He’s also a great one for conspiracy theories.
And he knows there’s nothing I enjoy more than disagreeing with him. I think he likes it too. So we have a discussion. One of us will make some wild generalisation, the other will jump in with both feet, and both of us will argue our point, giving ground only in order to redouble our attacks. As he gets louder and louder, I get quieter and quieter. The cows file past, one by one, and by the time we’ve exhausted two or three subjects the process will be over. Until the next year.
A few years ago, when I went to vaccinate his cows against malignant catarrhal fever, serious and often fatal, he’d crammed the whole herd into a pen that was too small, intending to send the cows and calves through an exit where I would vaccinate them and take swabs. The pen was really jam-packed, seriously overcrowded. He refused to take some of the herd out to make more space. The worrying thing was that the calves were pushing themselves into the spaces between the cows’ legs. Then the inevitable happened: a cow fell down on top of a calf weighing around 100 kilos, fortunately next to the barrier. There was no way we could lift her, as there were other cows more or less falling on top of her. And underneath her, the calf was turning purple. Between three of us we managed to haul it out. It was dead. I intubated it, gave it cardiac massage, injected it with analeptics, and with a good deal of luck managed to resuscitate it. The farmer spent the next couple of hours boasting about the calf that he’d brought back to life by sticking his wretched Bach flower remedies up its snout. Needless to say, my response was scathing.
This year he hit me with something new. He called me out for a cow with a ‘uterine infection’. When I got there, I discovered that the cow had given birth a week earlier, that she’d suffered a uterine prolapse (picture the uterus turned inside out like a sock), that he’d put it back in by himself, but only a day later, that the cow had pushed it out again, that he’d pushed it back in again, and hey presto, there we were. I suggested politely that he should call me out for this sort of thing, because when the uterus is put back properly it doesn’t come out again, or not usually anyway (it’s true it doesn’t always work), but he wasn’t even listening. ‘But the same thing happened a couple of years ago and I put it back no problem!’ I explained that there was something else: since the uterus had stayed outside the cow’s body for 24 hours it would have had plenty of time to become oedematous, or filled with fluid, for the mucous membranes to become lacerated, and for bacteria to make themselves thoroughly at home. And if he hadn’t even disinfected it all before putting it back, it would hardly be surprising if it developed the mother of all infections. And indeed, when I examined the cow I found she was suffering from a raging peritonitis, which might very well prove fatal.
‘But I gave her some pills!’
Pills. Homeopathy, you mean. Terrific. Sugar pills with an ‘essence’ of something or other that purports to have some kind of symbolic relationship with the infection or inflammation. Because that’s what it’s about, isn’t it? Here we have a plant that’s supposed to be effective against inflammation, or else on the contrary it’s highly inflammatory, so according to the theory of ‘like cures like’ and that sort of stuff it must be good, so you dilute it to a maximum of 10 on the ‘centesimal scale’, meaning that it’s diluted by a factor of 100 at each of the ten stages. In other words, it’s like diluting a thimbleful of alcohol in 100,000,000,000,000,000,000ml of water, or 10,000,000,000,000 cubic metres, or a lake of 100,000 cubic kilometres (for comparison, Lake Geneva contains 89 cubic kilometres of water, though if I’m out by a couple of zeros please correct me). I have nothing against plant-based medicines. Plants contain some highly active molecules. But I draw the line at homeopathy. I don’t doubt that homeopathy can obtain excellent results among human patients, notably through the placebo effect (and here I’m being completely serious), and that many illnesses get better by themselves if you wait a bit, even sometimes in veterinary medicine. But there are limits.
So. Personally, my thing is more evidence-based medicine. Science, real science, is perpetually self-questioning; it checks and rechecks its results, dismisses anything that doesn’t work (even if people have believed in it for ever), and constantly re-examines its premises.
And besides, there’s no logic whatever in the way he uses homeopathy. He’s got a big book on the subject, and he falls back on two or three ‘recipes’ – ready-made and bought over the counter – that have ‘worked’ once, and that he now uses like magic spells.
What I’m happy about on this occasion is that he gives me a hearing. And his son even more so: given the sort of man his father is, it can’t be often that he sees anyone stand up to him.
What I’m less happy about is that despite the uterine flush, anti-inflammatories and antibiotics I’ve given her, the cow’s chances of pulling through are slim. The peritonitis will probably gradually gain a hold, and she’ll fade away and die.
I just hope he doesn’t come out with some remark along the lines of ‘your antibiotics didn’t work any better than my pills’. If he does, though, I’m one step ahead of him. I told him that the treatment started too late. That she should have had the antibiotics when the prolapse happened, not when her intestines were flooded with fibrin. That her chances of survival were vanishingly small. He heard me out, but …
We’ll see soon enough.
Donkeys
‘Doctor, our donkey’s just had a baby foal!’
‘Oh?’
‘Yes, it’s her third foal. A female!’
‘Oh?’
‘…’
‘Is the mother OK? Is there something wrong with the foal?’
‘No, no, nothing wrong. It’s just that it’s the third in three years!’
‘Mmm, or a bit longer I’d have thought, given the gestation period of a donkey. Is she with the male?’
‘Yes, yes, we’ve got a pair, but tell me, do female donkeys have a foal every year all their lives?’
‘Mmm, pretty much.’
‘But that’s terrible! What are we going to do with all those donkeys? I mean, this is the third one after all!’
‘All females?’
‘Yes, they’re lovely.’
‘And soon they’ll be mothers …’
‘Oh no, they’re with their father, you see.’
‘…’
‘Are you still there?’
‘Yes, er, well that doesn’t mean he won’t cover them.’
‘It doesn’t?’
‘Well, if …’
‘But … so what should we do?’
‘The simplest thing in your case, Madame, would be to geld the father.’
‘Oh! We couldn’t do that! Poor thing!’
‘Or else buy another field.’
‘Ahh. Um, to have him gelded, would it cost a lot?’
‘Less than a field …’
To treat them is to love them
At vet school, we learned all about empathy and its false friend, sympathy. We were trained to anticipate mental blocks and to avoid them, and we were helped to understand not only the bonds of attachment between pets and their owners, but also the way in which money matters and medical matters are inextricably intertwined in our profession. We were taught to explain, to communicate, to enhance our work. We were shown the importance of both style and substance. We were prepared for the delicate business of imparting news, especially bad news – good news is easy. We were given advice on how to deal with putting an animal down. In short, we were taught all about the human side of our future profession, in the broadest sense of the term.
I’m joking, of course. In fact we weren’t taught a single thing about any of this. Absolutely nothing at all. Instead we had to learn off endless lists of symptoms and diseases, medicines and parasites: everything that you’d imagine, basically, as well as quite a lot that you wouldn’t imagine, such as statistics, electrostatics and thermodynamics. I liked thermodynamics.
But no one told us whether or not we w
ere supposed to like our clients, the owners of our patients, the farmers, the horse riders and all the rest. And I have to say the question never even occurred to me.
It should have gone without saying that, yes, of course we’d like our patients. After all, everyone knows you want to be a vet because-you-like-animals. But this was an area in which the coldly clinical nature of our teaching was about to make us question ourselves.
When I started out as a vet, I was the product of my education and training, like everyone else. I was opposed to hunting and bullfighting, racism and homophobia. I was in favour of world peace. And of having a sense of humour. I was opposed to religion, but I was in favour of positive Christian values – I’d been to Sunday school, after all. I wasn’t a vegetarian, and I’m still not. I was for, or I was against. Animals had to be treated, but not at any price: there was a limit, of course there was, I just never wanted to come up against it. I nurtured the idea that I would be discerning and nuanced in my approach.
Now nothing is so clear any more. Not that I’m in favour of hunting and bullfighting, or racism and homophobia, any more than I’m against world peace. But now I find I can like people who go hunting, as well as total cretins of racist conspiracy theorists. I can like eco-minded people of the far right as well as of the far left. I can like owners who are violent, who mistreat their animals, who neglect them, who are pig-ignorant. I can like men and women of every description. I don’t necessarily enjoy their company. I think I understand them quite often. I rarely agree with them, or rather I do, but only on some things. And I don’t have that many friends. I’m a long way from where I grew up, and I’ve been assiduous in not making friends. Not always successfully, I’m happy to say. Even if treating animals that belong to people I’ve grown close to can be complicated.
There are lots of my clients who I don’t find particularly appealing. Often they’re everything I’m not, everything I could never be.
But I’m fond of them.
I’m fond of the right-wing organic farmer. I’m attached to his twisted logic and his stubborn certainties.
I’m fond of the great beanpole of a half-witted teenager who quite simply let his dog die.
I’m fond of the couple with slight learning difficulties who adopted a new kitten the day their old cat died. The new kitten was called Tigrée, the old cat was Noireaude.
Noireaude was huge. Shut up in their tiny apartment with Monsieur who chain-smoked like an A&E doctor, Noireaude used to cough and throw up. They doted on her.
The first time I met them, they had an emergency appointment because Monsieur had punished Noireaude as a kitten – for I don’t know what trifling offence – by crashing her head against the sink. She had a minor traumatic brain injury. It was a distressing incident, and I had to explain to them very simply and clearly how to tell a kitten off. By holding it by the scruff of the neck and saying ‘no’, firmly but calmly. The level of their handicap wasn’t so severe that I could let them off completely and unreservedly, but they just needed to have it explained to them. And in any case, how had they themselves been punished in their time?
They didn’t have children. They had Noireaude instead. Noireaude who was bored. Noireaude who was restless, who miaowed, who was always clamouring for attention. The only way they could calm her down was by feeding her. And so she got fatter and fatter; she’d wolf down her food, then throw it up again. And then she’d stop eating altogether for a couple of days.
So they’d bring her in to see me, and every time I’d search in vain for anything wrong. It became a bit of a joke. And they’d always insist on seeing me. They wanted to try everything. So did we. High-fibre diet food. Stuff to help fur balls pass through. Because yes, she’d also pull out clumps of fur, swallow them and then bring them up again.
Noireaude was going crazy.
We told them this, in every possible way. We tried to find some way for her to be able to go outside, we tried to negotiate toys for her, space, freedom. They wouldn’t have any of it. They were too frightened that she’d be run over. They’d take her out now and then on a leash and harness. Just what she needed to put the cap on her frustration.
We tried anxiolytic pheromones to reduce her anxiety levels. With a bit of success, but not enough. We decided against giving her a stronger dose, as pills would never be the complete answer. Would we have to knock her out? Every time Noireaude started yowling again, Madame would pop an anti-anxiety pill. And in the morning she’d come to see me.
‘I haven’t slept a wink all night.’
And I could never find anything wrong, nothing at all.
Until the day when I did find something. You had to stay on the alert, and not just heave a sigh and go through the motions. You had to be aware that this time there was something different. That there was something behind all this vomiting.
Noireaude had lost weight. And not because of the diet.
Noireaude had stopped yowling. And not because of the pheromones.
So I put Noireaude down. I’d spent an hour explaining the complications and nuances of her illness to her owners, and they agreed straight away. Madame took her pills. Monsieur went outside for a cigarette.
And later that same day they came back with Tigrée.
But this time I was ready for them. I was going to become a dispenser of justice, sort of. I’d have to exaggerate a bit perhaps, to lie to them possibly, to be manipulative certainly. But Tigrée would be allowed to go outside, Tigrée would have her freedom. Tigrée would be able to escape from the gloom, the fug and the pills. She’d be able to get away from her owners who didn’t know how to love her.
You can always hope.
A world of pain
Just a normal Sunday on call. It’s half past eleven, the morning’s nearly over, and things seem to be calming down at last. I’m so tired – not quite on automatic pilot, just exhausted. I’m praying that the afternoon will be uneventful.
One last tour of the kennels, a check on all the drips, and I’m off.
Except that’s the phone again. We have a friend staying, and I’ve got a feeling I won’t be having lunch with him and the family.
Hold that smile.
‘Hello, out-of-hours service.’
‘Oh hello, I’m calling about Nestor, his back legs are paralysed, he can’t get up, he has to drag himself on his front legs when he needs to go out.’
OK, this is the emergency call no one wants. The dog’s probably been paralysed for a while, his life isn’t in danger, but he’ll be in unbearable pain. A herniated disc, acute arthritis or something else, I don’t want to put it off till later and spend the whole of lunch thinking about it. So let’s get on with it.
‘Can you bring him in straight away?’
‘OK, straight away, my son will bring him, thanks a lot!’
‘And what about y—’
He’s gone. No time to ask who he is, where he’s coming from, how long it will take to get here. I text home to tell them not to wait for me, and I get on with drawing up the weekly order for drugs and other supplies.
When that’s done, I chase up late payments. Flick through a few articles. It’s a quarter past twelve. It’s over half an hour now that I’ve been waiting for this guy. I bet he’s not going to turn up. I’ll give him till half past, then I’m off.
It’s 25 past when he arrives. Of course. As I go out to his car with him, I enquire politely what took him so long. He explains that he couldn’t find the car keys.
There on the back seat is Nestor. A twelve-year-old German shepherd. He looks at me uncertainly and makes a vague attempt to wag his tail. He exudes pain, he’s the embodiment of suffering. His features are emaciated, his back legs have wasted away, his undercoat is sticking out in grimy tufts, and he reeks of urine. His back paws are tensed and pointing forwards and his back is arched, braced on his front paws. He pants at me and says hello, just like all the other dogs that keep on wagging their tails however much misery we inflict on them.
>
I have no wish to talk to his owner. I was cross already because he was late, but I’m grown-up enough not to mention it. Probably he genuinely had lost his keys, which is stupid but not serious. And then there’s something about this great awkward stammering lump, barely out of his teens, standing there like a wilting maize stalk, with his spectacles and his too-tight jumper, his Citroën AX and his loafers, that makes me want to hug him even more than I want to hit him. But the fact remains that a whole history of chronic suffering is bound up in this heap of matted fur on the back seat of the car, this great rock of canine devotion. Of unconditional love.
It makes me want to cry.
I don’t even speak to the tall, dark-haired youth; instead I carry the dog into the surgery, holding him under the chest, his back legs dangling. He barely emits a whimper and tries to give me an awkward going over with his tongue. I put him down in a heap on the table in the consulting room and give him a rapid clinical examination.
He’s thin, but not exaggeratedly so. His hindquarters are bony and stiff, the muscles little more than tendons. The silence is making the youth uncomfortable, so he tries a couple of opening gambits. Talking to him is the last thing I want to do, but I need to know.
‘How long has he been like this?’
‘A couple of days.’
‘And you didn’t call me before?’
I’m not angry, I’m not angry, I’m not angry.
‘Well, erm, it’s my brother’s dog, he’s back tomorrow, but I thought it couldn’t wait because he had to crawl outside to do his business. He hasn’t done a poo since the day before yesterday.’
Imbecile!
‘OK, has he peed at least?’
‘Yes, on the grass, he dragged himself out and did it half sitting down, with his back legs stuck out.’
Don’t raise your voice. It won’t do any good. It won’t help the dog.
‘Fine, we’re going to do an X-ray, I think he’s got a major problem with his back. Is that OK with you?’
Monsieur le Vet Page 11