My Growth through the Chinook Project

September 19, 2022

Yoo Jin Chrsitine Kim, AVC 2023, travelled to Port Hope Simpson as one of the student participants on the Chinook Project. As part of the experience, the students craft various pieces of reflective writing.

The Chinook Project was the defining moment in my veterinary career up to that point, where my passion for veterinary medicine was ignited, and I saw myself grow as an individual and as an aspiring veterinarian. 

Prior to Chinook, my surgical experience was fairly limited to the few procedures that were performed through junior surgery and through our community practice rotation. While I was grateful to have had some experience before coming to Labrador, I quickly found that my confidence and skills were quite lacking on Day 1. 

My first spay in Chinook was a small breed female dog who had recently finished a heat cycle. While I possessed the knowledge of performing a spay, I was still hesitant and slow to physically perform various parts of the procedure and lacked confidence in the type of ligatures (knots around blood vessels) I was placing. Dr. John Ruffino - one of our veterinarian mentors on the trip - was instrumental in my first procedure, providing me with all the guidance and encouragement that was needed to successfully perform the procedure while allowing me to have some independence at the same time. After that procedure, I had moments of doubt in my surgical abilities, and would’ve no doubt spent the next few hours ruminating over every single choice I had made if I had the chance to do so. However, our first day was so packed with appointments and other surgical procedures that it left no time to think about anything else, so I was able to practice the skill of letting go- and focusing on the future, rather than the past. 

After that mature dog spay on day 1, I had the opportunity to perform 4-5 neuters and two less difficult spays on days 2 and 3. Our mentors gave us an increasing amount of independence with each procedure to the point of allowing us to perform neuters and cat spays on our own with minimal guidance. It was interesting to see both my surgical skill and surgery times improve with each procedure, which is something I wasn’t able to observe in the past due to having big lapses in time between surgeries in junior surgery and community practice rotation. 

Christine (L) and Lindsay in a spay surgery

My surgical skills were again put to the test on Day 4 when I performed a mature spay  on “Kalesi” (a large-breed female with previous heat cycles) alongside Lindsey - one of my Chinook team-mates. This spay, in addition to being difficult in terms of the amount of fat contained in her broad ligaments and the size of her blood vessels, was also the last procedure of a long 12-hour surgery day. While Lindsey and I were excited to perform a difficult spay, our energy levels were close to being depleted. The surgery was successfully finished with a final surgical time of close to 3 hours in length, which gave a sense of fulfillment, but the struggles that arose during the procedure were still fresh in my memories. However, I was eager to see what I can learn from those challenges and hoped to use those lessons on my final day of Chinook. 

Christine in surgery while Dr. Plater holds a light

The next morning, Lindsey and I had the privilege of performing another mature dog spay on Bubba Jane - a 7 year old large-breed female with a history of having 7 litters in the past. 

This surgery was the first one of the day for both Lindsey and me (and the last procedure of Chinook) so we were more than determined to perform the procedure well. While the procedure was similar to Kalesi’s, in that there were engorged blood vessels with fatty broad ligaments, the manner in which we performed the procedure was different. The tips and tricks we had learned from Kalesi’s spay the previous night were recalled in Bubba Jane’s surgery, and we were no longer struggling or having any hesitation with the procedure. Thanks to our mentors, we were able to complete the procedure in an efficient and smooth manner (+ with confidence!) which was the perfect ending to our Chinook trip. 

In addition to seeing my competency as a surgeon improve on the trip, I also saw myself become more comfortable with anesthesia, even to the point of wanting to experiment with different protocols to determine the best anesthetic protocol for our patients. 

To give an example, on day 1 of Chinook, we followed the standard junior surgery protocol of providing dexmedetomidine and hydromorphone to all our patients, followed by propofol for induction. While this would work relatively well for spays who would be maintained on isoflurane gas, I found that monitoring anesthesia for neuters who had to be maintained under injectable anesthesia (propofol) was quite stressful, as they were not sedated enough prior to catheter/induction, and they required very frequent boluses of propofol to keep them under anesthesia. After some consultation with our lovely mentors (Drs. Plater and Ruffino and Melissa), we experimented with using acepromazine/hydromorphone as pre-medications, and inducing/maintaining with ketamine/midazolam for the rest of the clinic days. This combination of drugs provided a smoother plane of anesthesia with a lower amount of drugs required. 

Anesthesia isn’t my strong suit by any means, so having the confidence and the opportunity to experiment with different anesthetic techniques and drugs to see what the best combination is for our patients was quite a big deal. I can only attribute this change to the amazing learning environment of the Chinook Project, where everyone was supportive of each other and of trying new things.

Team 2022 in Port Hope Simpson