by John Hicks
If your litigation succeeds there is a risk that Dr Rinkle-Sachs will develop behavioural aversion (testicular) syndrome (BATS). An independent psychiatric assessment by Dr Priapus of Genital Concern, has warned us that this could result in his institutionalization. We ask you to take these factors into consideration before proceeding with your suit.
Yours truly
Orchitis Wrangler Jnr
Don’t look at me like that! Alright, perhaps the letter is fictitious, but litigation is a serious matter and the consequence of lawyers obtaining increasingly ludicrous awards for damages has been counterproductive for the average pet owner and his vet. Veterinary practice is no longer the carefree jaunt I experienced when I first set out on my journey to become a vet.
I can see Mr Betts’ eyebrows twitching at all the extra paperwork involved.
Chapter Twenty-eight
Holiday in Hospital
The head of the hatchet was firmly wedged in the block of firewood that I was attempting to split. In an attempt to free it, I belted it with a hammer. That was a fateful mistake. A shard of steel shot out from the impact with the velocity of a bullet, and into my tensed thigh. Look! It’s frayed the fabric of my trousers. Hardly a mark on my skin, though and yet … yes, my leg is starting to feel tight.
I imagined this tiny fragment shearing through the fibres of my quadriceps and severing some deep-seated blood vessel. That is precisely what had happened. An x-ray revealed the culprit had traversed several inches of flesh and was nestling next to my thigh bone (femur). This wasn’t very good timing. Emily was just over two years old and our new baby was due any moment. I had had the skill-saw ‘surgery’ on my finger immediately before Emily’s birth, and it had provided a sound test of our resource-management skills. I suspected that Viv wasn’t going to be too impressed with the prospect of a repeat performance. We were new to the district and, like many immigrants, we had no family support in place should things go wrong.
My blood pressure was sky high.
Surgery couldn’t be delayed. We had no choice. Almost the next thing I knew, I was recovering from what I presumed would have been fairly routine surgery. It was night, but as an older generation would say, my leg was giving me ‘gyp’. Trying to find a small piece of metal buried in the largest muscle mass in the body must have been a bit like hunting for a needle in a haystack, so perhaps the surgeon had had to dig around a bit. But the pain should have been easing, not increasing. Moans floated through the darkness from other beds, interspersed with pit-patter scurrying, curtain-drawn-whispering. They were busy. I didn’t want to make a fuss, but the plea escaped my lips. Nurse!
Analgesia has its limits. Despite the nursing staff reluctantly dispensing ever more powerful pain-killers I was in a drugged state of agony. A tighter bandage was put round my thigh, and then a tighter one. That is a night I shall never forget.
When I woke up I was lying in a considerable amount of blood. As an aspiring vet student it had taken a fair amount of objectivity to learn to be unfazed by the sight of blood, and indeed I was: as long as it was not my own. Suddenly the body language of the hospital staff implied hurried professionalism. They were dealing with a serious haemorrhage. In the light of day I must have appeared very pale, a blood test showed that my red cell count had dropped alarmingly. It was too low for them to risk giving me a full anaesthetic, but they had to stop that bleeder soon.
A sweating junior doctor probed deeply into my leg while I sucked on a mask. He was (desperately) trying to locate and tie-off the leaking artery that had been so painfully pumping blood into my muscle through the night.
Between gulps of nitrous oxide—I could hardly think of it as laughing gas under these circumstances—I knew the signs. I too had sweated involuntarily when faced with a difficult surgical task. The young houseman was beading-up nicely. I could see the self-doubt and barely suppressed panic. I had been there myself.
More probing. He was scraping around next to the sensitive periosteum, the membrane covering the bone of my femur. Will it never end? … Success at last! I don’t know who was the more relieved.
The offending vessel was ligated and I was hooked up for a blood transfusion. I had had enough, but my ordeal was not to end there.
A few minutes into my transfusion I began to experience unbearable itching in my groin and armpits. Before long I was pleading for the nurse to fetch a doctor. Even in my enfeebled state I knew that I was having a potentially dangerous anaphylactic reaction to the blood transfusion. I couldn’t believe her response:
‘I’m sorry, you’ll have to wait. The doctors are having lunch at the moment.’
I was too ill to argue, but my condition spoke for me. I tore uncontrollably at my wealing skin. Eventually, I was disconnected from the ‘bad’ blood and properly treated for anaphylactic shock.
All’s well that ends well. I recovered sufficient health just in time to experience the joy of Morwenna’s birth. She was safely delivered in the maternity ward of the same hospital just a few days later. It certainly helped to erase the preceding unpleasant saga.
Medical misadventure—the sort of experience I have outlined—is not uncommon. The only truly disquieting part, for me, was the response of the nurse to my blood transfusion reaction. That was a matter of pure ignorance, or lack of supervision. The rest was a matter of bad luck. Sometimes unseen arteries can start bleeding after surgery; sometimes a pressure bandage is not enough to make them stop. Sometimes the consequence of a seemingly minor indiscretion may lead to death. I had seen it myself. I had caused it myself. Who am I to judge?
Chapter Twenty-nine
Sold on Southland
The farmer committee of the Western Southland Veterinary Club asked me to stay on once my period as a locum had ended, and I was duly appointed senior vet (of two). During six weeks of spring Viv and I had survived Southland’s undoubtedly robust climate. It was, however, significantly milder than weather we experienced even in the south of England, and so the climate wasn’t an issue for us. Our decision to stay was not difficult. Why? The hospitality of the locals is a good starting point. Almost invariably, whenever I finished a farm job, I was invited in for a cup of tea, often accompanied by home baking. The world is a busier place these days, but Southland hospitality is still a byword. The work was very varied and a day which could incorporate dairy or beef cattle, sheep, deer, cats, dogs and even the odd pig appealed to me. Any horse work seemed to involve children’s ponies or farm hacks—still widely used on the larger farms for stock work. Most of the small-animal side involved working dogs. The toy repair stuff was minimal, an interesting side dish to other work rather than an overwhelming main course. I felt I was being useful.
The working dogs are usually heading dogs, strong-eyed dogs of the familiar Border Collie type, or Huntaways. These are larger black and tan dogs which bark and push sheep ahead of them. Injuries are common, given the nature of their work. Broken legs, lacerations or torn ligaments are generally borne with stoicism by working dogs but Huntaways, in particular, have a wonderful temperament and it is generally a pleasure to work with them and their owners. They are far more biddable than many so-called pets and their owners are more down-to-earth and realistic in their expectations than the average city pet owner.
There was one drawback; I was now on a one-in-two duty roster. Nevertheless, the after-hours work was fairly minimal. A rrrring seldom disturbed our slumbers. I had previously found that farmers employing vets were respectful of after-hours time and tended to look after ‘their’ vets. It was part of the national ethos. Overseas visitors reported that New Zealand closed for the weekend. Not so good for visitors, but excellent for families. New Zealand has since joined the modern world and services are available at all hours. Veterinary practices in the towns compete with each other and hold routine evening, Saturday and Sunday clinics. Great for the spectators. Shame about the players.
In time the club employed three vets and, later still, after I joined in with a
partner to lease the practice from the club, we expanded more. With an influx of dairy farmers in the early nineties the demand for veterinary services increased dramatically and, where there were two vets, there are now seven.
Over the years it has been my pleasure to work with many characters. The qualities which make a good large-animal vet: intelligence, competitiveness, physical toughness and equability of temperament, combined in all of them in various proportions. But it is the capacity for humour that is most prized in the workplace.
Sooner or later as a vet, you will end up with egg on your face, or something a lot worse. As you might have gathered, every one of your five senses will be periodically assailed, singly or in combination. Humour is the only balm, sometimes at your own expense, sometimes at someone else’s.
For starters I will highlight assaults to the first cranial nerve, which deals with olfaction, our sense of smell.
Steve was prepared to tolerate the idiosyncrasies of his uncontrolled dog, Steelo. Being a Labrador type, Steelo had eyes bigger than his stomach. He always accompanied Steve in his car. It was often a surprise to find out what he found to eat while his master calved a cow or dealt with a lame horse, but find out he did, as it usually fetched-up, in a partially digested state, on the carpet. It is not easy to remove the stench of a regurgitated rotten cow placenta that has had time to develop an intimate relationship with the soft furnishings of your car. Trading-in some vets’ vehicles becomes problematical: especially since the Privacy Act precludes access to lists of potential buyers with severe olfactory lobe damage.
A vet in a neighbouring practice, who was notorious for the untidy and noxious contents of his car, became the butt of a rather unsubtle prank. Silage smells can be overwhelming in the open air, let alone the enclosed confines of a car. To the average driver a wad of silage placed under his seat would be a noticeable addition to the interior milieu, especially on cold winter days, with the heater cranked up and the windows closed. But Andy was not discomfited in the least and survived this trial by nose. The practical joker removed the evidence unremarked and undetected several days later. No point in continuing, the silage was losing its potency. I dread to imagine what was tried next.
I have already alluded to competitiveness. By nature, vets tend to watch their patch fairly carefully. To vets with ego, it is unimaginable that any of their clients would stoop to use another veterinary practice. Oh! The indignity of finding out that they are not invariably the chosen one. But, in a world of declining loyalties, it is the consumers’ right to chop and change as they see fit. Vets must be constantly aware of this, because mistakes can arise if conflicting medication is given for the same patient by two different vets. Professional guidelines insist that the second vet involved contacts the preceding vet to establish the best course of action for the animal concerned. Vets who don’t work in with their colleagues lay themselves open to a charge of ‘supersession’. Unfortunately, some vets can’t resist the opportunity to slag off their opposition under such circumstances. ‘Of course, if I’d seen him in the first place ... ’ Dr Shortfuse, the name given to one such individual by a Canterbury friend, was a past master at this and not particularly popular with neighbouring vets.
The scene unfolds as Dr S arrives at my friend’s practice for an appointment to sort out a dispute about supersession. He is getting decidedly puffy as he waits to see his colleague. He paces the waiting room, nostrils flaring. They were keeping him waiting deliberately. With time to kill he notices the day book, prominently displayed on the front desk. All part of the plan. He leans over the desk. Few vets could resist glancing to see what the opposition is doing. He catches a familiar name. Why is this crowd gelding colts for his favourite breeder? And further down, branding colts for another of his clients. More and more familiar names appear. Names of clients he thought he alone serviced. All part of the plan. The whole page was, in fact, an artifice: a fictional list doctored (not vetted) for the sole purpose of getting under Dr S’s skin. It is not a good idea to go into a meeting in an irascible state and Dr Shortfuse had not acquired his nickname for nothing. He had his come-uppance that day.
Thus we reveal ourselves, not far removed from our schoolboy pasts.
But some are above all this, for they are not political animals. They are doers. I present my erstwhile partner, Daryl—sometime deer culler, deer farmer, sheep farmer, hunter, diver, whitebaiter and veterinarian. A man wedded to the outdoors. Daryl had been the first vet employed by the Western Southland Veterinary Club when it was set up in 1971. He had built up the practice before retiring from it to devote more time to his farm. It was hard to fill his shoes. He still had a band of loyal followers for whom he did some part-time vet work. He tackled tasks at which a more cautious Brit-type personality, such as me, would have baulked. In the early seventies he was single-handedly performing surgical embryo-transplant work on beef cattle, a technically and logistically demanding procedure, and achieving top results. He had the support of entrepreneurial farmers of integrity and a relatively litigation-free environment. These days such pioneering fieldwork would be stifled by legal considerations, the costs of indemnity insurance and a different class of assertive entrepreneur wanting quicker returns.
After a few years of farming and specialising in deer work Daryl was ready to become a full-time vet again. It was my good luck that I had his drive and positivity with me when we formed our partnership. Both of us refinanced to lease the practice from the club. The challenge of running our own business and shaping our own destinies was one we eagerly embraced. Though Daryl, of pragmatic farming stock, would no doubt put it in less flowery language. ‘I mean, what is all this ‘embracing’ and ‘destinies’ stuff? It was a straightforward business deal.’
We had our own business. It was another step on life’s journey as a practising vet.
Chapter Thirty
Reproduction Revisited
One of Daryl’s most admirable traits was his willingness to tackle the largest jobs. His work output was remarkable. Pregnancy-testing cattle, blood-testing rams, develvetting deer: no one else could do the numbers as slickly as Daryl. Being naturally competitive, he liked to stay ahead of the rest of us in the pack. Then one day a truly gargantuan challenge fell in his lap.
Artificially inseminating cows is such a standard procedure that its importance tends to be overlooked. Semen from a top bull can be stored and transported in a frozen state around the world. The semen from a single ejaculate can be divided to fertilise dozens of cows. Most dairy and many beef cows undergo this annual ritual.
A technician suitably attired in shit-proof clothing: arm-length rubber gloves, plasticised jacket, over-trousers and gumboots—not readily available at your local menswear store—advances on the chosen cow. His left arm is inserted into the cow’s rectum. Once there, the cervix is palpated through the rectal wall and gently but firmly grasped. The right hand, holding a long pipette containing a straw of semen, inserts the tip of the pipette into the cow’s vagina and advances it towards the cervix. The pipette is manipulated through the cervical canal and the semen is deposited in the uterus ready to seek out and fertilise any eggs hanging about. What the cow thinks of all this is a matter of conjecture. I like the conjecture of one Henry Burgess:
I have just given birth to a heifer
of pride and milk I am full
But sad to relate – my pregnant state
was not brought about by a bull
How drab are the farmyards and meadows
Life seems empty and grey
For one bit of fun – on life’s dreary run
Has by science been taken away
I have never been naughty – I swear it
In spite of the calf I have borne
Like farmer Brown’s tractor – I’m ‘virgo intacto’
I have not had a bull by the horn
It must not be thought that I’m jealous
There are things that a cow shouldn’t say
Bu
t the ‘land army tarts’ who handle our parts
Get theirs – the ‘old fashioned way.’
Artificially inseminating sheep presents different problems. Most people are aware that sheep are somewhat smaller than their bovine cousins and there is currently a dearth of suitably trained gnomes to undertake the task. Although techniques have been developed to deposit semen in the cervix with a special pipette, conception rates are higher if it can be placed in the uterus itself, particularly if frozen semen is being used. It is just that little bit more debilitated by its long sleep in liquid nitrogen at minus 196ºC.
For sheep, the most effective way to implant semen directly into the uterus involves using a laparoscope. A laparoscope is a long metal telescope linked to a fibre-optic light source which can be inserted into the abdominal cavity through a stab incision and used to sight the uterus. A pipette is introduced via a second incision and the semen injected through the wall of the uterus. It requires much practice and good hand/eye co-ordination to achieve this.
Laparoscopic AI is a surgical procedure. The ewe is given a pain-killing sedative, strapped into a specially designed crate, and her belly shorn and disinfected—as for any other surgery. With an efficient team of assistants and good facilities it is possible for a skilled operator to do about fifty ewes an hour. Daryl’s gargantuan challenge was to inseminate 16,000 ewes.
It was a lucrative contract for all involved. Farmers, disillusioned with poor lamb prices, were easily persuaded to set aside a portion of their ewes for insemination with semen from Awassi rams. Awassis are a fat-tailed breed of sheep and the resulting half-bred lambs would fetch a premium price in Arab countries.