A nose job for a sawfish

DR. LANCE ADAMS preps for surgery, snapping on latex gloves under a clear blue sky.

Nearby, a medical team wearing hooded wetsuits administers underwater anesthesia. Members of the team hoist the doped patient out of the pool and muscle her onto a makeshift operating table.

Adams, gripping sterile scissors, confers with various specialists on respiration rates and oxygen levels.

“How’s her gilling?” he calls out to his dozen colleagues clad in black rubber.

He’s about to mend a wound with the aid of boat glue, rubber bands and Popsicle sticks. A baby diaper will be employed. Also a garden hose.

In this watery wing of surgery, it takes high-tech medicine and ingenuity to give a fish a nose job.

As staff veterinarian to the 12,500 animals residing at the Aquarium of the Pacific in Long Beach, Adams is among a growing number of aquatic specialists bringing treatment more common to humans and pets into the tank.

He is almost comically stoic when describing the nose job on the freshwater sawfish, a ray whose body looks more like a shark’s. He rattles off other recent cases. Removing an eel’s tumor. Bandaging the ulcer of a sea horse. Draining the wrist abscess of a sea turtle. Using ultrasound on a sea otter.

And then there are the fake fish eyes.

Tank injuries, parasites and bites from other fish make eye injuries common, Adams said, so he and other aquatic veterinarians, such as Dr. Mike Murray at the Monterey Bay Aquarium, do the occasional prosthetic eye job.

IN the past, most sick fish were pulled out of the tank and fresh fish dropped in.

“We used to call it replacement therapy,” Murray said. “Now we say, ‘Let’s fix them.’ ”

With an increasing number of aquariums, a booming commercial fish-farming trade and more collectors of pricey fish, the number of aquatic doctors has swelled in the last decade, said William Van Bonn, president of the International Assn. for Aquatic Animal Medicine. The group has 500 members.

Van Bonn said most of the roughly 30 accredited aquariums in the U.S. employed “aquavets,” as one of the trade websites called them. And they are inventing new ways to help animals live longer.

“The same technology that would be used to give you a tubal ligation or remove a gallbladder, we can use for sea otters, fish, birds,” said Murray, who put Adams at the forefront of aquatic medicine.

Take the eye job, for example. Adams said that, even in captivity, if animals sense another’s vulnerability, such as a missing eye, they are more prone to attack. In short, appearance matters, even to a red snapper.

Beyond medical care for animals, Adams and Murray agreed, there is a practical need for aquariums’ exhibited animals to look healthy.

“You can’t really put a fish on exhibit with a cavity where the eyeball was. The public just won’t accept it,” Murray said.

About 190,000 schoolchildren take field trips to the Long Beach aquarium each year, and Adams said you don’t want them grossed out by animals with gaping wounds.

“Part of what we do is cosmetic,” he said.

That was true to a degree with the sawfish.

The endangered fish, a freshwater species that can also live in saltwater, has a long, square-tipped nose ringed by horizontal “teeth.” It is “very unique in appearance,” Adams noted, and you can’t show children a sawfish that lacks a saw.

The Long Beach aquarium’s sawfish was obtained by a collector in Australia, where the species is threatened by dwindling habitat. Adams thinks a shark at the aquarium that usually wouldn’t bother the sawfish may have snapped at it, fracturing the saw and hindering the creature’s feeding.

The operation on that March morning took place outdoors near the turquoise shark pool, but started before the aquarium opened. The cloth diaper, soft and water-absorbent, kept the fish’s eyes wet and shielded them from light and movement.

Just after 10 a.m., as schoolchildren began streaming into the aquarium and heading for the popular shark lagoon, Adams and his team patted their patient under a wet towel, its wound stitched up, the Popsicle sticks affixed with waterproof boat glue to the side “teeth” (they eventually grow out like fingernails). Rubber bands held the Popsicle splints in place while the glue hardened.

The 6-foot-3-inch sawfish was safely plopped back into her post-op recovery room -- the shallow end of the lagoon -- and Adams went indoors to his infirmary, a sterile-looking white room like any other doctor’s office, to offer a tour.

A light board on the wall illuminated an X-ray of a fish -- front view, side view -- reminiscent of a cartoon sketch.

Clicking through his laptop photo gallery, Adams pointed out a puffer fish whose mouth is wedged over a clear oxygen tube (a bite wound). There is the green moray eel from which he removed a large tumor (equivalent to a 9-pound tumor in an adult human). The before and after images of a sea horse with a bandaged ulcer (fluid buildup, cause unknown). And, of course, the prosthetic eye for the red snapper, a type of fish on which plenty of visitors had probably dined.

Adams, 35, has a tanned, youthful appearance but a serious bearing, even when reminded that only a few hundred people in the world might utter a sentence such as “the rockfish had corneal difficulties.”

ADAMS never thought he would be making such remarks.

He grew up in the Orange County inland suburb of Placentia and worked at College Tropical Fish in Fullerton in high school. He found underwater life fascinating but did not realize there was a career beyond his hobby. When he started college, he said, there were fewer than 20 aquatic veterinarians in the nation.

While working toward his undergraduate degree in animal science at Cal Poly Pomona, Adams volunteered at the nearby Kellogg Arabian Horse Center, fell in love with horses, got his own horse and initially pursued equine medicine at Kansas State University’s veterinarian school.

But when students were asked to write a report on an alternative career, Adams learned he could be a fish doctor.

“It wasn’t just that I worked at a tropical fish store for a high school job,” Adams said. “I really liked fish. I think they’re incredibly fascinating and incredibly beautiful. How they live, their adaptation, their gilling, blood flow. Marine life and ocean life are

He recalled fellow students saying, “Well, yeah, you like this and you know about these things, but what kind of career are you going to have in fish?”

Adams started with a variety of internships and jobs: SeaWorld in San Diego, Denver’s zoo. By the time he finished the aquavet program at the University of Pennsylvania, Adams was convinced that he had found his field. He applied for and got one of two internships at the New England Aquarium in Boston.

“There were only two people in my invertebrates class who knew anything about fish physiology, and I thought, wow, this is something I know and can do, this is my niche,” Adams said. “But I assured my parents that I had a Plan B. If the aquarium field didn’t work out, I could always get a job in aquaculture, which was just taking off. I would not be out of a job.”

In August 2001, he came to the Aquarium of the Pacific in Long Beach, where he works with about 15 aquarists and other staff members.

“The passion and commitment Lance brings ... has elevated the quality of care,” said Jerry Schubel, chief executive of the Long Beach aquarium, and Adams has inspired colleagues with his quiet seriousness about finding creative ways to treat animals.

And “children just love him,” Schubel added. “He has a way of relating to kids.”

Adams said his colleagues were equally devoted.

Every year, the aquarium’s staff holds a fundraiser -- passing the hat among themselves -- to bankroll equipment they want in order to take better care of the nonprofit aquarium’s animals. Last year they raised $40,000 to buy an ultrasound machine.

Adams used it recently to check out a sea otter in the aquarium’s grotto-like exhibit.

And the sawfish?

“It’s doing just fine. It has no visible sign of an injury,” he said.

“When I sit down and think about what I’m really doing, I think, ‘Wow, I can’t really believe we are doing this, that this science works,’ ” Adams said. “But really the whole science of caring for fish like they were a domesticated pet or even a person, that level of care, and having them actually get better ... is the amazing part.

“Seeing the medicine work ... whether it’s the sawfish, a shark, the eye of a fish, using the ultrasound machine ... all of it’s a huge achievement,” he said. “Any time you take an animal that normally would be lost and make it healthy again, that’s it for me.”

nancy.wride@latimes.com