William's Gift

by Helen Douglas

  I got “Homer” that summer, an Appaloosa gelding that I traded for an overdue account. He was homely, tall, and spindly, unlike most Apps, but a sharp jumper, and he had an uncanny, almost canine, understanding of humans. He turned out to be one of the most enjoyable horses I ever owned. He was originally intended to be a school horse, but was green and too smart and would regularly run off with the students. I started to ride him myself, and we clicked. Full of pranks, he let himself out of gates, stood in wheelbarrows, and loved cross-country and jumping. Once he got the idea, he would take me over anything, even into water. He became our mascot. We jumped him over picnic tables and even brought him into the house for special occasions.

  Life went on in its new form. The horse practice had stabilized to a level I could accept — not enough to live on, but enough for me to be of service to lots of horse owners and patients and treat many interesting cases. My detractor had been somewhat backed off by a formally drafted legal letter pointing out in a reasonable fashion that it would be in both of our best interests to live in peace. Perhaps she realized I wasn’t going to give up easily. The small-animal practice grew steadily, and I found I was enjoying it. It had been great to accumulate all the skills and experience I had at both Brentwood and Rexdale Equine. Now they were serving me well. I continued to do horse calls “before work” and into the evening.

  One interesting job I had was to geld over twenty huge Russian warmblood stallions one summer. A local entrepreneur brought them back on livestock pallets that had been used to send Canadian dairy Holsteins to Russia. They were housed in Nova Scotia to be gelded, backed, and then sold all over North America. They were too large to drop to the ground easily, so I decided to geld them all standing. We worked our way through the herd, doing three or four each day. It was an opportunity for me to become completely comfortable with the best anaesthetic regime and technique for standing castrations, as well as learning how to handle complications, such as swelling or bleeding. By the time the last of the group was done, I had it really fine-tuned. The young horses didn’t even know they had had surgery!

  Meanwhile, the group down at the clinic had developed a good rapport. We really had fun working together. One afternoon, I had booked a special procedure on an ailing German shepherd with a cough. I suspected from her x-rays she was bordering on congestive heart failure. Elizabeth had come down to help us hold her for an EKG, which was to be sent via a battery-operated unit over the phone to a specialist who would interpret it and fax back a report.

  Sheba was a placid, older female German shepherd and lived alone with her owner way back along the shore. He was a reclusive backwoods bachelor. He had an overactive sense of smell and it distressed him greatly being in the clinic. The smells there upset him so much that he spent the whole time sniffling, grumbling, and even snorting, all the while blowing his nose. As this was distracting to all of us, I asked him to wait in the front room while we hooked Sheba up and ran the EKG.

  We put the lovely old dog on the table in lateral recumbency and hooked up the four leads with metal clips to her dampened legs. I dialled the phone, and we turned on the small unit. There was no power. The batteries were dead. Elizabeth jumped into her car and sped the one block to the nearest convenience store. Sheba had been difficult to convince to lie down and so it seemed best to leave her there. I stuck my head out of the treatment room.

  “The phone line is busy — we’ll keep trying,” I said.

  The owner snorted, “Well, just hurry up and get it over with.” He was desperate to leave.

  The phone rang. “The car won’t start. I need a boost,” said Elizabeth from the store. “I’ve got the batteries but I can’t get back.”

  We all stared at one another. The receptionist would have to go get her. We put the phones on hold, and the two of us remaining managed to keep the dog on the table and the clips on. The owner was totally unaware that two out of four of us had left the building.

  “Hurry,” I whispered between clenched teeth. When they arrived back, the receptionist went out front once more and reported, “They’ve just gotten through,” to the anxious owner. The phone rang right through, and we had the transmission done. When the owner left, we all collapsed in gales of laughter. It had been a comical ten minutes, but we had pulled it off.

  Sometimes we used the small animal clinic for equine cases. There was a work area there that had been used for both cattle and horses, but it was the gas anaesthetic machine that came in handy for foals on numerous occasions.

  I had an Arab foal arrive from two hours away. The flexor tendons on the left hind leg had been severed, and his toe was well off the ground. The referring vet had sent him in a cast. This had been going on for several weeks. The owners were distraught and became even more so when I told them the prognosis was poor, as tendons are notoriously hard to sew and slow to heal. I thought I had an idea, though, that might work.

  We anaesthetized the foal and clipped the hind leg. I had devised a plan, an experimental repair technique using some small bone plates we had in the clinic, and they were in the autoclave now. Each was stainless steel, smooth, about one centimetre wide and four centimetres long. I would use them to bridge the clean cuts needed to shorten both the superficial and deep flexor tendons and integrate them into my suture pattern. Perhaps they would prevent the suture material from slicing through the stringy tissue and letting go. One went on the front side of the innermost tendon, and the other went on the back of the outside tendon so they wouldn’t rub together. After an hour-long surgery, I sutured up the skin. We had removed two inches of tendon.

  We had a special shoe made with an elevated heel to take the strain off the newly repaired tendons. Three months later, however, the foal’s toe still tipped up dramatically. The owners sadly decided not to go on. They had spent far too much already. I asked their permission to take the little animal’s body, look at the surgery site, then cremate him in our crematorium. It was extremely interesting to see that the tendons had healed well and the plates were well incorporated into the process and causing no harm. Although the tendon attachment surgery had been a success, the stretched structures and joints could not normalize. But this improvised technique for tendon repair might possibly come in handy another time.

  We used our aged crematorium for our own euthanasias now, as well as for other clinics’ deceased patients and private owners’ pets that had died. It took all day to fire up the antique and run it, but it was useful to have, and we often had to prepare the pets’ ashes afterwards so the owners could take them home.

  One Sunday evening, I was called to an emergency, and we decided to euthanize the large, white Samoyed cross. It was late at night, and I couldn’t lift her into the freezer by myself; nor did I want the owner to see this. I made a decision to leave the poor dog’s body on the x-ray table, where we could cremate her early the next morning. When I opened the back door at around eight in the morning, I was almost knocked over by a smell so noxious I can’t find words to describe it.

  “Oh, no!” I thought, choking my way to the x-ray table.

  The dog was bloated to twice her normal size. Rare gas-producing bacteria had multiplied prolifically under the skin overnight and the animal reeked. I touched her and fur came away on my hand. The receptionist, who had followed me in, was gagging and opening windows. We were to open in twenty minutes.

  We had to move the dog urgently, but she was coming apart in our hands. Any pressure and a finger would burst through the skin. It was altogether a repugnant mess, and I felt incredibly sorry to have imposed it on my innocent staff member. Gloved and masked, we managed to roll her onto a tarp on a board and get her outside. What a disaster! With all our best efforts to open windows and spray disinfectant, the clinic was still barely tolerable. We cancelled some appointments. We apologized profusely to each and every client who came in that day and I vowed not to make such a careless mistake a
gain.

  Months went by, and now seasons, and it was clear that taking on the small-animal clinic had been a good idea. There was a nice mix of time in the clinic and at the farms. And the small-animal clients were kind, easygoing, small-town people. I worked closely with the S.P.C.A. and gradually built the business back up. It was certainly clear that horse practice alone would not have paid the bills.

  The second summer of my combined practice, I had an upset with Bruce, the western trainer who had trailered me down so long ago. I did very little work in his barn anymore, but a client there who still called me on occasion wanted me to see her horse, which had severe diarrhea. The horse sounded awfully sick.

  “I’ve seen a few like this, this week,” I said when I pulled up, feeling a bit uncomfortable … almost unwelcome.

  I examined the depressed horse, which was significantly dehydrated and hadn’t eaten or drunk for twenty-four hours. “Let’s start him on some antibiotics and electrolytes and see how he does over the next few hours. He’ll also need some Kaopectate orally by drench syringe,” I said, leaving a gallon, “and I’ll take this blood work with me.”

  When I got back to the lab, the blood work indicated a more severe dehydration than I had realized. I phoned Bruce back. “Could you bring him to the hospital for iv fluids and leave him for two or three days? He really needs monitoring,” I asked, knowing he had a trailer.

  “You already had this planned before you even saw him, you’re just trying to drum up business for that hospital,” he said. “And besides, the girl can’t afford it, or the trailer ride.”

  “But it could be more serious. It could be salmonella; iv fluids could be crucial. They are the accepted treatment for colitis.”

  I sounded anxious, as if trying too hard. I felt very strained. It hadn’t occurred to me that the suspicion still lingered. I was so absolutely sincere in wanting to do the best for the horse. I said, “Bruce, tell her I’ll pick up and treat him for nothing if that’s how you feel.”

  “Nothing you can say will change my mind,” he replied. “Treat him here or not at all.” “Would you prefer to have the other vet do it?” I asked

  “Yes, I would,” the answer was clear.

  Somewhere along the line, Bruce had lost respect for me; that much was obvious.

  “All right, I’ll phone the blood work over,” I said, hanging up, trying to disguise how upset I was. I put down the receiver and cried for the first time. Some of the stress was obviously getting to me, and I would have to be careful. I knew from past experience how that black feeling could creep in, and I must avoid it at any cost. I had set up the same kind of scenario for stress and exhaustion that had overcome me so many years ago.

  The most dramatic case I had in Nova Scotia occurred the following spring. It was a foaling, and the owners had already tried for some time to correct the situation by the time I arrived. The foal was dead and, by the size of its legs, very large. I scrubbed up and examined the birth canal. It was an uncommon and difficult malpresentation, one I had never seen before. The foal’s head had gone straight back and only the base of the throat was present. I worked for two or three hours to try to get the foal out. I had to remove one front leg to make room and do an epidural on the mare to stop her straining, but could not get anything round the base of the neck or find the head, which I might have been able to pull forward or cut off. I couldn’t get the foal to budge, and both the mare and I were tired.

  “Would you send her to the Island?” I asked.

  “No, that’s not an option,” the owner replied.

  “I can’t promise you anything, and we will likely lose the mare as well, but I could try to do a section here, in her stall, if you are prepared to euthanize her anyway,” I offered. Years later, looking back on it, I don’t know where I got the nerve. It was a real long shot. I called Elizabeth at the farm and, telling her what I needed, implored her to come as quickly as possible and be prepared to be the anaesthetist.

  “Bring catheters, fluids, drapes, lots of suture material, lots of anaesthetic,” I rambled off the list. “Don’t forget the surgery pack!”

  The barn was cold and dark, and a wind blew down the long aisle, making it a bitter tunnel. We hung trouble lights around the recumbent mare and prepped her. We had laid her against a wall on her back and her head was in the aisle, where our anaesthetist knelt on a blanket. I knelt against her other free side, tucked my knees under her huge body, took a deep breath, and cut. I succeeded in cutting the midline and uterus with no severe bleeding. The owner lay in the bedding behind the poor mare and pushed the foal back up to me slightly against gravity. I found its head was completely over its back. I found its muzzle at his tail-head. The poor foal never had a chance. A group of men got it lifted out, its length seemed to go on forever as we extricated it from the mare’s body. Then I started the intimidating job of sewing her up.

  Elizabeth knelt in the cold all night. At one point she had to go back to the farm for more anaesthetic. But we carried on. When the last suture was placed, two men carried me out of the stall, my legs so numb I couldn’t get up. It took the mare two more hours to get up after that. In all, we had been at it for twelve hours. Four days later, a foot of the incision herniated. The owner called me in a panic.

  “There’s bowel coming out,” he said. “I guess I’ll shoot her.”

  “I’m so sorry. Do you want me to come and euthanize her?”

  “No, I’ll just get it over with,” he said. I hung up with tears in my eyes.

  Would I try it again? I think not, but that’s easy to say. If we could have driven to the nearest vet school without a ferry ride — as one can do now — we might have gotten her there. Sometimes the situation is so difficult to give up on, and the option of euthanasia so final, that a vet will try against all odds and good sense to save an animal.

  I was approaching what turned out to be a critical decision in my career. The lease at the clinic was due to be renewed in three months, and the owner fully expected me to buy his practice. Although I was really proud of what I had done, I knew I did not intend to buy it. On the other hand, I found myself in a very interesting position, as I now understood without a doubt the horse practice alone could not provide me with a secure income. So it was mixed practice or nothing. In order to stay, I had to buy the clinic.

  There was the additional problem of overwork, straight and simple. It is hard to run two businesses single-handedly at the best of times, but when you have to be on call seven days a week as well, it is a recipe for burnout. I could get some help with the small animals, but not the on-call. It would become a familiar problem.

  Elizabeth and I were having dinner one night, with no agenda planned or expectation of talking about such important matters. I blurted out, “Do you think we should stay here?”

  “What?” she said, stunned.

  “I have to give Dr. Kemper an answer about the clinic soon,” I said. She knew it had been on my mind. We both knew that buying it meant moving to the town where the clinic was located and running both businesses there, as going back and forth for two years had been so hard on me. Something had to give, but we hadn’t discussed it yet. It had been almost too big a subject to tackle, because the prospect of more change was so daunting. I had finally opened the can of worms.

  “It’s all so different than what I had envisioned,” I said in a matter-of-fact tone, without a trace of bitterness. “And you know we aren’t making much above costs.”

  “I’m not sure it’s the right place for us,” Elizabeth replied, tentatively, “especially not if we have to move to another town and leave the farm.” She had never said anything to that effect before and was now speaking from the heart. I appreciated her honesty.

  “I don’t think it is. I don’t think we will be staying long term, so why get in deeper now?” I pondered, thinking out loud. I had been in N
ova Scotia for six years. Now what? Now what indeed?

  We looked at each other, almost shocked to have verbalized the possibility of leaving — and after working so hard to survive here. Yet we spoke with certainty, too.

  If Nova Scotia was not home, then where was home? Would I be driven once more to pursue my dream of practising high-quality equine medicine? I decided I would go for it one more time. But how? Perhaps going back to Lanark should be put on the table, too.

  As is so often the case, fate played its hand. The client who had the mare with the large bowel impaction had moved to B.C. and loved it. She was home visiting and told me about an opportunity out West. It was to be the next fork in the road.

  “There’s a job opening at the clinic I use,” she said. “It’s the best horse practice in the lower mainland. They do colic surgery for the whole area. It’s an amazing place to be part of. You should try for it …”

  I discreetly arranged to fly out West for an interview.

  Perhaps it would all be for naught. It would be such a huge move to make, and of course the farm would have to be sold. I would check it out, but it seemed a long shot. There seemed to be too many obstacles. Yet, it was exciting to think about being in a state-of-the-art facility again. How would I know if I would be treated as more than a nurse? Somehow Toronto and the years of experience since felt like a suitable footing from which to approach another high-powered equine patriarch.

  British Columbia was beautiful, and the horse scene and economy were very dynamic. The weather would be much easier than anywhere else I had ever lived. The clinic was top-notch, busy and well equipped. The owner was a very domineering individual, but also very knowledgeable, and I felt, after I had conversed with him, that I could hold my own due to all the experience I’d had in Nova Scotia. I was leery of getting into another peripheral or too junior a position. We both felt I could contribute a lot to the practice. I was offered a job. I flew home with much to think about. For one thing there was the problem of the B.C. Board Exams. British Columbia remained the only province to have separate licencing exams. I would have to look into writing them before I could move forward.