As my time here is wrapping up, I think I will probably do a series of short blog posts on topics that at one point I was considering spending a lot of time on. So first up, here’s a short bit on toxicology inspired by my trip to the National Botanical Gardens (possibly one of my favorite places in DC!). I hope I do The Antidote proud.
While walking through an exhibit on roots and root structure, I spied my first toxic plant! It was Johnson grass (aka perennial sudan, aka sorghum)! Look at those roots- amiright!? As any vet student will tell you, sorghum species are toxic by two mechanisms- they contain cyanogenic glycosides and nitrate/nitrite. Horses, cattle and sheep are the primary species affected, and toxicosis is most common in the southwest USA. Clinical signs include incoordination progressing to ataxia and flaccid paralysis. Look out for this one, guys!
Later as I was wandering around I saw a tall, beautiful, weird looking tree with big yellow fruits hanging off the trunk. The sign proclaimed “Theobroma cocoa”- the cocoa tree. It is fitting that a tree called Theobroma would be full of theobromines, which is the toxic part of chocolate and other cocoa products. The most common species affected is obviously dogs, who commonly eat things that aren’t even food so I guess we should cut them a break for getting into chocolate. Common clinical signs are vomiting, tachycardia, arrhythmias, tremors, hyperthermia, seizures and death. This is a super common toxicity (my dog got into some a few months ago!), but that doesn’t mean it’s not serious. Take your dog to the vet if you notice they’ve gotten into any!
The last plant I’ll tell you about is the most common plant around- you’ve probably seen it today. It probably grows by your work or school, or outside of your grandma’s house. It’s EVERYWHERE. It’s yew.
Taxus spp. are small coniferous shrubs who’s small elliptical leaves are toxic to all species. The most common species affected are cattle, but other herbivores are not uncommon. Death can come suddenly or can occur a day or two after ingestion. Symptoms include ataxia, diarrhea, hypotension, colic, hypothermia, coma, seizures, weakness, respiratory failure, bradycardia and sudden death. Oftentimes there will be no clinical signs apparent, except a dead animal in the vicinity of a yew bush with possible evidence of foraging.
It’s very dramatic.
Look out folks, toxic plants are out there!
On April 1st, 2015, the Blue Ribbon Study Panel on Biodefense convened its fourth and final session, hearing from expert witnesses on emergency response and recovery issues at both the national and state levels. While many topics were discussed, the overarching theme that emerged from the testimonies was that disaster response, regardless of the type of disaster, is a collaborative effort between many parties and that good communication is essential in successfully handling response efforts for both humans and animals.
The session was split into five panels: pre-event activities and emergency response; public health response; pharmaceutical response; recovery and mitigation; and leadership. Before the session began, Rep. Mike Rogers (R-Mich.) spoke about the states’ roles in disaster response and the media’s response. Dr. Irwin Redlener, a professor of health policy and management at Columbia University and the director of the National Center for Disaster Preparedness, spoke during the lunch session on the challenges of disaster response, such as limited funding and how our decentralized government makes effective planning difficult.
From a veterinary perspective, the most interesting testimony came from Melissa Hersh, a critical infrastructure consultant and CEO of Hersh Consulting. She reminded the panel that even though most emergencies deal with human health issues, it is important to keep in mind the importance of protecting herd health. She indicated that most policies place high priority on treating sick individuals, as opposed to isolating or decontaminating them, which can be problematic in a contagious disease situation despite being more popular from a humanitarian view.
As an example, Hersh discussed the potential bio-threat from Brucellosis, which is a zoonotic disease carried by elk in western states and has begun to make a recurrence in bison and cattle populations. This zoonotic disease has the potential to cause severe economic loss and is dangerous to those exposed, but yet, the agencies tasked with managing the threat have been playing a game of “hot potato,” she said. Because of the high risks involved in managing this disease, Hersh highlighted the need for response and action before the situation deteriorates. She indicated that when prevention is possible, it is important to take steps to minimize the dangers of a bio-event so that disaster can be avoided.
While most of the discussion centered on human health issues, the panel provided important insight into disaster readiness and recovery. Although I may be biased, I think more time and discussion should have been spent on issues affecting our vulnerable agriculture rather than just on the preparation of hospital beds and expedited vaccine development. While these are certainly important aspects of disaster response, I believe that a veterinary voice is needed to help direct discussion in order to develop a broadened response, which includes livestock management.
The Blue Ribbon Study Panel on Biodefense began in December 2014 and will identify and recommend changes to U.S. policy and law to strengthen national biodefense while optimizing resource investments. It plans to issue it report sometime in the spring of this year. For more information, visit the panel’s website.
That’s right; I’m talking about diversity, or rather our lack thereof. In November of 2013 The Atlantic declared the veterinarian the “whitest job” in the US at 97% white. And as the number of women in the profession continues to grow, male veterinarians continue to be far more likely to take on leadership roles in student organizations, VMA’s and in practices.
Yesterday I sat down with Lisa Greenhill, who is the associate director for institutional research and diversity at the AAVMC (Association of American Veterinary Medical Colleges- the association that brought you VMCAS and the Journal of Veterinary Medical Education). We talked about barriers into vet school for people of color, the LGBT community, the disabled and other minority groups. Obviously a diverse community is a strong community, and ideally the veterinary population would reflect the diversity of the public we serve. So what can we do to welcome more people into the fold?
Well the diversity initiative at AAVMC has taken steps to do just that- and since the initiative began in 2005 the number of racially/ethnically underrepresented students has grown 90%. The first step in supporting underrepresented students is to understand the climate at in institution. In 2011 all vet students were asked to complete a survey which asked about their experiences and interactions with other students, faculty, and staff. It was discovered that nearly a third of racial/ethnic minority students had experienced racism, mostly from other students. Similarly, 20% of LGBT students reported hearing homophobic slurs in the academic setting. These unwelcoming environments contribute to lower retention rates for these students and less representation in our profession.
Another barrier to entry into the profession for minorities is simple geography. The only vet school that is part of a historically black University is Tuskegee, where POC make up a much higher percent of the class than in other programs. Additionally, in certain areas of the country it may be harder to recruit people of color onto the faculty simply because the culture of that area is perceived as unwelcoming.
I know that this is an unpopular area of discussion, but I think it is an important one. When I walk from main campus over to our CVM at Missouri, I am shocked by the difference between the groups of students. I want vets to be an integrated part of the communities they work in, no matter what that community looks like.
For more info on the diversity initiative, check out: http://www.aavmc.org/Programs-and-Initiatives/Diversity.aspx
At this point I’ve been in DC about two weeks, and am settling into a little routine- or at least getting used to the lack thereof. Congress was on recess, so getting started has been a little bit slow, but it’s given me a good chance to meet a lot of vets around town and get some exploring done. DC is BEAUTIFUL right now- the cherry trees are blooming, along with what seems like every other flower. It is a great time to be here!
Last Wednesday however the weather was gross (raining in the 50′s), and so I was glad to be tucked up inside all day at USDA- APHIS. I met with 11 different veterinarians there, who are involved in all kinds of interesting things! I met with people who helped regulate the import and export of animals- which is apparently much more complicated than you would think. However when you spend time working on importing exotic species for zoos you are rewarded with cute pictures of their offspring later, so it’s not entirely thankless. I also met with vets who were involved with emergency response and preparedness, tracability of diseases (such as brucellosis and tuberculosis), BSE management, scrapie eradication, and more! The vets had landed in government work for a lot of different reasons, but all seemed really happy to be there.
The vets of APHIS are very passionate people, and gave me amazing advice as a student and as a young doctor. Many of them told me to discover what I was passionate about, and to do what I love. It’s hard to convey in text how moving and honestly emotional it was to hear these vets talk about finding their passion in life and encourage me to find my own. So get out there, young doctors! Discover what excites you and move forward with your dreams! And most importantly- remember that it’s people that matter in the long run.
My extern-mate Anita has dutifully attended the blog until now and I am eternally grateful. Thank you, Anita! Rather than revisit material already covered, I thought it would be more meaningful to share some recurring themes that I’ve identified during our adventures in the nation’s capitol.
- It’s really difficult to exact change in Washington. Many people want to laud this reality as testament to our elaborate system of checks and balances, but I would argue that when Congress grinds to a screeching halt (or worse, when both parties begin to subvert each other), our government ceases to satisfy its core function. Congressional efficiency historically ebbs and flows, but we are at an all-time low: the 113th Congress was the least productive in recent history, passing a mere 3% of proposed legislation (a far cry from the 6-7% average over the last 65 years). Although the concept of bipartisanship appears universally accepted, concrete examples of “reaching across the aisle” seem few and far between. Consider the House Republican’s letter to Iranian ayatollahs or President Obama’s executive order regarding amnesty – these are not actions indicative of a government that hopes to work together to exact meaningful change. How did we get here? Surely that topic is hotly debated, but I think it boils down to a period of economic recession and an inflammatory, omnipresent media. In this kind of environment, even a Republican like Mitch McConnell (R-TN), who has dutifully towed the party line for over 30 years, can be condemned by Tea Partyists for “waffling” under pressure from the President, the economy, and the entire American public during the economic shutdown last year.
- While the Dow Jones Industrial Average climbs toward historic highs and Janet Yellen is training Congress to prepare for rate hikes, the average American still feels like we are in an economic recession. Financial resources are limited and the government continues to argue over the best way to allocate diminishing funds. When resources are scarce, strategic and targeted spending becomes even more important. Unfortunately, the opposite is true in the current political landscape. Rather than anticipate problems and safeguard against them, the legislation that passes is “often reactionary and over-reaching” (in the words of Sen. Sheldon Whitehouse, D-RI). At the Blue Ribbon Study Panel on Biodefense, Dr. Julie Gerberding (former director of the CDC, now with Merck) echoed these sentiments. She emphasized the need to invest in preventive programs aimed at curtailing major threats to our national security, rather than simply react when an affront occurs. Dr. Gerberding described the U.S. government’s collective, strong and unified response to the Ebola outbreak as an example of when all parties worked together harmoniously, but argued that the outbreak itself may have been avoided with better disease monitoring programs. (Notably, Dr. Gerberding also highlighted agroterrorism as a threat to national security that warrants as much attention as biomedical warfare aimed at human populations.)
- As an Economics major at the University of Virginia, I remember studying John Williamson’s “Washington Consensus,” a set of ten, neatly devised economic policies that could resolve insolvency and economic upheaval in developing countries. Long story short, these “one-size-fits-all” policies did not work as expected and their efficacy is still hotly contested today. That lesson seems to have hit home with the policymakers we’ve met these past weeks. At the Farm Foundation Forum, Stephan Polasky (Professor of Ecological and Environmental Economics, Univ. of Minnesota) and Jerry Flint (VP, Dupont Pioneer) underscored the importance of constructing relief programs that incorporate the unique sociocultural customs of each targeted demographic. In particular, Flint emphasized the importance of articulating the benefits of GMOs to societies that are reticent to accept them (likely due to the varied and widespread misconceptions that surround the acronym). Suffice to say, a panacea does not exist and there is no “quick fix” to universally address the issues facing our society or those of our world neighbors. Rather, in an atmosphere where each dollar of discretionary spending is meaningful, outlays should be tailored and incorporate the specific needs of those they are intended to benefit.
- It’s really difficult to exact change in Washington. (Have I said that already?). Acknowledging that our profession consists predominantly of Type A personalities, I find myself asking a lot of veterinarians around the Hill: “how do you reconcile your inherent drive for progress with the barriers you face every day?” The response from people like Gina Luke (Associate Director, AVMA-GRD), Gerald Rushin (Veterinary Medical Officer, USDA-APHIS Animal Care), Michelle Colby (Agriculture Defense Branch Chief, DHS) and others is that when you genuinely believe in the positive change for which you are campaigning, fatigue is not a factor. In fact, said Kevin Cain at the AAVMC: when the bill you’ve poured your heart and soul into finally passes, it makes the victory that much sweeter.
Acknowledging what I’ve written above, I often find myself thinking ‘I probably don’t want your job, but I sure am happy there’s someone like you here doing it.’ No truer words have been written. If nothing else, this experience has taught me that there is a legion of capable, dedicated, and altruistic people undertaking very challenging and sometimes thankless work on behalf of our profession. Regardless of where a veterinarian lies along the political spectrum, we should all be thankful for the sacrifices these advocates make for the betterment of our profession every day.
On 17 March, key members of the United States Animal Health Association (USAHA) joined AVMA-GRD leadership to discuss issues and priorities pertinent to appropriations season in Washington, D.C.
When meeting with the Animal Agriculture Coalition, hot topics included the Veterinary Medicine Loan Repayment Enhancement Act (VMLRPEA), support for the National Animal Health Laboratory Network (NAHLN), and the National Antimicrobial Resistance Monitoring System (NARMS).
VMLRPEA would remove the steep 39% withholding tax associated with the Veterinary Medicine Loan Repayment Program, an initiative that places highly qualified veterinarians in rural communities to provide much needed veterinary care to underserved areas. Since 2003, this program has placed over 280 veterinarians in areas that would otherwise go without veterinary services; had the 39% tax not been withheld, an additional 100 veterinarians (and communities) would have been benefited from the program.
NAHLN is part of a nationwide effort to track and address animal disease outbreaks. The NAHLN brings together numerous organizations and laboratories strategically located throughout the United States to more efficiently and expediently respond to disease threats. Unfortunately, the President’s budget did not provide any funding for this strategic initiative.
What the President did prioritize was a massive $1+ billion budget across government agencies to address the breadth and impact of antibiotic resistance. While members of today’s meetings were supportive of efforts to combat and prevent antibiotic resistance, there was concern that the magnitude of this outlay necessarily diminished funding for other important projects (such as the NAHLN).
We had a very full day Thursday. We started out by attending the first panel of the Blue Ribbon Study Panel on Biodefense: Surveillance and Detection. The study panel included members such as Tom Ridge, Kenneth Wanstein, Jim Greenwood, Donna Shalala, and Joseph Lieberman. Their objective was to gather information from qualified members of the intellectual community to put together some long- and short-term recommendations for Congress regarding biosecurity. The event started with Senator Sheldon Whitehouse (D-RI) addressing the panel on his perspective. He stated that he thought the risk bioterrorism poses is a greater threat than even cyberterrorism because of the immediate and severe consequences as a result of each and every attack. He proposes that we increase our sense of urgency because of the increased ease of access to materials and methods to build bioweapons. He also encouraged them to ask Congress not only to prepare themselves for the possibility of physical damage an attack could result in, but also the psychological damage. He talked in length about the challenges of addressing biosecurity as a topic, including the fact that the issue is touched on by so many different committees in Congress that one, single unanimous decision or plan will be challenging to form.
Next, we heard from the panel on The Biosurveillance and Detection Landscape. The panel including Dr. Julie Gerberding (Executive Vice President for Strategic Communications, Global Public Policy and Population Health, Merck; former Director of CDC), Dr. Julie Fischer (Associate Research Professor, Department of Health Policy, George Washington University), and Dr. Norm Kahn (Consultant, Counter-BIO LCC; former Director, Intelligence Community Counter-Biological Weapons Program). They talked about the need to put into place a plan that included funding to national laboratories responsible for surveillance and preventative research consistently, and not just ramping them up when there is an outbreak or crisis. The surveillance would need to not only need to be consistent but also in context with the surrounding animal, social, and cultural environment.
An interesting discussion that arouse was that of the ‘lone wolf,’ an individual who initiates an attack without support from a group. The main concept was the degree in which intent of action and ability meet to create the greatest threat. Dr. Kahn spoke about the need to create a culture of moral obligation in students and researchers in the field of biology to encourage the ‘bystander’ to be more willing to alert authority to a threat created by one single individual.
The part of the discussion that piqued my interest the most as a future member of the research community was the panel encouraging the increase in funding to ‘high risk’ research and not just ‘sure result’ research. While there will be many failures along the way, this is one of the only ways to make significant progress and major discoveries.
At the very end of the discussion they noted that biosurveillance needs to account for the agricultural industry as well as for human pathogens because an attack/outbreak in either crops or animal agriculture would be devastating to the industry and ultimately the national economy. The lunch keynote speaker was going to further elaborate on the human-animal interface, however due to our very full schedule we were not able to attend. I am hopeful however that they will not disregard issues such as high pathogenic avian influenza, just because it is not infectious to humans.
This morning we walked over to the National Press building for a Farm Foundation Forum on Nexus of Technology, Agricultural Productivity, and the Environment. We had the pleasure to hear from a panel of speakers that included Derek Byerlee (an economist and independent agriculture researcher), Dr. Jerry Flint (Vice President, Industry Affairs and Regulatory at DuPont Pioneer) , and Stephan Polasky (Regents Professor and the Felser-Lampert Professor of Ecological and Environmental Economics at the University of Minnesota). While all three members had slightly different interest and jobs, there were a few key things that resonated among all of them. They all spoke on the issue of Genetically Modified Organisms (GMO) in agriculture and the importance of them in today’s world and the future. While GMOs have been bashed in the media for being ‘unhealthy’ or ‘unnatural’, these three distinguished researchers were indicating that the advancements of biotechnology (GMOs) has lead to yield intensification, meaning each acre of land and drop of water produce more crops, ultimately being one of the biggest advancements in environmental conservation in agriculture. They all agreed that there is absolute need to increase product yield to meet the increasing needs of the steeply growing world population. To do so without any use of biotechnology would be unsustainable, even if we used every bit of arable land, essentially destroying the biodiversity and environment. One of the audience members asked if it is so clear that the use of biotechnology is so key to making crops more efficient, decreasing pesticide use, preserving natural land, and feeding the growing population why are consumers in the US so against them? It seems as a society we should try to promote agriculture and research that helps advance environmental conservation, decreases pesticide use, increase small farmer productivity and sustainability, and meet the increasing food demand. Instead of intentionally eating items labeled ‘organic’ or ‘natural’, maybe we should be selecting our food from farmers that use biotechnology for better land management, decreased carbon output, and increase water quality.
If you are interested in learning more about the growing population, production yield demands, and environmental impact here are some good resources to check out:
Yesterday, we took the green line out to Riverdale, MD for a full day at the USDA APHIS facility. Dr. Gary Egrie, USDA-APHIS Farm Animal Welfare Coordinator, met with us at the beginning of the day to go over the history, structure of USDA, and purview of the organization. He gave us an overview of his job at the USDA and left us with the take away message that working in D.C. is all about getting along with people and money. He handed us off to Dr. Dean Goeldner who had an intriguing life history of doing many different jobs before working for USDA, including being a former AVMA GRD fellow. Next, we met with Dr. Silvia Kreindel, USDA Senior Staff Veterinarian and Emergency Prevention Service Expert, who gave us insight to her job evaluating foreign countries’ disease status for importable diseases and commodities. She has traveled to many different countries to evaluate their disease status and help determine if trade should be resumed and to what extent. Then we met with Dr. Langston Hull, USDA Staff Veterinary Officer in the National Center for Import and Exports, who told us about the challenges of imports and having to enforce regulations to protect our nation from foreign animal diseases. Next on the list was Dr. Darrel Styles, USDA Sr. Veterinary Officer, who has done lots of research in virology and currently works to organize the development new vaccines. Then we met with Dr. Rory Carolan, Veterinarian of Surveillance Preparedness and Response Service (SPRS), who had a facinating career that included a 20+ year career in equine medicine followed by a career in the Army Veterinary Corps and USDA. The last meeting was with Dr. Gerald Rushin, USDA – APHIS Veterinarian in Animal Care, the devision responsible for oversight of research, zoos, and animal welfare. He previously worked for the AVMA GRD as an Administrative Director and told us about his experience lobbying. The message that was consistent throughout the day was that there were many opportunities for us in the public sector as well as elsewhere, we just needed to keep our eyes open for them in our futures. It was a long day, but well worth it!
Being an extern is not just attending meetings and participating in the political process, it is also about experiencing Washington, D.C. The city is a serious package deal with endless amounts of history, museums, monuments, and restaurants to visit. The National Mall is lined with Smithsonian Institute Museums (free entrance) with the Capitol at one end and the Washington and Lincoln Memorials at the other. It seems like a month would be a long time to be here, but in reality it would take longer than that to even explore all the marvels of just the National Mall. The Smithsonian Institute in comprised of 19 museums, the National Zoo, and nine research facilities spread throughout the capitol. This alone provides endless opportunities for out of the office entertainment.
On Saturday, I met up with my classmate from Purdue, Catie Belding, for an outing on the National Mall. We spent most of our day in the Smithsonian Museum of Natural History seeing giant squids and flashy gems.
I finished off the day meeting up with some of my University of Arizona alumni friends and getting the full Washington, D.C. experience.
Sunday, I adventured out on my own, enjoying the 50 degree weather, to the National Archives. There are no pictures allowed inside to preserve the historic documents it contains, so you will just have to trust me when I tell you the exhibits are fabulously designed. As a special treat there was a new special, limited time exhibit ‘Spirited Republic, alcohol in American History.’ I got an up close look at important documents such as the Magna Carta, Declaration of Independence, Constitution, and Bill of Rights. This is an experience I recommend for anyone visiting Washington, D.C.