A stocky, leathery-looking man in his late sixties flung open the back door of the cab and strode towards my office. His movements were brisk, and the rap on the door was far from timid. Clad in heavy woolen clothing, he had the look of a man who spent a great deal of time in the bush. Although his garments appeared well worn, they were clean and in good repair. The moment he entered, I could detect the distinct odour of wood smoke about him.
"Dr. Perrin?" He offered his hand. "Bruno Schmidt."
"Dave Perrin—glad to meet you."
His grip was strong; his rough, calloused hand pumped mine with an air of confidence and authority. He said nothing but stood with poker-straight posture, looking me up and down. Finally his eyes met mine, and he stared at me with an intensity that I found unsettling.
"I bring Heidi now?"
"Yes." I nodded.
Mr. Schmidt ducked into the back door of the taxi and emerged with a bundle swaddled in a heavy woolen blanket. Only Heidi's head protruded, but what I saw as she passed by me was distressing—her face had the look of a wasted and starving animal.
"Right on the table, Mr. Schmidt." I quickly guided him to the back room. As he folded the blanket down, I stared at the dog in disbelief. Mr. Schmidt's focus flitted back and forth from Heidi to me and, although I tried desperately not to show my emotions, he was able to read my thoughts.
"No gut," he said, directing his gaze away from Heidi to the floor at his feet.
Heidi appeared to be a golden retriever cross. Her hair coat had probably been reddish-blond, almost copper in colour, when she was healthy. Now it was dull, lacklustre, a muddy brown. Every bone in her body stuck out; her abdomen was pendulous and ballooned. Her face and skull were totally devoid of muscle, and the prominence of the bones beneath her eyes and over the crest of her skull gave her a hideous appearance.
Mr. Schmidt watched attentively as my hands traveled over Heidi's emaciated body. She was lying upright on the table but possessed so little strength that she was having difficulty staying that way. The muscles of her head and neck were weak enough that she could hardly hold them up. As she shifted her lower leg to get more comfortable, she collapsed onto her side.
"Gute Heidi! Du bist ein guter Hund! Dad's girl, Dad's girl," he whispered, gently stroking her head.
"Has her colour been like this for long?"
"Colour?" Holding his hands out to his sides, he shrugged. His blank expression confirmed he had not understood my question.
I held Heidi's head in my hand and rolled back her lip. The mucous membranes exhibited the sickly orange of jaundice. The texture of her tissues was leathery from dehydration and long-term lack of nutrients, and her lip hung back like a piece of folded cardboard. I deliberately replaced it and raised her eyelid to reveal the same yellow-orange colour to the whites of her eyes.
"Ah," he said, sadly nodding his head. "Gelbsucht."
I lifted her tail and inserted the thermometer. Heidi lay with no change in expression and appeared not to notice the intrusion.
"When was the last time she wanted something to eat?" I moved my hand to my mouth to mimic eating.
"Eat, three days nothing." He pursed his lips and slowly shook his head. "Not eat gut, long time." Gesticulating with his hands, he pointed to himself, then motioned towards Heidi's mouth.
"Yes. Yes. You force fed her. Did she ever vomit?" I made retching motions.
"Ja, Ja." He nodded his head enthusiastically and went on with an explanation I didn't understand. Again, I nodded my head in acknowledgement.
Securing the stethoscope in my ears, I listened to the rapid pounding of her heart, then carefully checked her lung field. I could feel Herr Schmidt's eyes burning into me. He was waiting with anticipation for me to say something revealing and looked disappointed when I removed the apparatus and set it back on the side table without comment. I retrieved the thermometer and held it up to the light.
"Her temperature's almost two degrees below normal."
When he shrugged, I showed him the thermometer, pointed to the 38.5 and then to 36.8 and explained, "Normal here, her temperature here. See line here." I rotated the thermometer so he could see the mercury reflected by the light.
He nodded and let his gaze focus again on some imaginary spot on the floor.
With Heidi still lying on her side, I tapped her abdomen and watched in fascination as fluid sloshed back and forth like water in an unbaffled waterbed. Then, I slid my left hand under her abdomen and began palpating for what I suspected I'd find. It was huge, irregular, and occupied the entire anterior abdomen. I ran my fingers back and forth across and around it several times before I said anything.
"Mr. Schmidt, put your hand under here where my hand is. Put your other hand up here."
He looked confused by my instructions, so I took his hands in mine and placed them on either side of the dog's abdomen. I moved my hands back and forth together with his. From the look on his face, I could tell that he was feeling what I was feeling. He pulled his hands away from Heidi as if pulling away from a hot stove and, as I talked, he looked down at his spot on the floor.
"Cancer, Mr. Schmidt? You understand cancer?"
He lifted his eyes until his gaze met mine, then he slowly nodded.
"Jawohl, cancer."
"The tumour is involving her liver and extends as far up as I can reach. When cancer involves other organs like the spleen, the bowel, or the mesentery, we can operate to remove it, but when it involves the liver there's nothing we can do."
My words were falling on deaf ears. Mr. Schmidt no longer felt it was worth the struggle to try to understand me. I was looking at his face, his downcast eyes, his stooped shoulders, and wondering what to say next when there was a sudden change in his demeanour. A resolute, determined look came across his face.
"X-ray! You have X-ray?"
"Yes, I have X-ray. But the tumour is so large and well defined, an X-ray won't tell us anything we don't already know. I honestly think that with Heidi's symptoms and with what we can feel, doing an X-ray would be wasting your money."
"X-ray!" he said, jutting out his jaw. "X-ray!"
"All right, we'll do an X-ray," I replied in resignation. "Let's carry her into the other room."
Mr. Schmidt wrapped Heidi in her blanket and lifted her. She acted as if she were startled when he moved her—as though she'd been awakened from a deep sleep and wasn't quite sure where she was. When he set her down on the X-ray table, her head jerked up and down and her legs splayed out as she struggled for control.
"Let's just lay her on her side so she's more comfortable."
He looked at me with a blank expression and shrugged. "Was ist los?"
Lifting her myself, I motioned for Mr. Schmidt to remove the blanket, then set her gently on her side. She took a deep breath as I eased her onto the table; before I removed my hands, I felt a shiver run through her body.
After measuring Heidi's abdomen for thickness, I checked the technique chart for settings and calibrated the machine. Moving the cone until it was properly positioned over Heidi's abdomen, I slid a large X-ray plate under her.
Mr. Schmidt sat quietly with his dog, stroking her head and occasionally bending down to whisper to her.
"We're ready, Mr. Schmidt." I handed him one of the heavy lead gowns that are worn to protect against radiation exposure when helping to position patients.
"Just put your arms through and tie like this." I demonstrated with my own. Mr. Schmidt slipped into the gown then returned to Heidi.
I exposed the first X-ray with her lying on her side. Changing the plate and the calibration of the machine, I balanced her as best I could on her sharp, very prominent spine and exposed the view of Heidi from front to back.
Fifteen minutes later, I emerged from the darkroom carrying the film holders that suspended Heidi's still-dripping X-rays. Mr. Schmidt's face was brimming with expectation, his steel-grey eyes focused to mere slits, his forehead creased with worry. He was intent as I carried
the radiographs to the view box, held them up, and began studying them. He peered at them expectantly, then turned to focus on me.
"You see this shadow, Mr. Schmidt?" I pointed to an irregular, blurred line that extended from the top of the X-ray to the bottom. "That's the outline of the liver. Normally it would be much clearer, but Heidi's so full of water that it blurs the contrast."
He didn't comprehend a word I had said. "Hold please." I handed him the film holders. "Book! I get book!"
Mr. Schmidt looked puzzled as I left but smiled for the only time during his visit when I returned with a radiology atlas that was written and illustrated in both English and German. I thumbed through the pages of the atlas to the X-rays of the dog abdomen.
"See this line, Mr. Schmidt?" I pointed to the shadow in the book that outlined the furthest reaches of the liver. "Normal liver in front here." I indicated the outline of the last ribs on the X-ray photo.
"See Heidi." I showed him the same line on Heidi's X-rays. "Liver very big, bumpy." The irregular shadow that delineated the edge of the mass went far beyond the margins of the last rib to take in the anterior third of the abdomen. Several large knobby lumps could be seen extending out from it. We were both silent for a long time, standing side by side staring at the shadows of Heidi against the light of the view box.
"Cancer," said Mr. Schmidt. It wasn't a question.
"Cancer," I confirmed.
His torment was evident. He knew deep down that Heidi's situation was hopeless but somehow still hoped for a miracle. Again, he spoke in German, his voice so low that I could barely hear him.
I shook my head and shrugged my shoulders to indicate that I didn't understand him.
"Operation!" he said forcefully. "Operation!"
"Oh, operation—surgery." For several minutes, I tried to think of some way to explain the gravity of Heidi's situation—that all of the symptoms indicated severe liver disease. That if that wasn't so, I could put her on intravenous fluids for a few days to see if we could build her strength enough to do an operation and explore the condition of her abdomen. How was I going to get through to him that Heidi's liver was beyond repair and certainly couldn't be removed?
"Cancer too advanced," I finally blurted, moving my hand back and forth over the tumour.
Mr. Schmidt rambled on in German. He shook his head to indicate that he hadn't understood me. The look on his face suggested otherwise.
"Too weak! Too sick! She would not survive the anesthetic." I shook my head emphatically.
"Put Heidi to sleep?" Mr. Schmidt queried flatly.
"I think that would be best for her. If she were my dog, that's what I'd do."
"Put Heidi to sleep."
I nodded. Mr. Schmidt turned away and walked over to Heidi. Taking her head in his hands, he whispered into her ear. I felt tears welling up as I watched him with his dog. I was about to take away what could be this man's only source of companionship. Going to the lock cabinet, I withdrew a bottle of euthanasia solution and filled a twelve-millilitre syringe.
I retired to the waiting room while Mr. Schmidt said goodbye to Heidi. Fingering the syringe full of liquid that would take Heidi's life, I reflected on how little college had prepared me to deal with such situations. Every day of my life was like a bloody soap opera. So much pain! So many decisions! So many types of people, each likely to handle the same situation in a different way! Who had made me God?
"Are you ready, Mr. Schmidt?"
He nodded and, putting his lips next to Heidi's ear, whispered to her. "Meine beste Freundin, Heidi. Meine beste Freundin."
I wiped her foreleg with alcohol and drove the needle into her vein. As I withdrew the plunger on the syringe, a jet of blood shot back into the clear liquid. I began a slow, deliberate injection. Heidi took a deep breath, exhaled gently, and lay still. That indefinable "light" which, moments before, had flickered in her eyes—that mingling of pain and love and desire to please—had disappeared.
Mr. Schmidt turned to me with a questioning look. He whispered softly in German to me, as if afraid to waken Heidi.
"She's gone," I whispered in return.
His face became a mask of pain and misery. His body convulsed, and he emitted the most tormented wail I'd ever heard. Throwing himself upon Heidi's body, he wept uncontrollably. I put my arm on his shoulder for a moment, then left him alone with his dog.
As I sat in the waiting room, I pictured Mr. Schmidt returning to a one-room cabin in Gray Creek and sitting alone in front of his wood stove. No radio, no television, no telephone, and now, no best friend. I closed my eyes, laid my head back, and let the tears trickle down my cheeks.
It was fifteen minutes later that a more composed Mr. Schmidt walked out to the waiting room.
"Taxi? Phone taxi?" He spoke quietly.
While waiting for the taxi to arrive, Mr. Schmidt was subdued. He paid his bill. While I prepared Heidi for her trip home, he sat in the waiting room with his head in his hands. I wrapped Heidi in her woolen blanket and slid her inside a large plastic cadaver bag.
"I'll carry her out for you," I said, when the cab arrived.
"Nein, ich." He pointed to himself. "Thank you, Herr Doktor." He stared at me as if searching for something that was eluding him.
"I go." He stiffly turned on his heel and went back to Heidi. I opened the office door for him. Bill, the cab driver, saw him coming with his burden. Maneuvering his bulky frame from the seat, he trudged around to open the trunk. Mr. Schmidt walked directly to the back of the vehicle, supported Heidi's body with one hand against the car and, with the other, opened the door. Without paying the slightest attention to Bill, he slid Heidi's body onto the back seat and followed her in. Looking only at the black bag on the seat beside him, he closed the door.
Bill stood for a moment by the open trunk and scratched his balding head. I could see he was considering asking the old man to move the body. He looked at me and raised his eyebrows. Finally, with a shrug of his shoulders, he closed the trunk.
I was in a sombre mood as I wandered about the office putting things away and cleaning up. The best part of the day was now gone, and I was trying to decide what to do with the rest of it. I sprayed the exam table and X-ray table with disinfectant and, after washing them down, checked on the hospitalized patients in the kennel room.
I was leaving the office a half hour later when there was a knock at the door. To my surprise, it was Mr. Schmidt. Without saying a word, he entered and closed the door behind him.
Perusing the waiting room and the counter for something he had left behind, I asked, "Did you forget something, Mr. Schmidt?"
Resolutely, he walked to within a few feet of me and blurted, "Not baby!"
"Pardon me, Mr. Schmidt, I don't understand," I stammered.
He took another half step towards me, looked almost straight up into my eyes and repeated, "Not baby!"
I could see that his mind was racing, that he was frustrated with his inability to communicate what was tormenting him. I couldn't imagine what would have been important enough for him to pay a taxi to drive him a good part of the way home and then back again! My God, what had gotten him this upset? I wondered if he had misunderstood something I'd said.
He spewed forth a torrent of German. I didn't understand a word of it, but the passion with which he spoke was unmistakeable. In frustration, he stopped mid-sentence and raised his hands as if to tear at his hair. "Verdammte Scheisse!" he hollered.
Finally, with intense concentration, he took a deep breath and pointed to himself. "Me 30...Germany...army." He looked intently into my eyes to see if I was comprehending.
I nodded, still baffled by what was going on, and he continued, "I fight...three years. Kill. I not cry! Not baby!"
That's what it was all about! Mr. Schmidt was frantic because I'd seen him cry. He didn't want me to think that he was weak—that he was a baby.
"Don't worry, Mr. Schmidt. I don't think you're a baby! I'd have felt the same way if Heidi were my own
dog—it just showed me that you cared for her."
He wasn't the least bit placated by my words. Not only did he not understand, he was so distracted that he wasn't listening to me at all. As he was searching for the words to continue, I wondered how in the world I was going to get through to him.
"I fight!" He was shouting. He struggled for the words he wanted, then broke into German again.
My blank expression told him that I hadn't followed. He rapidly unbuttoned his shirt and pointed to a long, jagged scar that meandered across his abdomen.
"Verwundet! Verwundet!" He stared at me for some sign of comprehension.
"Wounded?"
"Ja, Ja, wounded! Not cry! Not cry!"
He spoke slowly and forcefully in German, willing me to understand. When he saw that he had lost me again, he shook his head and rolled his eyes.
"Krankenhaus, Krankenhaus." Suddenly, his eyes lit up and he pointed to the sign stenciled on my window. "Hospital, Hospital! Three Monate, Hospital."
"Three months in hospital," I affirmed.
"Jawohl, ja, three months."
The charade began once again. He repeated the same thing several times, putting his hands together and moving them towards himself. When he saw that I was not getting it, he said, "Meine Einheit, meine Einheit," searching for the word from the ether that would convey his meaning.
"Company?" I guessed. "Your unit?"
"Yawohl! Mein Bruder...Mein Freund...Einheit..." He waited for me to comprehend.
"Your brother and your friend were in the same unit," I suggested, getting into the flow of the conversation.
"Ja, ja, Bruder, Freund, same Einheit..." He looked more serious than ever as he continued, "Einheit go Russia." The very mouthing of the word "Russia" was difficult for him.
He stopped—not fishing for words this time. He just didn't seem to be there. I stood only two feet away from him, not wanting him to go on torturing himself, but not wanting him to stop telling his story either. His voice was almost a whisper when he carried on.
Don't Turn Your Back in the Barn (Adventures of a Country Vet) Page 21