Memoirs of a Cotswold Vet

by Ivor Smith

  Back down to earth were the farmers and the folks who spent their whole life working on the farm. Many of my ancestors were simply described as agricultural labourers but I hope that they were as invaluable to the success of the running of their farms as so many of the loyal characters that I have had the pleasure to work with. Throughout my professional career there have been countless occasions when my job would have been very difficult, and at times impossible, without the company of the professional farmworker whose only qualifications were an abundance of common sense, a natural affinity with the animals and years of experience

  Farm life at Witcombe would certainly have been less interesting without Arnold and Hubert. There is little that I need say about Arnold other than he was a very likeable, helpful and dependable member of staff. Hubert was a little different. Not so many years before, when we were at war with Nazi Germany, Hubert had been a member of Dad’s Army and officially one of a group of part-time soldiers manning an anti-aircraft gun on the top of Birdlip Hill.

  I find it difficult to describe Hubert. Such a likeable person could have been any one of television’s Dad’s Army, other than Captain Mainwaring, whom he definitely was not. He freely and bravely admitted that they would have defended to the last man the Cheeserollers, the Twelve Bells, the Royal George and the Royal William. There were probably other pubs a bit further a field where they played darts and there too they were prepared to make their last stand.

  Not so very far away along the A46 towards Cheltenham was another farming client, John Ganley at Hunts Court Farm. The evidence of a German Messerschmitt fighter attack on the farm can still be seen today: the imprints of the machine-gun fire pockmark the walls in abundance. I do not know why this German pilot swerved away from the aircraft factories at Brockworth to attack cattle and sheep at Shurdington. Perhaps he had got wind that our ace anti-aircraft gunner Hubert and his men were defending the local skies.

  I remember Hubert’s proclamation of intent to protect the pubs well (a big mature bullock was standing on my foot at the time), but I better remember the day we were tuberculin testing cattle at Coopers Hill Farm. For whatever reason, things were not going particularly well and our patience and vocabulary was being stretched. Perhaps the cattle had been through the cattle crush once too often recently for other farm husbandry procedures. It was certainly the wrong day to receive a visit from a disgruntled European tourist wanting to explore the remains of the Roman villa.

  ‘Who the ’ell’s this?’ Hubert questioned, as a huge black saloon car approached menacingly up the farm drive. A large, smartly dressed balding man emerged from the shiny Mercedes.

  ‘I am looking for a Roman villa and all we can find are some stones in a field’, the guttural voice announced. ‘Bloody ’ell, it’s a German’, Hubert remarked. Our visitor’s next few words were highly critical of our useless tourist industry and advice on how we should avoid deceiving people. We thought his criticism was a little inappropriate.

  ‘Shall I tell him to piss off?’ Hubert asked Mark. Mark was far too diplomatic. After further aggravating comments I felt that one of us would have to challenge the man. Irritated, I put my tuberculin testing syringes to one side on a straw bale and turned to him.

  ‘Look sir, there was a time when the Roman villa here was quite a big place, but one night on their way back home from Coventry the Luftwaffe flew over, chucked a few spares out, and flattened it.’

  There was a brief moment of silence.

  I got the impression he was not deeply impressed by my comments. He muttered something, probably not terribly flattering, to the other occupants of the Mercedes, climbed back in and quickly disappeared down the drive. One hopes they enjoyed their visit to our wonderfully still intact Gloucester Cathedral, and we continued tuberculin testing our fractious English beasts.

  ‘I was just about to tell him to frig off’, said Hubert.

  Mark telephoned early one morning to ask if I would go along and assist a young beef cow that was having trouble calving. He sounded dreadful: he was obviously suffering from an infection of some description. He asked me to call at the farmhouse where Celia would take me to where the labouring cow had gone down a couple of fields away. On arrival, I could see that Mark was very much under the weather: he was standing in the kitchen in his pyjamas with a mug of tea in his hand, looking for all the world as though he were advertising Beecham’s Powders. I collected my gear from the back of my car and off we marched.

  It was another fantastic late spring morning. There was a nip in the air but you knew it would soon become a very warm day. Hubert was standing guard with the patient when we reached him.

  ‘Don’t worry, young lady’, I reassured the cow, watching her strong abdominal muscles straining and achieving nothing. ‘We’ll soon sort your problems out.’ I stripped to the waist, shivering as the freezing cold rubber of the protective calving gown came into contact with my skin. We had carried buckets of hot water with us from the farm and soon the area surrounding the occasional appearance of a calf’s foot was as clean and aseptic as it could be in these circumstances. My hand and arm disappeared into the depths of the cow’s uterus exploring the extent of her obstetrical problems. The calf was not in an ideal position for delivery, but the postural defect should not take long to correct. One of the calf’s legs was pointing backwards instead of forwards and the head was looking at it. These are quite common bovine obstetrical problems and are usually quickly corrected, except in those cases where the calf is exceptionally large and there is little room to manoeuvre. This was one of them.

  Introducing ever-increasing amounts of obstetrical lubricants around the calf Hubert suggested that the spare pint of Castrol XL that he had in his car might be of some use. On this occasion we ignored him. By now my operative left hand was numb from the enormous pressure inside the uterus and it was the wrong time for smart remarks. ‘Another quip like that, Hubert, and you’ll get some lubricant where it might surprise you’, I thought to myself. I refrained, and asked him politely to pass me one of the clean obstetrical ropes. Celia passed me a rope, which I somehow secured to the absent foot with senseless fingers. I had already repositioned the head and instructed my assistants to haul on the rope to draw up the leg to its rightful place while I protected the uterus from the calf’s sharp hoof with a cupped hand. We were making good progress until suddenly the traction stopped.

  ‘What’s up?’ I enquired.

  ‘I’m getting covered in filth, that’s what’, Celia complained. She had come to assist me calve a cow dressed in a white designer blouse and a floral skirt. ‘Just give me a half a minute.’ I did, and she unbuttoned her blouse and handed it to Hubert for safekeeping.

  With the calf in the correct position and the ropes attached to both forelimbs, I was able to guide the head through that important canal. More spirited traction and the calf would emerge safely. At a critical moment there was another adjournment and everything stopped. The floral skirt was now getting covered in a mixture of foetal fluids and lubricants. Celia was not happy.

  ‘I don’t believe this’, I thought to myself, as her skirt disappeared in the same direction as her blouse. With me hauling on one rope and Celia on the other, now looking like a model for Gossard lingerie, the calf at last lunged forward, safe and well. With our bovine patient and her new calf secure in Hubert’s safe hands, we returned to the farmhouse.

  I had removed my calving gown – now plastered in every conceivable biological substance known to man – and walked up the garden path with a filthy face, stripped down to my jeans. Celia was covered in the same multi-coloured war paint and was, well, just stripped down. We walked slowly towards the house and Mark greeted us at the kitchen door, asked how things had gone and was delighted to hear of the successful outcome. I was pleased that he was delighted and moreso that he didn’t seem to notice anything unusual about our appearance. Hubert was indeed a fortunate chap to be able to enjoy magnificent views of the Cotswolds every working day, bu
t I felt it was unlikely that he would ever again enjoy the wonderful views he had seen that day.

  Throughout the decade things were slowly, but significantly, changing in the world of farm veterinary practice. Vet practitioners everywhere were aware that there were fewer call-outs to the farms. There were sound economic reasons why this was happening but sad ones all the same. Instead, the small animal, the companion animal side of the practice, was expanding quickly and the response had to be fast to satisfy the demands of the pet-owning public. If a professional vacancy arose in the practice, the job seemed only to attract those vets interested in the welfare of companion animals. Their vision of the future of veterinary practice was probably right, but these youngsters missed out on an awful lot of fun.

  So in a short space of time we were assumed by our clients to be experts in the world of small animals. I may inadvertently be giving the impression that we were not already competent in this field. We had to be, the Royal College kept an eye on that. There were still days devoted to the TB testing of cattle but that day probably began and ended with small animal surgeries, and in between the cat and dog emergencies were somehow fitted in – all without the aid of the now obligatory mobile phone.

  What we were lacking was the veterinary specialist, the person whom today the general practising vet is able to contact at any time for advice or an urgent second opinion. Beyond the Vet Schools there was really nobody to turn to when you were unsure of how to deal with a particular problem. The university specialist was more than willing to see your patient, and although they were often overwhelmed with requests from local practitioners, their advice and support was extremely useful. Following a lengthy telephone conversation and surgical instructions, the consultant often ended the viva with, ‘It’s really not that difficult, have a shot at it yourself.’

  ‘I might need to think about it.’

  ‘Okay. Let me know how you get on. Good luck.’ The upshot of this was, of course, that we were forced into performing operations that initially we would have preferred to refer.

  Prime examples of this situation – and there were scores of them – were the dogs with a rupture of their cruciate ligaments. The condition obviously existed when we were at Vet School, but there was no emphasis attached to it and we were not taught how to correct it. Strangely it seemed to be a rare condition in the human field at that time. Forty years on and the reverse seems true: the stars of the rugby and football world are hobbling into their doctors’ surgeries and the dogs are lined up at the vets with the same complaint.

  It was time for reluctant action when George, a mature black Labrador, hobbled into my surgery one day. I discussed my diagnosis with his young lady owner, who happened to work in the orthopaedic department at the Cheltenham hospital. The abnormal movements of one of his stifle joints cried out for surgical exploration and a probable repair of his ruptured ligaments. George had great difficulty standing and needed help without too much delay. Analgesics would minimise the pain but he needed an operation now. It might have been possible to fit him in for an operation at the Bristol Vet School in about a month’s time. Taking a deep breath I informed the owner of my decision. I would operate the next day. I could hear the words of the Vet School surgeon: ‘It’s quite straightforward’, and ‘Let me know how you get on.’ Funny how he never asked, ‘By the way, is your professional negligence premium paid up to date?’

  The following morning, after a sleepless night, it was time to commence the day’s operative surgery. George was prepared for surgery in our routine manner. RANA Rosemary took control of the anaesthesia. Surgical assistant Debbie scrubbed up and, at appropriate times, passed me the instruments that I requested. I began the operation. Having surgically explored the joint, it was my intention to replace the ruptured anterior (now referred to as the cranial), ligament with a prosthesis. My technique of choice was Patsaama’s method, where my skin prosthesis would be inserted through femoral and tibial bone tunnels and anchored at either end. I approached the stifle joint from the lateral aspect by a parapatellar skin incision which extended from the lower third of the femur to the upper third of the tibia. I then incised the underlying fascia together with the joint capsule to open the joint. I dislocated the patella medially to expose the trochlea and infrapatellar pad of fat. With Debbie’s assistance, I drilled the femoral tunnel from just above the origin of the lateral collateral ligament. The drill emerged on the medial surface of the lateral condyle at the point of attachment of the cranial cruciate ligament. With the stifle joint in maximum flexion I drilled the tibial tunnel from the intercondyloid fossa so that it emerged towards the distal extremity of the tibial crest.

  I cut a 4mm skin transplant the length of, and parallel with, the edge of my initial skin incision. I passed the skin through the femoral and tibial tunnels by twisting it up and attaching a length of monofilament wire to one end, and then passed the wire through the femoral tunnel and pulled the skin through. The wire then continued down through the tibial tunnel, followed by the skin prosthesis. I repositioned the patella in the trochlea. I anchored the skin transplant at the femoral tunnel by suturing it to the joint capsule and fascia with two mattress sutures of monofilament nylon and cut off the excess skin. I extended the stifle and pulled the skin transplant tight, reflecting its end over the tibial crest, and attached it to the fascia with another two mattress sutures of the monofilament. I co-apted the joint capsule and fascia with mattress sutures and closed the skin incision with interrupted sutures of monofilament nylon. I then washed my hands and had a cup of strong tea.

  While George recovered from his anaesthetic Rosemary applied a Robert-Jones dressing; a heavily padded cotton wool bandage from one end of his leg to the other.

  In his hospital kennel George gradually and quietly recovered during the day and awaited the arrival of his owner. Naturally, after the initial ‘How is he?’, she asked the next inevitable question: ‘How did the operation go?’

  ‘Very well’, Debbie replied.

  ‘Were there any complications?’ she queried.

  ‘None at all; everything went perfectly’, replied my young, inexperienced and too-truthful-for-her-own-good nurse.

  ‘Has Mr Smith done many of these operations?’ That was definitely the wrong question to ask honest Debbie.

  ‘He hasn’t actually done this particular operation before so he had his surgery book open on the operating table all the time telling him how to do it.’

  Debbie survived many years in our practice without me ever getting round to gagging her. When she left our practice we lost an excellent nurse. Sadly, I believe her admirable qualities became ignored and unappreciated by a ‘paper qualifications only’ workplace society, and more than three decades later the same argument as to whether the veterinary profession should recognise experienced ‘unqualified’ nurses rumbles on. I suspect her reasons were a combination of knowing that without formal paper qualifications she would be unable to rise to the position of Head Nurse, which I think she undoubtedly deserved, but also feeling that she was possibly blocking the career opportunity of a younger qualified person.

  George’s owner was happy and a few weeks later I knew he was too. He was walking soundly. More than a few thanks were also due to the surgical textbook notes of my university mentors. Some things in life you have to do by the book. To reassure any concerned owners who may be reading this, I managed to complete the third operation without reference to any book. Today I could almost carry out the procedure in my sleep. I much prefer to dream of other things these days. Despite all this justification for DIY surgery, unless the animal’s treatment was an emergency, it was usually of enormous benefit to make an appointment with a consultant member of staff at our nearby Bristol Vet School even if it meant a wait of a week or two.

  One mysterious case involved a Springer Spaniel called Rufus. His owner was an officer at RAF Innsworth. When his dog began to vomit occasionally, I was not too concerned because dogs are opportunist eaters and th
e dog that has never been sick from ingestion of rubbish of some description has probably never existed. I began to get more concerned when he failed to respond to increasingly sophisticated treatments. His abdomen did not feel especially abnormal when I palpated it and I certainly could not feel anything resembling a hard foreign body. I gave Rufus a general anaesthetic and X-rayed his abdomen. There was nothing particularly abnormal to be seen on the radiographs to account for his problem and yet I had an intuitive feeling that the stomach was not as it should be. More X-rays – following barium swallows to outline any abnormalities – still did not convince me that there was justification for carrying out an exploratory laparotomy and taking a look inside his stomach.

  A trip to Bristol University would allow an examination of his stomach with an endoscope. In due course, after yet more X-rays had been taken, the surgeon carried out the endoscopy examination. Within minutes the investigative tip of the instrument brushed against something strange. There was indeed a gastric foreign body present: the surgeon had discovered a piece of clothing. He clamped on to it with the tiny grasping jaws of his endoscope and slowly withdrew the small garment. I can only guess what he said when he pulled it out through the dog’s mouth. We chatted over the telephone and, later that day, I rang the owners to give them the news of Rufus’ successful visit to the Vet School. His owner’s wife’s response to my good news was a bit surprising.