All doctors have troublesome patients, and this week, Mitch Finnegan's is Batik, a 22-year-old endangered Sumatran orangutan who is severely ill, supremely uncooperative and suspicious of caregivers trying to help.
In early June, keepers at the Oregon Zoo noticed the shaggy, auburn-haired, 108-pound primate had lost her appetite. An ultrasound showed a gut full of trouble. When a surgical crew opened her up last week, they found infection that appeared to have spread from her intestines to her gall bladder and liver, says Finnegan, the zoo's chief veterinarian. They removed her gall bladder and enlarged right kidney.
The day after surgery, Batik took a turn for the worse. Vomiting, she lost so much blood because of suspected stomach ulcers that she required a transfusion with a liter of blood from her 16-year-old exhibit mate, Kutai. The procedure required anesthetizing both animals.
And Monday morning, Batik refused to take her medicine.
"She's a perfect example of the challenges of zoo medicine," Finnegan said. "Orangutans are some of the most difficult patients to work with because they become suspicious of you when you try to medicate them."
For instance, Finnegan said, when a keeper hid Batik's medicine in jelly, a treat on Monday, "She kept it in her mouth 20 minutes before she spit it out."
So for now, keepers and the medical crew must deliver antibiotics via darts and try to find ways to disguise ulcer medicine so the orangutan will swallow it.
This week, she'll start on diuretics to try to reduce fluid gathering in her abdomen. Were she human, her doctor would monitor her weight and electrolytes, under the circumstances. But with an orangutan, that would require anesthesia, and Batik's health is too fragile for that.
"She's eating a little," Finnegan said, "and drinking enough to keep her going ... but we're still really not sure which way she's going to go."
If Batik does not survive, she'll miss out on an opportunity her keepers have long wanted: a move outdoors for Batik, Kutai and 50-year-old Inji.
Since arriving at the Oregon Zoo in 1996, Batik has occupied an indoor enclosure in the primate building, constructed in 1959. But the new Red Ape Reserve exhibit, due to open in late August, includes 5,400 square feet of open-air space, giving animals the chance to experience the elements -- wind, sun and rain, and maybe birds that can fly through the mesh walls.
The zoo's white-cheeked gibbons will move into Red Ape Reserve soon, but the orangutans' move has been delayed indefinitely, to keep Batik's stress to a minimum.
"When we can move the orangutans, we'll have a big celebration," said Kim Smith, zoo director. "And hopefully, Batik will be with them."