by John Hicks
At first sight you would not have picked that there was anything amiss with Tony’s calves. I needed to examine them more closely. I stepped into the pen with a thermometer at the ready, a stethoscope round my neck and a few plastic gloves in my pockets. Ninety per cent of the illnesses vets see in calves of this age involve enteric infections – scours. Avid followers of TV documentaries about beautiful young vets’ encounters with doe-eyed calves will have been misled about this. TV directors are obviously well aware that enteritis in calves, in glorious Technicolor, is not a welcome televisual feast for viewers. But Tony’s calves would have been easy to film. They sat in their clean pen and did nothing. Even when I climbed in amongst them, they hardly stirred. Healthy calves would have been up and bunting me, looking for milk. These calves couldn’t do that. They were deaf and blind – not that this was obvious from a brief glance. Their eyes looked normal, but they didn’t blink or respond when something was waved in their faces.
Even before I’d examined the calves properly, Tony was applying the pressure. “I don’t suppose you know what it is, then?” I was tempted to use a word I had chanced upon at some stage in my studies, a fatuous diagnosis – amaurosis – a blindness of unknown origin. But why blind him with science? There was more than enough blindness in that barn already.
When confronted with a novel set of symptoms, it is useful to try and pin down which body system is involved. The lack of diarrhoea around the calves ruled out a primary involvement of the alimentary system. If anything they were slightly constipated, so my plastic gloves remained in my pocket and I reached for my thermometer. Thermometers provide thinking time. While the farmer keeps asking him what he thinks it is, it is the vet’s task to concentrate and carefully scrutinize his thermometer. If he is older, and has acquired the skill, he may even furrow his brow. At this stage it is important to remember the purpose of the furrow. It is there to inspire confidence. The vet must take care not to tip it into the realms of the furrow-of-worry or, even, the furrow-of-alarm. If the correct balance has been achieved the caring clinician will convey the semblance of being deep in thought, and that he is not to be disturbed. Great things are stirring behind that careworn forehead.
If, like me, this is the first lot of calves he has ever seen with these presenting signs, he’ll be thinking something like: What the f*** makes calves suddenly go deaf and blind? If he is confident, he will discard all thoughts about his last visit here when he did a caesarean and the cow died half-an-hour after he left the farm – and its corollary: so he can’t afford to stuff up this time.
Despite my brain wracking ploys, I had yet to come up with an answer.
Tony, naturally enough, was concerned about the cost; he kept banging on about how much the calves were worth. I hadn’t even made a diagnosis and he wanted to know if I had something to get them better. My do-not-disturb furrow had not been read; besides, the temperatures of the first two calves were normal. I would have to resort to the stethoscope trick. Stethoscopes are much more useful than thermometers in such situations. The ears are physically blocked, and although I could still hear Tony’s muffled burblings, I had a good excuse not to be able to render them intelligible, and I could legitimately gaze into the middle distance and strain to catch every significant nuance of bovine cardiac and respiratory pathology. I expected none. There were none. Eventually a calmer voice from my clinical training pricked through: central nervous system [CNS] involvement, afebrile and bilaterally symmetrical – these calves aren’t circling or head tilting – so this is unlikely to be an infection. Could be a CNS toxin. Yes, but what? Well, what is the commonest CNS toxin on farms? And so I started thinking about lead poisoning.
Lead poisoning in livestock used to be very common on farms. Classical sources were old car batteries left lying around, or old paint tins. Lead-based paints haven’t been used for years, but corrugated iron sheds painted with them abound. Sheets of tin from dismantled sheds make handy pens for calves. But Tony had raised many batches of calves through these pens over previous years and never had anything like this happen. I scrutinised the walls of the pens and found the evidence I was looking for. The calves in this batch had definitely started to lick them. We could see where their rough tongues had taken the paint off – right down to the bare metal. It just takes one curious calf to start and the rest copy. Could this be a case of lead poisoning? I had never seen lead poisoning in calves before and at the back of my mind were the textbook descriptions of the clinical signs – and they didn’t tie in at all. Frenzy, maniacal excitement, bellowing, staggering, convulsions, head pressing, attempts to climb walls or even to attack people: these were all text book descriptions of what to expect in cattle with lead poisoning. But the fascinating thing with so many poisonings, as we have seen, is the variability of symptoms. As with statistics, look hard enough and you will find a source to back you up. Sure enough, one book suggested that the neurological signs could manifest as either excitation or depression.
The rest of the calves slowly recovered with the expensive chelation therapy I started, even before we had laboratory confirmation of the cause. The chelating agent binds to lead and allows the body to excrete it in an inert form. I had no choice but to act immediately on my hunch since laboratory analyses can take several days, by which stage more of the calves would have died. Eventually, confirmation of my diagnosis arrived. There were abnormally high levels of lead in the kidney I had submitted from the dead calf, and the source was undoubtedly the paint – further tests proving that this was lead based. My reputation was saved.
Subsequently we saw several cases of lead poisoning in calves on other farms from ingesting lead paint, and all presented with similar signs to Tony’s. Likewise, another perplexing case of lead poisoning: two out of four dogs on a farm had stopped eating and were losing condition. Their presenting signs only partially tallied with the classic picture, as tersely described in one textbook: Dog: May be found dead. Abdominal pain. Vomiting. Diarrhoea or constipation. Anorexia. Loss of condition. Blindness. Paralysis. Convulsions. Barking fits. Death within minutes to weeks. The clinical history alerted us: close questioning established that the kennels of these two dogs had been recently reconstructed from old, painted, timber. The penny dropped. A blood test confirmed our suspicions. Not surprisingly, the dog that removed his food from the bowl and then ate it off the floor was worse affected than his companion, who ate mostly from his bowl.
Lead is a cumulative poison; once it’s in the body it is only slowly eliminated. Ingestion of small amounts of lead over many days obviously results in a far less dramatic set of symptoms than those from a sudden large intake but, either way, if left untreated, the end result is death.
The wonder is that it took so long for mankind to discover this. The association between lead and poisoning is a relatively recent discovery. Two thousand years ago, Latin plumbarii (lead workers) plied their trade with this useful metal, unaware of the danger that may have contributed to the collapse of their civilisation.
In the sixteenth century Elizabeth I popularised the use of lead as a cosmetic. Lead carbonate powder mixed in various ways with additives, such as egg whites and vinegar, was slapped onto ladies’ faces as frequently as Pond’s Cold Cream by our mothers’ generation. It conferred that interesting pale look to its wearer. However, lead was known to damage the skin and, later on, it became fashionable to cover up the resulting craters and eruptions with black patches. It is hard to break people of dangerous habits, and it took over two hundred years before lead carbonate was finally replaced by zinc oxide as a skin whitening agent.
In many situations, lead is inert and benign. Its very stability in neutral conditions made it safe for routine house plumbing. The main concern for local authorities came with pollution and acid rain late in the last century. In acid conditions lead slowly dissolves. Any lead which is ingested is very effectively absorbed from the acid environment of our stomachs. Once it has been absorbed, it is not readily excreted from
the body. Minute amounts slowly build up, interfering with the complex biochemistry of life: clogging up those Krebs’ cycle enzymes.
Conversely, large lumps of lead in the form of bullets or shotgun pellets can remain harmlessly inert in the more neutral tissues of our bodies for years. Many war veterans harbour shrapnel in various parts of their anatomy with no risk of lead poisoning. Vets quite commonly find shotgun pellets peppering the hindquarters of gundogs that may have been x-rayed for an entirely different reason. Generally speaking, they are best left alone – an observation that perhaps goes for the patients’ owners as well.
Chronic low-level ingestion of lead was linked with high levels of juvenile delinquency in British cities. Unfortunately the progressive removal of lead from plumbing and motor fuels does not seem to have resulted in any general improvement in behaviour. I had a well-leaded Liverpudlian childhood, along with millions of other Brits. I am the product of a lead-plumbed house. I quaffed the leaded petrol fumes from a thousand car exhausts as I cycled to school each day. But perhaps I was lucky, for mine was a privileged childhood, I was never forced to eat my meals off the linoleum (another lead-containing product), and I have yet to make the transition from eccentricity into barking madness.
~
Daryl had the privilege of a clean-and-green Kiwi upbringing in New Zealand’s unspoilt air. Only Giles shared a background as polluted as mine. He had emerged, apparently unscathed, from the ghastly “Black Country” of the English Midlands – so named in reference to the many coalmines and slagheaps that despoil the countryside of his childhood. By contrast, Rosie came from the distilled purity of the Scottish Highlands; no British vet could claim a less tainted background.
Sid, the vet who was about to join us, had entirely different origins, and he was bringing his family from a land of many dangers.
Chapter Thirteen
The Reluctant Immigrant
A great emigration necessarily implies unhappiness of some kind or other in the country that is deserted. – Thomas Malthus
In his few moments of relaxation at work, Daryl was challenged by the bewildering eccentricity of our tearoom chatter. He was outnumbered by Poms. Being a straightforward Kiwi the pedantry and puns eluded him at first. But our cultural mix was about to become even more diverse.
In the 1990s the dairy industry was expanding into Southland, and there was a shortage of endemic vets with the requisite skills or inclination to service it. Daryl was an exception, because other New Zealand vets seemed to have an aversion to working in the Deep South. We were forced to recruit from abroad. Fortunately, there were still overseas vets with an interest in farm animals who, owing to depressed rural economies – particularly in Britain – were eager to work anywhere in New Zealand. Many also came from South Africa. That is where we acquired our fourth partner. Marshall and Hicks was no longer an apt name and, in a fit of pragmatism, we renamed the expanded practice Otautau Vets Ltd (OVL).
For Sid, his wife and their four children, all under the age of five, the decision to emigrate must have been heartbreaking. Rather than leaving their country of birth by choice, they felt compelled to move, for the safety of their young family. Though Sid enjoyed the more serene political environment of New Zealand, there were some aspects of his new career that he found less appealing.
Veterinary life in New Zealand lacks the drama of Africa’s. A pathological sword of Damocles hangs over every man and beast in that vast continent. Vets and their clients in South Africa face a far greater range of virulent viral diseases, bothersome bacteria, remorseless energy-sapping parasites, perfidious pests and predators and, yes – potent poisonous plants. A vet can have real fun in South Africa dealing with dramatic deaths, mysterious maladies and exotic epidemics. Life for a vet in New Zealand, after the drama of Africa, could seem colourless and bland. Sid’s anecdotes certainly added diversity to our tearoom conversations.
The corollary is that South African vets are widely respected for the excellent standard of their university qualifications and their practical abilities. We listened as Sid spoke of rinderpest and bluetongue, biliary and baboon attacks, jaagsiekte and weidektankheit. We tried hard to impress him with the longer and more complicated versions of clinical syndromes we had seen, “Remember that case of pulmonary hypertrophic osteoarthropathy we saw in that hind last week, Giles?” But for everything we had seen, Sid had seen it too, usually with knobs on – not as a matter of show, he really had – and his skills were highly valued by us. He added another dimension to our team.
Being bilingual in English and Afrikaans would not appear to be an asset in Southland, but on occasions it was. Entrepreneurial dairy farmers seeking cheap land were flowing into the province and gradually displacing long-established sheep farming families. This was an economic blessing for an area depressed by years of poor returns to sheep farmers and, because dairy farmers use vets far more intensively than sheep farmers, it was providing a major boost to our veterinary business.
There was increasing optimism that Southland would be restored to some of its former affluence, the days when wool fetched a pound (sterling) for a pound (avoirdupois). Unfortunately, some silver linings are shrouded in cloud. The carefree, sunlit days lessened. Successful entrepreneurs are hard-nosed businessmen. Assertiveness has its place, but it is not always a virtue when you are on the receiving end. A few of these new clients were unreasonably demanding.
Southland farming was being infused with new farming blood, not just from dairying areas of the North Island, but from around the world. Some Dutch dairy farmers had sold up their milk supply quotas in Holland and were able to build up sizeable herds in New Zealand on the proceeds. It took guts, skill and hard work, qualities for which their countrymen are well known. Naturally, some of them tended to import labour from their home country and though they had a good grasp of English, Dutch – to mix metaphors – was the lingua franca on those farms.
For all the vets, with the exception of Sid, visits to such farms gave us a good lesson about the insularity of English speakers around the world. We are generally ignorant of other languages. On farms where Dutch prevailed the tables were sometimes turned on us and we worked without the usual ribbing and yarns that make farm visits so enjoyable. Afrikaans is, basically, mediaeval Dutch; so Sid did have a fair idea of what was being said, though he didn’t usually let on.
One evening Sid was called out to assist a cow that was having difficulty calving. The farmer and his worker were waiting for him at the milking shed. As he unpacked his gear he heard a comment in Dutch along the lines of “Let’s hope this bastard isn’t as useless as the last one”. Sid, knowing that the vet to whom this slur applied was both extremely experienced and competent, decided to bite his tongue.
The calf was too big and Sid had no choice but to perform a caesarean. He was going to have to listen to the conversation for a good long time. It continued in the same vein. Even for the slickest of operators, with ample assistance and good facilities, a caesarean takes between an hour and an hour-and-a-half. Sid clipped the skin area and administered the local anaesthetic. Apparently this wasn’t done half as well as they would have done it in Holland. Apart from a few basic instructions and requests for assistance (in English), Sid bided his time. The surgery went as well as could be expected. The farmer and his worker helped to pull the large calf from the incision in the flank and attended to it while Sid carefully stitched up the wound, repairing the uterus first and then bringing together the muscle layers and the tough skin. The cow remained standing throughout. The calf was alive and soon attempting to stand. It was a job well done, not that he expected any praise for it. The Dutch conversation had veered round to how much the owner expected to be ripped off for the vet turning out at this time of night...
Revenge is sweet. Sid gave careful instructions in clear English about the cow’s after-care and supplied antibiotic injections for the following days. When he had packed his gear and was ready to drive off he casually remarked,
in Afrikaans, “Goodnight gentlemen. I’ll send you my account in the morning.”
A splutter sounds the same in Dutch or English!
Paper work was never Sid’s strong point, so his threat was empty; but the farmer wasn’t to know that.
~
In the beginning Sid hid his light under a bushel. This is a wise strategy for any vet starting a new job. If you’re not too careful you will land the veterinary equivalent of the new builder’s apprentice being sent to purchase a left-handed hammer, or tin of striped paint. I myself had been caught out this way.
One of the first jobs I was assigned on my arrival in New Zealand followed this pattern. “John, would you mind going up to ‘old man Palmer’ and dehorning a couple of heifers for him?” I always looked forward to visiting the rougher farms tucked up under the gleaming cone of Mount Taranaki, right next to the National Park boundary, so I keenly assented. What nobody told me was that “old man Palmer” (OMP) would not have been out of place in the previous century. He was single and ninety-nine per cent deaf, and therefore had no use for a phone. He didn’t drive. If he needed a vet for a routine matter (don’t ask me what he did in an emergency) he wrote a letter. The visit would be arranged and written in the desk diary at the clinic for a few days later, allowing time for a letter of confirmation to reach OMP so that he could be ready for the vet. This also provided adequate time for all the vets “in the know” to arrange to be busy at that particular hour. That excluded me, and my naivety was duly rewarded.