Monsieur le Vet

by Sylvain Balteau

  He regrets it now. The calf survived and is in rude health, without any ill effects. Not one.

  My sodium chloride and dextrose drip with two lines is now famous locally. I’d also added a vitamin solution that was coloured red, so red is now absolutely the last word.

  There are times when you perform truly virtuoso feats of diagnosis or surgery, and there isn’t a soul there to appreciate them.

  And there are others when you cobble something together with two bits of plastic and you do something inconceivable. Like carrying a calf inside a house. And it’s the talk of the town.

  Go figure.

  Brave remember

  I the panic in her voice, the darkness of the bedroom, the still of the night shattered by the ringing of the on-call mobile.

  I remember her words, the visceral fear and razor-sharp clarity with which she’d grasped the distinction between a benign incident and the death of a companion. You didn’t need to be a vet, that night, to realise that this was an absolute emergency.

  ‘He’s shaking, he was sleeping peacefully, his breathing is terribly laboured and he’s making a dreadful noise!’

  I remember my sense of resignation, as soon as I realised that I was 30 kilometres from Brave, with the surgery halfway in between. I told her to put her dog in the car and meet me there.

  ‘But will he be able to cope with the journey? Couldn’t you come to us?’

  ‘Time is of the essence, we need oxygen, and we need the equipment at the surgery.’

  ‘But what if he dies on the way there?’

  ‘If it’s that much of an emergency, I wouldn’t be able to do anything for him anyway.’

  Cold logic, born of experience and empiricism. She understood completely. There was no time left, not a minute to spare.

  I remember the second call on the mobile, two minutes later, as I was pulling on my jacket and heading out to the vehicle, knowing all the while that there was no point. I knew she was calling to tell me that Brave was dead.

  I remember the tears in her voice, the lamentation.

  I remember the desperate loneliness, the violence of her grief.

  Brave was dead, and there was nothing more I could say. But what was my impotence in the face of her grief?

  I stammered out a few words that wouldn’t reach her now, not yet, but that might perhaps help her later not to blame herself. If I could at least give her that?

  The call can’t have lasted even as much as a minute. There was nothing to be said. Just tears and silence. Grief and impotence.

  I remember the blood drained from my face.

  All these years I’ve remembered Brave and his young mistress, the fiancé who’d bought him for her and who had left him with her when he moved out, the accidents and minor mishaps, the worries and joys, Brave as a puppy and Brave as an old dog. I’ve remembered a dog’s life, and a piece of a human life.

  Colic

  Alouette is waiting.

  Sheltered from the wind, in the passage between the loose boxes and the hay bales, the bay mare is more comfortable now, after the medication I’ve given her for her attacks of colic. She could die. From shock, or from pain.

  In the rickety stable silence reigns, despite the deafening howling of the wind between the corrugated iron sheets of the roof. There are five of us. Madame Tolzac, two of her friends, my work experience student and me. We’re all looking at the young woman, and over her shoulder at the old mare waiting patiently, relieved after the removal of her nasogastric tube. Between Madame Tolzac and me is the bucket containing the reflux siphoned off by the nasogastric tube: ten litres of water, paraffin oil and unidentifiable stuff that would be more at home in the mare’s intestines or stomach, where I had sent them a few hours earlier, on my first visit.

  Intestinal transit has seized up again, although the anti-inflammatories will still be working. It was only a quarter of an hour ago, moreover, that I allowed myself a huge smile of relief when a belly tap, puncturing the abdominal wall, had revealed the absence of peritonitis and gastrointestinal rupture. But this bucket of reflux is seriously bad news, casting a gloomy shadow over any optimism we might have felt. The illness is still out of control. The mare is still distended by intestinal gases, even if she doesn’t appear to be in too much pain.

  I have to make some phone calls. I’ve managed the emergency and I’ve reached my limits. Of course there’s more I can do. A caecal tap, abdominal decompression, a drip, drugs containing morphine. But the longer I wait, the slimmer the mare’s chances if I get it wrong. Or if she needs surgery.

  *

  ‘We should be able to find a specialist vet in this area who can take her. They’ll be able to give a better diagnosis and provide you with a prognosis. Suggest surgery, if necessary. Medically, there are a few more things I can do, pretty much everything we can do in cases of colic. But it might not be enough, and I don’t have many diagnostic tools. You need to decide now, as Alouette’s condition could worsen and it might be too late. So I suggest we call a specialist colleague to ask their advice.’

  She says:

  ‘How much would that cost?’

  She’s still shivering. From the cold?

  ‘I don’t know, I’ll ask. A consultation and hospitalisation would be reasonable, for sure. Surgery would be much less reasonable though. Fifteen hundred euros, at least. I don’t know.’

  She drops the cigarette she’s in the middle of rolling. I’m on my mobile before she can say a word.

  I manage to get through to the first colleague I call. He’s snowed under, with three cases of colic in his clinic already. He can’t see her, but he gives me some rapid words of advice instead. He’s not reassuring. A second call, I go through it all again:

  ‘A mare, seventeen years old, on heat, high levels of small strongyle worms, partial response to anti-spasmodics given by her owner and anti-inflammatories added by me. Moderate tachycardia, no fever, but she’s been struggling for a while: could it be parasites? Or piroplasmosis? We’re waiting for the results of tests. Her abdomen is distended, her owner says. Palpation reveals a mass of intestines with a build-up of gas, with no change since this morning. Six hours ago I did an NGI without any problem, no reflux, paraffin, magnesium sulphate, bicarbonates. This evening ten litres of reflux, containing all I administered to her this morning. Paracentesis normal. Could you take her in? And if she needs surgery what would the estimated cost be?’

  No time for my colleague to get a word in edgeways. He asks for a couple of details, and then, very quietly, he gives me his answer. He can take her in no problem, but if he has to operate the starting price would be 3,000 euros.

  I thank him and hang up, saying I’ll call back in a few minutes. Then I issue Madame Tolzac with an ultimatum. I tell her she has to make a decision now, on the spot. Does she want to take Alouette to my colleague or not? If the treatment I’ve given turns out to be successful, it could all be for nothing. On the other hand, she’d get a better diagnosis, a prognosis, possibly a more specific medical treatment, and in the worst-case scenario the option of surgery.

  *

  Madame Tolzac tries to light her cigarette again, nearly drops it again, apologises for smoking near the hay, struggles to speak, chokes, tries not to cry. She’s spent the last three minutes rolling that cigarette, the automatic, habitual movements failing to conceal the shaking of her hands. Alouette’s tether rests on her shoulder.

  She heaves a sigh, takes a deep breath, abandons her roll-up. She’s stopped shaking, but she looks as if she’s on the verge of tears. She hesitates. Standing there, in the middle of her tumbledown stable with its salvaged corrugated metal roof, its improvised loose boxes and its hay bales, surrounded by her rescue horses – animals that have been put out to grass, abandoned because they were too old or mistreated – she gives me her answer, half-swallowing her words:

  ‘I haven’t got money like that. And if I could find it and I spent it on Alouette, then the others would have nothing to
eat, and I wouldn’t be able to make this place work at all. So there’s no point in going to see the specialist if he can’t really do anything more without surgery. We’ll have to do what we can here, we’ll have to make do with what we’ve got.’

  So over the next three days, I punctured, drained, catheterised, transfused, administered morphine, gave advice, wormed, and answered all her calls. I thought of all the horses I’d seen throwing themselves against the walls of their stables in pain. I thought about the ones that had collapsed. About the ones I’d had to put down because I couldn’t save them.

  There were some highs over those three days, quite a few of them, and some lows. Alouette pulled out her drip, the catheter got folded back. She escaped to be with her foal. There was no rapid improvement, and it was a while before we dared to hope for the best. I went back to see her again, twice.

  *

  Alouette did pull through.

  *

  In this strange unequal lottery, this weighted contest in which the means existed but were beyond our reach, we took a punt. We gambled, and this time we won.

  Mad cow?

  He called me because his cow was behaving bizarrely. And the way he told me about it was odd, too. He sounded a bit embarrassed. I’d assumed he was afraid it was BSE, mad cow disease, the worst thing that can happen to a cattle farmer. I wasn’t unduly concerned: we’ve got rid of BSE.

  He was calling about a Holstein, a black-and-white dairy cow. She was five or six years old, nice and plump, had just calved after a good match.

  All hunky-dory.

  ‘She’s gone crazy. She’s all skittish, like a kid goat, she’s licking the walls, and she’s giving me such weird looks!’

  Ah.

  And on top of all that, her breath smelt nicely of acetone. Ketosis is a classic condition in dairy cattle, the result of an accumulation of ketones following the massive mobilisation of fats in the early stages of lactation. It occurs quite frequently in cows that are too fat when they calve, and that produce a lot of milk. The ketones, with their distinctive smell of pear drops, spread throughout the cow’s body and cause nervous disorders, generally benign and completely reversible. The cows go a little crazy, but not mad as in BSE. It’s easily diagnosed by the pear-drop smell and confirmed with a straightforward urine test strip, and the treatment is simple and aimed at putting the cow’s metabolism back on an even keel.

  As I was chatting to the farmer and preparing the drips and injections, the Holstein was standing just behind us. Without warning, she suddenly lunged at him, her mouth wide open. As I jumped out of the way and landed in a heap in the straw, the cow clamped her jaws round the farmer’s belt and yanked his trousers down around his ankles. Then she let go and resumed her place.

  ‘That’s the fourth time she’s done that this morning!’

  And she did it one more time while we were doing her transfusions.

  No doubt about it, she was in love.

  All hunky-dory? The jury’s out.

  The first time

  It was somewhere in the region of Nantes. I was 23. I wasn’t yet a doctor of veterinary surgery, and I’d only just qualified as a veterinary physician. I was doing an internship in a large and almost exclusively rural practice, with a density of livestock that was truly mind-boggling. That still is, doubtless. The vets in that practice were responsible for 50,000 head of cattle a year, meaning they were treating 50,000 adult cows, each of which calved every year. Virtually all of them Charolais.

  The team would carry out four or five caesareans every night. I say ‘the team’, as a single out-of-hours vet wouldn’t have been able to cope. They worked in pairs, at least, with another pair as back-up. And I went with them, day and night. I was on a steep learning curve, calving a breed with which no one ever takes any risks, so high are the chances that the calf will get stuck on the way out.

  I also learned how to calve a cow the traditional way, with all the subtleties of manipulating the calf in utero, and everything you need to know and do. In this practice, though, these were risks that weren’t often taken, and for good reason: in this practice, they operated. Charolais cattle are an excellent learning tool for surgery, not so much for obstetrics.

  The clinic also treated dogs and cats. The younger vets there had realised that there was a demand for it, that it wasn’t enough any more to just give a dog an injection when you happened to be visiting the farm. They had invested in training and equipment. And in time. The older vets weren’t keen, but they could see the relevance of this newfangled development and they put up with it.

  On this particular day, it was the senior vet of the practice who was conducting a surgery for dogs. Dr Vailleux was an old-school vet in the textbook mould: his shirts and trousers were always crisply laundered and ironed, he lived in a substantial family house, and he drove a top-of-the-range car that he kept scrupulously, gleamingly clean. ‘It doesn’t take any longer to be clean and tidy in your work’, was his axiom, the principle that he did his best to drill into me, whether the matter in hand was surgical methods, cars or boots. With varying degrees of success, to judge by the state of my car. ‘It’s not just a matter of the quality of your work, but also of the image you project.’ The leather seats in his car didn’t even smell of cows.

  He had known the time when every village had its vet, or couple of vets. Now vets formed group practices, and had bought up any vets who held out in single practice. He was a pillar of local society, in a way that his younger colleagues would never be.

  That day, Dr Vailleux was seeing an elderly couple. He knew them well, as they’d had cattle. He let me examine their bitch, an elderly, worn-out German shepherd cross.

  I didn’t say much to them, listening instead to their answers to the scant questions he asked them. The diagnosis was obvious, even to me. A purulent vaginal discharge: I did a scan, which confirmed pyometra, a uterine infection. The next step was equally simple: check for absence of kidney failure and operate. There was no real alternative.

  I don’t think Dr Vailleux even explained the diagnosis to the old couple. I can’t remember exactly how he phrased it, but basically he told them she was done for. They stood up, shook his hand, thanked him respectfully and left, all the while doing their best to hide their feelings. Dr Vailleux left the dog to me.

  ‘Right then, you can put her down.’

  I stood there, rooted to the spot.

  Not rooted to the spot as in but I’m here to treat her; as in, ‘But that’s monstrous, there’s no question of my killing a dog that can in all likelihood be treated!’

  Not rooted to the spot as in informed consent; as in, ‘But he hasn’t even discussed the diagnosis and prognosis with them!’

  Not rooted to the spot as in uppity student; as in, ‘The bastard!’, or ‘What a moron!’

  But rooted to the spot as in … a piece of furniture, a black hole, a free will-free zone, an unquestioning underling-who’s-only-obeying-orders.

  I’m not even convinced that I managed to squeak out a ‘but couldn’t we operate on her?’ To which he would have replied, in cold and sarcastic incredulity, ‘an old bitch like that?’ I put up no resistance, and I put the dog down. I anaesthetised her, I euthanised her. All on my own in my consulting room. Dr Vailleux had gone back to his office.

  I should have stood up to him, I should have yelled at him, I should have argued with him, I should have stamped my foot, I should have …

  To all intents and purposes, this was my first consultation and my first diagnosis, for a dog at least.

  It took me a while to understand what had happened that day. To understand that he was wrong. At the time, it would never have occurred to me to seriously question his decision: I knew he was competent and intelligent. I put the dog down because he told me to.

  Of course there was an alternative.

  I’d followed his instructions.

  Despite the awful leaden feeling in the pit of my stomach, the nausea that I couldn’t accoun
t for.

  I was crushed.

  She was dead.

  Clémence

  ‘They’re so brave, the soldiers.’

  She strokes my cheek, takes her hand away and looks at me tenderly, then gives a little skip of happiness and twirls around. She laughs.

  I watch her, astonished.

  Squatting down beside her dog, I watch her as she skips and twirls.

  A woman gives a little embarrassed laugh. A man smiles at her.

  Her eyes sparkle.

  ‘Why are you here?’

  I crouch on the lawn, in the garden, beneath the plum tree that’s losing the last of its blossom, beside her dog that has so much difficulty in standing.

  ‘I’m looking after Follet, Clémence, I’m here to take care of Follet. I’m the vet. The vet. You know?’

  She gives a little trill of laughter, mischievous, elegant, the childish laugh that I knew already from the time when I looked after the horde of hamsters that her husband used to keep. She thought keeping hamsters was a bizarre, hare-brained fad for an old gentleman. An old gentleman who was a little lost, a little eccentric. She used to look at him in that same tender, indulgent way, the way you’d look at a child, the way she looked at that soldier long ago. The way she looked at me. A minute ago, or 90 years in the past.

  The hamsters are gone now. What happened to them?

  What happened to the cats, all of them called Minette (the females) or Minou (the toms)? Minou the grey tom, Minette the black cat with a white patch, Minou the tabby tom, Minette the white cat with a black patch?

  Now the only one left is Follet.

  Clémence’s husband is dead and buried. And her memory with him, perhaps? Clémence, her smiles, her indulgence and her exquisite manners. She still has her laugh – her laugh and her joie de vivre. Her exquisite manners are not those of an old lady, more those of a young girl.