Pizzles in Paradise

by John Hicks

  He can be made bold by healthy exercise and games and sports; but that is quite a different thing. And even these games and sports should bear some proportions to his strength and capacities…

  Why should the laws of civilization be suspended for schools? Why should boys be left to herd together with no law but that of force or cunning? What would become of society if it were constituted on the same principles? It would be plunged into anarchy in a week.

  What an insight, FD! In retrospect, I can now see how I was part of those anarchistic tendencies.

  I will not open the door for you because you wear a prefect’s tie. I will hear, but not heed, the message of those modulated tones that you project over that massive lectern bible. I will not conform to your expectations, and I will be subversive. Paradoxically, when I leave here for the real world, I will not be inspired to join the university demonstrations and follow the denim and kaftan-toting leaders of my own generation against the conservatism of my elders. I have glimpsed the worst excesses of my generation and I have little faith that they can offer any improvement over the old guard.

  I suspect that this is the insight that propels many ex-public schoolboys. Those with the courage of their convictions will perhaps tend to an Orwellian model of individual protest to engineer change and rail against human injustice, rather than rally to the cries of rent-a-mob. They will be suspicious of any form of authority, unless it was thrust upon them at a tender age and gave them a lifelong taste for its abuse.

  Physical courage is present in some as of right, in some it is determined by a lack of imagination. For many it comes as a consequence of character: mind over matter. The requirements are a supportive and non-judgemental upbringing. He who is loved can love himself and love others. From love comes confidence and from confidence, courage. The ultimate use of courage is to secure justice.

  ~

  … So what part does it play when TB-testing stags approaching the rut in marginal facilities?

  This facetious interruption of childhood reveries raises a question seldom discussed by practising vets, or indeed farmers and others working with animals; it comes as second nature to them. We all have jobs to do around potentially dangerous animals. It is a matter of training and facilities that enable us to work with a minimum of danger. There is no room for heroics with a 600-kilo bull. It matters not whether you are a strapping 100-kilo prop forward or a fifty-kilo woman; brain, not brawn will be required. Odds of one-in-ten may be acceptable to a hero, but a vet has to be on the job every day. It has been said of another profession, ‘There are old soldiers and there are bold soldiers, but there are no old, bold soldiers’.

  Nevertheless, accidents do happen. I will never again TB-test stags in marginal facilities. They have very hard heads, even when the antlers have been removed. They push powerfully. When they pin you against a wall and start working their heads from side to side you never know when they’re going to stop. The owner, who told you how quiet they were, seems to have no idea what to do. Once cornered, twice shy. I just haven’t got the guts to get back in that pen again. I know it’s going to cost you more, and Daryl did some last month without any sedatives, but I insist on sedating them first, thank you very much.

  Chapter Thirty-five

  Change, Success and Failure

  It has been remarked that in this modern world the average person should anticipate at least eight career changes through his working life. This magic number crops up in many unsubstantiated forms. London’s inhabitants should know that when they drink from the tap, eight people will, on average, have preceded them in quaffing the recycled contents of the artesian wells of the Thames Basin. The average man or woman can anticipate the joys of eight sexual partners in a lifetime. Although I concede that this is a more variable figure, depending whether you defer towards the statistical analysis of The Inquisitive Nerd or Cosmo-smut, and that certain career choices would stretch the concept of ‘the average’ beyond meaning in this context. The lucky first person to drink that glass of water from the Thames Water Supply Authority, is not materially better off than the last. Whereas the eighth lover ... Ah, statistics!

  For some, a career change would be as stressful as a broken relationship but, for the vast majority, change creeps up on them as insidiously, as innocuously as that recycled water. Career change doesn’t necessarily leave us all at sixes and sevens.

  From the day he or she qualifies, a veterinarian is on a constant spiral of change. There may be no more exams except for those seeking additional post-graduate qualifications, but the cycle of learning must continue. It is sobering to look back at our veterinary textbooks of the early 1970s. What was then encompassed in one handy volume now spills into several tomes. The seventies vet was at the end of an era where, with confidence, he could stride onto a farm and deal with whatever was thrown at him—dog, cat, horse, cow, sheep, pig. He could be relied upon to cope in these disparate areas of veterinary medicine with reasonable competence. It was a nice feeling. In ignorance is bliss. Thirty years later and even a small-animal expert may refer a skin or orthopaedic case on to the relevant specialist. That old school report lacked foresight. We have moved away from the polymath ‘Renaissance man’ model to an era where it now is a virtue to know more and more about less and less. But is specialisation better for our animals and their owners? It is easy to assume the cure rates will be better, but the costs are proportionately greater. In my opinion it is a major shame if a high-tech and expensive solution is offered for a patient without the low-tech alternative, which may be the only one that the owner can afford.

  So I think back to the tips that as a youth I gleaned from the older practitioners who taught me. One of the commonest injuries to dogs, one that they share with footballers, is rupture of the cruciate ligament in the knee joint (or stifle as it is more accurately referred to in four-legged animals). The cruciate in fact comprises two ligaments in the centre of the stifle joint which permit the thigh bone (femur) to hinge on the shin bone (tibia), yet at the same time prevents the two bone ends from sliding on each other. Because the two ligaments cross over, the Latin term cruciate was applied by the early anatomists (Edinburgh graduates rejoice!). If one of the ligaments is torn, the joint becomes unstable, the dog cannot put weight on the leg and, if nothing is done, the unusual wear eventually damages the joint, setting up an irreversible arthritis.

  It never pays to ignore the healing power of nature. Many injuries heal without intervention, perhaps not to perfection, but to an acceptable level. This is not generally the case with ruptured cruciates and many untreated dogs limping round the streets attest to this. They have three other legs, so generally they manage, but there is pain involved with arthritis and laissez faire can hardly be condoned.

  For the vets of Miss Joshua’s pre-war era a simple solution was to strap the stifle with a firm support of sticking plaster for a couple of weeks, perhaps injecting some of the dog’s own blood into the joint. Thus immobilised, the damaged tissues could scar up and help support the joint, even if the ligaments themselves weren’t repaired. This was better than doing nothing and in light dogs leading a fairly inactive life it is still a cheap and sometimes workable option.

  But, as you may have guessed, there are at least eight ways of tackling a cruciate rupture. Since the last war surgical methods have been developed. Repairing the ligaments themselves is not an option for several reasons, but replacing them with fascia from surrounding tissues or even skin strips has become fairly standard. The stifle joint is opened and various tunnels drilled through the adjacent bones, depending on whose technique the surgeon prefers. The results are mostly favourable, even for active working dogs, perhaps partly due to the large amount of supporting scar tissue the body produces in response to the surgical insult. There is a simple elegance to such techniques, utilising existing tissues to create a structure that bio-mechanically simulates the damaged ligament.

  Subsequently methods have evolved using synthetic implants, and
even techniques requiring expensive equipment and specialist training. Great marketing, but certainly not practical for general purposes.

  I have always derived satisfaction from treating injured dogs and the orthopaedic interventions required to restore them to health. Cats present less of a challenge, implicit in the maxim, ‘as long as they’re [that is, the two parts of the break] in the same room, the bone will knit’. Cats heal remarkably well, but not that well! For dogs and cats many bone fractures require stabilisation either externally, with casts or scaffolds, or internally, with pins, plates, wires or other devices. There are at least eight different ways to fix a fracture.

  One day I was presented with Prince, a young black and white Border Collie who had fallen off a farm bike and fractured his femur close to his stifle joint. The x-rays showed the two broken ends of the bone over-riding each other. This was certainly something that required surgery but Prince’s owner, David, was unwilling to spend much on a young and as yet unproven working dog. Prince was taken home and kept as quiet as it is possible to keep a six-month-old puppy: cage rest.

  A few weeks later he was walking around with a slight limp. Although plenty of three-legged dogs work sheep, I still suspected that Prince’s deformed leg was going to impede him, and I couldn’t see him ever standing up to the rigours of working sheep without amputation. But Prince was a young dog and the fracture did heal. Quite often I saw him on the back of David’s farm bike eager for work. Many years later I had the opportunity to take another x-ray of his old break. There was only a slightly abnormal curvature of the femur as a reminder of the fracture. Bone is not inert, as our familiarity with skeletal remains might lead us to imagine. In the body it is a living tissue with the ability to remodel, and that is precisely what had happened. No surgery, no comfrey, no cider vinegar, no magnetic bandages, no colour therapy; though of course, if they had been used, success would have been attributed to them.

  The boundaries are constantly explored and pushed with new knowledge and technology, but none would be possible without the healing power of nature and, given our belief in our interventions, often despite them or without them.

  Is it any surprise that cats have nine lives?

  ~

  A vet sees many strange and unusual events in the course of his career. The average punter with an interest in astronomy may have looked skywards on a clear night and seen a red dwarf. I confess that this is something of which I have only read. However, I have witnessed the castration of a Polish Dwarf in the bowels of the earth. Likewise, a Flemish Giant. Before you are carried away by any Frankensteinian imagery I have to confess that these are both breeds of rabbit, and I suppose that describing the cellar of the Victorian house where Craig Harrison had set up his surgery, in these terms, is a poetic exaggeration. Besides, castrating rabbits is scarcely thrilling fare. Once you have worked out a safe anaesthetic, the procedure can be completed in a calm and controlled fashion.

  Castrating horses is another matter. The potential for drama is ever attendant, although modern anaesthetics have improved that aspect of the job. For much of my working life barbiturates injected into the jugular vein have been used successfully, but there is the drawback of a nasty local reaction to the drug should it be inadvertently injected into the tissues surrounding the vein, rather than the vein itself. If you are dealing with a frisky colt that is only partially broken-in, and you often are, the risks are obvious. ‘Just hold still for a moment; you are going to feel a slight scratch’, doesn’t seem to work on horses. Humans can be conned into submitting themselves to all sorts of painful medical procedures. Not so your average horse. Pain infliction, or even the prospect of it, can invoke a violent response. Most horse vets have had a good kicking at some stage in their careers. For this reason a previous generation of horse vets had enviable roping skills and many had adopted the supreme technique of standing castration.

  Approach your patient with a syringe loaded with local anaesthetic. Inject it into the skin of the scrotum. Once you have placed that first vital bleb, it is possible to slowly work from the desensitised skin and infiltrate the whole area. The colt can be gelded while he chews indifferently on some nuts. The risks to the operator as that first bleb is placed are considerable. The firepower in those back legs is enormous. One false move may be your last. I have never worked in a practice where standing castrations were the norm, and so never felt pressured into using the technique. Throughout my life I have ‘cheated’ with barbiturates. The pressure did fall on a colleague who, newly graduated, went out with trepidation to his first standing castration. He had done the difficult bit and now approached the colt with scalpel in hand when it suddenly reared up. Inexperience took over and, in an attempt to evade the flailing hooves, he forgot about the scalpel poised in his hand. The horse landed on it, the sharp blade easily slicing right through the tensed abdominal muscles.

  Anyone who has dealt with intestines will appreciate that they have a life of their own. The very peristaltic movements that drive food within them can impel them through the smallest hole. Show them a gap and they will run for it. Gravity assists. Horrific war footage of soldiers clutching their escaping intestines is no exaggeration. A frightened horse has no incentive to do this and the end result of this sorry tale for my colleague was a scene of carnage. By the time the colt had trampled his intestines into the straw, the damage was irreversible and the poor animal was euthanised. I suspect that it was one very subdued vet who ventured out to castrate his next colt.

  This salutary tale is always at the back of my mind when I breeze up to another horse castration, but with barbiturates (or their modern equivalents), there is so much more control. It couldn’t happen to me, could it?

  Every year Raewyn had a few colts for me to geld. It was a pleasant half-day outing. Her colts were well handled and she took no nonsense from them. This morning there were three to do. I had just finished the last one when the first was making its first staggering efforts to stand up. Raewyn was familiar with supervising recoveries from anaesthetics and ensuring that the worst effects of the drug had worn off before releasing the horses from their head collars and turning them loose to graze.

  ‘John, I think there’s something wrong.’ There was a measure of anxiety underlying her usual calm competency. I glanced at colt number one. His intestines were sliding down his back leg. Very soon they would be in the dust. If ever I needed calm competency it was now.

  ‘We’re going to have to knock him out again,’ I stated. Panicking is counter-productive and I have never felt that urge in such circumstances, but I did have a feeling of dread. The odds were stacked against a successful outcome. Raewyn was wonderful. She, too, would have had doubts, but she never let on.

  Calmly, she steadied the colt’s head while I slipped in another dose of anaesthetic. Calmly, she fetched a clean bucket and helped me to bathe the dust off the intestines and return them through the inguinal canal, the channel between the scrotum and abdominal cavity down which they had decided to eviscerate. This was not an easy procedure. The canal had to be enlarged, and yet it still required persistence and the dexterity of an octopus to finally overcome their obtuse writhing. It was with only partial relief that I put in the last sutures. Despite our care and attention to hygiene, horses are extremely prone to infections. There was still a grave risk of a fatal peritonitis, even with a heavy course of antibiotics. It would be several days before we knew his fate.

  The colt recovered uneventfully. We had snatched victory from the bowels of defeat. Was this success or failure? Had I at the outset missed detecting a scrotal hernia, which would have alerted me to just this risk? In retrospect I felt not; I had had to enlarge the hole considerably merely to replace the intestines.

  Such are the quandaries facing the veterinary clinician. For all the thousands of successes, it is as much from the hundreds of mistakes and near misses that he learns. It is these that stick in his mind. We can only learn if we have a measure of self-doubt. Life never
comprises endless chapters of glorious success.

  Chapter Thirty-six

  League of Nations

  These days there is a shortage of New Zealand trained vets who are prepared to work in isolated rural communities. When Daryl and I sought to employ another vet the only suitable responses were from overseas applicants. Over the years we recruited a married couple, both Edinburgh graduates, and later a South African. Daryl, as the sole New Zealand vet, was starting to feel isolated. Our practice was the product of universities from around the world and as a team we liked to think that this gave us collective strength.

  From university days I have delighted in the unique cultural differences that mark us out. On my first day I befriended a Welsh lad who most probably said something like, ‘Hello, boyo, and where are you from?’ Richard Griffiths was raised in a Welsh-speaking family from South Wales. It was miraculous to hear him conversing rapidly over the phone with his family. Welsh was his first language, but that meant English was his second, and he good-naturedly fielded the teasing that was the inevitable consequence. A placid and sunny disposition frequently accompanies disarming gullibility, and Richard was no exception.