: The Life of a Yorkshire Vet
Page 6
In the early days of ‘Sinclair and Wight’, the practice predominantly dealt with farm animals – cattle, sheep, pigs and horses. Horses were very much regarded as working animals, and were often integral to the functioning of a farm.
Many people, too, had a pig at the bottom of the garden, providing an easy supply of bacon and ham, and acting as the 1940s equivalent of a recycling bin. Dogs and cats, referred to as ‘small animals’ in veterinary parlance, were far fewer. Dogs were almost always working farm dogs. Cats, as the Tippers’ Vitalis medicine bottle suggested, were not held in high regard. Even their potential role in rodent control was often filled by the wily Jack Russell terrier.
By the time I started work in Thirsk, the balance of work was approximately fifty-fifty. Half our time was spent seeing farm animals and horses, and the other half with small animals. While many hours were spent in the cold rain, trimming the feet of a lame cow, treating a pen of calves with pneumonia or grappling a downer cow in a muddy collecting yard, a similar amount of effort went into small animal work back at the practice. A typical day, if there ever were such a thing, would start with a couple of consultations. These were often animals that had been ill during the night, so their owners would need to bring them in before they went to work. There would usually be a case of vomiting and diarrhoea, the inside of the kitchen having been redecorated during the night (only yesterday did I see a rather handsome Doberman who had apparently ‘splattered the radiator’), or these morning slots could be filled by rechecking a cat with a high temperature or blood testing a dog with diabetes, whose blood sugar levels needed to be stabilized.
After the initial half hour or so of organized chaos (it was never actual chaos, but often it felt like it), all the vets would congregate around the day book. This was where the visits for the day were written down. Some were prearranged and regular, for example ‘routine visits’ for dairy farms, where batches of cows were regularly checked for pregnancy. It is important that dairy cows are quickly back in calf, since this ensures a steady milk supply, so any problems must be picked up early, by regular veterinary attention. There was often a colt to castrate – a simple job if everything went according to plan, but a nightmare if things did not go smoothly. These needed some planning because two vets were required. On top of these arranged visits, emergency (and not such emergency) calls would be added to the list as the day wore on.
So every morning we would gather around the book and jobs would be assigned. As a junior vet, this was a pretty straightforward process. Typically my initials went next to all the rubbish jobs, such was the hierarchy of veterinary practice. We would also try to create a round of calls, incorporating anything from three to ten jobs all in a convenient loop, to maximize efficiency of time and travel. This was dictated by the geography of the calls and their urgency. In this way, every round inevitably encompassed a wide variety of work. Nowadays, we do far fewer visits, as there are far fewer farms, so rounds tend to be allocated according to a particular vet’s area of expertise or experience, rather than down to geography.
Back then, however, it was immensely satisfying to complete a round of half a dozen calls, and manage to return to the practice before lunchtime to help finish off the ops list, invariably by polishing a cat’s teeth. The vets who had been operating during the morning would do the major operations first and dental procedures would be left until the end of the ops list. This meant that dental work was always the job that I would get to finish off when I arrived back at the practice. Cleaning the teeth of a dog or cat after spending the morning wrestling with cattle, horses, sheep or pigs was a great way to round off a busy morning of work.
For veterinary surgeons who weren’t out on visits, the morning’s work consisted of operations, x-rays, ultrasound scanning, blood tests and so on. The practice had a busy surgical caseload, including a large number of routine neutering procedures for several local dog and cat rehoming charities (Alf Wight was instrumental in setting up one local charity based in the nearby village of Catton). Males were castrated and females spayed. Castration is relatively quick and non-invasive, but a spay is a more complex surgical procedure, involving the removal of the uterus and both ovaries. Both have considerable health benefits for the animal and, crucially for rescue charities, remove the risk of unwanted pregnancies.
Some days we would have as many as eight of these routine neutering procedures, and it could feel as if the sole purpose of a vet was to remove the gonads from our patients. It was, however, a great way to develop good surgical skills and I quickly became a confident surgeon.
The afternoon began with an open surgery from two until three and then again from five until six. Pet owners could just turn up with their sick pets during these times, without prior booking. Nowadays most veterinary surgeries operate an appointment system, where slots are booked in advance by telephone. While we now offer this system throughout the morning, we still like open surgeries and find they work well for us. The downside is that they are unpredictable and can be very busy, but there are many benefits. We have three or four vets all consulting at the same time so the workload is equally shared. If one vet gets delayed because of a complicated case, then another, with a series of more straightforward jobs, will catch up. It also allows clients to see whichever vet they want to see, most days of the week. This allows for great case continuity, which is good for the patient and client as well as the vet. It is always satisfying to follow a case through from beginning to end. Furthermore, since there are several of us consulting together, it is easy to get a second opinion from a colleague on a complicated case. Even if it is just ‘Peter, can you have a quick look at this cat’s eye’ or ‘Tim, could you palpate this dog’s abdomen’, it is very helpful, particularly when we have newly graduated vets working with us, because good support at an early stage of your career is incredibly important.
The atmosphere in a busy waiting room is usually bustling and vibrant, and there is usually lots of chat about the animals, how they are progressing or why their bandage is so big. It would be nice, one day if we weren’t so busy, to sit in the waiting room as a ‘fly on the wall’ and listen to these conversations.
When afternoon surgery has finished, we usually have a couple of calls to do, or maybe an urgent operation that came through afternoon surgery. These can range from simple things like a grass seed in an ear, to exploratory surgery on a dog’s abdomen. It is also a time when we try to catch up on paperwork or maybe even have a chat about practice planning or management issues. Before long, though, it is time for evening surgery, which is often the busiest part of the day. It always amuses me when I return to the practice just before five, after my afternoon visits, that so many cars are leaving the nearby workplaces to go home for the day. They must be really fit, I think, with all that free time to go to the gym or go running or cycling. Imagine how tidy their gardens must be with all that extra time in a day!
As you can see, then, our days are busy and unpredictable. One particular day, however, soon after I had started in Thirsk, was more impossible to predict than any other.
I had been out on visits all morning, and had returned to the surgery prior to heading home, via the bakers, for lunch. A call came in, and I could hear by the tone of the receptionist’s voice that it was something unusual. The words ‘RSPCA inspector’ were mentioned followed by lots of ‘okays’ and then the phrase that always quickens the pulse (or makes your heart sink, if an RSPCA inspector is involved): ‘I’ll get someone out straight away.’ As I glanced around to see my colleagues all heading out of the door with great haste, I knew this call was mine. I looked at Cathy, who had taken the message. ‘You are not going to believe this, Julian … ’ she said and described the situation.
The RSPCA had been called to a house, its owners having been away on holiday for a week. The neighbours were concerned because these folks had pets. There were rabbits in a hutch in the garden and some other animals in the house, which hadn’t been fed or attended to fo
r the whole week. My job, at the request of the RSPCA, was to check the animals and ascertain the state of their health. The next step, for the RSPCA, would be to establish whether cruelty had occurred. These cases can be challenging and, as the overseeing veterinary surgeon, we have to tread a delicate path, because situations are seldom quite as clear-cut as they first appear. However, for me the case had an added complication. One of the animals that had been left home alone was a Burmese python. My experience with reptiles was (and actually still is) rather limited. The ‘Exotics’ lectures at university were considered by many as ‘semi-optional’ and I am fairly sure I took the opportunity, when these lectures were scheduled, to get out on my mountain bike. On top of this, I have a dread of snakes. Snakes are, in fact, the only animal of which I am nervous, so I was not looking forward to this call, especially since this one was, apparently, huge. It would have been a challenging enough visit, had it just been the rabbits to assess. The owners (who had just returned from holiday) and the neighbours would all be stressed and anxious but, in this scenario, so would the vet.
I pulled up outside the house in my car and took a deep breath. I was greeted by an RSPCA inspector, who I knew quite well. He was very fair and helpful. He was also tall and, in his uniform, looked just like Postman Pat. This did little to lighten the atmosphere for me, though. After he had briefed me on the situation, I inspected the rabbits. They appeared healthy and had a large pile of food in their clean hutch, and they didn’t need much investigation. Of course, leaving any animal unattended while heading off on holiday is never to be recommended, but the rabbits were well fed and comfortable, and seemed oblivious to their owners’ absence. However, the python did not look in any way as healthy as the rabbits.
The house was a small bungalow and the main bedroom was on the ground floor. To my surprise, this was the room into which I was ushered by the inspector, to meet his assistant and the rather bewildered owners. It was a strange sight. Next to the double bed was a large glass vivarium, right in the place where most of us would have a bedside table. As if this wasn’t strange enough, inside the vivarium was coiled a large, black snake. Its heat lamp was not switched on, so it was dark in the glass tank, but the form and extent of the animal was ominous and unmistakable and it was not moving.
All eyes were focused on me and I needed to do something. I remembered the advice of a fellow student at vet school: ‘In times of crisis, plug your stethoscope in your ears. It’ll give you time to think what to do, without being able to hear anything that people are saying to you.’ So that is what I did. It gave me a moment or two of calm. Well, maybe not calm, but quiet at least.
‘Right, now, what’s my plan?’ I thought, as I stood in the tiny bedroom. I quickly realized that I should make use of the stethoscope now it was plugged into my ears. Surely that was the best way to examine the snake. It then dawned on me that I wasn’t exactly sure where along the length of its body I needed to place my stethoscope to hear its heartbeat. However, as it happens I didn’t quite get the chance to find out because just as I was about to plunge the stethoscope into the tank, the owner of the snake shouted: ‘Wait! Be really careful, ’cos he’s very dangerous with people that he doesn’t know and he doesn’t like being handled!’
Great, I thought. Just what I need. Not just a massive python, the largest snake I had ever seen, but also a dangerous one. I would have been frightened by a thirty-centimetre harmless grass snake. I had to reassess my plan. At that moment, two fragments of reptilian knowledge floated to the front of my brain (I must have gone to at least one of the lectures after all). The first was ‘torpor’, a state of deep sleep, more like a coma, that snakes can enter when they are cold (for example, when their heat lamp is turned off) and the other was that they only need to eat infrequently, so can happily last for several weeks without food. Excellent! I had a new plan. I would suggest simply re-warming the snake by turning on the lamp in the vivarium. This would reinvigorate the reptile and I would return the following week to see it happy, awake and warm and I wouldn’t need to handle it at all. Hooray.
I carefully explained my new plan, and everyone seemed satisfied. As I waved goodbye, I had a comfortable feeling of having solved the problem, avoiding certain death, and having kept everyone happy.
A week later, my plan did not look quite so brilliant.
I met the inspector at the surgery and we went to the bungalow together. We were greeted warmly by the owners, and were shown into the bedroom again (still bizarre). I had no stethoscope this time as I had no intention of handling the python, especially as I now expected it to be larger than life and happily warmed up. However, this was not the scene that met me. The first thing I noticed was the rather sweet but fetid smell. When I peered at the glass box, I was horrified to see that the snake was larger, but not larger than life. Its diameter was approximately twice what it had been the previous week. It also had a crusty topside where it was closest to the lamp. It was horribly bloated and was starting to cook. Oh dear. The poor snake. It had actually been dead the previous week and, following my instructions, it had been gently warmed up over the last seven days, hastening the process of decomposition, right next to the double bed in this small house.
We took the dead snake back to the practice to perform a very smelly post mortem examination and, at the insistence of Postman Pat, to measure it. I felt very guilty that I had subjected the owners to an increasingly malodorous week. I did wonder why on earth they hadn’t called us back sooner!
Since then I have thought long and hard about this case and I can’t help wondering if it was actually dead before they went on holiday, hence the reason for switching off the lamp. I guess I’ll never know. The owners received a stern reprimand from Postman Pat, but I think the embarrassment and the stench were sufficient to teach them a lesson about animal management. One thing, though, is for certain – I will never forget that case. It hasn’t done much for my wariness of snakes either. Or bungalows.
7
Up in the Night
Being ‘on call’ or ‘on duty’ can take a challenging and often tiring job to another level. Our working day is a long one and our skills of decision-making, diagnosis and communication are frequently tested. Within a ten-minute consultation, for example, we greet the owner, acquaint ourselves with the patient, take a history of the condition, carry out an examination (sometimes needing to employ all our powers of calming and soothing to avoid being scratched or bitten by an anxious or just plain angry patient), decide whether further tests are needed, make a diagnosis, decide upon a treatment plan, discuss this with the owner, prescribe the appropriate medication, arrange a checkup, and then cheerfully bid them both farewell. Repeat this twenty or thirty times, add a handful of operations, a list of calls and maybe a calving or lambing and that makes up a standard day in mixed practice.
When the day comes to an end, the phones are put through to a message handling service. They answer the calls that come in during the evening and through the night. One lucky person gets to put bleep one in his pocket. Another, slightly luckier, gets to have bleep number two. Being on call is a necessary evil for a veterinary surgeon, and puts considerable constraints upon our home lives. The first-on-call vet, with bleep number one, is paged by the message handling service as calls come in. These can be absolutely anything, from life-threatening emergencies like calvings, horses with colic, bloated cows or cats that have been run over, to people wanting to book an appointment for the following day, a guinea pig with a piece of carrot stuck in its mouth, or a dog that hasn’t eaten its tea. The vet who is second-on-call is there to help out if two emergencies arise at the same time (this often happens at lambing time) or if the first-on-call vet needs assistance with an operation, such as a caesarean. It is usually much quieter on second call than it is on first, although there are exceptions.
One Easter weekend, Tim was called to rescue a dog from the fast lane of the A19. The dog, subsequently christened Mac (short for Tarmac), had been
hit on the road more than once, and had broken all four of his legs. So severe were his injuries that on this occasion three vets had to be called in, all to operate at the same time to repair his broken limbs. Mac went on to make a full recovery and was adopted by our practice cleaner, Julie, who owns a smallholding in Thirsk. I would see Mac lolloping around with the hens whenever I called at Julie’s to help lamb her sheep or vaccinate her horses. A couple of his broken legs were left a bit wonky, but his recovery was spectacular, considering the terrible injuries he had sustained.
The rota is equally shared, and we all work two nights on call during the week (one on first, one on second) and approximately one in two weekends. A weekend on duty can sometimes feel equivalent to a full week of work if it is busy, and we are straight back into the breach on Monday morning. One summer, I remember working four weekends in a row, a first, then a second, then another first followed by another second. It was thirty-three days of work without a day off.
Friday night marks the beginning of a weekend on call. I love coming down Sutton Bank on the way back from the first visits of the evening. If the weather is clear the view stretches from Swaledale in the north, through Wensleydale and Nidderdale with Wharfedale behind, and on into the far distance, where you can see Emley Moor mast in the heart of the West Yorkshire Pennines. Looking down the Vale of York, it is sometimes even possible to see the tower of York Minster. Our patch, at least for farm animal and equine work, is spread over a radius of about 15 miles, and it always feels a privilege to be looking after all the animals in this beautiful landscape. It tempers the anxiety one feels when wondering what the rest of the weekend might have in store. If an evening call takes me in the opposite direction, towards the Vale of York, my return journey brings me back through the middle of town, where there is the bustle and excitement of busy pubs and restaurants, full of folks relaxing after their week of work. There is no relaxation for the vet on call though.