Monsieur le Vet

by Sylvain Balteau

  Sometimes the failure is on the owner’s part. There are owners who refuse to accept a diagnosis of an illness, or the treatment for it, because of their own convictions, their own fears. In these cases I have to explain my reasoning, dissect it, justify it, occasionally resort to being manipulative. Make them understand the consequences of their decisions, of their awkwardness. Get things back on track, if I can. The longer this type of failure goes on, the more it becomes my own failure. I appropriate it to myself jealously, snatch it away from the irresponsible owner, accuse and condemn myself. I am judge and jury, I act as my own prosecution and my own defence. I should have seen it coming, I should have guessed, I forgot to make it clear. They couldn’t have known, they must have misunderstood, it’s all my fault. This type of failure wears you down, dragging you into lengthy explanations, prevarications, precautions, justifications. I need to sustain the support and commitment of the owner and their family, nurture and maintain their motivation, be aware that you can say something one way to one person, but you need to say it quite differently to another – with all the risks that go with this of losing the plot, of losing myself, or of losing the person I’m trying to protect. Too much explanation is self-defeating, and after the lengthiest ones I always finish up by saying: ‘I’ve deluged you with information, I know, and it’s not all straightforward. If you’d like me to explain more, or if you have any questions, don’t hesitate to call me.’

  And then there are the times when failure can be laid neither at my door nor at the owner’s.

  This is when it’s the failure of a system. Money, or the lack of it, invariably places restrictions on the possible treatments we can explore: therein lies one of the fundamental differences between veterinary medicine and human medicine as practised in France and other European countries. How much is a diagnosis worth, whether for a simple infection or for a serious illness? Or if it condemns an animal to certain death, or to a lingering and painful demise? Or if it doesn’t even lead to treatment, as there’s no point? How much is a life worth? This type of failure is by its very nature unfair. It may be possible to rationalise it, to justify it, but – unless you take refuge in cynicism or harden your heart – it’s still monstrous. So you have to accept it and find ways round it. Whenever I can, I offer staged payments, a discount, or some other solution. Sometimes I even offer treatment for free. But an animal is still an animal. However abhorrent we may find this sort of failure, we should never forget that.

  Failure can also be laid at the door of society, and of its stupidity, for which we all bear a responsibility. Like putting down a dog that’s done nothing to deserve it, for instance. I try to negotiate a way round such cases, to limit the damage – but at what cost? How many other responsibilities does this endanger? In a modest way I try to make a difference, and it makes me shiver when I read about – when I have to live through – failures of this sort, which never ‘just’ affect the animals concerned.

  Finally, failure can simply signal our impotence in the face of illness, or of death. Natural and ineluctable, clearly this failure is the easiest to accept – although this doesn’t necessarily make it any easier to bear.

  No dialysis or kidney transplant for an animal suffering from kidney failure, just pain and loneliness.

  No more analgesics for terminal arthritis, pain or paralysis. No more playing, no more pirouettes.

  No more antibiotics against bacteria, now victorious, resistant, immortal.

  With the passage of time, these failures become harder to bear, more violent to endure. Because I used to be a locum, or an assistant, safely behind the scenes, veiled in obscurity. There were pillars behind which I could hide, or prevaricate; there were other people on whom I could lean. Animals were cases, always new, and their owners were strangers.

  But time passes.

  Now I’m not on my own, but other people count on me, lean on me. And I’m not ready for it, not yet! Gone are the days when I could listen to the words of a wise mentor, put blind faith in him or her. Now I view the opinions of my peers with a creeping doubt, the doubt that’s essential to every diagnosis, every decision. I’ve lost that blithe confidence and trust, and there can be no doubt whatever that my patients are better off for it.

  A doctor who was coming up to retirement used to tell me that his patients were ageing with him, and that now they would be dying.

  So what about three-year-old Corneille, who’s dying tonight?

  I witnessed his first steps, I bandaged his broken paw when he fell down the stairs. I entrusted him to the care of my colleagues for his fracture, his eye problems, his skin infections. I was with him when his owners hatched up crazy schemes to make him a father, dreams that were never to be realised. I was there when his intended paramour arrived on the scene, forever to remain his platonic friend. I reassured his mistress, encouraged his master. Corneille always had something wrong, and over time we made a good team. Now his bumps and bruises are gone, his wretched soft palate is gone, the pink tip of his tongue that always vanished when I tried to get hold of it, all are gone. Because a bacterial infection decided to become resistant. A ‘banal’ skin infection.

  So as not to cry, I focused on listening to his heartbeat as it weakened tonight, to his heartbeat as it fibrillated, then stopped.

  A failure, but one that we accept, that we can justify, that no one can reproach themselves for. But no less devastating for all that, no less painful.

  Silky

  He’s a farmer, with a hundred or so head of cattle. In his fifties, with four children and stepchildren. The oldest boy is set to take over the farm, and is already finding his place there. The farmer reflects on things, thinks ahead, develops his herd, keeps abreast of the latest methods.

  But he’s not optimistic, all the same.

  He can’t see a future for his farm. ‘Children? They’re mollycoddled, over-indulged. How can you expect them to work when they already have everything? At their age I had nothing.’

  He leans on his stick, cap on head, watching the drip flow.

  ‘Oh, my wife wants you to go and see that wretched animal. If only it would give up the ghost! It’s not like a blasted cat. They don’t need any looking after, do they!’

  I follow his gaze to the seat of his tractor, where his favourite kitten used to sit, the one that he used to carry around under his cap. That got run over. That he misses.

  ‘What a charrracter! Extrrraordinarrry!’

  Not even the legendary local singer Claude Nougaro, whose accent you could cut with a knife, rolled his ‘r’s with such extravagance.

  ‘He’ll soon be costing us more than a calf does, that stupid animal.’

  ‘The guinea pig?’

  ‘What a waste of space!’

  *

  It doesn’t cost you anything, as you know full well. It was you who brought it to me. When you brought it to the surgery with your youngest son and he said, ‘It’s going to die, it’ll have to be put down’, it was you I heard in the car just beforehand, putting him up to it.

  When I suggested that I should operate instead, for the same price as putting it down, and if it didn’t work to put it down anyway, you allowed yourself to be persuaded with good grace. And when your son said again, ‘It’s going to die, it’ll have to be put down’, you even swatted him lightly on the head and said, ‘Come on, son, leave the vet in peace to get on with his work.’

  I gave Quenotte an anaesthetic, lanced and cleaned its abscess, filed its teeth. I even did an X-ray, to be sure. It was bad, it would get worse again. Then I took it home for the weekend. To hand-feed it, get it back on its feet.

  It was Madame who came to fetch it. I told her that its life was saved, for the moment.

  ‘You’ll have to carry on hand-feeding it, as you have been already. It’s not in pain now, so it should be easier. You’ll need to give it these antibiotics, and this for the pain. And obviously it’s not over. Not by a long way. The roots of the teeth are at an angle, they�
�ll never grow straight, they’ll need regular clipping. Maybe as often as once a fortnight.’

  She paid what it would have cost to put it down, as agreed. Then I was a step ahead of her.

  ‘I know your husband will complain because we’ll need to see it so often and you’ll often have to hand-feed it. And how much will the darn thing cost! So you can tell him that for one thing, my two-year-old daughter has been feeding it for the past two days, and she’s called it Silky. And for another thing, I won’t charge you for filing its teeth, only for the medication and food.’

  *

  She never really accepted this gift. And since she couldn’t bring herself to accept it, she took it upon herself bring us little cakes, biscuits and other delicious treats. Because she knew that we at least appreciated the cakes and gateaux she would always offer us with our coffee after a calving or a transfusion. It was an arrangement that suited all us vets at the surgery extremely well.

  *

  So you can see we’re not about to let that guinea pig give up the ghost.

  Not on your life.

  Her hand on my arm

  Her call had been a sob and a cry, urgent, instinctive, incoherent. I’ve never been able to recall what she said, I just remember dropping the drawer of resuscitation meds, abandoning the appointment I was in the middle of, flinging myself in the car, and almost ploughing into the wall of her house, barely a couple of hundred metres from the surgery.

  She used to refer to us as her ‘cruise’. Every week, virtually, she would come to fetch medication for Boule’s heart. Boule was some sort of labrador cross, big and solid, easy-going and imperturbable. His heart was rubbish, his heartbeat a drumbox mix of dub, reggae, waltz and disco. Every time she came to pick up his pills for the following week she’d chat to us about Boule, about the weather, and especially about the cruise that she would never go on.

  I think she came every week in order to avoid having to write any ‘big’ cheques.

  I sprinted out of the car, stethoscope in one hand, box of medication and syringes in the other. She pointed towards the laurel hedge. She was in tears. Boule wasn’t lying down, he’d fallen down. All I could see was his ample rear end, the tail that I’d only ever seen wagging now lying still.

  No pulse, no heartbeat, I gave him heart massage, inserted the tracheal tube as never before.

  She was crying. He’d jumped up out of the blue, run outside, fallen down.

  Much later I heard that her family, though she never mentioned them, had parked her here, in this little village in the middle of nowhere, when she’d followed them to the south of France from her own village in faraway Alsace. She hadn’t followed them a second time. She’d kept her house, Boule, her few friends and her solitude. And her dreams of going on a cruise. To the Caribbean, or the Pacific, Madagascar or Réunion, the Windward Islands or the lagoons of New Caledonia.

  Whenever she signed a cheque she’d look at us with a wistful smile; each time it was ‘a little bit of her cruise’.

  Boule used to hate coming to see us at the surgery.

  Now he’d stopped breathing, but only just.

  I put the ligature in place, picked up the catheter.

  She put her hand on my arm.

  ‘Has he gone?’

  He’d gone, but only just.

  ‘Then leave him be, doctor.’

  She put her hand on my arm, and I sat down heavily on my backside like an idiot, and it was all I could do stop myself from crying.

  *

  She never did go on her cruise.

  ‘Oh cruises, they’re full of boring old farts who’ve never had a Boule.’

  The last calf

  The mobile rings.

  It’s 8.35 in the morning and I’m on call, but the surgery opens at nine. Probably someone else wanting an appointment. I’m not even going to bother to answer. If it’s urgent they’ll leave a message. If not, they’ll call back.

  And there it goes, the beep-beep-beep of a voice message. Most likely just the click of someone ringing off.

  ‘Oh. He says he’s out on call, what shall I do?’

  She’s holding the phone away from her face, I imagine her arm dangling. I hear a second voice behind her. I can see her standing in the doorway to her house, I know who she is already.

  ‘Oh. Well, leave a message?’

  Just what I was going to say.

  ‘Yes, hello, it’s Madame Colucci, it’s about a calving, it’s twins and they’re both breech, it’s urgent.’

  I’m already in the car. On the way the mobile rings again, same number. I confirm that I’ve got the message and I’m on my way. Within ten minutes of her call I’m there.

  *

  As I park the vehicle and undo my seatbelt in a single move, the heavy door to the cowshed slides open. I’m already rummaging in the boot as Monsieur and Madame Colucci emerge, trudging over with a heavy tread. I’m already kitted out in calving apron and examination gloves, ‘birthing box’ in hand, as I remove my head from the boot to say hello. I bid them a bright and breezy hello, which proves to be star-tlingly at odds with the doleful expressions they’re wearing.

  On the way to the cowshed I learn that the cow is old-but-not-that-old, that she’s a good size, and that Monsieur thinks it’s twins because there’s a head and there are hind feet. He only mentions about ten times that of course he can’t be certain of this, in a tone of voice that makes it perfectly clear that in fact he’s in no doubt at all.

  It’s only when I reach the doorway that I remember what I’d forgotten.

  A blonde cow is gazing at me, her tail comically raised for a contraction. She’s certainly big. And she looks as if she’s doing just fine. It’s the pair of heifers waiting at the other end of the big building that drag me back to the sad reality of the situation, however. A month ago, Monsieur and Madame Colucci’s herd was dispersed and sold. Now there are just three animals left. There’s someone else there, someone I don’t know, a neighbour I assume. I say hello absent-mindedly. Then they tell me that he’s come to collect the cow.

  There’s a bit of a lump in my throat. It’s a long way from the jovial atmosphere I’m used to at calvings where you have an instinct that all will go well, where experience and observation, obstetric manipulation and sheer physical effort come together, where there’s no risk of a caesarean, no danger to the cow, and probably none to the calf either.

  Madame – sturdily built and an imposing figure in her blue-and-white striped housecoat, her hair gathered in improbable bunches – rather overshadows her husband, a slight figure in his blue overalls. They are breeders of calves reared by their mothers, whose products used to clean up all the prizes at every agricultural show. As reliable and unchanging as the Pyrenees.

  It isn’t twins. The calf is on its back, feet in the air, and those are indeed the hind legs. It’s the position they’re in that made Monsieur Colucci and the buyer confuse the calf ’s knees with its hocks. A classic mistake. The birth passage is wide, the cervix is dilated, there’s just a slight torsion that’s soon sorted. The calf is alive.

  It’s the sort of calving I love best, the combined efforts of manual traction and the mother’s pushing, working in concert and without the use of a calving jack or aid; the sort of calving from which you emerge with your nostrils filled with the smell of amniotic fluid, your ears deafened by the cow’s lowing, your eyes dazzled by the image of the newborn calf shaking its head indignantly as it receives its first bucket of icy water full in the face. The smell of straw and manure, the cool morning air on your bare arms, and washing your hands in icy cold water with Savon de Marseille and a spotlessly clean hand towel.

  One of those calvings that you want to share, that are everything I love about this job. One of those perfect calvings, if it weren’t for the things that are missing: the typical commotion struck up by other inquisitive members of the herd, the blasé indifference of the seasoned matrons, the deft tongues of the calves as they try to grab my overalls
through the bars of their box.

  One of those perfect calvings, if it weren’t for Madame Colucci’s tears, incongruous and startling, coursing down her cheeks at a volume to match her bulk and her bunches. Madame Colucci rubbing her eyes and apologising in the heartbroken voice of a small girl, while her husband looks on with the mournful expression you reserve for the funerals of friends.

  If it weren’t for the buyer, in his black overalls, looking sheepish and unobtrusive.

  And if it weren’t for me, the vet, here for what will certainly be the last time, privileged to be a part of, and to witness, this little slice of human history, wondering with a heavy heart when it will be my turn. Me, the vet, wanting more than anything to just sit down in the straw, to pull this calf to me and hold it tight.

  As if we’ve read each other’s thoughts, Madame Colucci does it for me.

  There’s only one of us here who’s not musing on the old days.

  Who shakes his head, with his great dark doe eyes and his damp, matted coat, struggling already to get to his feet, his instincts kicking in with dazzling, demented speed, gawky and bursting with the will to live.

  His mother licks him with a passion.

  The last calf.