“Okay.”
Sally frowned. “It’s going to be horrible tonight, telling them.”
When the Freemans returned that evening, to pick up Muffy, Sally gave them the bad news. They took it well. Mrs Freeman told Sally she had suspected something like this must have been going on, and that she was glad they now knew the full story, that it was cancer. Mr Freeman thanked Sally for telling them the truth straight up, because it was better that they knew. He said he understood Sally couldn’t tell him exactly how long Muffy had left, but that he would do the right thing and bring her back when she finally took a turn for the worse, because they would not let the little dog suffer. Sally could tell that, behind the brave facade, the old couple were devastated, even if they did thank her warmly as they said goodbye and took the cheerful little dog back home that night. It broke her heart.
Her next consultation was a vaccination. It was a bouncy Doberman puppy, just sixteen weeks old. The little black-and-tan dog ran happily around the consulting room, even after Sally had injected the five-in-one vaccine. Somehow it made Sally feel so much better, to see a young, healthy dog at the beginning of its life, after the heartbreak of having to tell the Freemans that the life of their beloved old dog was coming to an end.
The owner of the Doberman puppy was a young woman with a baby. Sally liked her. She seemed like a nice person, and for once Sally wasn’t busy, so she talked to her. “It must be hard, having a puppy and a baby to take care of all. I bet Scooby must be a bundle of mischief.”
“He’s always chewing things,” said the woman. “And knocking stuff over. He never sits still. But he’s just perfect with the baby. I only let him near her when I’m watching, but he’s so gentle.”
Sally smiled. “He’s really still just a baby himself. He’ll settle down as he grows up. I think he’ll be a great dog. Dobermans are very intelligent dogs, and if they’re properly trained, they’re great with kids.”
The baby squirmed uncomfortably in the woman’s arms. “I’d better get this one back home. Thank you, doctor.”
“You’re welcome,” said Sally. “Do you want me to give you a hand to get Scooby back to the car?”
“My husband’s waiting outside. He can help me.”
“Okay. We’ll see you next time, then.”
“Thanks.” The woman left, carrying her cute baby daughter in her arms. Her new puppy trotted excitedly out behind her.
As a vet, Sally thought, she saw the start of life and the end of life, almost every day. That night, as she lay in her bed, Sally wondered how much longer Muffy would live. She hoped it would be a long time.
Chapter 10
Michael flipped through the diary, looking for anything which might give him a better insight into what Sally had been through. Many pages ahead, he came across a tragic entry which caught his eye.
Friday, 27 October, 1995
Dear Diary,
Today was the worst day of my life. I had an anaesthetic death. The owner went mad. I don’t know who to turn to. I only feel like running away, but there’s nowhere to run ...
It was a routine operation, a dog spay, so Sally didn’t mind talking to Heather Lorayne to pass the time. She had removed the first ovary and was working on removing the second one, soon to be followed by removing the uterus itself. Although it was a busy day, this was the second-last surgery, so Sally felt she could afford to slow down a little. Outside, it was a lovely spring day.
“Wish I was out there, instead of in here,” said Heather.
“Me too,” said Sally, as she placed a ligature around the ovary. The dog, a rangy German Shepherd, was lying on its back connected to the anaesthetic machine, breathing a mixture of oxygen and halothane, the anaesthetic vapour, which was supplied at a controlled concentration by the machine. Sally had made a three-inch incision in the middle of the abdomen, and it was this hole that she worked through in order to perform the operation. The dog was fairly skinny, which meant that there wasn’t much fat around the ovaries, so it made the operation easier. Sally was fairly relaxed as she worked. “Still, it’s my weekend off this weekend.”
“Are you going to do anything?”
“No, I’m too tired. I just want to have a rest.”
“Lucky you,” said Heather. “I’m working the weekend with Thomas. And it looks like we’ll be busy, too.”
A high-pitched, electronic beeping noise interrupted their conversation. It was the breathing monitor, which had recorded that the dog had not taken a breath for thirty seconds. It was very common for animals to do this under anaesthesia. It happened most days of week and was usually no problem at all, but Sally was always vigilant when doing anaesthetics, so she stopped operating and asked Heather to check the dog.
“How does she look?”
“It’s a bit funny,” said Heather. “She looks really deep.”
“Deep? How could she be deep? She was light, a minute ago, and she’s only on two percent halothane. Are you sure?”
“Well, her eye isn’t rotated, and there’s no blink.”
“How’s the jaw tone?”
“It’s loose.”
“Right, turn her off, then. Just pure oxygen.”
“Okay.”
Sally kept operating. She had to pass instructions to Heather, getting her to check the dog and work the anaesthetic machine, since Sally had to keep her gloves sterile. “How’s the heartbeat?”
Heather put a hand on the chest. “It’s fine.”
“Okay. Pump the bag, then.”
The nurse squeezed the oxygen bag, a dark balloon that hung from the anaesthetic machine and which allowed animals to be artificially ventilated. As Heather squeezed the bag, the dog’s chest inflated with pure oxygen.
Thirty seconds later, the alarm sounded again. The dog had still not taken a breath on its own. At the exact same time, Sally suddenly became concerned, since the tissue she was working on, the uterus, was normally a bright pink colour, but all of a sudden it was a deeper, ruby red, as if the blood was not as well oxygenated as it should have been. Sally couldn’t understand it. There was no way that should happen, unless there was a problem with the dog’s cardiovascular system. Sally suddenly felt sick to her stomach with fear and shock – a heart attack could do that to a dog. It was incredibly unlikely, very rare, but it could happen. Although halothane was a very safe anaesthetic for animals, it could very rarely be associated with arrhythmias – abnormal heartbeats – and the worst cases of arrhythmia could result in a sudden heart attack. The heart could simply stop beating. This flashed through Sally’s mind in an instant. This can’t be happening to me, she thought, feeling sick. But she didn’t want to jump to the worst conclusion. She had to remain as calm as she possibly could. “How’s the heart?”
Heather felt the chest again. “Um ... I’m not sure ...”
That was enough for Sally. She ripped off her surgical gloves, pushed Heather aside and felt the chest. She couldn’t feel a heartbeat.
That can’t be right, she thought. It just can’t be.
Sally grabbed a stethoscope and put it on the chest. At the same time, she lifted back the dog’s lip and checked the colour of the gums: they were slightly blue, instead of the healthy pink they should be. But worse was what she heard through the stethoscope: nothing, nothing at all. The heart had stopped completely, suddenly, without warning. The dog must have had a massive heart attack. Sally felt dizzy, almost as if she were going to faint. Desperately, she tried to pull herself together and to approach the emergency from a purely logical point of view. She had to push her emotions to one side, as much as possible.
“It’s a cardiac arrest! Get the emergency kit. Now!”
Heather ran through to the treatment room, to retrieve the small box which contained adrenalin, doxapram, and the other stimulants which could be used in this situation.
Sally turned the dog off its back, onto its side, ignoring the still-open abdominal incision, and pressed firmly down on the chest five times, p
erforming external cardiac massage. Then she squeezed the oxygen bag, pumping fresh oxygen into the dog’s lungs via the endotracheal tube which was already placed in its windpipe. This was the anaesthetic equivalent of CPR. And it was just about all Sally could do. “Give me an adrenalin syringe, and get ready with some doxapram!”
Heather passed Sally a syringe. It had a long, one-and-a-half-inch needle on it. The needle wasn’t meant to be used in a vein. It was for emergency use only: direct injection into the heart. Sally measured carefully where she was going to inject, between the ribs, then plunged the needle gently down, vertically into the heart, and injected the adrenalin. “Heather, take over the CPR. Five pumps on the heart, then squeeze the bag.”
“Right,” said Heather. She was efficient, an experienced nurse, and she did not have to contend with feeling sick to her stomach, as Sally did, because ultimately it was Sally, and Sally alone, that the responsibility rested upon for anaesthetics.
Sally took a syringe full of doxapram and went quickly to the dog’s mouth. She pulled the tongue out and turned it over so she could see the delicate sublingual veins. She carefully inserted the fine needle of the doxapram syringe into one of the veins and injected a hefty dose of the respiratory stimulant. It was a futile gesture, since the heart was not beating and there was no circulation to distribute the drug, but she wasn’t about to do nothing. She would try everything she could.
After that, things seemed to happen in slow motion. They continued the CPR, injected drugs into the heart, and worked tirelessly for twenty minutes to try to resuscitate the dog. But once twenty-five minutes had passed, the heart was still as lifeless as a stone, the gums were grey, and the pupils of the eyes were fixed and dilated. The dog was brain-dead, the victim of a rare and sudden heart attack, and there was nothing that Sally, Heather, or anyone else could do to bring the dog back, given the circumstances. It was hopeless, and although it made Sally nearly want to collapse, just to admit it, she knew the dog was dead.
“Okay,” Sally said, very quietly. “That’s enough.”
Heather stepped back from the dog.
Sally looked silently at the body for a moment. Then she walked out of the operating room, out of the clinic entirely, and sat down on the grass under the eucalyptus tree in the tiny garden behind the building.
The sun was still bright. It was warm.
Sally felt utterly ill.
Five minutes later, she walked back into the clinic. Heather had put the dog into a black, heavy-duty plastic body bag.
“We’d better call the owner,” Sally said.
“We can’t,” said Heather. “She said she’d be out shopping all day, and won’t be contactable until she comes in to pick up the dog at five. There’s no way we can reach her.”
“I’m going to try, anyway,” said Sally. She picked up the nearest phone and dialled the owner’s number. There was no answer. “She’s not there. Damn. When she comes in, bring her straight into the consulting room and I’ll talk to her. Okay? This is going to be awful.”
“Don’t blame yourself, Sally. It’s happened to Thomas, too, many times. It happens to every vet. It’s not your fault.” Heather was trying to be nice. She knew that Kellerman would lie and certainly not admit to Sally the times it had happened to him. He would keep quiet and blame Sally, and if there were any legal trouble, it would then be Sally’s problem alone.
Sally knew this, too. “I don’t feel too well, Heather. But thanks.”
Sally had heard of a human anaesthetist, the year before, who had lost a healthy patient from a freak heart attack and had not been able to cope. The anaesthetist was only a young man, and he had his whole life ahead of him, but he had killed himself. She had to admit, right at that moment, that she could understand why a person might do that, now that she found herself in the middle of a similar nightmare.
Sally didn’t know whether to blame herself or not. She knew it was not actually her fault, but somehow she wanted to think that she could have saved that dog, that if only she were a better vet she could have miraculously brought it back from the dead after its unexpected heart attack. But there was a limit to what even the best anaesthetist in the world could do, working in a small practice with limited equipment, facing up to whatever sudden emergency might occur. Nevertheless, Sally soon came to blame herself, even though she knew she had done nothing wrong. She could not bear the thought of facing the owner.
The woman who owned the dog was due back at the practice at five, and Sally would have to be the one to break the awful news. The woman might get aggressive. She might scream. She might yell at Sally. To Sally, the thought of that only reminded her of her childhood, of the many nights when Karl Johanssen had come to her room and yelled at her, told her she was no good, and beaten her. She remembered how her mother had not protected her, how it happened again and again, how her father’s breath stank of beer. She remembered the fear, the sheer, undiluted terror, as each blow would come down upon her, as Karl Johanssen would beat her for no good reason other than because he could. And he would tell her that she was no good, that she was a bad girl. Sally could never understand why she was bad. She had just accepted that she was, for her father had told her so. The bastard had never raped her, had never touched her in that way, but he had beaten her, and he had forever destroyed her faith in herself. Sally, somehow, no matter how hard she tried, was not good enough. It only took a trigger-event to remind her of all of this, to make her tremble. And the thought that the owner, when she arrived, might yell at her, made Sally shake.
Sally tried to calm down. When four o’clock came, she saw the first few clients and tried to get back into some kind of normal routine, but by ten to five she felt she could hardly go on. The anticipation was too much. The waiting room was full, however, and there would still be a lot of people to see even after the owner of the dead dog had arrived.
At five past five, the owner walked in. She was dressed in an impeccably cut, blue, pin-striped business suit, and she carried a briefcase. Ms Amanda Richardson was a marketing manager for a rental-car company, she was thirty-eight years old, and she did not like to be kept waiting. “I’m here to pick up my dog, Cleo.”
Heather took her immediately to the consulting room. There were a few confused glances from the five people already sitting in the waiting room. They didn’t understand why this pushy businesswoman should jump the queue. “The vet will be with you in a moment,” said Heather, very glad that it was not her responsibility to tell the woman the bad news.
Sally took a deep breath. She was deeply saddened by the death of the German Shepherd. That much alone broke her heart. But she had no time to dwell on that. She now had to break the news to the owner, and help the owner to deal with it as best as she could. Sally knew that this could well be the end of her job, and, perhaps, if she were unlucky, even the end of her career, despite the fact that she had done nothing wrong and that anaesthetic deaths could happen – and indeed did happen – to every vet, sooner or later. Sally pushed open the consulting room door and walked in.
Amanda Richardson was in a hurry to pick up her dog and get going. She was not accustomed to being kept waiting. In fact, she was going out for dinner that night and wanted to get Cleo back home and settled with the dog-sitter she had arranged, before she left for the dinner party.
“Hi,” said Sally, rather stupidly, not knowing what else to say. “Ms Richardson, you’re here to pick up Cleo?”
“Yes. I’m in a hurry, if you don’t mind, so if you could just bring her through right away, I’d appreciate it.”
Sally was shaking. Her voice was unsteady. “We’ve ... we’ve been trying to contact you all afternoon. I’m afraid there’s been a problem with her anaesthetic. I mean, something went wrong.”
Amanda Richardson spoke quickly, but not in anger. It was just confusion that made her say, “What? Sorry, what are you saying?”
“Ms Richardson, I’m very sorry, but Cleo had a heart attack while she was under
the anaesthetic. It’s very rare, but sometimes a dog can have a reaction to the anaesthetic and ... die. Cleo’s heart stopped suddenly, during the surgery, and we couldn’t get it to start again. I’m very sorry.” Sally didn’t know what else to say. The words were coming out all wrong. She wanted to take them back and say them again, only better. But it was too late.
Amanda Richardson looked in horror and disbelief at the young vet who was telling her, her dog was dead. Was that what this girl was saying? she thought incredulously. It couldn’t be. This time, her voice was angry. “What? Are you saying that Cleo is dead? Are you saying my dog is dead?”
“I’m very sorry, Ms Richardson, but, yes, she passed away under the anaesthetic, and we couldn’t revive her. We worked on her for twenty-five minutes, but we just couldn’t bring her back. It was a massive heart attack. I’m so sorry.” Sally was beginning to shiver uncontrollably.
This time, Amanda Richardson did not merely speak. She yelled at the top of her voice. “You bitch! You killed my dog? You must be joking. You can’t be serious. You killed her?”
Sally wanted to run and hide, she wanted to die. She felt that she would faint. She thought of Karl Johanssen, beating her, she thought of how he used to scream at her while he hit her. But she stood there and took it.
Amanda Richardson started to cry. “Cleo’s dead? She’s dead?”
“Yes. I’m so sorry. She had a reaction to the anaesthetic. It’s ... very rare but it happens. It happens to people, too. We just couldn’t save her.” Sally somehow was still managing to speak.
Amanda Richardson regained her fury. “Goddamn you! How could you let my dog die? What’s your name? What is your name?”
“Doctor Sally Johanssen.”
“Well, Doctor Johanssen, you picked the wrong person’s dog to kill. My father is a very prominent lawyer, and I’ll make damn sure you never practise again. You people think you can get away with anything. Bastards!” Amanda Richardson spat the words out, in pure anger.
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