I’m off to vote now, quickly, as I can’t be sure I’ll have the time later on. At the polling station there’s a handful of elderly villagers and a plate of crêpes. I give a few quick handshakes, wolf down the crêpe offered to me by the lady mayor, and shoot off again, waving my mobile as my alibi.
Emergencies, that sort of thing.
*
It’s nine o’clock when I arrive at the clinic. The dog that should have died three days ago is doing well. Really well. The phone rings, a labrador that’s off his food, down in the dumps, not himself. It could be a case of piroplasmosis, caught from a tick bite. I won’t make his master wait. You can’t take any risks with piroplasmosis. It’s endemic in this region, it’s the season, it’s a killer. While I wait for him to arrive I call the guinea pig woman and tend to my major surgery patient. The cat that had surgery last night is just fine, there are no concerns, he’s purring away peacefully in his cage with his cushion, his bowl, his litter and his morphine medication. Unlike many cats, he hasn’t even disturbed his catheter. I leave him in peace. He’s a soothing presence.
*
The labrador and his owner arrive before long, so there’s no time to take out the dog that’s had surgery. The young lab, usually irrepressible, barely wags his tail. His master was right to bring him in. There’s no fever, the clinical examination is normal, the piroplasmosis smear negative, the dog’s not even really ill. But there’s something.
He’s clearly in pain. The stomach is soft, but when I palpate it he gives me an accusing look.
‘Does he scoff any old rubbish, this young rascal?’
‘Um, no, he stopped all that a few months ago.’
I pull on a glove, making it snap like they do on the telly. A finger in the rectum, I can feel hard bits and there are drops of blood. Dumb dog. What’s he gone and eaten? I scowl at the poo: streaks of blood.
Analgesics, antibiotics as a precaution, paraffin; if he’s not better tomorrow I’ll see him again: I don’t think I’ll need to operate on this chap.
Meanwhile, as I’m dealing with the labrador, the guinea pig woman has arrived. I remove the tick with the little hooked instrument that works so brilliantly, show her how to do it. Four euros fifty for waking me up on a Sunday, for being reassured even if there was absolutely nothing to worry about. It seems crazy to me, but I can’t see any other way round it. I send the woman and her guinea pig home. What can you say? I save lives. I tell myself that I understand why some doctors don’t offer an out-of-hours service any more, since the genuine emergencies go straight to Accident and Emergency anyway, which just leaves them with dumb stuff. Like this.
*
It’s eleven o’clock, and my neighbour arrives with his dog. We arranged the appointment yesterday. The dog, an elderly setter, had helped himself to a bowlful of fat the day before, and it was having trouble working its way through his system. I wanted to check on him, even if yesterday everything seemed to be happening normally. The old dog has already had hepatitis, pancreatitis, prostatitis and uveitis (an eye inflammation), so all we need is a merry cocktail of all that topped off by raging indigestion. Dog-itis. No poo since yesterday, but no vomiting either. I do an X-ray to check there’s no blockage. Nothing to report apart from his arthritis and the lead shot he got peppered with years ago. I give him some analgesics; we’ll see how he is tomorrow.
I take my in-patient – a griffon – out for his walk, and inform a chap who’s found a dog that its owner has had the sense to have it microchipped. A beep, the chip is read, I send him back home straight away. This too is a public service: I never charge for this sort of thing, except when I have to keep the dog for a while until its owner can come and fetch it.
Finally it’s midday, and I’ve done with my emergencies. I check my drips, do a tour of the surgery, lock the door.
Outside the little town hall, also a polling station, a crowd of people has gathered in the sunshine. There’s a queue stretching between the baker’s, the tobacconist and the town hall. But here there are no crêpes.
*
Ten to two, and for once I’ve managed to have lunch. The phone rings again.
A calving. This client couldn’t be more different from the guinea pig woman. I grab a lollipop in place of dessert. Watermelon flavour, my favourite.
A twenty-minute drive, stopping off at the surgery to pick up the embryotome, just in case.
On the way the phone rings again. A dog with a torn claw. Painful, obviously, but not serious. I give the woman some advice on what to do, but she still wants me to see it. I explain to her that I’m on my way to a major emergency, that I might be a couple of hours. That I’ll call her back.
Draughts whistle through the little cowshed. It’s freezing cold despite the sunshine, but I’ve got my calving gear to shield me from the wind. The client doesn’t often see me dressed up like this. With his fifteen Salers cattle we never have to do any obstetrics. Salers practically always give birth unattended. But he’s done the right thing: he’s spotted a cow that’s looks sick, moved her to a sheltered spot, pushed the calf that was already half engaged in the birth canal back inside her.
I pull on my gloves, plunge my arms into the warmth of the birth canal. The young cow doesn’t like it, but she doesn’t protest. There’s the calf, anterior presentation, normal. One foreleg was bent backwards, the farmer says. A minor thing, but still, when you’re not used to it … What concerns me is the emptiness, the feeling of space in the uterus. Normally the uterus hugs the calf closely, even if it’s slack through exhaustion, and there are no expanses of space. But here my hands seem to be feeling their way through a cathedral of mucous membranes. And I can make out the left kidney too clearly, and the belly, there at the bottom. Ruptured. I take my gloves off to get to the bottom of it, to feel the detail: it’s catastrophic. The cow is torn, from the vagina to halfway down the uterus probably, with the cervix hanging loose in the middle. By a stroke of good fortune the arteries are intact and the calf is still alive. I slide my fingers over the ends of the tear, I can feel an ovary in passing.
Oh well.
I pull a gloomy face. On seeing my expression, the farmer and his wife look glum too.
‘OK. Your calf has tried to come out via a C-section, all by itself. It’s managed to open up the uterus, though the incision is pretty much the work of a beginner, but the peritoneum, muscles and hide are a complete bloody shambles. I’ll finish the job off: I’ll open up here [indicating her flank], we’ll get the calf out through the hole it’s made, and I’ll close everything up again. It’s a hell of a mess, it’ll take a couple of hours or more, it might not work, she could die of shock, or she could get peritonitis in the next few days. The calf should be OK. I’ll need two buckets of water, cold will do.’
They hesitate. They’re shocked – they’ve never seen anything like this – as well as reassured by my pathetic excuses for jokes. I know what I have to do, I feel confident, and they can sense it. They trust me.
At times like this you feel a strange sensation of power. Every country vet has had a go at this sort of surgery. With varying degrees of success, I can only imagine. It’s not taught at vet school. It can’t be taught, full stop. It’s a total shambles, you never know what you’re going to find when you open the animal up, you have your little surgical kit and your hands, and you’re completely on your own. It’s exhilarating. Especially when you’ve done it before and you know it can work.
The first time it happened to me, I had to make it up as I went along. Since then I’ve refined my style a little. This morning I removed a tick from a guinea pig. Now the life of a calf and a cow depend on what I’m about to do. Even if I do well, she could die. But I have to try. You always have to try.
While I scrub the cow, anaesthetise her flank, tie her back legs and insert a nose clamp, Madame returns with the buckets of water. I set out my surgical kit, get out my suture material and my scalpel, disinfect my hands and arms, explain to Monsieur how to pull the
calf and when I will present it to him. He’s nervous, and rolls a cigarette that he’ll light a hundred times during the operation.
I make the incision, dodge a kick that’s fairly feeble and in any case hampered by the stirrups. A Salers hide is thick. It’s the first time I’ve operated on one, I think. Beneath the hide, two fine layers of muscle, then the peritoneal cavity. I push the stomach towards the front, slip my arm behind it. There’s the opening. From the middle of the left uterine horn to the vagina. More or less straight. The calf is reasonably well positioned for an extraction. I pull out its legs, hold them out to the farmer, who positions the nooses, and with my help pulls the calf out without any difficulty. The animal is shaken, has difficulty breathing. A shot of analeptics to stimulate the nervous system helps. I observe it for three minutes before going to wash and disinfect my hands again. Now things are about to get serious.
We’re on a small country lane, and the cowshed is open to the road. With the election going on, there’s a terrific amount of coming and going. Just like outside the town hall, people stop to have a chat. Old people, young people, a little six-year-old girl who wants to know if it hurts the cow, and why the calf is trembling like that. She’s cold too. A woman gets a blanket out of the boot of her car to put over the calf, and helps the little girl put her jacket on.
I’m wearing my dustbin-green overalls, with my arms plunged up to the elbows in the abdomen of a cow. There’s no way I can bring the uterus out, even partially, so I’m doing the stitches completely blind. I call it finger-suturing, as I prick my fingers every time to stop the point of the needle. I tighten my continuous suture over my fingers, cut into my joints. As I write this, I can count a dozen cuts and puncture wounds on my fingers. The only painful ones are on the second joints of each index finger, over which the thread passes when I tighten it. The first continuous suture is the riskiest. The wide ligament and the placental debris make it awkward. Damn fool calf. It takes me nearly three-quarters of an hour to finish this first suture. Not completely watertight, but close. The second, buried deep, takes me close on half an hour. Oh what fun it is to do a continuous suture between the serous membrane and the muscle membrane without stitching through the mucous membrane, when you’ve got both arms inside the cow and can see precisely nothing. Tell me about it.
An old woman watches me as I work, smiling. She used to have cattle, a while back, before my time. Not a single person talks about politics, not one. They chat about the neighbour’s little daughter, about the sheep, about the rain, about how fine the weather is, about a christening, about how the grass is growing, about the calf and how he’s quite big, but not that big. They talk about everything, about all the most important things in their lives. They talk about the vet who was here before me, who’s dead now. The Pyrenees are magnificent in the sunshine.
I feel useful, even if – when it comes down to it – they’re not that interested in me.
I’ve finished my continuous sutures. A man, the farmer’s father I think, wants to know how much thread I needed. Two and a half metres. He can’t believe it. Someone who I didn’t see arriving or leaving comes back with a bottle of colostrum borrowed from the dairy farmer next door. It’s come out of the freezer and has been warmed up over a pan of hot water.
I empty a bottle of penicillin into the mother’s abdomen. More out of habit than conviction, but it’s an eloquent gesture. Just as good as an intramuscular injection. First muscular continuous suture, second muscular continuous suture. This time it goes very quickly. I suture the hide, a neat job in satin stitch, all the while dodging kicks from the patient, who doesn’t appreciate my artistry – the anaesthetic’s effect on the skin is always wearing off by the end.
I’m done.
All that remains is to clean up, and wash off the dried blood. I’m plastered with it. The water in the buckets is hot. I don’t feel the cold particularly, but I could weep for joy.
*
Everyone’s gone. But the calf still has its blanket.
I explain a bit about post-operative care to the farmer and his wife. Nothing very complicated. Their confidence is tragic.
It’s a lovely day, even in the teeth of the wind.
In the car, the mobile reels off its messages. An injured cat. I’m thinking about the woman whose dog has torn its claw out when I get a call from a hunter: one of his dogs has just had its stomach ripped open by a wild boar. I make appointments for both dog and cat at the same time. The first to arrive will be the first on the operating table, while the second will be hospitalised. I call back about the dog with its injured paw, apologise, and explain to its owner that there are other animals that I have to treat first. She accepts this without a fuss, and asks for a few words of advice. Tomorrow she’ll go to her own vet (who doesn’t offer an out-of-hours service).
At the surgery I wait a little, tidy up a few papers, squint at my paperwork from afar. The tax return. I log on to Twitter. The usual babble. It’s spring.
The hunter arrives first. A good big hunting dog, like a Bleu de Gascogne basset hound with a lot of other things thrown in, with a fine wound on its upper leg. And a small hole in the abdomen. Easily enough to justify a general anaesthetic. I’ve inserted the catheter and attached the drip by the time the cat arrives. A hefty tomcat, clearly half-feral if not more, with a nasty wound on its neck, probably an old abscess that’s ruptured. Pretty disgusting. I talk to the woman for a few minutes, suggest I should take advantage of the anaesthetic to neuter him. She agrees – that’ll teach him to get into fights, she says – so I’ll keep him in overnight and she can pick him up tomorrow.
It’s past five o’clock, and I still have two operations to do.
*
The big dog is quickly anaesthetised. The wound on his leg barely needs stitching, but a drain won’t hurt. The hole in his abdomen turns out to be nothing to worry about. Half an hour later I leave the dog to come round and give his owner advice and explanations about the aftercare he’ll need.
It’s six o’clock when I attempt to anaesthetise the cat. I manage to do the injection, but – as a tough and semi-wild tom – he tries to rip me to shreds, wriggles out of my grasp and destroys the prep room before finding a safe spot under a cupboard. We’ve deliberately left enough space there to make a cat hideaway, precisely for cases like this. While I wait for the anaesthetic to take effect I pass the time in tending to my big hunting dog and chatting away online.
Catheter in, drip attached. The phone rings again. A very sick calf. I tell the farmer I’ll call in after I’ve finished operating. Dealing with the abscess takes a good twenty minutes, the neutering five more. I put the cat in a cage, check everything’s OK, and I’m off.
*
The calf is a ten-minute drive away. It’s twenty past seven by the time I examine it. Severe pain, bad enough to finish it off. Nasty haemorrhagic diarrhoea, high fever. Colic, salmonella or coccidiosis? I’m inclined to the latter, but bits of fibrin and necrosis in the diarrhoea make me less certain. It’s very sick, in any case. Unsure, I treat for both bacteria and protozoa, take a specimen, and above all ease the pain. At a quarter to eight I’m back at the surgery, decanting the diarrhoea for a coproscopy. At eight o’clock I have the result. Massive coccidiosis.
I don’t call the farmer. He’ll come tomorrow anyway for the rest of the treatment – if the calf survives the night, which is far from certain.
I walk the hospitalised dog, a great soppy Alaskan malamute. We have a new President of the Republic, Twitter babbles on at such a rate that I’ve lost track, and the cat I operated on yesterday is still here. Full of beans. The one whose abscess I sorted and whose cojones I’ve just cut off is coming round gently.
I leave a message for the malamute’s owners, and the prep room for the cleaner. In a woeful state. I feel for her, but I just can’t do any more.
I lock the door. In the distance, cars hoot in celebration.
*
When I get home it’s twenty to nine.
Time for an early night. Tomorrow’s a busy day.
Entente cordiale
He’s in the waiting area. He looks tired and sad, with his dog, a Pyrenean shepherd, on the knees. He’s lost in his thoughts, and as he moves his lips silently his magnificent moustache quivers in sympathy. He’s British, a retired RAF officer.
I see a lot of British people and their pets in my everyday practice. Families who have moved here for … a different life?
Often they’ve bought a dilapidated old house and refurbished it. People in the area would complain because this pushed prices up much higher than they used to be. But the people who sold to them weren’t complaining, I imagine, nor the people they employed to do the work. And let’s be honest. We love to see these old ruins brought back to life, as beautiful farms with lovely gardens and magnificent stone walls.
Some of them are retired. The younger ones are ex-members of the military, the older ones used to be teachers, secretaries or lawyers, or they had a shop or worked in a factory in some London suburb. I see artists, too, a sculptor, and even a crazy musician. Listening to their accents, I often wonder where they come from.
Some of them are rich. That’s what we often used to think: ‘Rich enough to buy stone houses and to rebuild them.’ Well, now I know better. Those of modest means have had a hard time as the falling rate of exchange has dramatically shrunk their pensions. Some have even packed up and left, or have stayed on a part-time basis, or have sent their partner back to the UK to earn an income.
And they have pets. Not all of them, I suppose. It’s possible that I have an over-representation of pet owners among my clients, is it not?
In our practice, all the vets and half the nurses speak fluent or nearly fluent English. So British pet-owners sometimes drive a long way to see us.
When I hear an English accent in the waiting room, I always start speaking English. I try not to, and it would be better to ask first. Some of my British clients speak very fluent French, but I can’t help myself. I start off in English, then when they answer in French I stop to think. We often finish up like this: I speak English, they answer in French; that way we can both be sure of what the other is going to understand.
Monsieur le Vet Page 3