John Simms, VMD
April 2009: Q: What’s one of your most memorable cases? A: An Amish neighbor walked his Percheron mare named Belle to my clinic because she was showing signs of colic. We diagnosed an intestinal impaction and began medication and mineral oil via gastric intubation. Nothing worked and after two days in the clinic, it was time to make tough decisions. Economics ruled out the referral for abdominal surgery that she needed, but Amos asked us if we could do the surgery. We explained that we were not equipped for anything but bovine surgery and the requirements were very different. Not wanting to euthanize her without trying something, we gave Amos a 15% prognosis and prepped her for surgery ... standing up. Unheard of. We found a 12” diameter dorsal colon that we could not budge to exteriorize to empty. Our only idea was to inject DSS into the solid masses of fecal balls in the colon in as many places as we could reach. We closed the incision, and Belle stood stoically throughout the whole procedure. On the next day, she started to nibble some hay and drink enough water that we removed her IVs. On day two, we found a huge cannonball of manure in her stall and they continued to pass, so Amos walked her home. Our instructions were to feed bran mash, give antibiotics and keep her tail tied up since she will develop diarrhea and the incision will be drenched in it by her wet tail. Amos called eight days later to say that things didn’t look so good. The 16-inch incision was dehisced and the only layer between us and her intestines was the peritoneum which was paper thin. Her tail was untied and soppy. More distressing was the presence of several hundred fly larvae, known in the trade as maggots. We hosed them out in the driveway of the clinic, fashioned a fly sheet cover, dispensed fly spray, more antibiotics, and tied up her tail again. She walked home. Amos never called. About four months later, Amos was resting his 6-horse team at the end of a row of fall plowing. I pulled off the road because I saw a huge black Percheron in the lead horse position, and she looked familiar. It was Belle. Amos had become a better nurse and Belle made it. There was a thin twirl of hair in her flank where the scar was hidden. I learned the power of Mother Nature as a healer and how sometimes staying out of the way may be the best treatment. I remember that one. Q: What’s the most significant change you’ve seen in veterinary medicine since you graduated? A: There are too many significant changes to pick just one, but some of the bigger ones would include what our clients expect of us as veterinarians; technological and medical advances; our failure to see the erosion of recruitment and retention of food animal practitioners until we are now in crisis mode to provide safe food for our species. That’s a big one. Q: What do you think the biggest challenges are as a mixed animal practitioner? A: Keeping up with everything in previous question. The practice has to be run as a business or it won’t be a practice for very long. Making yourself valuable to food animal clients who are struggling to survive themselves is a huge challenge. Q: Your wife, Dr. Nadine Oakley, is also a mixed practice veterinarian and you work together in your practice. What are the pros and cons to being married to another veterinarian? A: There are no cons. (Nadine will be editing). A partnership where you are both in the same harness, pulling in the same direction toward the same goals seems to work for us. Q: You and Nadine were interviewed by Roger Caras for the program “20/20” years ago. The piece was supposed to highlight the life and work of mixed practice/large animal veterinarians. Do you think the finished piece was an accurate portrayal of what the job is like? A: Yes. “20/20” received a record number of viewer letters from veterinarians and the general public which were very complimentary. We also received a huge number of letters from colleagues all over the country. Most said “thanks” or “way to go.” One guy scrawled “nice job” on a prescription pad and mailed it to us. With that kind of response from the trenches, we were satisfied the piece was accurate. “20/20” had followed us around for two weeks and shot 62 hours of tape to create that 14-minute episode. We actually became friends with Roger Caras and his family until he passed away a few years ago. Q: What’s your typical day like? A: Typical is not a word. Since large animal practice is less scheduled than small animal practice, my days are never the same except for scheduled herd visits. Scheduled small animal appointments begin around 8:00am while I hit the road with dogs in tow for farm calls. Cows come to our clinic for surgical procedures—those are usually done in the afternoon when veterinary technicians are finished with their small animal duties. It’s a mixed practice for them too. Nadine also schedules equine calls in the afternoons. Any nutrition or other herd management tasks are usually on home time and involve a computer. Economics on most dairies is driven by the reproductive status of the herd, and that demands multiple reproductive exams on my part daily. Broken cows occupy another segment of the day since small dairies pay close attention to individual cow health. Emergencies aren’t shipped off to emergency clinics and can turn any day planner into a blender. Q: What do you think measures like California’s Proposition 2 will have on food animal production and veterinary medicine’s role in caring for food animals? A: Legislating animal husbandry will come around to bite the voters in the butt, but it will be too late when there are fewer producers, higher prices, and chicken, veal and pork chops are imported from China. Only 2% of our population produce the food we all eat. Regulating them by passing legislation written by folks who don’t want animals used for anything but photo ops will lead to a very hungry nation. Fewer veterinarians will be interested in an industry that is regulated by people without a clue of what the reality of the industry really is. Producers have and will provide a husbandry or management practice that strikes a balance between production and welfare. They are good at that or they wouldn’t be in business. Animal activists and legislators are naive to think that they can do it better and still provide a safe, affordable food supply. Q: If you could change one thing in your career, what would you do differently? A: I’d get accepted to veterinary school on my first application, not my fourth. Q: Words of wisdom for someone considering being a mixed animal practitioner? A: Consider the lifestyle you and your loved ones can be happy with before everything else. If you thrive on change, work ethic, and using your education to advocate for animals and the quality of life of their owners, you can receive the satisfaction of never having to work for a living. I’ve always considered work the things I didn’t want to do. Mixed practice has given me the opportunity to avoid it. Q: What’s the best/worst part about being your own boss? A: Lack of business training in veterinary school makes the learning curve steep and the pitfalls many. You have to learn from others’ mistakes because you won’t live long enough to make them all yourself. Good medicine is good business, so positioning yourself to deliver the best quality services will ensure a positive cash flow. Recruiting and retaining veterinary and technical help is always a challenge. The good news is that the buck stops here; then, I deposit it. Q: What issues do you think will have the largest impact on food animal production in the next ten years? A: Consumer confidence in our ability to provide a safe food supply; lack of veterinary input to the food suppliers; and legislating production practices (see above). Q: What inspired you to be a veterinarian and did you always want to do large/mixed animal? A: I was in pre-med in college when I evaluated their lifestyle and decided to change. My interest in science, animals, and outdoors led to the only obvious solution. I didn’t know it at the time, but medical school would have been an easier path. Mentors in veterinary school encouraged my large animal track, but enjoying the diversity of mixed practice made it a goal. The privilege of having a key influence on producers’ successes and failures, quality of life, and profitability has kept my interest and provided gratification for 35 years. The uniqueness of that position is like none other in veterinary medicine or anywhere else.