by Jo Hardy
Luca’s owners, a lovely family, were extremely happy to see him. They made a big fuss of him, thanked us profusely and promised to spoil him. After the discharging consultation I walked out with them to their car. It was a black London cab, which Luca stepped into as if he were a fare. He plonked his rear end on the seat while keeping his front feet on the floor. It was hilarious. Luca had been an amazing character and one of my favourite cases. He had a huge personality and he kept everyone amused. He was also a real trouper; he went through a very tough time very bravely. I was glad he had such a loving home, but I was sorry to see him go. I was going to miss my revision buddy.
I’d picked neurology as one of my elective subjects because it was an area I felt I didn’t know enough about. Before I started I was nervous and spent a lot of time in the weeks running up to the rotation reading over all my neurology notes. But I needn’t have been so worried, as it turned out that the neurology team were really welcoming. They didn’t expect us students to know much when we first started, which took a weight off my shoulders as most other rotations expected a lot from students. In neurology they were more focused on teaching a subject that they were really excited about, and trying to inspire us to take a career path in neurology. I was pretty sure I wouldn’t be going down that route – disorders of the nervous system were not what set me on fire – but I was glad of the opportunity to learn more about it and work with a nice bunch of people.
To my surprise, neurology was hugely busy. In most other departments we had looked after around four animals a day, but here I had up to seven at a time. Right from day one I was piled high with cases.
My first was Sergeant, a springer spaniel whose owner, a rather timid man, said Sergeant had collapsed. On careful questioning it seemed that Sergeant collapsed like this about once a year. I reported back to Gareth. ‘What kind of condition can cause a dog to do that?’ I puzzled.
‘Laziness,’ Gareth laughed, after he’d thoroughly examined Sergeant. ‘There’s nothing wrong with him. He just can’t be bothered.’
Sergeant’s owner accepted this, probably because it came from a specialist. Plenty of animals came to the QMH with conditions their first-opinion vets had already diagnosed, but which the owners wouldn’t accept until a specialist confirmed it.
Gareth, who had a place on the QMH unofficial list of hottest clinicians alongside Vincent and a select few others, was a dedicated vet who treated animals with great skill and care. Like so many others at the hospital he put in ridiculously long hours, just to make sure that his patients got the best possible treatment.
The day before I arrived he had operated on Fifi, a very sweet black miniature poodle. She’d had a few disc prolapses and was recovering from surgery when she was put under my care, and I had been told she would need lots of special attention and post-surgery rehabilitation. Fifi’s was a dramatic case as she had come in after losing all function in her back legs. Tests confirmed that she could barely feel them; when her toes were pressed she didn’t respond at all. This loss of deep pain perception meant the prognosis wasn’t very good. When I was shown her pre-surgery MRI scan I was shocked. The spinal cord usually looks like a light greyish line running through the vertebrae, but in Fifi’s case the line showing the spinal cord was compressed by three separate prolapsed discs and it looked as though it had almost been cut into sections. Her owners were told that even after surgery, which would be costly, she might never regain her ability to walk, but they loved her and wanted to give her the best possible chance, so with their blessing Gareth went ahead and operated.
Now we were at the tense post-op stage, waiting to see how far Fifi would recover. The physiotherapist was spending a lot of time with her, and since I was checking on her every couple of hours I got the opportunity to learn a bit about dog physiotherapy, which was both useful and fun.
As the days passed Fifi surprised the whole department. Not only was she starting to regain her deep pain sensation, she was also trying hard to move her back legs. Every few hours either the nurses or I would take her for a walk in what were known as her ‘silver pants’ – a support that wrapped around her back legs and had two long handles so that we could hold them up while she walked with her front legs. We gave her lots of praise and encouragement, and it took me back to the start of rotations when I was in the dermatology room wondering who on earth those crazy people were outside the window making all that noise with a dog. Now, I knew it was the neurology department helping a patient to walk again. And it was working. Fifi, responding to our every encouragement, wanted to play and she was already starting to move her legs rather than dragging them.
Tilly, another of my cases, was a fluffball of a dog, a little white Pomeranian with a tiny, foxy face and beady eyes, who was undergoing chemotherapy for an inflammatory central nervous system disease. Her spinal cord and brain had become inflamed but we had no idea why. The condition is known as MUO, meningioencephalitis of unknown origin. When this happens chemotherapy drugs seem to help. Poor Tilly was in the midst of her treatment, so she was feeling pretty rough and looking like a cuddly toy, flopped in her small kennel, so I kept a very close eye on her.
My fourth patient that first day was Billy, a gorgeous whippet who had a haemorrhage into the spinal cord from a car accident and who was recovering with rest and anti-inflammatories. But the case that touched my heart most was Herbie, a Lhasa apso, an unusual, long-haired Tibetan breed. His hair trailed along the floor behind him. Herbie was blind and although they didn’t look at all alike, he reminded me of Tosca, who was also coping stoically with her blindness, and who had been such a stalwart and loyal companion throughout this tough year of rotations. Every time I went home Tosca was waiting for me. When I sat reading or revising she sat with me, and instead of disturbing me with her usual demands for attention she’d simply put her head on my lap, or sit on my feet, giving me quiet, comforting support.
The film crew loved her, and we had a lot of laughs over the fact that one of the newer members of the crew was also called Tosca, particularly when we were talking about something silly Tosca the dog had done and someone only caught half the conversation.
In Herbie’s case a scan revealed that he also had an inflammation of the central nervous system, which in his case had caused his optic nerves to swell. I was glad of the opportunity to see for myself, as eye diagnoses were one of my weaker points. In this case the problem was obvious and I could see that Herbie’s optic nerves were swollen. They usually look like a cream circle at the back of the eye when you look through an opthalmoscope, but Herbie’s were massive and bulging inwards. He was put on the same treatment as Tilly for MUO, a type of chemotherapy that decreased the inflammation in the nervous system.
Herbie started to make a good recovery, and like most of my other patients went home before the end of my two weeks there. But like all chemotherapy patients he would be back many times over the next few months for repeat treatments.
All my patients behaved with remarkable fortitude and restraint, until I met Kevin the cat. Kevin had come in with facial twitching and odd behaviour, and he took an instant dislike to me. Every time I went near him he tried to bite me, which didn’t make doing his regular checks any easier. It turned out that his worst problem was his heart, so before he could inflict any more puncture wounds on my hands and arms he was transferred to the cardio ward where I could only hope that whoever looked after him would have better luck.
A few days into my first week Gareth asked me if I could give him a hand with an emergency case, a crossbreed called Casey who had a slipped disc and was now dragging his back legs. He was a tough little dog; he looked a bit like a beagle, with floppy ears and a habit of tilting his head to one side as if he were thinking.
He was in a lot of pain, so we operated that afternoon. Once again it was a long, hot four hours in the operating room, but by the end Casey’s disc was removed and there was every likelihood that he would make a full recovery.
My final
case was Bertie, a Staffie who had collapsed. If I’m honest, with the exception of Clunky, who stole my heart, Staffies weren’t my favourite dogs. With their square frame, barrel chests and squashed faces, they aren’t exactly cuddly. But I know that, like most dogs, they can be loving, sweet-natured and loyal, and I decided I should get to know them better, not least because Jacques often said he’d like us to get one in the future.
Bertie was a brave little ambassador for his breed. Like all the dogs who found that they suddenly couldn’t walk, he must have been very frightened and confused. But he was patient while we sedated and scanned him, and thankfully we found that his was a treatable condition. Bertie had a fibrocartilagenous embolism (FCE), otherwise known as a spinal stroke, where an embolism had blocked the blood supply to a small part of the spinal cord, meaning the cells in that area could not survive. As a result Bertie’s left back leg had become paralysed. He was lucky, though, as it could have happened higher up in his spinal cord, which would have meant that all four of his legs would have been paralysed. With rest, gentle stimulation, anti-inflammatories and physiotherapy he had a good prognosis, and the clinicians hoped he would make a full recovery in four to six weeks, most of which he could spend at home, with regular visits back to the hospital for hydrotherapy and physiotherapy sessions.
By the time I came to the end of my fortnight Fifi was ready to be discharged, to continue her rehabilitation at home. She was able to stand without the support of the silver pants, and although she wasn’t yet walking without aid, she could lift up each back leg and confidently place them back on the floor without stumbling. Her owners were delighted. They knew she might be a little wobbly for the rest of her life, but after the initial bleak prognosis she had done so well. I had grown close to Fifi and when I went to see her off I found myself feeling a little choked up. I was so proud of her for pulling through.
On my last day at the unit I brought in cakes for everyone. This had become a ritual for many of us on rotations, to say goodbye each time we moved on. However tough the rotation had been it marked the ending in a nice way. And when it came to leaving neurology, I was genuinely sad.
It was good to go home for the weekend, to catch up with my family and do a bit of frantic revision for the practical exam, which was now days away. Dad was a real help with that. He’d patiently helped me revise all through my A levels and the vet exams at the end of each year, putting up with my mini-tantrums and last-minute panics, and reassuring me that I’d be fine. We had a system; I would explain something to him, and if he understood it then I trusted that I knew it. He sometimes joked that he would probably be able to work as a vet, too, by the time I graduated.
The practical exams were known as the oskeys to us. This was our version of OSCEs, although what the letters stood for I never knew. In fact, the exam had just had its name changed to OSPVEs, but everyone ignored that.
Many of the five-minute tests were pretty simple – washing my hands, taking an X-ray, doing a consultation with an actor who played the part of a pet owner. Others were much harder and I messed up a few. The dermatology microscopy station was hard. I had to identify two slides. On one of them I found demodex parasites, tiny mites that live on the hair of dogs but don’t generally do any harm. Phew. But the other was hard to identify. I needed a much higher magnification of the microscope, but the high-power lens wasn’t working well and I couldn’t see a thing. In the end I made a random guess and went for cocci bacteria. It could have been anything, though.
Then there was the horse leg bandage. I can bandage a leg just fine, but because I had to do it quickly I kept dropping the bandage, and it sprang back and smacked the model horse on the other leg with a thud. But worst of all was the sheep tip. For this one I was sent into a stable with eight sheep in it and told to catch a specific one, tip it over and examine its udder. I spent four of my five minutes running around after a sheep that was clearly annoyed at being tipped multiple times through the day and was not playing any more. I actually pulled a muscle in my arm when tackling it, but I had to ignore the sudden surge of pain that shot up my arm and push on, and in the last minute I managed to get the sheep over and do a quick examination.
By the end I felt wrung out. And this was just the start – there were five more exams to go, each one as terrifying as this first. It was hard to imagine coming out the other side without my brain being fried and my nerves shredded.
CHAPTER NINETEEN
The End in Sight
By Easter, which fell in early April that year, we were all revising for finals. Two months to go and suddenly I felt as though I knew nothing. I couldn’t remember one end of an animal from the other. I felt as though I had somehow been getting away with it all this time, but I was about to be found out. How had I ever thought I could really be a vet?
It wasn’t just the non-stop revision that was worrying me. I’d always thrown myself into everything, but now I was beginning to regret getting involved in so much. Why had I taken on planning the graduation ball? And offered to be in the Final Year Revue, appearing in the sketches as well as being in the band? And agreed to be in the TV series? Hadn’t I realised that all these things would be coming to a head at exactly the same time that my future career was hanging in the balance? Clearly not, but it was too late now. I didn’t have a spare moment, from waking to crawling back into bed again. It was turning into a mad, mad month, and May was looking even worse.
This wasn’t the right moment for ITN to start insisting on last-minute filming sessions, and they were very apologetic that it was coming at a bad time, but they were still missing a lot of footage so we were summoned to film the opening sequence, some studio shots and more linking scene shots. We also had to have press photographs taken and film more of what they called the master interviews – one-to-one interviews with each of us that they slotted into the films.
For the opening sequence ITN had hired a vast studio and brought in lots of animals. Since I was one of the few horsey people I had been given the horse to hold. His name was Barron, known as Baz, and I felt really star-struck. He was famous, having appeared in Downton Abbey and Pirates of the Caribbean. But despite his sparkling credentials he wasn’t an easy partner to deal with. The crew had decided to put out bales of hay in the studio for us to sit down on or stand behind. Baz and I were supposed to walk in and take our place to one side, behind the bales, but every time we appeared he would drag me to the hay and shove his head down for a munch. We must have done close to twenty takes before the producer was happy.
The studio shots were also in a hired studio, but this time they were filming each of us individually, with animals. For this one I got an obese ginger cat that was moulting, and I kept sneezing and needing tissues. Despite this, Isobel, the producer, kept insisting on retaking shots of me putting my nose on the cat’s nose then bringing my head up to look at the camera. By the end I looked like an allergic mess, face red and eyes streaming.
The linking shots were less fun. I had to walk in and out of the QMH so many times I lost count. The reception staff kept laughing every time I came in through the doors and stood and waited for them to close so that I could go back out again. Putting my bag in a locker was another sequence that took many takes, as they filmed this remarkably unexciting event from every angle. It didn’t help that the first time we did it I walked in and tried to open my locker, but found that it was stuck. I was trying for ages, and finally I gave up and asked Sam to come and help prise open the locker. Rob was standing behind Sam in hysterics, almost crying at how incompetent I looked, and insisted that was a blooper shot. I wasn’t impressed. And finally, the master interviews, which were always filmed late in the day in the clinical skills centre after everyone went home. This meant filming took up a whole evening, but the bonus was that we got free pizza.
While it wasn’t easy fitting all this in, and some of it was pretty tedious, for the most part I enjoyed it because I had become good friends with the film crew. In fact, I was d
reading the end of filming because I’d grown to enjoy their company; we’d shared a lot of laughter together over the many mishaps of the past year, and I was beginning to think that I might actually feel quite bereft without their constant presence.
It wasn’t time for goodbye, though, as we’d be seeing them for results day in July and then once again for our graduation. I didn’t dare think about that, however, as it all seemed a lifetime away.
Graduation would be a couple of weeks after results day, and two days after that we were holding a graduation ball – our final event of the year. When we set up a graduation ball committee we decided that whoever found a venue would head the organising committee. I decided to check out Hatfield House. I went for a tour, took lots of pictures and put it to the committee. They loved it, so suddenly I found myself chief planner for a party for 300 people with a budget of £25,000.
Slightly horrified that I’d put myself in this situation, I had hastily delegated jobs to everyone, hoping they’d sort out all the details, like flowers and tickets and photographers and entertainment. But despite my best efforts to get all the others to do the hard work, I was forced to roll up my sleeves and do some of it myself. It was extraordinary just how much was involved – we’d had numerous meetings and looked at endless menus, samples and pictures, and we still had all kinds of last-minute decisions to make, from the pre-dinner drinks to the food to the flowers.
Most important of all, I needed to find a dress to wear. Jacques had promised to come over for my graduation and to come to the ball with me, so in between revising the anatomy of pigs and potential causes of fits in dogs I scoured the internet for a gown that would magically convey the grace, style and poise I felt the occasion merited.
The ball would be held in July, as our final event, but the Final Year Revue – a stage production with a mixture of singing, stage acts and pre-filmed videos, was to be performed over two nights in early May. A college tradition, the Revue was a chance to let our hair down, take the mickey out of ourselves and party before the final push towards the exams.