Memoirs of a Cotswold Vet

by Ivor Smith

  Ringworm is less common in smaller animals but common enough to be diagnosed frequently in the surgery. Cats are usually the patients brought in with skin changes that are sometimes scabby eczematous circumscribed lesions but may be little more than a dull coat and a few broken hairs to suggest that the fungal infection is present. Most cat owners have very close contact with their pet, and if ringworm was suspected the question was routinely asked, ‘Do any members of the family have any unusual skin lesions?’ It was always a good diagnostic question to ask and often resulted in advising the owner to have a chat with their doctor.

  Traditionally vets, until quite recent times, wore smartly pressed white smocks in the consulting room, which I am sure impressed the client, certainly at the beginning of the surgery. Any stain on your uniform stood out like a sore thumb so on a bad day you could get through two or three coats. It was common practice for doctors to wear similar white coats at that time and an embarrassing situation occasionally arose when owners got carried away during the consultation and forgot that they were addressing the animal’s doctor. It was amazing to hear the owner ramble on about their own ailments before I could remind them of my professional, social and legal limitations.

  I suspected that Mrs Higginbottom’s cat had ringworm when she placed him gently on my examination table. I asked the usual questions, including the one relating to a possible family skin problem.

  ‘Yes, there is! It’s all over me. I’m covered in it’, she proclaimed, unbuttoning her blouse.

  ‘It’s all up my legs’ she affirmed, lifting her skirt. All I need now, I thought, was for a nurse to walk in – and I have no idea how I am going to explain away this one. I rapidly assured my client that I had seen enough and pointed her in the direction of the doctors’ surgery. I hoped that she wouldn’t simply ask them to confirm the vet’s diagnosis.

  I think my main concern was going down with flu. It was impossible to avoid the virus when the ailing pet owner brought an animal to surgery and, for ten minutes or more while the examination took place, we shared the same air space.

  Rotten colds we could cope with, but flu was a challenge we could do without, particularly in the early days of the practice when we were trying to maintain a twenty-four hour service single handed. We used to joke about the diagnostic test to distinguish between a bad cold and flu. If you came across a £5 note on the pavement and you were suffering from a cold you would bend down and pick it up. If you had flu you would leave it where it was. There were two or three occasions when I would have been happy to have left it there. Turning out to calve a cow on a winter’s night, hoping the Beecham’s Powder would soon kick in, was one thing. Failing to calve the cow, and spending the following couple of hours doing a bovine caesarean operation, is something which I am pleased to have few memories.

  There were of course many more infectious diseases that we were always aware of. We did our best to avoid them and generally we succeeded. What we were not quite so clever at from time to time was avoiding physical assaults from our patients. Surprisingly, we were rarely bitten by the Rottweiler. We were occasionally, but the villain was more likely a Jack Russell or one of his terrier friends.

  A vet in practice quickly develops a sixth sense regarding a possible or impending attack. You simply do not push your luck with a large aggressive dog. That is what the strong leather muzzle was designed for. Experience taught you to get that muzzle on before the handsome, unpredictable golden retriever got his retaliation in first, and the apparently surprised owner exclaimed, ‘I’ve never seen him do that before!’ We tried to remain polite and just muttered to ourselves, ‘Pull the other one.’

  The occasional serious bite usually came out of the blue, and a bad one occurred on Saturday 5 November 1973. Morning surgery had been uneventful until my receptionist quietly mentioned that she had received a call on behalf of a couple whose neighbour was on his way to the surgery to have their dog put to sleep. It sounded rather dramatic. Apparently the owners had been taken to hospital with serious facial injuries caused by their pet dog and the neighbour had been delegated the job of sorting out the veterinary side. It had been customary on a Saturday morning for the husband to take his wife a cup of tea to the bedroom. For whatever reason on this particular morning the dog took exception to this, dived on to the bed, ignored the crockery and began to attack the wife, starting with her face. Naturally the husband went to her defence and he too was badly savaged. Both of them left in the ambulance.

  When the shaking neighbour arrived at surgery we assured him that we fully understood the circumstances and would do what was necessary. It was shortly after that he unwisely released the lead from the dog’s collar. Now we were alone in the consulting room, two strangers and a poor demented dog who wanted to attack everyone. I had met the dog previously but on this occasion, no matter how reassuring I had been to him in the past, now it meant nothing. I tried to speak to him quietly and did manage to get a hand to his head and stroked it gently. There was some response but his mind was in complete confusion. I grasped his collar, introduced the sharp needle under the skin of his neck and injected a very powerful sedative. He would have felt nothing from the injection, but he responded to my tightening grip on his collar, which to my dismay was too slack to control him. He squirmed and twisted and turned. Within seconds he had rolled over and now his jaws were in contact with my arm and his teeth were tearing into my wrist.

  I could tell immediately that this was not an ordinary bite, and needed to know quickly how much damage had been inflicted. The unfortunate neighbour had been forced to watch the tussle and, as I looked up from the canine, I realised that I may soon have another patient requiring treatment. He said something like, ‘Oh God, did he get you?’ I probably replied, ‘Yes, but it’s nothing to worry about’, and hoped he would quickly leave. I remember the next lines clearly.

  ‘I think you’ve got a nasty bite there, son, let me have a look at it.’ As I lifted my arm and exposed the wound at the end of the sleeve of my white coat the jagged margins of the lacerated skin parted and revealed quite a remarkable dissection. Every artery, vein, nerve and tendon sheath in that region seemed to be on display. Some of the tendons looked a little frayed to me as well. Perhaps they did to the neighbour too. He suddenly turned paler and buckled at the knees. Now there were three of us in the room in varying degrees of being a bit under the weather. I’m sure, as he lay on the floor next to his neighbour’s dog, that he hadn’t reckoned on something like this happening when he offered to take the dog to the vet this morning. A rough and ready sterile bandage sufficed until the end of morning surgery, when my veterinary nurse cleaned the wound in the iodine-based Pevidene, applied a sterile gauze that was impregnated with antibiotic, applied a soft dressing to protect the injury, secured it with a gauze bandage and finally applied our secret weapon: a long strip of narrow-width sticky Elastoplast tape. The latter usually outwitted most of our patients’ attempts to remove a dressing.

  As she wrapped the tape snugly around the hairs on my wrist, I am sure my nurse was experiencing a secret delight, taking pleasure in foreseeing someone else taking it off roughly. She rang our local doctor’s surgery, explained what had happened, and they suggested I went along to see the doctor as soon as I could. When the elderly doctor on duty that morning removed the dressings from my arm his first words were, ‘Where did you get these from?’ before discarding them. I explained what and who and when, and the conversation mellowed. He changed his spectacles and looked inquisitively at my wound, took interest in the tendons and tweaked at the fragments with forceps that I hoped were straight out of the steriliser.

  ‘It’s obviously quite painful’, he said sympathetically. I agreed. ‘I think you may have some nerve damage, so perhaps I should send you to the Casualty Department in Gloucester.’

  ‘Do you think so?’ I replied, knowing full well that I would not be seeing a neuro-surgeon by chance on a Saturday morning.

  ‘Perhaps not then�
�, he agreed. ‘I’ll put a dressing on the wound and I suggest you make an appointment to see Dr Caldwell on Monday morning.’

  We were in full agreement again and the doctor produced his bandages. He started to cover his dry dressing with what seemed like yards of cotton bandage that he struggled to remove from its cellophane wrappings. When he accidentally dropped the bandage roll, it sped across his surgery floor, unravelling as it went. The doctor got down on his hands and knees to pick it up, spent ages rewinding it, and then unwinding it back onto me. I eventually managed to politely escape and thanked the kind old doctor for his efforts. By Monday I was well on the mend and while relating the events of the weekend, Jimmy and I enjoyed a few professional wry smiles.

  When I left the doctor’s surgery I suspected it would not be too long before one of our veterinary practice members would be back for treatment. It was not very long and, going out of turn, it was me again. At the end of morning surgery a few weeks later, I quickly swallowed a tepid cup of coffee that the nurses had made half an hour before, heaped a pile of dressings into the car, and sped off to visit a bay mare that I had seen on several occasions over the last couple of weeks. She had suffered an extensive shin wound – the result of a kick from another horse – and had been very cooperative when I had dressed the leg and given injections of antibiotics and tetanus vaccine at the time of the injury.

  I had been to the small riding centre and given more injections over the following few days. Even without the presence of the lady owner I had been quite happy to examine the mare in her stable without any assistance, and she had stood quietly as I firmly patted her neck, inserted the needle on the third pat and attached the syringe. She hardly flinched as the large volume of antibiotic entered her neck muscles. She seemed so trusting and well-behaved that I could never have imagined what was to follow.

  I pulled into the yard and was greeted by the friendly smile of the owner. Her mare looked well and was clearly recovering from the injury she had sustained. Before giving her the all-clear, I wanted to check her out fully and to do this the rugs she was wearing needed to be removed. The owner began to unbuckle her while I stood in the safe area in front of her left hind leg, the position where in theory, because a horse cannot kick forwards, you are assumed to be safe.

  What I did not know was that this horse had a serious vice. She panicked when rugs were removed. She bucked once and, before I knew it, she was in front of me and I was behind her – in the firing line. Then she let me have it. Her first kick caught me in the abdomen, and I had never experienced anything like it before. She put me into the air and kicked out a second time. This time she caught me in the chest and turned me over. To a spectator it must have looked like a circus act as I somersaulted and landed yards away on a woodpile. I tried to stand up but then fell back onto the logs as my legs gave way. I truly believed that the first time she kicked me her foot was inside me and it was the end of the road.

  I eventually recovered enough to get back into my car and somehow drive back to Churchdown. I turned off Pirton Lane into St John’s Avenue and pulled up outside the doctor’s surgery. It was a little embarrassing slowly hobbling into the reception area, but it was reassuring to know that I was in good hands. There was no doctor available but the nurse’s expert hands prodded me all over. Every diagnostic poke was followed by the question, ‘Does that hurt?’ I am sure I must have answered ‘yes’ to every one. My entire body hurt, but her final words were reassuring. ‘I think you will survive again on this occasion, Mr Smith.’

  Our children were amused by the equine foot imprints on my torso that changed from red to blue to yellow over the following weeks. Unfortunately I did not take pictures but I wish now that I had. It would be satisfying to remind my wife that my waist and abdomen were once a few sizes smaller.

  From time to time other members of my veterinary staff did take their turn and attended the St John’s Avenue surgery at short notice. Every day there was a chance that one of us would suffer a nasty dog bite, but we generally worried far more about cat bites and scratches. The worst occasion I experienced once again came out of the blue.

  Every day in the ’70s my RANA nurse Rosemary and I gave general anaesthetics to several cats and carried out their routine spays and castrations, the neutering operations. Today we would normally administer a potent sedative pre-operatively to the feline patient, intubate and then connect the cat to the anaesthetic machine. Between thirty and forty years ago we may still have used the same reliable and safe gaseous anaesthetic, but back then it was probably administered through a small face-mask. This was the situation on the day Rosemary and I carried out a routine cat castration.

  How many times have I tried to impress on ambitious youngsters that nothing in veterinary practice is routine? The powerful cat released himself from Rosemary’s grasp and sprang at her. His front claws tore at her head while his canine teeth sunk deep into her face and neck. Every moment resulted in more scratches; it was becoming horrific. I gripped his scruff and secured his head, easing the cat from her, but the painful scratches continued. Each time a foot was released and an attempt made to release another, the cat lashed out and clawed again. I forced his neck ever further backwards away from her, fearing that a claw would find Rosemary’s eyes. It was many minutes before I managed to finally release the cat from every attachment and her desperate cries stopped.

  My nurse’s appearance was horrific; blood oozed from a seemingly endless array of punctures and scratches on her neck and face. Rosemary was tough, but the nightmare experience had sent her into a state of shock and she was in urgent need of medical attention. Within minutes she was in my secretary’s car en route to the St John’s Avenue surgery, and then on to Gloucester’s Royal Hostpital. As I expected, she was back in our own surgery the following morning. She took antibiotics with her coffee for the next two weeks, and needless to say she made a rapid recovery. No doubt if I asked her today if she remembered the incident she would reply, ‘You bet, I still have the scars to remind me.’

  ‘Always expect the unexpected’ was good advice to reduce the risk of being injured by your patients and only occasionally did I stray from it. From time to time I was reminded that there was no room for complacency. A painful reminder happened at the end of an evening session. This was often the time of day when owners arranged to bring their pets to the surgery for the last time so that they could be put to sleep. I believe it was a well-considered and understandable arrangement to avoid other owners and perhaps to postpone the distressing occasion for just a few hours longer. I fully understood those feelings.

  This particular evening was a little different. The young Border Collie that arrived with his emotional owners was there as a result of having seriously bitten various members of the family and friends. From discussions I had had with the owners it was clearly a no-hope situation and I had agreed to carry out the euthanasia. They decided not to stay while I did the necessary and left my consultation room in tears. Although he had been brought to surgery muzzled, he had always seemed a nice dog to me and I had never been threatened by him on the several previous occasions I had examined him. We shaved his arm with the electric clippers, and my nurse swabbed the injection site. She raised the vein and I injected the barbiturate overdose painlessly into the prominent vessel. His tense body began to relax, and, in a moment of unwise sentiment, I removed his leather muzzle and stroked his head. The opportunity to have one last bite was too much. He snapped at my outstretched hand, connected, drew blood, and expired.

  In my forty years in practice I have had my fair share of retaliation from my patients. I have never experienced physical violence or injury from any client and neither has my staff. I mention it because in this new violent world of ours it has become an occasional problem in veterinary practice and alarmingly a regular occurrence with our medical colleagues. Has my life ever been threatened? I hope only with tongue in cheek.

  Overnight our profession became aware of the world of compen
sation and litigation-minded clients, and, every time someone left their animal at my surgery for a procedure that varied from extensive abdominal surgery to simply taking blood samples, they were asked to sign a disclaimer form. One lady who owned numerous pets that I had treated over the years was asked to sign the form for the first time.

  ‘Why do I need to sign this?’ she asked quite reasonably.

  ‘Well, in case anything goes wrong, it means you won’t be able to sue the practice.’ It was blunt but true, and if you have read any of the previous chapters in this book then you can guess which honest, straight-to-the-point nurse said it. But surely it’s better to come right out with the facts rather than have a client discover it hidden away in the small print at a later date? My trusting client replied, ‘I don’t need to sign that. If anything goes wrong I won’t be suing him, I’ll kill him.’

  Decades on, we are still very good friends.

  CHAPTER ELEVEN

  CRIMINAL COTSWOLDS

  Crime must seem an odd topic for someone whose career has revolved around the relatively peaceful world of animals, but strangely, by the end of some days, there was often reason to believe that not everything that day had been fair and square. The reason of course was that animals had owners, most of them anyway, and the vast majority were kind, responsible people who appreciated all that my practice did to help them and their animal families. It was the odd unappreciative, rude and unkind individual that made you feel you were losing faith in human nature. Strangely it was not particularly society’s rogues who made me despondent. They seemed to live on their wits, diddled everyone, and frankly they occasionally brought a smile to our faces.

  In an account reflecting on a lifetime of experiences in practice an occasional association with a villain was unavoidable. Many of these encounters produced unforgettable stories, some sad, some happy and some just plain unbelievable. Perhaps there is a little degree of criminality in many, perhaps all, of us but at least my clients had the reassurance that they had the support of the Royal College of Veterinary Surgeons’ Disciplinary Committee to help keep their vet on the straight and narrow. A chastisement and a warning from a local magistrate to a vet for a particular misdemeanour, from a driving offence to a punch-up, might well be followed by an appearance before the DC, and the vet found guilty of unprofessional or disgraceful conduct and no longer worthy to practice, until they said so. That could be a very expensive secondary judgement.