Week Seven Part II - How to save a life...

Buckle continued to improve during my weekend. She had become active enough that the catheter had to be removed. We were ‘swimming’ her in a 50/50 salt/warm water mix that was just high enough to get her flippers wet. This is done to wash the urine and feces that we missed rinsing off and to promote bowel movements (more information than you wanted to know I’m sure).

When I came in on my Monday she was having a bit of breathing trouble and her temperature was elevated. We (as in me and another intern, Laura) continued on with the routine of the afternoon while the seasonal girls continued to monitor Buckle’s respiration rate and temperature. Elizabeth decided to drop in have a look at her as well.

Buckle had been closely monitored for a couple of hours when her vitals began to crash. Michelle and Elizabeth snapped into action and quickly had Buckle on the floor manually stimulating the seal to breathe and maintain a heartbeat. Elizabeth was prepping meds for injection from our ‘crash kit’ that contained a plethora of medications for saving a life (i.e., dopram, atropine, epinephrine, etc.). I was asked by Elizabeth to assist her in prepping these medications by keeping track of the meds being used and how much was needed. In the kit is a chart that outlines dosages for each drug and the dosage is dependent upon the weight of the individual. Some of the dosages were in fact ranges of amounts. This posed a problem. There was no one on site to consult. Our two resident veterinarians were out at the Steller Sea Lion colony helping to brand pups and were only available by satellite phone. Tim was absent as well at a network meeting in Homer. We were fortunate enough to reach both Tim and one of the vets by phone. The situation became highly intense with Michelle on the floor manually stimulating Buckle and calling out respiration and heart rates, Elizabeth on the sat. phone with the vet, and Laura on the phone with Tim relaying everything that was going on. And then there was me, like a deer caught in the headlights. I wasn’t sure of my role in the chaos. I had never been in a situation like that before. When I worked at The BCWP if we had an animal crash like Buckle did we would euthanize it. We didn’t have the same resources as The Center did and life saving drugs were not available to us. I felt as useless as a third nipple.

I kind of just did what was asked of me. I would cap needles for Elizabeth or get passed the phone and relay info to Tim or be the timer for respiration rates. At this point Buckle had received both a dopram injection to stimulate respiration and atropine to stimulate the heart. Her vitals continued to be irregular despite this. Her heart beat was infrequent, beating once every 30 seconds and her breathing had arrested. No one was able to get the oxygen up and running so the only alternative was to bag her. I was asked to breathe for Buckle using the bag and to pay close attention to her respiration. I had found a purpose among the chaos and I finally felt I was doing something for her instead of waiting for orders. I focused on only her and watched her mouth and nares for a breath. I would call out, “Breath!” every time she inhaled. I made sure I was depressing the bag at a steady pace. I was hoping I wasn’t missing anything and I was nervous about missing any breaths she may have taken. She was taking in air less and less despite my efforts. It wasn’t long before she stopped breathing altogether. Her heart stopped beating as well and Elizabeth prepared to inject her with epinephrine in a final attempt to save her. The epi was injected and I could see Buckle gasp and then nothing…

She was gone… We all sat with her tiny lifeless body out of respect for this creature and took a minute for ourselves. I silently wept to myself and caressed her head. I could finally touch her in a loving manner which was a bittersweet moment for me. I whispered an apology to her expressing how sorry I was that we could not have done anything more for her. I again looked for solace in the fact that we could learn from her and circumstances she came to us in.

Elizabeth sat down with Laura and me after talking to Tim and told us this was a great opportunity for us to examine a seal more closely than ever. So I did just that starting with her head. I opened the mouth and had a look inside: ran my fingers over her teeth and gums, probed the back of her throat, had a look at her tongue. I looked at her vibrissae and whisker beds, her eyes, examined her third eyelid and her ears. I next moved to her fore flippers and had a look at her nails and just how the joints all worked. Elizabeth brought out Buckle’s feeding tube, gave us a bit of a tutorial on tubing and we tried it for ourselves. Tim had suggested having us try a blood draw as well. So Elizabeth talked us through a blood draw: finding the proper site to insert the needle, how to redirect the needle and how to draw up blood. I was appreciative of the hands on education.

When we were finished, Elizabeth packed up the body and refrigerated it for necropsy. I had hoped I could be involved in Buckle’s necropsy. It would have brought the whole situation full circle for me. I was grateful when someone from vet services dropped the next day by to ask if any of us in rehab wanted to be involved in the necropsy. I eagerly shot my hand into the air and so did Laura.

Laura and I participated in the necropsy and we were responsible for cutting and labeling tissue samples. We got a candid look at what hyperthermia does to the internal organs. There was a notable amount of blood congestion in some of Buckle’s organs, most importantly in the brain. This was indicative of hyperthermia. Initially Buckle was exposed to excessive heat because she sat in an airport wrapped in a winter jacket in a poorly ventilated area for three hours. That heat essentially fried the part of her brain responsible for regulating body temperature. Buckle’s core temperature continued to rise, causing blood and fluids to be dumped into the vital organs. This caused the breathing problems; she had fluid in the lungs and the blood congestion seen in the organs. If the suspicions of her being septic were true then there was nothing we could have done for her. Her homeostatic mechanisms in her brain were totally damaged and was not able to fight this infection.

So there it was…closure. That was how I dealt with this unfortunate event. I needed to fully understand how and why Buckle died to cope with the loss. That was what happened with Axle as well. Getting to the heart of the problem gave their deaths a purpose, a reason why.

Everyone grieves in their own fashion in this line of work. Some will throw themselves into caring for the other animals. Some clean or occupy themselves with busy work. And some just cry. That is how we can come back in the next day and the day after that and so on.