by Gillian Hick
I can remember the feeling of almost awe and reverence, that I had finally made it through those gates, after the setback of illness and three attempts at the Leaving Certificate before I finally got that much-coveted offer in the post for VET MED DN005. The weeks leading up to college had seemed surreal, and finally I was here. Professor Mc Geady, the dean at the time, terrified us all with a welcoming talk on how tough the course was going to be. If we weren’t one hundred per cent committed to it, then to walk away now without wasting any further time. I was going nowhere. I was sure that this was the path for me.
Despite the fact that in our first year, we spent half the week in the general campus in Belfield, only making it to the Ballsbridge veterinary college mid-week, we soon slotted in. Being such a small faculty, there was perhaps a closer bond between us, especially as the years went by and we were divided into increasingly smaller groups for more advanced clinical work. My clinical group in final year consisted of only five of us – four from Cork and me from Dublin, but now living in Wicklow. By the end of final year, I had developed as a good a Cork accent as any of them and still, some twenty years later, find myself lapsing into the Cork lilt in times of extreme duress!
I remember the vet ball in first year, only a few months into our time in the college. When myself and Donal made to leave in the early hours of the morning, not partaking of the college bus, one of the final year lads stopped him in the corridor while another took me carefully aside to ask was I sure I was okay going off on my own with him!
Far more difficult than the time in college, were the first few months in practice, when the stark reality of the road ahead became clear in a way that no text books or college lectures could have prepared us. It was surprisingly lonely to suddenly be in charge. Having gone from seeing practice in a vibrant family business for much of my time in college or from sitting in tutorials with a group of students you had worked with for years, to suddenly being out on the road or in a clinic or makeshift surgery was tougher than any college exams.
The expectations of clients were high. A vet was a vet. Many didn’t seem to see or care that you did not have the twenty years’ experience of the guy you worked for. And in fairness, they were paying the same money for the job, so they were right to have high expectations. The animals, be they farm animals or beloved pets, had the right to good treatment. No one wanted them to bear the brunt of our inexperience. And even more so, I, and I am sure most of my colleagues, had even higher expectations.
Since the tender age of six, I had decided to be the best vet I could possibly be. When I first qualified, I didn’t see that even years of study and of seeing practice could not give me the skills that only time and practice would bring. To this day, the most depressing day of my life was the day I qualified as a vet. The hard work and the stress and anticipation and the excitement of all the years had all bundled into the morning when I took the bus up the N11 for one of the last times the get my results. I was reasonably confident that I had got through, but somehow I felt that deep down, having the piece of paper in my hands would in some way magically transform the little I had learnt into a state of all-knowingness.
Seeing my name on the board was, of course, a relief – but then it hit me that that was all it was. There wasn’t going to be a magical moment of transformation. All I had was what I had learned and my fumbling practice, and a huge awareness of all the gaps in my now supposed ‘professional expertise’.
I didn’t even go out to celebrate that night as I fell into the depths of despair over what suddenly to me seemed like a total failure. And over the next month, while we waited to graduate, suddenly for the first time in my life I felt like I had no focus. In that month, instead of looking forward to starting work, I become more and more anxious and apprehensive about the whole thing. And of course when I did start, it wasn’t all smooth sailing. Things went wrong. I screwed up. Animals didn’t do the things that it said they did in the text book. Surgeries didn’t look like they did in the pictures. I quickly discovered that the most difficult and unpredictable animal was the two-legged one! To this day I maintain that final year veterinary should include modules on people care as much as animal care.
But slowly, with time and with experience, things started to settle. ‘Routine treatment’ began to actually feel routine. I became more optimistic in my prognosis. I subdued the urge to whisper in surgery.
Bitch spays are probably the biggest fear of small-animal vets after graduation. Although now, with increasing specialisation and multi-vet practices, it is less common, when I first qualified, it was not uncommon for the first bitch spay a new graduate would carry out to be in a clinic and unsupervised; I myself had undergone this ordeal in my student days. Although it is a routine surgery, it can still be tricky – especially if the dog is large or overweight. The biggest risk is of haemorrhage either during or after the surgery. For years the first thing I, and I suspect many of my colleagues, would do would be to check if there were any spays booked in for the day. A phone call in the evening from an owner to say the patient was bleeding would send me into a panic.
I don’t know how long it was after I qualified, but I clearly remember the night that I first felt like a ‘real’ vet! I had spayed a deep-chested and considerably overweight cocker spaniel earlier that day. Although at four years of age, Chester had never had puppies, Erika her owner could never quite bring herself to get her spayed. Apparently she had even gone as far as booking the surgery on a few occasions, but never quite been brave enough to allow the increasingly chubby bitch to go through the procedure. I had seen the booking, and half thought she might cancel, but obviously my discussion on the risks of pyometra – a potentially life-threatening uterine infection in older unspayed females – had sunk in.
The surgery was certainly not one of the easiest, as I had to wade my way through folds of fat until I could find the uterine horn and ovary. The uterus already looked thickened and not as healthy as I would have liked, indicating the slow build-up of infection had already begun. Often this sub-clinical infection builds slowly over repeated heats, resulting in an increasingly dull and lethargic animal, which the owner puts down to increasing age. With these dogs, when we spay an older female, the owners report afterwards that the dog has a new lease of life – free from the low grade infection they have been carrying for prolonged periods of time. In Chester’s case, I was delighted to be removing the organs before she developed full-blown infection which would make the condition, and the surgery to treat it, potentially life threatening.
Although the surgery was not life threatening, I still sweated as I worked to tie off the vessels along with the ovary, while constantly having my surgical view obscured by rolls of friable fatty tissue. As her surgery was somewhat trickier than operating on a young, healthy, normal-weight dog, I double ligated both ovarian horns and the uterus, suturing the surgical material through the tissue to ensure that the sutures could not slip, which could potentially result in significant post-operative haemorrhage. With each incision to detach the ovary and uterus, I carefully held the stump with the forceps to check that there was no bleeding before releasing it back into the fatty depths of the dog’s abdomen. It took multiple layers of sutures to bring the internal muscle and fatty layers together before I sutured the skin, a neat row of sutures hiding the invasive surgery.
I discharged Chester that evening, with strict instructions to keep the Buster collar on at all times to stop her licking at the wound; to keep her quiet until the sutures were removed; and to dramatically reduce her food intake. After the evening surgery, I went home, had dinner and went to bed that night without a further thought. In the earlier days, I would have been worrying about her and would not have relaxed until the three day wound check by which stage further complications were unlikely.
When the phone rang shortly after midnight, it took me a few seconds to recognise the panicky tone of Erika who told me that Chester was lying in a pool of blood. I tried to ask a f
ew leading questions as most owners can be overly concerned by what can sometimes be just normal amounts of post-operative bleeding, but it quickly became apparent that Erika was not going to rest until I saw Chester. Without wasting any further time I agreed to meet her back at the surgery and as I drove the short distance, I mentally replayed the surgery in my mind and was quite happy that my overly cautious nature had ensured that any serious bleeding requiring further surgery to investigate it was unlikely.
Erika struggled to carry the oversized Chester into the surgery and as I went out to help her couldn’t help but notice that Chested looked remarkably bright for a dog who had undergone surgery that morning and her tail wagged constantly, clearly enjoying the late-night excursion. I also noticed that the Buster collar which we had fitted her with before she left the surgery was no longer there and that her once-white muzzle was clearly bloodstained. Resting her gently on the consulting table while still wrapped in her blanket, I quickly checked the reassuringly pink gums and her heart rate and pulses, all of which were perfectly normal. Erika, in stark contrast, looked totally blanched and she kept talking anxiously as I tried to listen to the heart rate.
I carefully unwrapped Chester from the blanket to reveal the ‘pool of blood’, which was little more than a sprinkle from where Chester had overenthusiastically licked at the sutures, resulting in one of the subcutaneous vessels to bleed. Purely to reassure Erika I wrapped a loose, comfortable bandage around Chester’s tummy and reissued instruction to her to replace the Buster collar as soon as she got home.
I was almost home before it dawned on me that I was almost as relaxed as Chester about the whole thing. When I had first qualified, even the surgery would have stressed me so much, never mind the phone call to say the dog was lying in a pool of blood. But suddenly, out of the blue, I had felt confident throughout the whole situation and for the first time since qualifying I actually felt like a real vet!
Of course the ‘feeling like a real vet’ came and went, dealing with different cases and in different situations, but over the years, and although I never did achieve my six-year-old idealist view of becoming the perfect vet, I began to feel less of a fraud.
But more than anything, the things that brought my back to the passage of time were my patients. The tiny puppies that had first presented for vaccinations when I first set up practice on my own quickly grew and became young adults and then with a speed that was at times just too quick, became old. New pups arrived to replace older dogs and it just seemed that the generation went by so quickly as I watched the patients grow alongside my own family. Sometimes old pets were put to sleep and I never saw the owners again. More commonly, in time they would make that difficult first visit with a new pet. Mixed emotions as we all remember the older pet.
I have a terrible habit of remembering people only by their pets so I might meet a middle aged man in the supermarket and without thinking call him Cuddles after the family pet. One lady was delighted when I bumped into her in a local petrol station and called her Angel, after her long-legged willowy lurcher! It was strange that when pets passed away and new pets came, I still seemed to remember the owners by the original pet.
The cycle of life in animals seemed in a way to speed up my own perception of passing time. One day I was received a call from a well-known client, Aoife, to make the final visit for her beloved Sammy. I had known Sammy for a long time – in fact longer than even the owner, as I personally had delivered him many years previously by caesarean section – one of the first caesareans to be carried out when we moved to our new building. Sammy’s mother Bella was a Samoyed – hence the name. The father was of questionable origin, as until the day of Sammy and his siblings’ arrival, Bella’s owner had no idea that she was pregnant. To my mind, Sammy was always ‘Kermit’, although I never explained why to the owner.
Sammy was delivered late one evening, as is always the case, long past usual clinic hours. By that stage, Molly, now well tall enough to see over the operating table, was an enthusiastic spectator any evening she was free. The first two pups were delivered dead, and had been for some time. I sometimes worried about exposing any of the kids to such stark reality, but they always seemed to take it in their stride. Sammy was delivered next and initially the bright green staining on his coat indicating a prolonged and difficult delivery and his lifeless body suggested that he was also in trouble but as I vigorously massaged his tiny body, he took his first breath and gave a little cry. Once his breathing was steady, I handed him to Molly, who was well versed in neonatal care.
What was to become in time a beautiful glossy snow-white coat like his mother’s was bright green. ‘Eew, said Molly, wrinkling up her little nose, ‘he looks just exactly like Kermit!’ For some reason Molly had developed a severe aversion to The Muppets from an early age, veering on absolute hysteria every time they came on the television. In fairness she didn’t hold it against him and by the time Bella was waking up, Kermit/Sammy and his two sisters that followed after were very much alive and thriving.
The two siblings were rehomed together to a sister in Waterford, and so I never saw them again. Sammy was the last to find a home, but when he came in for his final vaccination, another client saw him and fell in love and a few days later had eventually managed to talk her husband into letting Sammy join their family. Life was good for Sammy and I was always glad to see him coming in over the years. He was a calm type and never really got himself into any sort of trouble until in his later years.
On a vaccination visit I noticed that despite the thick coat, Sammy had lost weight. On questioning, Aoife agreed that he was drinking more frequently and had become slightly incontinent in the house. I booked him for bloods the following week and when the kidney enzymes were sky high, followed it up with an ultrasound examination. The right kidney was enlarged and had a very obvious growth on it, while the left one looked small and shrunken. The size of the mass on the kidney and the speed with which Sammy was losing weight suggested that this was an aggressive tumour and unlikely to have any positive outcome even with extensive surgery and follow-up treatment.
I discussed the options with Aoife and her partner that evening when Sammy was going home and they rang the next morning to say that they would rather not put Sammy through any further investigation and treatment. For Sammy I was glad, as I really didn’t feel it would prolong his quality or quantity of life. It was only three short weeks later that the inevitable call came. Despite all the palliative treatment we could offer, Sammy was now vomiting and refusing to eat. Knowing that it’s coming still doesn’t make it an easier decision to make and I knew Aoife. When I arrived, she was sitting on the floor with Sammy, who looked to have aged by years in the few short weeks since I had seen him. Aoife’s friend had come to be with her and once Sammy was sleeping soundly from the sedative injection, she asked if I would mind if she went outside with her friend, as she couldn’t bear to watch him take his last breath.
And so, just as I had held Sammy/Kermit as he took his first breath, I sat on the floor with his head on my lap as I injected the overdose of anaesthetic and held him as he released his last breath. Although it was a peaceful passing, and in ways less dramatic than his prolonged and surprise entry into the world, it really affected me. I realised that, although in the years of running a practice I had seen many animals come and go, to the best of my knowledge this was the first time I had been with an animal for their first and last breaths of life.
I couldn’t go straight back to the surgery afterwards, but found myself sitting on a quiet spot on the beach, wondering about life. Why the drama? Why the heartache? Why the joy? What really is life all about and what are the experiences we encounter trying to teach us?
Suddenly, I felt like my journey was only beginning.
About the Author
Gillian Hick was born in Dublin and has practised as a vet both in Dublin and in Wicklow. She lives in County Wicklow, where she has her own practice, with her husband, three children a
nd a large assortment of four-legged companions. She has also written Vet on the Loose and Vet Among the Pigeons.
Copyright
This eBook edition first published 2018 by
The O’Brien Press Ltd,
12 Terenure Road East, Rathgar,
Dublin 6, D06 HD27, Ireland.
Tel: +353 1 4923333; Fax: +353 1 4922777
E-mail: [email protected]; Website: www.obrien.ie
First published 2018.
The O’Brien Press is a member of Publishing Ireland.
eBook ISBN: 978–1–78849–066–5
Copyright for text © Gillian Hick 2018
Copyright for typesetting, layout, editing, design
© The O’Brien Press Ltd
All rights reserved. No part of this publication may be reproduced or utilised in any form or by any means, electronic or mechanical, including photocopying, recording or in any information storage and retrieval system, without permission in writing from the publisher.
Read more adventures of an Irish vet, by Gillian Hick …
Whether castrating horses in Dublin’s inner city or dehorning cattle in the wilds of Wicklow, rescuing mangled cats from mongrels or tending to stoned guard dogs, vet Gillian Hick’s sense of humour never deserts her in this engaging account of the challenging situations she encounters in the course of her work as a newly qualified veterinary surgeon.
Not only does she have to deal with the animals and their ailments, but she also has to contend with the perils of matchmaking mothers and macho farmers – not to mention the guys who want to know ‘where is the real vet?’
