A Seaside Practise

by Tom Smith

  I arrived at the house at eight-thirty the next morning. I walked into a kitchen smelling of freshly cooked porridge and coffee, and that didn’t resemble at all the room I had been standing in the night before. There was no smell, except for furniture polish, and Ellen sitting up in bed with a tray, tucking into a large brown soft-boiled egg and hot buttered brown toast, and already looking better.

  Flora had been back in the middle of the night to give a second injection, and the antibiotics had obviously already done their stuff. There was no need to send Ellen to hospital. Rab, however, was nowhere to be seen. I asked Ellen where he was. Ellen, mouth full of egg, inclined her head towards the corridor that led off the bedroom. I wandered through to the guest bedroom, where I could hear heavy breathing. There was Rab, flat on his back, fast asleep, still with a kitchen cloth in his hand.

  I walked back along the corridor to Ellen. She laughed when I explained how I had found Rab.

  ‘He’s been up all night cleaning and polishing and putting things right, and now he’s exhausted. But there’s an alarm clock there. Nurse Flora put it there and set it for eleven – that’s when he’s to bring me my coffee’.

  Ellen recovered fully, and two months later, when she felt she could travel, she and Rab went for the first holiday together in their forty years of marriage.

  There was another outcome of that visit to the Jackson house. Word soon spread that the doctor had helped to deliver a calf. Not long after its birth I was visiting an elderly lady, a Mrs Buchanan, on a farm near Braehill. It was a regular monthly call, more of a social visit than a medical one, and I always enjoyed a cup of tea with her. I had just raised the cup to my lips when her son Angus rushed in.

  ‘While you’re here, Doctor, could you come and see this? Maybe you could help?’

  He showed me out of the house to the byre. Not again, I thought. I carefully studied the byre floor as I walked in behind him. It was covered with straw, and reasonably clean. The cows, too, looked cleaner than Rab’s.

  We approached a single stall with a cow standing over a female calf that was lying in the straw, making no effort to rise. It wasn’t difficult to see what was wrong. The calf’s navel was opened, and the intestines were hanging out through it, still encased in the peritoneal sac – the membrane that surrounds the bowel. The condition in humans is called exomphalos: I presume vets call it the same.

  ‘The mother has pulled too hard on the cord,’ said Angus. ‘It doesn’t happen often. Maybe there’s a weakness there. Can you do anything about it?’

  ‘Shouldn’t you call the vet?’ I asked. ‘It’s more in his line.’

  ‘There’s no time for that,’ he replied. ‘The vet’s in Ayr, and it would take more than an hour for him to get here. By that time, the calf will be dead – the bowel will swell up, and we won’t be able to push it back. It’ll get infected. We wouldn’t be able to save it. I’ll have to shoot it if we can’t put the bowel back now.’

  I swallowed, and thought about it. I knew what to do. The surgery wasn’t difficult. If I could push the intestine back without twisting or telescoping it, then sew the edges of the muscles and skin together, it could work, but I didn’t have the tools to sew through tough animal skin. Mrs Buchanan solved that problem: despite her frailty, she had walked slowly to the byre door to find out why I was needed. She offered one of her strongest darning needles and Angus brought out a pack of fishing gut, and we were all set.

  It was easier than I thought. The loops of bowel slid easily back into place, the edges of the muscles and skin came together nicely and smoothly, and Angus gave the animal a ‘shot’ of veterinary antibiotic to cover possible infection. The calf didn’t react at all to the stitching, which suggested that she was unconscious. I needn’t have worried. Within a few minutes she had already started to revive. I heard later that it thrived, and some two years later, on one of my regular visits, Mrs Buchanan proudly gave me my usual cup of tea, but this time with a drop of the calf’s first sample of milk.

  After this I began to get worried. There’s a popular view that vets are allowed to treat sick humans, but that doctors are definitely not allowed to treat sick animals. I don’t know that this is strictly true, but I do know that I didn’t want to step on my vet friends’ toes. I didn’t want them to think I was usurping their place in our relatively restricted rural society.

  Feeling like this, I took a lot of persuading before I performed my last act of animal therapy. It was the day of the Ayr Gold Cup, the biggest day in the West of Scotland horse racing calendar. I have to admit here that I wasn’t fond of horses. They have big teeth at one end and nasty hooves at all four corners, all of which can inflict considerable damage to human soft tissues, and it wasn’t long before, as a country doctor, I had to deal with bites and kicks. I felt that if you were mad enough to ride them, you would inevitably fall off them, and then they could roll over you. I even thought they might well do that for spite, in a subtle reaction to all that kicking their sides to gee them on, or pulling at their mouths to slow them down.

  My experience of tending to people who have been injured by these various equine attacks upon them (I wasn’t of the opinion that they are accidents – there was something of the night, I thought, about horses) made me shy away from close contact with them. So Ayr Gold Cup day was a normal working day for me. I didn’t expect it to be busy, because most of the population had decamped up to Ayr, dressed up and determined to enjoy themselves, leaving the Stinchar villages to philistines like myself.

  Morning surgery attracted only a few regulars and the odd holidaymaker who had forgotten his pills, so I was able to start early on my routine visits for the day. It was a beautiful morning, quiet, peaceful and sunny, and I drove slowly on the road inland from Collintrae towards a farm near Kilminnel, nestled in the centre of the valley, its fields stretching upwards to the hillside to the north.

  The lady I was visiting, Eileen Rawson, had lived there all her life, and was well into her seventies. Years of breathing in the dusts from mouldy hay had finally got to her lungs, and she needed a lot of support to help her breathe. So Flora and I took it in turns to visit her once or twice a month to check on her. There wasn’t much we could do for her physically, but the visits seemed to give her confidence, and we thought them worthwhile.

  Mrs Rawson and I were chatting over the mandatory cup of tea - I must have drunk gallons of it on visits over the years - when there was a massive roar from outside. The farmhouse sat halfway up the valley, facing south. I turned my head towards the window just fast enough to catch a glimpse of a jet aircraft, exactly at my eye level, speeding like a bullet towards Collintrae.

  The sudden noise had startled both of us. Mrs Rawson told me that this had just started to happen: the valley was being used for low-level flight training, and all the farmers along the flight path had been sent letters warning them about times and the noise. We settled back into our conversation for a while, then I rose to go. As my hand settled on the door handle, it was opened by someone from the outside.

  It was Eric Rawson, Eileen’s son. A slim, athletic man of around 45, he made his living, like most of his neighbours, from his lambs and beef cattle. But the loves of his life were his horses. He had ploughed with heavy horses as a young man, and when tractors replaced them he had turned them into a hobby. He bred hunters for point-to-pointers, show jumpers for three-day eventers and Clydesdales for professional ploughmen, and he loved them all.

  He was looking for me, and was in a fury.

  ‘That blasted jet,’ he raged. ‘Doc, seeing you’re here, could you come and see Lowland Lad for me?’

  I knew enough to recognise that Eric wasn’t referring to a stable boy. In the yard, in a lather and wild-eyed was a very large horse, his reins being held firmly by Danny, Eric’s handyman and groom. Danny was from Ireland, and apparently what he didn’t know about horses wasn’t worth
knowing. A retired National Hunt jockey, he had ridden several times in the Grand National. Danny was also in a sweat and breathing hard, but he was coolly trying to pacify the horse by whispering in his ear.

  I could see at once why he and Eric were concerned. Lowland Lad was bleeding freely from a cut about four inches long just above his left eyelid. The blood was flowing past the outer corner of his eye, down the side of his jaw and dripping on to the cobblestones at his feet.

  ‘Do you think you could stitch it for us?’ asked Eric.

  ‘Stitch a HORSE?’ I exclaimed. ‘How would I keep it still when I put the needle in?’

  Danny grinned and told me not to worry. He would guarantee to keep the horse quiet while I did it. And no, I wouldn’t need to give a local anaesthetic.

  ‘That horse has big teeth,’ I said. ‘How do you know it won’t bite?’ I asked him.

  ‘We’ll put a twitch on him,’ he replied. ‘All we want to know is, can you do it?’

  ‘I really think this is a vet’s job,’ I said. ‘Why don’t you call him?’

  Eric laughed. ‘You do know it’s Gold Cup day? All the vets are at the course. We wouldn’t be able to get one till tomorrow.’

  I wondered where I had heard that before.

  Lowland Lad did look a mess. There was a triangular flap of skin hanging over the upper eyelid, leaving the red flesh underneath exposed. It certainly wouldn’t heal by itself without leaving a big scar, and the hanging skin would become infected and die off, possibly even endangering the horse’s life. Someone would have to do something. I just wished it didn’t have to be me.

  ‘If you can guarantee that the horse will stand still, I can sew that flap back,’ I said, with an outward optimism I didn’t feel. I turned towards my emergency box, and looked for the biggest suturing needle and strongest thread in it. While I was doing so, Eric told me that the horse had been ‘spooked’ by the sudden noise of the plane and had thrown his head back. His eyebrow had caught on a nail – for hanging tack – at the side of the stall door, and this had ripped the skin.

  As I prepared my materials, Danny produced a short piece of wood to which was tied a loop of smooth cord. Standing with his face at an angle to the horse’s muzzle, he continued whispering into his ear. As he did so, he slowly slid the loop of cord around Lowland Lad’s nose. When it was in exactly in the right position, he tightened and rotated it, twisting and closing the nostrils.

  Suddenly Lowland Lad was standing absolutely still. His eyes were no longer rolling, he just stood, looking straight ahead. Not even his tail moved.

  ‘We’re ready,’ said Danny. ‘Go ahead. He won’t move until I loosen the twitch.’

  Amazingly, that’s exactly what happened. I washed out the torn area of flesh with sterile saline, and inserted the first stitch. Even when the needle pierced the thick skin, Lowland Lad didn’t move – not an inch. I was able to insert five stitches to bring the flap and the surrounding skin edge together within less than a minute. When it was finished, the only sign that he had cut himself was the row of stitches. I washed off the blood, and stood back. Danny removed the twitch, and Lowland Lad shook his head a little, but remained docile. Danny led him back to the stable to rest.

  From then on, I looked on horses in a different light. Eric knew better than to offer me payment for the job, but he did offer me a riding lesson. Not on Lowland Lad, who would have been too lively a ride for a beginner, but on one of his Highland ponies, a docile and slow – and aged – nag who learned to tolerate me, and I him, reasonably well over the years.

  Chapter Fifteen

  Drunks – and dead drunks

  The Scots are drunks: that’s the reputation we have, and it’s totally undeserved. All right, some of us get drunk some of the time, a few of us are drunk all the time, but quite a lot of us, more than half in fact, have never been drunk at all. Our near-Puritan Presbyterianism ensures that just under half of all Scots, particularly in rural areas, are teetotal. I’m told that this is by far the biggest proportion of abstainers in any European nation. Another quarter of us feel so guilty about enjoying ourselves that we stick to the ‘wee dram’ each evening, and satiate the rest of our thirst with tea. It was the Scots, after all, who developed British tea drinking to a fine art, with Sir Thomas Lipton marketing the leaves that were grown and processed by the Findlay estates in Kenya and the Far East.

  Tea, happily, causes little trouble for country doctors, except when we refuse yet another offer of a cup on, say, our sixth house visit. Alcohol, on the other hand, is often a worry. Here I’m not writing about drunken doctors (I have to draw the line somewhere) but about plastered patients. Over the years, Willie Tait, the Collintrae constable, and I had our share of them.

  Fondness for alcohol has no social barriers: it afflicts the gentry, the farmers and their employees alike. The first may be more discreet, the second more devious, and the third wholly blatant, about their addiction, but in the end it’s the doctor who has to come to their rescue, provided they are willing to co-operate. Most of the time they aren’t, but there is a time in every drunk’s life when he (or she) has to face reality.

  Usually that time is when they find themselves in the hands of people like Willie Tait and me. Willie rang me at eleven one Tuesday evening in June to say that he had been told there was a dead body on the South Shore Road, a few yards from its junction with the main road to Stranraer. Some holidaymakers, just arrived from England, had come across it on their way to the caravan park a mile further on. Could I meet him there?

  It was only five minutes from the house, but even in the short time it took us to get there, a small crowd had gathered beside the halted caravan and the car that had been towing it. The body belonged to a man who was lying face down, with one arm underneath his head and the other stretched out at a right angle to the torso. The legs were splayed apart.

  In the grey light (it doesn’t get completely dark in June on the Scottish west coast) Willie and I did not recognise the body until we were standing over him. As we bent down, we both heard a gentle snore. The man wasn’t dead – he was dead drunk. We knew him well, of course. Jack Hunter lived in the first farmhouse on the road. His regular night out was always a Tuesday, after the weekly market in Ayr. Every Tuesday morning he and his stockman would drive the Hunter lorry filled with livestock the forty miles to Ayr, where they would sell their beasts and have lunch together at the Market Inn. The stockman would then pick up the new stock they had bought and drive them home, leaving Jack to enjoy the rest of the day with his cronies. They would bring him back in their truck when the Market Inn closed, which in those days of strict licensing was at ten o’clock sharp. By this time Jack was always well oiled.

  Not wishing to incur the wrath of the formidable Jean, Jack’s wife, Jack’s mates were in the habit of leaving him about a hundred yards short of his gate. Most evenings, Jack would have been able to walk the rest of the way home, but not this time. He hadn’t fallen down or been knocked down: he had just found the road a good place to lie down, crook his head on his arm, and fall asleep.

  He roused a little when Willie and I moved him to check that there were no injuries, and we decided to help him home. We each took an arm and walked him, albeit unsteadily, towards the farmhouse. The crowd quickly dispersed, a bit disappointed that the body had turned out to be alive.

  Arriving at the locked front door of a completely darkened house, we rang the bell and waited. A light snapped on in the room immediately above us, the sash and cord window was thrust upwards, and a roller-crowned head leaned out.

  ‘Wha’s there?’ They were only two words but they imparted the instant message that Jean was not in the most benevolent of moods.

  Willie decided to speak up. I was for taking the less than honourable option of leaving Jack on the doorstep and making a run for it.

  ‘It’s the polis and the doctor
, Mrs Hunter. We’ve brought Jack home.’

  Jean screwed up her eyes at these intruders on her doorstep. She didn’t like what she saw. She sized us up for a while, then spoke.

  ‘Well, ye canna leave him there, and he’s no comin’ inside ma hoose in that state. Jist pit him in the hayshed roon’ the back. I’ll see tae him in the mornin’.’

  At that the window slammed shut and the light went out, leaving us in the dark and looking for the hayshed. Behind the house was the usual yard, beyond which was a long, low building with several wooden doors in it. We opened one of them, and it was pitch black inside. We had left our torches in our cars because they would have been an encumbrance while we were escorting Jack to his door, so we had no idea what lay beyond the blackness, but we were sure of one thing: we were not disturbing Jean again to find out where to put her husband.

  Willie and I had to make a judgement. It was like one of the TV quiz shows of the day – which door hid the prize and which hid the forfeit? The smell of the first door suggested midden, so we tried the second. That smelt only marginally better, and was mixed with a strong smell of cow, so we tried the third. The air from that was much warmer, and it smelt more of hay and straw than of animal. Willie and I looked at each other and helped Jack in. He was singing quietly to himself, not loudly enough to disturb Jean, so we judged that he was both conscious and comfortable, and sensible enough to know that he shouldn’t disturb his good lady’s sleep again that night.