harry’s use of his potions book is very useful to veterinary professionals who want to blindly follow the annotations they find.  Plenty of valuable veterinary information is available that is not published in textbooks.  But, sometimes un-published recommendations can be incorrect and dangerous.  So, how do we tell the difference better than Harry did?
 
The truth is that many of the annotations in veterinary references are based on reputable resources.  Those notes didn’t just magically appear.  Someone read a peer-reviewed journal article, attended a continuing education conference, or refined a technique over years of experience.  That person who wrote down the new recommendation had a reason to believe it was better than what the book said, and they know exactly what their notes mean.
 
Danger comes when someone new looks at that note and misinterprets it.
 
For example, I have heard of a veterinarian looking at a colleague’s recommendation for a dose for fish anesthesia and then later discovering it was actually the euthanasia dose!  That’s a huge potion-making mistake!
 
One thing that was tough early in my career was determining whose recommendations I could trust like they came straight from Professor Dumbledore versus who I should approach more skeptically - like a Gilderoy Lockhart or Dolores Umbridge.  Not all recommendations are equally weighted.  Learning who is more reliable seems daunting, but discussions with your colleagues and mentors can be a valuable tool to help you find the Dumbledores.  Discovering which mentors, teachers, presenters, and authors align with your ideal way of practicing medicine will help you develop your own annotated references that work best for you.
                                                                                                      
One of the mistakes we can make in vet med is acting like Hermione did when faced with the annotated potions book and ignoring helpful adjustments to prior protocols when they appear.  Yes, the skepticism can be helpful to avoid following incorrect information, but ignoring all new ideas can reduce your ability to improve your medicine. 
 
(Let’s be real though… as a vet, Hermione would have welcomed innovative discoveries and have the best annotated evidence-based medicine notebook with up-to-date advances from cutting-edge research – and we would all be begging her to share it with us!)
 
Also, to avoid colleagues feeling left out like Ron, we as a profession need to continue to get better at sharing the tips, tricks, and advancements that we discover.  We rise better when we rise together.  The time of protecting secrets to have an advantage over our competitors is gone.  There are plenty of pet owners out there for us to help and to create a profitable and sustainable business around.  We have the opportunity to continue to advance the entire profession by sharing what we learn with each other.  If presenting at conferences or posting in online resources gives you too much anxiety, then please at least have these discussions with your friends in this profession. 
 
The part that is most upsetting to me about the marked-up potions book is that Snape had clearly created better recipes for Potions, but he refused to share them with his students.  That is not helpful.
 
Thinking back to my memory from vet school, the best thing our attending surgeon did was to teach us his technique.  After all, that’s why we were in school – to learn.  My friend received a valuable lesson that day about an unpublished technique for that surgery, but also learned the value of being open to another way to perform a procedure even if it’s not what the book says.  I am proud to say that my friend built on that lesson and is on her way to becoming a board-certified small animal surgeon… and I use that lesson to ask her for surgery advice when I cannot find the answer in a book. 
 
Our vet school teacher taught us to discover the magic in learning techniques that may not be published in the textbook.  The challenge is finding similar trustworthy mentors willing to share their unpublished knowledge.  By utilizing sources that you find dependable, you can discover the magic of veterinary medicine that was not written in your textbooks.