Monsieur le Vet

by Sylvain Balteau

  We’ll get there. Between the effluvia emerging via the tube and via the nostrils, in the end it will be enough. I’m squatting down over Korn’s right nostril, fiddling with the tube. Monsieur Dussans is crouching beside me, ready to hold the tube in position when I go to operate the pump.

  The horse is completely knocked out by the sedative. He doesn’t make any attempt to raise his head, which helps the partially dissolved granules to flow out. The green liquid oozes gently down the tube. A little more water.

  I push the tube deeper, twisting it gently on itself. I can see that Korn is starting to get restless. Still sitting beside me, Monsieur Dussans strokes the horse’s cheek. Here I am, my green heavy-duty overalls pulled on over my T-shirt, squatting on a hillside, in the entrance to a loose box, enjoying the sunshine for which we’ve been waiting for weeks now. Monsieur Dussans is beside me, still crouching down, his green dungarees half open.

  Korn shakes his head to left and right. Then quickly raises it for a moment and without any warning gives a sneeze. The accumulation of alfalfa and saliva in his nostrils shoots out in two great plumes. The left-hand one hits Monsieur Dussans’ neck, spot on. The right-hand one hits mine. We’re both covered in mucus, saliva and alfalfa. Madame Dussans fails to suppress a laugh.

  It feels … tepid.

  *

  A quick sluice down in the bucket of water and I carry on with the job. I’m a bit more wary now, though. A quick dive to my left and I manage to avoid the next sneeze altogether. Not so Monsieur Dussans. My eyebrows are drying out, the hairs all stuck together. This time I think that’s it. I insert the tube a bit further, give a little push, go deeper. I’m not quite sure how we’re doing, so I go back to the pump. The water flows in, no problem. Another go, then a third: this time I know it’s reaching the stomach. I draw the tube halfway up the oesophagus, wait a little, then remove it completely.

  It’s over. I listen to the lungs again. I can’t hear anything untoward, but the heartbeat is so loud that I can’t be completely sure. The trachea is still dry. The larynx is less painful. This time it’s all good.

  An antibiotic, a few words of advice.

  By the time I get back to the surgery it’s eleven o’clock. Time to start the morning’s work.

  Ending a life

  It’s a moment like no other. For me it’s always the same, a moment when I swallow hard and accept a choice, our choice: the choice made by the animal’s owner and by me.

  *

  ‘Right. Before we start, I need to explain briefly what’s going to happen. But first of all you need to know that you can choose whether to stay or to leave. The nurse can help me, you can wait in the waiting room, or you can stay with us. You can be on your way home. Or you can hold your pet. I’ll shave a patch on her paw with a razor. That might scare her a little, but I need to do this in order to insert the catheter. This will be the only difficult part for her. Once this flexible plastic needle is inserted in a vein, I’ll be able to anaesthetise her. It will be a proper anaesthetic. She’ll be unconscious in no time at all, probably before I’ve even finished the injection. It will be so quick that there won’t be any feelings of nausea or disorientation: she won’t even be aware of it.

  ‘It’s a real anaesthetic. She’ll be in a very deep sleep: I could operate on her and she wouldn’t feel a thing.’

  Her owner nods.

  ‘When she’s in a deep sleep, I’ll be able to give her the second injection. This will deepen her sleep into a coma, and it will paralyse her breathing, and then her heart.’

  *

  The owner may stay, or they may choose not to. It’s easier for me if they go, naturally. But of course it’s completely fine if they decide to stay.

  Most owners give their pet a last cuddle while I go off to fetch my tourniquet, alcohol, two catheters, some sticking plaster, and the anaesthetic and euthanasia drugs. On the way to the room where these are kept, I signal to the nurses: euthanasia in progress, do not disturb on any account.

  I often feel a bit wobbly. Or else I’m panting like an ox. It all depends on how the consultation that led to the decision went. Did they come with this in mind? Is it the culmination of a long-drawn-out series of treatments? Is this the outcome we expected, or is it the result of some brutal accident? Have I had to negotiate to avoid it happening earlier? Or, on the contrary, have I had to raise the subject?

  As I go to fetch the drugs, the time for all these considerations has run out. And yet. It hasn’t been difficult to set up a process that suits us all for making this type of decision. All the vets who work here reserve the right to refuse to put an animal down. Our reasons for doing so would be more or less the same, and we wouldn’t put down a dog if one of our colleagues had refused to do so.

  Unjustified requests to have an animal put down are rare. But they’re spectacular. We’ve experienced slammed doors, raised voices, and spluttering objections: ‘But he’s going into a home and we can’t look after his dog!’ We’ve experienced accusations and threats. And we’ve experienced clients who have stalked out, declaring, ‘Well, if it’s like that I’ll go to a different vet. He’ll put him down!’

  Yeah, right.

  And then there are the clients who try to manipulate us. We’re aware of this, to a greater or lesser extent. And with all this, we have to make the decision. To put them down or not? If you refuse, what would be your reasons, and what would you hope to achieve? You have to bear the animal’s interests in mind, but you shouldn’t use them as an excuse to avoid a difficult decision. If the owner can’t keep an animal any longer, it can go to a rescue centre or home. Most people can’t bear to admit that their pet can have a life without them.

  *

  I go back to the consulting room. The owner’s eyes are red. The animal is waiting, usually very patiently, at the limits of its endurance. It’s asleep. It’s anxious, blind, deaf, disabled; it’s unable to understand what’s happening to it, as it can neither hear nor see, and it’s aware only of that worrying smell of the vet’s surgery and of its owner’s distress. So many people feel that they are betraying their companion. And in a sense they are. And me? I’m here to heal, not to kill. But …

  If all goes ‘well’, this will be an ‘easy’ euthanasia. Sometimes I won’t be able to insert the catheter because the animal is too dehydrated or panicky. In such cases the injection has to be done into the muscle. I don’t like doing it this way. It’s too slow, too unpredictable. But often I don’t have the choice. There’s an alternative method I can use, a mask and gas. Keeping the mask in place isn’t always easy though.

  The second and final injection has to be delivered intravenously. There’s no choice in the matter. If there isn’t a vein, it has to be done directly into the heart.

  ‘I’m so sorry, I can’t do this injection intravenously as I can’t find a vein. I’ll have to do it another way, which might be rather upsetting. I’m bound to explain to you what’s involved, but you don’t have to watch. He’s asleep, and he can’t feel anything at all; I’m going to inject the drug directly into his heart. Death will be instantaneous.’

  *

  I hate it when I have to do this. It’s too easy to get it wrong and to inject into the pericardium. And then the animal still feels nothing, granted, but death is far from instantaneous. The drug takes minutes to circulate, and it seems interminable. And then it’s so, well, violent.

  But my clients are never so grateful as they are when I have put their pet down. Of course people are grateful when I manage to treat a disease or operate on their dog. Sometimes for treatments that are extremely complex and impressive. Sometimes for minor things that are frankly completely routine.

  But when I’ve put their pets down, they send me cards, letters, sometimes even little gifts.

  ‘Merci, docteur, merci.’

  But … I’ve just killed their cat, I’ve just killed their dog.

  Light as a feather

  It was a few days before Christmas when
he arrived with us.

  So frail and fragile that we didn’t dare touch him, for fear of hurting him.

  Winnie the nineteen-year-old Siamese cat. Nineteen long years.

  Winnie wouldn’t eat, was slightly dehydrated, and if he did manage to swallow the odd scrap of food, promptly vomited it up again.

  He seemed so light, light as a feather – a feather of grey fur with black markings, a touch unkempt, with a few clumps of matted fur, a touch unsteady on his paws.

  He was standing on the edge of the table, hesitating, wobbling, teetering, not daring to jump. His mistress stroked him, drew him back to safety; there’s no way he’d have been able to stop himself from falling.

  I thought his old kidneys had finally failed. I’d started to prepare his mistress. But Winnie didn’t have high levels of urea. Winnie had diabetes.

  Who would ever have imagined that at nineteen his diabetes might be treatable?

  Was there any hope of stabilising him?

  A small tumour, a failing pancreas or a chronic inflammation that we’d never suspected, who knew what might be at the root of it? It scarcely mattered: too much sugar in the blood, not enough in the muscles, too much in the brain and the urine, a metabolism that was completely out of kilter because insulin wasn’t being secreted as it should be.

  It would take several days to get him back in balance. To adjust his doses, check and verify them, feed him, hydrate him, transfuse him and stroke him.

  To be there for him.

  His family were due to go away in a few days, for Christmas. And despite the nineteen years they had shared with him, they couldn’t change their arrangements.

  Winnie would be spending Christmas at the surgery. On the ward. Cuddled, fussed over, looked after, but on the ward.

  They knew there was a chance he might not be there when they got back.

  It was the 23rd; they’d be back in five days, on the 28th.

  By then he might be dead.

  So Winnie stayed behind. The treatment was working a bit, not enough, and crucially he wouldn’t eat. He was in better balance, Christmas was coming, and Winnie stayed on.

  All alone in his cage. If there weren’t any call-outs on Christmas Day, I might not go to the surgery at all.

  So it was purely and simply to avoid making a few return trips for his treatment and tests that I took him home with me. Obviously. It was past nine o’clock when I went into the bedroom. What a festive way to spend Christmas Eve. I had a basket, a bottle of insulin in an insulated bag, a few needles and syringes, a blood sugar meter, and Winnie.

  My wife felt him rubbing himself against her hand, light as a feather, as the weary old cat tiptoed his way up the duvet and settled down to sleep. Much to the chagrin, the total outrage, of our two resident cats.

  And then we stroked him.

  Fussed over him.

  Looked after him.

  Hydrated him.

  And tried to get him to eat, but to no avail.

  Not diabetic cat food, anyway. Not any cat food, full stop.

  Home-made wild boar pâté, on the other hand? Now that was a different kettle of fish.

  Just the once: after that he wasn’t interested.

  The next day it was foie gras, no less. Just the once.

  Then scrambled egg.

  Grilled chicken.

  Smoked salmon.

  One laboriously chewed mouthful at a time, swallowed with difficulty. And only ever just the once.

  The aromas of pâté, foie gras, salmon and eggs lingered on in the bedroom, but he’d lost interest.

  His diabetes was getting into better balance. I was coming and going to work.

  He stayed at home, on our bed, almost until the end of the holidays, until his mistress came back. I delivered him back to her, advising her to tempt him with all the treats we hadn’t yet tried. Winnie was leaving, lighter than ever, purring, pampered, but dying.

  He died two days later, in the bosom of his family.

  And the diabetes? In balance … but at nineteen it was too much to hope for more.

  But he’d tiptoed up my duvet, light as a feather.

  He’d stretched out there.

  He’d purred.

  Boots off

  It’s Sunday morning, half past six. An old farmhouse perched on a hillside, an old-fashioned cowshed, four cows no longer in their first flush, a small herd of sheep and a retired farmer and his wife.

  The cowshed is clean, with wholesome aromas of cows, straw and hay, hens in the manger, a Border collie on a hay bale and a red Massey Ferguson tractor that’s older than me.

  The front door to the house is reserved for Sunday best (if then, even); on other days the way in is through the cowshed, where a couple of steps under the stairs up to the hayloft take you straight into the kitchen.

  The old farmer, a tall and rangy Clint Eastwood looka-like in beret and braces, has called me out because his cow is dilated, and she’s turning round and round in circles, but nothing’s happening.

  ‘You’re an early riser!’, I’d remarked when he called.

  ‘Mais non, I’ve been up all night with her!’

  ‘Ouch. In that case you go to bed late! In any case, I’m on my way.’

  He hadn’t called me earlier because, well, it was the middle of the night, but now that he’d waited he was afraid he might have put the calf ’s life at risk.

  *

  The cow is a big blonde. Huge. Laid back. Placid as a Volvo estate. With a boot capacious enough to accommodate the most outsize of calves.

  I pull on my overalls and gloves and go out of the rain and into the cowshed. He pulls the stable door shut, first the bottom and then the top, and we position the cow facing it. One arm in. Her waters aren’t broken, I can feel a front leg. A nice calf. I grope around a bit and find the other front leg, then the head. Facing down. And, crucially, a textbook uterine torsion. The uterus and vagina have twisted through 180 degrees, and however hard the cow strains the calf won’t pass through the birth canal, as the tissues can’t dilate far enough. The calf is alive, but as usual I say nothing – especially as I haven’t been asked.

  I’d heard the door to the kitchen as it opened behind me. Madame has closed it behind her and is standing on the bottom step, waiting. She’s wearing the dress and pinafore that look so right on her but that only she can carry off, the sort of dress and pinafore that are like a uniform, so natural that you take them for granted. You could poke fun at Monsieur, in his beret, braces and checked shirt. You could poke fun at Madame, with her little glasses on a string round her neck and her print dress. But if anyone dared to laugh at them I think I might whack them in the chops with the metal pulley of my calving jack. I feel so comfortable here, in this little cowshed, my arms in the birth canal of a blonde cow, wisps of straw in my hair, in the warm, with this old couple, while outside it’s raining.

  You have to rotate clockwise. Positioning my right arm is easier, but I lack sufficient strength and it’s breaking my wrist. The left arm then, my back to the cow almost, and a major twist from the shoulder to the spine: yes, but my wrist’s still breaking. Still, in this position I have more traction. Left arm, then right arm again, little by little, steadily. The calf is still in the amniotic sac, and I know I’ll get there in the end. I swap sides, pushing, turning, moving round. Gradually, barely five minutes in, I find the right rhythm, the right impetus, syncopated this time. My left wrist hurts. The ribs on my right side are pulling, tight across my back.

  The calf is facing in the right direction again. I breathe a little more easily.

  We’ve got time.

  *

  Everything is in place. Monsieur is setting up the jack, Madame has gone to get a saucepan full of water. Stainless steel, not copper. My resuscitation box is here, with my caesarean equipment, which won’t be needed. I’ve got my calving ropes. The cow starts to paw the hay again.

  I could stop there and go home: she doesn’t need me any more. But the farmer wo
uldn’t understand why I’d left, for one thing. I’d be chewing my nails not knowing if I had been right to leave, for another. And for a third, I want to get this calf out.

  So I plunge both arms back in up to the shoulders. Warm, slippery, comfortable, with that sweet, sickly smell of amniotic fluid. It feels good. Just the place to be at seven o’clock on a Sunday morning. Outside, the sun is rising after the rain. The Border collie stirs on its bale of hay. One leg, two legs. I grasp them firmly, draw them towards me; the mother strains a little. Everything is in place for the birth. It’s a big calf, but there’s room for it. The mother’s waters have broken now: the fluid gushes down my overalls and over my boots into the straw that fills the gutters. It’s all good.

  Now the second sac, of that thick, runny mucus, of that indefinable white colour, from which life flows.

  I draw the feet towards me, the head follows gently, the baby’s forehead gets stuck against the pelvis. It will come, we just need to give it a little pull.

  Madame brings me the ropes, my good old stout calving ropes that have been bleached and put through the wash hundreds of times. I position them around the calf ’s cannon bones, well above the fetlocks, and I lean back, my body almost horizontal, shifting my weight first to the right then to the left, my feet wedged in the gutter. The calf is so strong that it manages to pull me up by retracting its left foreleg. My weight against its weight, my supports against its supports. But I’m not plastered all over with calving mucus, or not as much as it is, and I’ve done this before.

  The cow is well dilated. The farmer took his time before calling me, so there’s no danger of an episiotomy, of having to make a surgical incision.

  It’s all good.

  We attach the jack. The cow lies down, exactly as she’s supposed to. Monsieur pulls, Madame takes care of the ropes, while I guide the ‘baby’ as it comes into the world. In absolute strength and power, a gentle violence. And absolute confidence.