by Ivor Smith
While all this was going on I had to keep one eye on young Johnny. His favourite sport was belting around my room on the anaesthetic trolley. Then he would empty my cupboards and drawers of bandages, cotton wool, Elastoplast, bottles of disinfectant and everything else a vet needs to do his job. I could have made good use of the calving ropes but I wasn’t allowed to tie him up. One Monday, after dismantling everything, he tried a new trick and started playing with the pneumatic pedal that adjusted the height of the operating table. He forgot that he had lowered it and when his mother told him to get out because they were leaving he stood up and hit his head on the solid metal underside of the table. He bawled his head off and, with great difficulty, I managed to keep a straight face and refrained from saying, ‘Got you at last.’
‘It serves you right’, his mother shouted, louder than he was yelling. ‘I keep telling you to behave yourself at the vets.’
CHAPTER TEN
IN SICKNESS AND IN HEALTH
From a very early age it was clear to me that one of the most important things in life was good health. I thanked my lucky stars that by hook or by crook I overcame the early setbacks that I had experienced as a child and went on to enjoy what was essentially a fit and happy life.
I had learned, perhaps subconsciously, that no matter how much wealth you accumulated in life, contentment, happiness, respect and the company of true friends were things you could not buy. Having said that, the health and fitness ideal was often a struggle for this particular veterinary practitioner to maintain, particularly when his patients were determined to prove otherwise. Frequently, at the end of the day, I eased my sore body into bed and refused to count sheep to get to sleep. I had seen too many of them.
The mental picture of the lad in the back row in the schoolroom wearing his baseball cap would have appeared in my mind. ‘Have you ever been bitten, Mister?’ He could also have enquired about being kicked, scratched, trampled, gored, stung or punched, to add a few of the occasional indignities. I could have replied in the affirmative to all of the above but I did not want him to get too excited. Much more seriously, I probably played another aspect of my professional life down as well: the constant exposure to infectious organisms that caused illness and death in my patients and were ready to make life rather unpleasant for the vet too.
One of the biggest fears for the practising vet was the possibility of contracting anthrax, and because it was not a rare disease, farm animals found dead without an obvious cause were tested for it. Because anthrax is officially a notifiable disease, the owner is required by law to report the sudden death to his vet, who then takes the necessary samples to examine in the practice laboratory. A smear of the animal’s blood is carefully taken from a superficial ear vein on a glass slide and the specimen is stained with methylene blue. After further brief heat treatment the slide is ready to be examined under a microscope. At Vet School the stained appearance of the large microscopic encapsulated bacterium was drummed into us.
You hoped you would never see them and usually you did not, and having assured yourself and MAFF that the cow had not died from anthrax the carcass would be transported to the local knacker’s yard. In our case it was usually to the local family firm of Ormond Eeles & Sons, of Longlevens. From schooldays until almost the time I retired, the boss was Walter Eeles. If you had the pleasure of meeting him it was difficult to believe that anyone else could possibly ever have been the boss. Walter ruled the Paygrove Lane establishment like a human Rottweiler, but as so often in such people, I believe he had a heart of gold. As a veterinary surgeon he treated me with the utmost respect, and I am sure other local vets experienced the same courtesy.
Nevertheless, I was careful never to remind him that as a 1960s teenage vet student studying first year anatomy at Liverpool I had, with a little trepidation, one bright wintry Sunday morning requested a horse’s head and other superfluous equine bits and pieces.
‘What the bloody ’ell do you want those for?’ he’s asked. I managed to look him in the eye and almost recognised a suppressed grin. He knew darned well what I wanted them for. He told me to come back the next day and I did what I was told (just like everyone else there I imagine). By then the selected bits of skeleton had been boiled in order to remove the soft tissues and to sterilise the bones, and they were ready for me to collect. I left Walter’s yard on my bike with a sack on my back containing a horse’s skull, and other large bones of significance.
To the local veterinary surgeons who at the time were mainly involved in large animal farm practice, and that was most of us, Walter was worth his weight in gold. As the years went by his weight in gold became quite substantial, but his deftness with a knife and ability to expose the viscera of a horse, cow or sheep – and probably anything else brought to his yard – was quite remarkable. Within minutes we often found ourselves discussing the post-mortem pathology of equine hearts and bovine livers, which had been a clinical enigma in life.
Walter called a spade a spade more frequently and vehemently than any north countryman I have ever met, though often with good reason. There was one occasion when a cow suffering a sudden death had escaped the diagnostic net and the carcass appeared in Walter’s yard for routine butchering. Walter sliced open the cow’s abdomen and a gigantic diagnostic spleen rolled on to the floor in front of him. I suspect that this was not the first time he had observed one of these because, on good authority I am assured, his immediate response, ‘It’s friggin’ anthrax!’, was bellowed loudly enough to ensure that everyone within half a mile understood the seriousness of the situation.
It was no surprise that Walter’s diagnosis was correct but official confirmation was needed and within minutes of a telephone call to MAFF and the Veterinary Investigation Centre at Elmbridge Court, a mile or so away, a Ministry vet arrived and took the appropriate pathology samples. Within the hour Walter’s yard had been officially declared an Infected Premises, complete with all the legislation that went with it. He was not too pleased with the inconvenience and did not take kindly either to the newspaper reports that naturally followed. He did after all provide hundreds of owners of carnivorous pets with a very economical and nutritious supply of meat. In theory, it was just possible that if any anthrax-contaminated foodstuffs were fed to the pets they too could become infected, and he was not amused by the adverse publicity. This was another occassion where he did not mince his words!
By coincidence at that time a worried lady brought her very dejected Lurcher type of dog to surgery. He had not been well for several days, but other than being ‘off colour’ he had shown no particular signs of ill-health. I lifted him gently on to my consultation table and began my routine examination. I removed the thermometer from his rectum, wiped it with a swab of spirited cotton wool and read his temperature. The column of mercury seemed to be trying to escape at the other end. To check my findings I once more inserted the thermometer. My patient buckled before me, collapsed onto the table, and died. To add to my concerns, the owner had offered the information that she had been feeding him meat purchased from – well, you can guess where.
Still trying to make sense of what had taken place in the last few minutes, I decided that I should just check the dog as a possible anthrax case, aware that the chance of this was remote in the extreme. Minutes later, I stared unbelievably down my microscope at the large bacillary organisms in the blood sample I had taken from the dog. They were not dissimilar in appearance to anthrax organisms. I telephoned my veterinary colleagues at Elmbridge Court and explained my findings to the micro-biological experts. ‘Bloomin ’eck’, said the vet pathologist on the end of the line. ‘Just lock your surgery door and get the slide down here as quick as you can.’
Unfortunately, I tried to get the samples to them too quickly, as I explained to the police officers who waved me down in Parton Road. I admitted I was doing more than 30mph but I was definitely doing less than 40mph. I was clocked somewhere in between. In the ’70s the road was still a relatively quiet v
illage road and I believed on this occasion there might be mitigating circumstances. The officer noted at length most of what I had told him and informed me that it was very interesting and the facts would be passed to the chief constable, who would decide whether or not to prosecute me.
The chief constable was clearly not an animal lover. I paid my fine and hoped the accountants would look upon it as an essential motoring expense. By lunchtime, and to my great relief, the Ministry vets had confirmed that the anthrax-like bacteria were another group of similar organisms and my surgery would not be officially designated an Infected Premises. I had had more than enough legislation for one day.
But what was the Lurcher’s cause of death? I can only guess, but over the years I have thought a lot about this case. Within weeks, in our small part of the world we saw many cases of canine parvovirus disease, which was spreading rapidly across continents. This was possibly the first case I had encountered, and thank heavens it was a new disease that we humans could not catch. It would, however, be devastating to the dog world. We did not need any new ones to add to the list of zoonotic diseases; there were already enough out there to cope with.
Probably the one of most concern to young vets going into farm practice in the 1960s was the realisation that you would never be far away from Brucella abortus infection. We were lectured at Vet School about the seriousness of the disease and the enormous economic loss it caused in dairy herds. The disease was suspected when several cows in the herd aborted their calves in late pregnancy. Many of the aborting animals needed obstetrical assistance and the later in the pregnancy the problem arose, the more difficult it often was to remove the unborn calf. It was not uncommon to spend an hour with your arm inside the patient’s reproductive tract. We did our best to avoid direct contact with infection, but it was a hopeless task. The arm-length plastic gloves were just too thin, and dealing with a difficult case resulted in torn gloves within minutes. Then you knew that your skin was in direct contact with foetal fluids that were teeming with Brucella bacteria. At the end of the delivery we scrubbed and scrubbed our skin with soapy iodine-based disinfectants, and hoped for the best. This was probably the way most young vets were infected initially, but there were other routes.
Most cows, following a normal healthy calving, will part company with their foetal membranes quite soon after birth. Cattle that had aborted tended to hang on to the placenta for many days and frequently became ill. Once again you hoped the plastic glove would not split when you plunged your arm into the vaginal tract and the uterus and carefully removed the infected tissues that were often bathed in foul-smelling discharges. The odour remained with you for the rest of the day and it was astonishing how often this task was carried out just before it was time for lunch.
Unfortunately, no matter how careful you were in avoiding skin contact, it was possible to become infected by breathing infectious dusty particles from the rear of the cow. This source came to light when a couple of window cleaners at the government’s Central Laboratory at Weighbridge, who had never been near a cow in their lives, became infected. A glass vessel containing Brucella material was accidentally broken and a small amount of the substance was drawn into the building’s air conditioning system. The bacteria wafted into the room where the cleaners were working and, in due course, they developed the clinical signs of brucellosis. There was however a rough and ready way of reducing the risk of breathing in infected particles. The first thing to do before examining the cow was to throw a couple of buckets of hot soapy water and disinfectant over her rear end to lay the dust.
As if inhaling the bacteria was not enough, another frequent entry for Brucella bacteria was through digestion. From the first day we moved into Odd Farm in Crudwell we accepted our neighbours’ generous offer of supplying us with delicious milk straight from the cow, and walking to the farm for a chat was a pleasant daily routine Angela enjoyed. But within weeks both of us were suffering from a type of flu-like illness that lasted for weeks. It was months before Brucella infection was identified in Stanley’s dairy herd and probably by then we had both been infected by our fresh daily pints. Angela recovered from the illness within weeks and made a full recovery. It could have been much more serious, but fortunately she was not constantly exposed to the infection.
A worrying aspect of the situation at the time was the medical profession’s apparent lack of awareness, certainly at local level, of the public health significance of Brucellosis. The prevalence of the infection did not seem to be recognised, even though in country practices doctors would have been surrounded by the disease. This was my experience and it was many years before I encountered a doctor who appreciated the importance of it. During the few days I spent in the small cottage hospital in Cirencester having my tonsillectomy I had the chance to strike up a friendly relationship with a newly qualified young doctor and enjoyed many chats with him between the very restricted visiting hours. He had indeed heard of human brucellosis, but he related this to a form of the illness known to medics as undulant fever, which was caused by Brucella melitensis. This was more likely contracted as a result of contact with infected goats in hot climates.
Strangely it was several years, despite almost daily exposure to the infection, before it began to cause me a serious health problem – no doubt I had developed some immunity to it. I was then living in Churchdown and had been involved in cattle practice for about ten years before the classic signs began to develop. I began to wake each morning with the characteristic muscular and joint pains and wishing I could spend the rest of the day in bed. Analgesic tablets were taken with my morning tea and off I went to surgery. By lunchtime the nurses were mopping the sweat from my face as we stood around the operating table, and I longed to sit down and take more analgesics. When the symptoms dragged into the third week I knew it was time for a trip to the doctor. As so often happens, you seem to find yourself improving the day you consult the doctor. I walked into Dr Jimmy Caldwell’s room and explained that I was feeling much better.
‘You don’t look much better to me’, he remarked. ‘Sit down, and put this in your mouth.’ He passed me a thermometer. He picked up his telephone and rang the Public Health Laboratory in Gloucester. Half an hour later the array of blood samples he had been asked to take were lined up in tubes on his desk. Jimmy telephoned me a few days later, and I am sure it came as no surprise to either of us that my antibody levels to the various brucellosis blood tests were sky high. Over the next couple of months, and following weeks of antibiotic treatment, the blood picture returned to normal and, touch wood, brucellosis has not troubled me since. I think today’s aches and pains must be due to something else.
A few years later I became a bit concerned when another apparent bout of flu once more dragged into a third week. I began to think to myself, ‘Oh dear, here we go again.’ Jimmy took the required blood samples and we chatted about how rapidly things had improved over the years in the diagnosis of so many diseases in both the human and veterinary fields. Now the Public Health Laboratory had put together a diagnostic package where blood tests for numerous diseases were incorporated that were particularly relevant to vets, farmers and anyone else who worked with animals. It was interesting that as well as brucellosis being on the list, so too was psittacosis, the illness occasionally contracted from birds and caused by the bacteria chlamydia psittaci. While we joked about ‘sick parrots’, I happened to mention a mynah bird that I had treated some time back for a large painful conjunctival abscess, and thought no more of it until many weeks later. In many ways it was frustrating not to have shown an antibody response to any of the tests. I still felt very much under the weather.
‘I think we’ll do them again’, Jimmy said. He was right; when the tests were completed on the second occasion the laboratory rang to tell us my blood titres to chlamydia psittaci infection were rocketing. I had psittacosis. I was back on the antibiotics for another couple of months. Occasionally this disease can lead to serious complications and I was relieved
to find that the results of my ECG and chest X-rays showed that I had not suffered permanent heart or lung problems. These despondent recollections are rather gloomy. Let’s move on quickly.
The skin infections transmitted from animals were a nuisance but not usually serious, and the most troublesome of the lot was ringworm. All species of animal have their own particular pathogens but most of these different fungi are happy to grow on human skin if the opportunity arises. Ringworm is a very common skin disease of cattle, particularly in young stock, and not surprisingly there is often a heavy level of infection in buildings where they are reared. In my early days in practice I quite enjoyed the daily sessions of disbudding calves or in the case of the older animals, where the farmer had not got round to arranging the job, removing the horns by sawing them off. In either case the calves had to be caught, and restraining the larger animals was as close as I came to playing a game of rugby at that time. Having lassoed the liveliest of the animals it usually took another couple of circuits of the barn before he was outnumbered and gave up further resistance. On one occasion I had a calf in an armlock when my wrist – in contact with a Cotswold-stone wall – was pulled rapidly forward, resulting in a deep skin abrasion to the back of my wrist. The wound appeared to heal satisfactorily and the pruritus I believed was part of the natural healing process, until the enormous scab lifted a few weeks later. Beneath it was a classical textbook ringworm lesion. This took longer to clear up than the original wound. Whitefield ointment prescribed by my doctor was applied daily, and I am sure this ancient application would be a useful remedy today if still available.
