The story of a young, attractive female vet, examining the upper, inner thigh of a farmer, behind a tractor, with his trousers round his ankles, could have become a legend of Arthurian proportions, and it would make a great story if this was the reason for us moving away from the Cotswolds and back up to Yorkshire. But it isn’t. Fate had intervened again and, back up in Thirsk, Jim was looking for someone to buy his share of the partnership at Skeldale. This would give me the opportunity to become junior partner at the practice. Life was about to change direction again.
12
Back in Thirsk
The opportunity to buy into a veterinary practice is an exciting prospect, but also a daunting one. It brings with it a huge financial burden and a lifetime of commitment. As I discussed the situation with Pete, he likened it to a marriage. He was right in many ways.
Suddenly, Anne and I had a lot of decisions to make. We had expected to be fairly settled for the next few years, living in Winchcombe, but now there was the chance of a long-term investment in our future which, hopefully, once the enormous business loan had been repaid, would put us in a robust position for the rest of our lives. Once we started to discuss this, we thought it only fair to bring it to the attention of the partners of the practice where we were working. To their enormous credit, they quickly made us the offer of a partnership in their practice. This added another twist to our situation, especially as Anne loved her job immensely, and could see her own future there, as a partner.
After many evenings of debate and countless nights of broken sleep, we eventually made the decision to make the move back up north. We needed a house, and I set about the arrangement of a business loan, to pay for the partnership. The constraints of our rota meant that we were only off together one weekend in five, so house hunting was tricky. I made the journey alone on one occasion and, after looking at a couple of properties and taking lots of photographs, we made an offer on an end-of-terrace house. Anne hadn’t even seen it at this point, apart from via my not very professional photos. It was a bold move and one that seemed rash when we both did eventually manage to visit Thirsk to look at the house together.
We had been at a wedding in Cambridge on a Friday evening in early December, and made the trip from Cambridge to Yorkshire on a gloomy Saturday morning. It was a journey I had made many times, but this was the first time I had done it with a view to inspecting our future house, and indeed, our actual future. Thirsk could not have looked a more terrible place to move to, on this particular day. It looked a world away from the beautiful Cotwolds. Everything was dark grey and mist hung heavily in the air. Thirsk is on the edge of the North York moors but also at the end of the wide, flat Vale of York, so fog and damp lingers here on a bad day in winter. This was such a day and although I loved the area, even I had to admit that it looked rubbish. Anne managed to put a brave face on it, and we pressed on with the purchase of the house. Three months later I was back in Thirsk for good, back in my old patch. Last time I was here, my most valuable possession was a mountain bike. Now, I owned a house and part of a practice, and I owed a whole load of money in all directions. It was the start of a new millennium and everything was exciting, if daunting.
Anne stayed on for a few months in Winchcombe, so that the practice wasn’t left suddenly short of two vets. I felt responsible for ‘stealing’ their dynamic assistant, Anne. It was only fair she should stay on for a while. I embarked enthusiastically on all sorts of DIY projects in the new house. This was dangerous without direct supervision from Anne, as I am not known for my fantastic DIY skills. Painting was OK and I actually managed to get most of the house decorated before Anne moved up.
The grouting of the hall tiles was altogether different, though.
One weekend we decided we would lay quarry tiles in our new entrance hall. It was more of a job than we expected, as our tile cutter wasn’t up to cutting the solid tiles, and we had to hire a power tool. Anne returned to the Cotswolds on Sunday night, suggesting we leave the grouting until she was up next, three weeks later. She didn’t seem entirely convinced by my assurance that I knew what I was doing, but I was determined to get the grouting completed before her return. How hard could it be? I smeared the concrete-like mixture into all the gaps between the tiles on Friday evening, after I had finished work, then headed back down to see Anne for the weekend. When I arrived, I enthusiastically explained my progress with the tiles, how I had left it all to dry and my plans to wipe off the excess on my return to Thirsk on Sunday. Anne’s ashen face made me think this would not be so straightforward. Sure enough, the grouting had set like rock and the mixture, which I was planning to wipe off with a cloth, was cemented on, rock hard and immovable. It took the next two weeks and many rolls of wire wool to solve the problem. With good reason, I have never been asked to do a serious DIY job again.
Before long, Anne was up in Yorkshire for good. The old problem of finding the right sort of work close by reared its head again, but she managed to secure two part-time jobs in nearby practices, and we settled down to our new life. We were also engaged to be married, and Anne’s parents had enthusiastically been looking at venues for a wedding in late springtime of the same year. To the disappointment of Anne’s father, we quickly realized that buying a house, moving to the opposite end of the country, buying into a business and getting married all in the space of a few months was not going to be possible. However, we found a date in October that was perfect. It was a lovely autumnal day in rural Hampshire (Anne’s childhood home) – damp and misty but so calm and serene. I went for a mountain bike ride very early in the morning with my mates Ben L and Ben C, and my best man, Mike (the funniest man I know – he did me justice with his speech that day). The bike ride did a lot to steady the nerves. The day went so quickly and with jaws sore from smiling and talking so much, we all enjoyed cigars later that evening. If being a partner was like being married, I thought, it was going to be a doddle.
I hadn’t really appreciated that being a partner in a practice also meant running the business. We had received expert training at vet school in how to be a veterinary surgeon – examination, diagnosis and treatment of all manner of diseases and injuries and all types of animal. Nobody had given us any training on how to make a business work. I quickly realized that I had very much to learn. Until this point in my career, my only priority had been the treatment of my patients. Now I had to make sure that we could pay our staff and our massive monthly bills for drugs, rates and insurance as well as new equipment and repairs to old equipment. The repairs and maintenance to our dental machine would regularly cost several hundred pounds. Since, at this time, we charged about £50 for a dental, after taking off other costs, we needed to do about ten dentals a month just to pay for the machine’s regular maintenance. Running the x-ray processor was even worse. On top of this, Anne and I had a mortgage and I had a hefty business loan. Financial pressures were suddenly huge, and it made work, for the first time, very stressful. I devised a system of measuring the cost of something in terms of ‘how many anal glands’ it equated to. Anal glands are a major design fault in the dog and they pose a daily, smelly challenge to vets. The glands are marble-sized structures on either side of the anus, which fill up with foul-smelling pasty liquid. Their purpose is to scent mark, but sometimes they don’t empty properly and the full anal glands can cause discomfort or sometimes great pain. Occasionally the contents leak out onto the sofa or onto the owner’s trousers, which causes just as much distress to the owner. I cannot recall a working day that hasn’t involved emptying some anal glands at some point. It is a simple but unpleasant job and we charged about £5 for such a procedure. Therefore a new autoclave machine (used for sterilizing surgical kit) that cost £8,000 would be equivalent to emptying about 1,600 anal glands. It was a useful way to quantify costs, but I dared not calculate the anal gland equivalent of my business loan!
Contrary to popular opinion, most veterinary surgeons do not earn huge salaries. The majority of vets in private practice
work, primarily, for the benefit of their animal patients. The financial motivation is not, generally, a primary factor. We would rather treat an animal and make it better than earn an enormous salary. Our margins are pretty narrow, especially on drug sales, and our typical mark-up on most dispensed drugs is twenty per cent. I quickly realized that this did not give much room for wastage. If we buy a bottle of shampoo for £10, and sell it for £12, we make £2 profit. If one bottle gets wasted, or is used and not charged for, we lose £10. Therefore, to break even on the shampoo, we need to sell another five bottles. The pair of artery forceps that falls into the straw and gets lost during a caesarean on a sheep, costs more than the price we charge for doing the operation in the first place, and the bottle of antibiotics that falls off the cattle crush and smashes on the floor costs £158. All these figures I can now pluck out of my head, but as an assistant I had no idea how much things cost or how much impact this wastage had on the practice finances. During my first few years as a partner I lost many hours of sleep, worrying about what I had bought into, my enormous debt and the stability of our future. I do not think I was the only vet in the country with such nocturnal anxiety – it is well known that the veterinary profession has one of the highest suicide rates of any of the professions. This may be more to do with ease of access to drugs used for euthanasia, but must also be, in part, due to these financial worries.
The other major problem facing veterinary practices was, and is, that of the outstanding debt, owed by clients who have not paid for the veterinary attention they have received. Since our first and foremost priority is always the health and welfare of animals, we are often stung by individuals who have sick animals but no intention of paying. It is a huge burden, particularly for large animal and mixed practices, and it is miraculous that many still exist as businesses at all. We still have several farms that owe us many thousands of pounds. One has not paid us anything for over four years. I went there in 2006 to replace a prolapsed uterus in a cow. It was after midnight and the middle of winter. I was completely asleep when my beeper went off, and it almost didn’t wake me. A prolapsed uterus is very urgent and needs immediate attention. It was pretty serious, and I attended to the cow, replaced the uterus and gave all the necessary medication. To this day, the practice has not been paid for my work, ten years later.
It was not all doom and gloom, though. In fact the financial pressure was really the only negative thing about being a partner, and I was slowly developing ways of handling these new pressures, mainly in the form of gin and tonic. Life was good and married life was great. We were enjoying the fun of bringing up our young border terrier, Paddy, who was now approaching adolescence. Free weekends usually involved long dog walks on the moors or in the Dales, and Paddy was a great companion as Anne and I explored all the paths and byways of this lovely area. Two or three times his youthful exuberance got the better of him as he raced off into the woods, chasing deer, then got completely lost. On all these occasions, we spent hours searching with torches as it got dark. Eventually he would turn up, exhausted and muddy after his adventures, at a house nearby. We learnt that the best strategy was for one of us to go home to sit by the phone, while the other searched.
Our house was in a village on the outskirts of Thirsk, which Paddy was beginning to consider his own. He was a lovely, friendly dog, but he was starting to see younger, male dogs as challengers to his self-appointed status as the top dog in the village. One Monday afternoon, his attempts at village dominance became too much. As I stood chatting to the owner of a younger male dog, Paddy growled, snarled and then rushed at the pup, intent on attacking him.
‘This will not do,’ I thought. I could not let him attack the other dogs in the neighbourhood; it was a terrible example to set to the local dog-owning community. So, we marched him straight round to the practice to remove his testicles. Anne and I both knew that castrating him was the best solution for a young male dog who was beginning to show his dominance. Wasting no time, we dosed him with his pre-med (the pre-anaesthetic sedation given to patients prior to the actual anaesthetic). Little Paddy seemed to be more sensitive to the sedative than most dogs. He wobbled and swayed all over the prep room, seeming not to realize that his legs were going in different directions, before I gave him his anaesthetic.
As a vet, operating on your own animal is a tricky dilemma. On the one hand, you don’t really want to trust anyone else with your beloved pet, or give them that burden of responsibility. On the other, you are very much less detached than normal, and this can often lead to mistakes or complications that would never otherwise happen. Some vets (including my wife) absolutely refuse to operate on, or treat their own dogs. One colleague was castrating his parents’ dog, also a border terrier, when the most freakish accident happened. An unligated blood vessel recoiled back into his abdomen, squirting blood internally like an out of control hosepipe. It took three of us, and major abdominal surgery to rectify the situation.
So, I embarked on the process with just a small amount of trepidation. It was the first time I had needed to operate on my own animal. Having given him the anaesthetic induction agent by injection, I inserted a breathing tube to provide oxygen and the gas that would keep him asleep while I operated. All went as normal. It happened that on that particular day, a new head nurse had started, and she was keen to impress. She had taken apart and thoroughly cleaned our two anaesthetic circuits and left them to dry during the afternoon. When I blustered in with my dog, needing a seemingly emergency castration, she had quickly reassembled the circuits, ready for the procedure. I connected Paddy to the anaesthetic machine, but no oxygen flowed down his tube and after a few moments the circuit shot off the machine like a cork shooting out of a bottle of fizzy wine. I had never seen this happen before and immediately replaced the circuit with the other one. The same thing happened, and the circuit fired off the machine yet again. Anne, who was monitoring Paddy’s anaesthetic, started to verge on panic, and I started shouting. This was very irregular and not at all what should be happening to any dog, let alone my own beloved pet. The third circuit we tried worked fine and the rest of the operation proceeded without complication. As the little dog slowly recovered from the procedure, we investigated the cause of problem. It became clear that one short length of tube in each circuit had been connected the wrong way round, so the flow of oxygen through the circuit was not possible. Our new nurse was mortified and very apologetic. No harm was done, but needless to say, this simple mistake did not happen again!
Paddy made an uneventful recovery, quite oblivious to the anxiety that had ensued during the operation. He rested quietly that evening, feeling very sorry for himself and probably presuming it was yet another hangover. The positive effect on his behaviour with other male dogs was instant, and never again did he even so much as bare his teeth to another dog. That is until we introduced him, only a couple of years ago, to our tiny new puppy, Emmy. By that time he had reached a great old age, and was not even slightly impressed at this young intruder trying to climb into bed with him.
While my first year as a business owner had been challenging, and an exciting learning process, I eventually began to realize that coming back to Thirsk had been a sensible move. I could see that my debts would eventually be paid off, and, despite the money owed to us by too many farmers, the future was rosy. I was becoming an accomplished veterinary surgeon, I was learning the ropes of practice management and I generally felt optimistic about the future of the practice, and for Anne and me.
However, on 19 February 2001, the turn of events made it seem likely that the face of farming in Britain, and of rural mixed practice, might change forever.
13
Foot-and-Mouth Disease – a Return to the Dark Ages
On Friday 19 February 2001, a suspected case of foot-and-mouth disease was reported at an abattoir in Essex. A veterinary inspector had identified suspicious lesions in a pig as it stood, drooling, in the lairage. These were the days before the rapid dissemination of inf
ormation via email and the internet, and we received the news by fax from MAFF. MAFF stood for the Ministry of Agriculture, Fisheries and Food. It was the government department responsible for overseeing the health of the nation’s livestock, both in terms of animal welfare and disease control.
The news was clearly alarming. Foot-and-mouth disease is extremely infectious, causing severely debilitating illness in many animals, very quickly. It had not been seen in the UK since 1968. It seemed like an old-fashioned disease, and was not something that the majority of practising vets had ever seen, although we had all learnt about it in detail at vet school. Jim Wight had been involved in the previous outbreak, so was immediately sent off to Staffordshire to help with the control measures, even though he, like most of his cohort of veterinary surgeons, had recently hung up his stethoscope. Most of our knowledge was, therefore, based around black and white photos of desperate-looking cattle attended by vets with serious faces and long, black, plastic coats that reached to their feet.
Pete, Tim and I knew that this was a potentially serious situation for the country, and for the farming and veterinary industries, but Essex was a long way away and we were not really aware of the full implications of the outbreak. However, Stewart, a perpetually cheerful Scottish vet who was working with us at the time, had previously been employed by MAFF as a veterinary investigations officer. As part of his training, he had learnt much about foot-and-mouth, and he fully understood how grave things were. He was going on holiday skiing for a week the very next day, and his parting comment as he bade us farewell was, ‘Oh, lads, this is gonna be really bad. Things will not be the same when I get back from Austria.’
: The Life of a Yorkshire Vet Page 12