by Gillian Hick
‘Hello there. Gerry O’Donnell speaking. I don’t think we’ve met before.’
He sounded like an affable enough sort of person – definitely not like the usual late-night troublemaker that decides at ten o’clock at night that the sick calf (the one which they didn’t think justified a call-out for the last three days) suddenly does – urgently.
‘What can I do for you?’ I inquired politely.
‘Well, I’m sorry to disturb you at this hour and it’s probably nothing, but I don’t want to leave it go and then have to get you out of bed later. I’ve a Limousin cow here that’s due to calve and she’s been off on her own for the best part of the day but nothing much is happening. She’s not forcing or showing any signs of getting on with the job. I wonder would it would be safe enough to leave her?’
‘Well, it’s hard to say without examining her. Has she put out a water bag at all?’
‘She did around lunchtime. That’s why I was expecting a bit of progress by now.’
I got a sudden sinking feeling in my stomach. I tend to have an over-vivid imagination, especially late at night, but this cow sounded like she could possibly have a twisted uterus and I’d never dealt with one on my own before. Even at the best of times, I knew it wasn’t an easy job.
‘Sure, she’ll probably come to no harm before morning, will she?’ Gerry interrupted. ‘I don’t like dragging you all the way out at this hour.’
It was so tempting to agree with him and forget about the cow for the night, but my imagination had gone into overdrive and I was already visualising the twisted uterus filling up with fluid, making a bad situation worse.
‘No, I think you’re right to be worried. If you could get her into the shed, please, I’ll be down to you in about half an hour.’
‘Well, if you’re sure it’s not too much trouble. She’s a good pedigree cow, right enough.’
His words didn’t exactly console me but the sooner I got there, the sooner I would know.
Reluctantly, I turned the jeep around and continued back down the road I had just driven up. Before I knew it I had reached the yard, following Gerry’s clear instructions – another first for a Wicklow farmer.
‘You made it in right good time,’ said Gerry warmly. ‘I hope I haven’t put you to a wasted journey.’
The Limousin cow eyed me suspiciously as she stood in her stall, carelessly pulling at the odd wisp of hay. Certainly she didn’t appear to be in any distress. Looking at her, I cursed my overactive imagination, thinking I could have been sitting in front of the fire by now if only I had left well enough alone. Hopefully, it would be only a matter of a quick pull and I’d be on my way again. I felt happier as I placed my gloved hand into the swollen vagina.
In a job as unpredictable as large-animal veterinary, it’s normally a lovely feeling when your gut instincts prove to be right, but this time, I would have been delighted to be wrong. With a sense of dread, I felt the tense bands of tissue sweeping off in a tight circle. I could just fit my fingers in through the narrow opening, to feel two enormous cloven hooves. As I prodded at the sensitive tissue between the feet, I felt the indignant twitch of the calf who was probably wondering what was going on.
‘Well, you were right to be worried, Gerry. I’m afraid she has a twisted uterus.’
‘What the hell is that?’ he enquired, looking puzzled. ‘I’ve come across a few things in my time but I’ve never come across one of those!’
‘Well, count yourself lucky. It normally happens with a big calf like this one and, for whatever reason, the whole womb twists over on itself, leaving only a very narrow opening, so the calf can’t get out.’
‘Sounds like a hopeless case then. Is she a lost cause?’
‘Hopefully not. But there’s no denying it’s a messy job. What we’ll have to try and do is get her down on the ground and roll her over – hopefully then the uterus will twist back into place. If that doesn’t work, then we’ll have to do a caesarean. But that’s not an easy job either with a cow like this. Either way we’re going to need a bit of muscle power, though. Any neighbours we could root out?’
‘We can do better than that for you. John and Robert, my two sons, are up in the house. I’ll give them a shout.’
I couldn’t dispel the feeling of dread as I made my way back to the jeep to get my sedative and the ropes that I’d need to cast the cow. I had by now learnt the hard way that performing a procedure was never as straightforward as it sounded.
I was somewhat relieved to see Gerry coming back from the house flanked by his two strapping sons. They definitely looked like they might come in handy.
‘What do you want us to do?’ asked Robert, who wouldn’t have looked out of place in the front row of a scrum.
‘If you could just grab hold of her, please, while I give her a sedative shot, that would be great.’
I drew up a small dose, just enough to take the edge off her. She didn’t stand a chance as Robert towered over her, enormous arms encircling her head while he held her by the nose. I quickly tied two ropes around her body, thanking God that I had managed to make it to that practical in college. At least I could start the job looking like I knew what I was doing.
‘This looks a bit like a cowboy and Indian film,’ said John, the younger son, as the cow stood snorting in disgust to find herself unable to move against the ropes. With Robert holding her head and Gerry, John and myself pulling steadily on the rope from behind, the cow slowly sank to the ground with surprisingly little resistance. So far so good.
‘This is where the fun starts!’ I said to the three men, explaining how they would have to roll the cow over from one side to the other as I lay on the ground, with my hand against the uterus inside the cow. If the situation hadn’t been quite so desperate, I would have been amused by my compromising position as I lay, face down in the muddy straw, hanging out of a cow’s rear end with three enormous men cheering me on encouragingly.
As soon as I had myself in position, I called out, ‘Right, now, flip her over!’, wondering how many times I would have to repeat the scenario before admitting defeat and scrubbing up for a caesarean.
With an enormous lurch, I felt the cow heaving over, unable to resist the brute force. I pushed against the dead weight of the uterus and just as the cow flipped over, I felt an unmistakable squelch as the uterus slipped away from my hands and a gush of fluid poured out from the vagina. I took a few deep breaths, allowing the numbness in my arms to recover and then gingerly had a feel.
I couldn’t believe it – everything felt perfect.
The two feet were now in place in the vagina, followed by a large head. Although it was a big calf, the cow was broad and roomy, and I was confident that I would get him out easily enough with a bit of help and patience.
‘What’s the story, will we try again?’ asked John, starting to warm to the job.
‘Oh no, not at all. Everything’s fine now. That did the trick,’ I replied airily, hoping they wouldn’t be able to hear my heart which was still thumping in disbelief.
‘God, that’s great. I thought it would have been a bigger job than that,’ replied Gerry. ‘You must have done a right few of them before.’
‘Well, you know, some of them are easier than others, Gerry,’ I replied non-committally.
Before long, the calf’s forelegs and head were visible and the tiny nose twitched with impatience after his long wait.
‘He’s alive and all!’ shouted Gerry, delighted with the outcome.
Soon the huge bull calf had been delivered and lay shivering at his mother’s nose, none the worse for wear. The cow seemed a little surprised by his arrival and sniffed him warily as though wondering where the little creature had come from. I held my breath and then relaxed as she began to lick him with increasing vigour. As Robert went up to help rub him down, she shook her head angrily at him and I knew that all would be well.
‘You’ll have to come in for a cup of tea after all that,’ said Gerry, clearly deli
ghted with the result.
I happily agreed. By the time I had washed my instruments and peeled off the mucky overalls, a fine spread was laid out on the kitchen table. The successful outcome of such a potentially daunting job was enough to put me in a good mood which was only enhanced as my plate was piled high with an assortment of home-made breads and cheese followed by hot apple tart and freshly whipped cream. It took a few mugs of hot tea to wash it all down. As I sat chatting with the family, I realised this was the part that made it all worthwhile. The hospitality shown to me by many farmers was just second to none. There couldn’t be many professions where such appreciation was shown for a job well done.
CHAPTER TWENTY-ONE
DOCTORS AND VETS
One of my sisters studied medicine at UCD, and was already a surgical intern when I started at veterinary college. By the time I qualified, she had risen to the rank of specialist registrar in orthopaedic surgery. We got on very well and often spent an evening in the pub comparing case notes. In some ways, the similarities between our chosen professions were remarkable; in others they couldn’t have been further apart.
‘So, what did you do when you realised that the horse had a twisted gut?’ she would ask, taking a swig of her black rum and Coke.
‘Sure, I had to shoot him,’ I replied dolefully. ‘The owner had no money and, even if he had, I don’t think the horse would have survived the journey to the referral hospital.’
Often, I would be in the middle of telling her some tale when I would notice her incredulous face as she pictured me doing the best I could in some arduous circumstances. She made gallant attempts to hide her shocked reactions to some of my more vivid descriptions of the various emergency situations I had encountered.
‘Why couldn’t you have referred the bullock to one of the hospitals,’ she would ask, ‘instead of just slashing him open in the field in the middle of the night without any help?’
‘But they’d never pay for that! Sure, he was worth very little by then,’ I would answer lamely. Luckily, the expression ‘economically viable’ doesn’t register in the world of human medicine.
Such scenarios became more complicated where pets were involved. Ongoing advances in veterinary medicine meant that new treatment options were constantly becoming available, especially in the case of ‘companion animals’. More and more, we found that our clients were becoming familiar with new procedures from sources such as the internet and popular veterinary programmes on television. However, these programmes often failed to mention the price of such a level of care, which in many cases would be beyond the budget of the average pet-owner. When owners couldn’t afford the expensive procedures which we were increasingly able to offer, it was left to the practitioner to carry out what could only be described as a ‘salvage procedure’.
‘You don’t mean to say you amputated his leg when he only had a fractured talus with a dislocated hock?’ my sister would ask in amazement (after my brief sketch of the anatomy of the joint on a beer mat).
She particularly found it hard to believe that straight out of college you were expected to be able to do more or less any job on hand without any backup. ‘So you just washed your hands and started cutting the cow open, despite the fact you’d never done a caesarean before?!’
I think she was slightly jealous, if truth be told. After one year out of college, I had probably got more ‘hands-on experience’ in surgery than she had gained in her years of intensive training. Of course, I wouldn’t like to start comparing success rates or mortality rates and I’m glad I never had to operate on a human. The trial-and-error principle isn’t always very satisfactory when it comes to surgery.
It took my sister a while to stop asking questions like: ‘Why didn’t you send him for a brain scan?’ or ‘Why didn’t you put him in the intensive care unit instead of leaving him lying in a kennel?’
One night, having described to her how frustrated I was by my lack of equipment, I opened the back of my jeep to show her my array of drugs and instruments.
‘This is my hospital,’ I said. ‘This is all I have.’
I was glad she didn’t notice the humane-killer lying in its pouch under the car seat.
Often I envied her her job as she would describe a night in the trauma unit: ‘Well, we weren’t sure how severe the damage was, so I sent him off for an MRI scan. When that came back, we decided to operate, so I rang the consultant and then the anaesthetists came in to get him ready. When the consultant and I had finished on his orthopaedic injuries, we called in the plastics team and went off for coffee. We spoke to the relations after. They were so grateful to us.’
I would nod knowingly, mentally converting the scenario into the veterinary equivalent: ‘Well, I wasn’t sure how severe the damage was so I just hoped for the best and gave him a shot of steroids. The owner said the last bill he’d got from us was a bloody joke – imagine charging fifty euro to calve a cow at night! – and he bloody well wasn’t going to pay this time. I decided I’d have to operate on the bullock but I’d never done it before so I rang my boss to ask him if he could give me a hand and he told me to get stuffed, he was in the pub. So I just got on with it as best I could, knowing the farmer had no intention of paying the bill anyway. When I finally left the yard at half-past one in the morning, having spent another hour stitching up the animal’s wounds after I’d finished treating the other injuries, the farmer told me all bloody vets were a waste of time anyway and he didn’t know why he’d bothered to call me out in the first place.’
But despite all that, I wouldn’t have swapped jobs with her for all the money in the world. At the end of the day, as a vet I was dealing with animals and the worst that could happen would be a very upset owner or a court summons with the Veterinary Defence Society to defend me.
At times, my sister would describe cases where she and the medical team would be dealing with young men left paralysed for life after a motorbike injury, or a young mother or child dying on the surgical table. Matters of life and death took on a whole other dimension in her job.
It is amazing the number of people who have said to me that a vet must be better than any doctor because we study so many species of animal and have to do everything – no referring of patients off to the specialists. In ways, they are right, but they forget one simple point. Although we do indeed study many different species of animal, we don’t study the human one.
Even so, it was not uncommon for me to arrive out on a call to a yard and be asked: ‘Oh, while you’re here you couldn’t ever check my wife’s leg? She went down to the doctor yesterday but those people know nothing. She’d be much happier if you had a look at it.’ I would politely decline, explaining that our veterinary insurance didn’t extend to carrying out nixers on humans.
Despite the differences between our professions, my sister and I would often find it useful to check things with each other. Once she rang me from casualty wondering what sort of antibiotic would be suitable for a farmer who had stabbed himself with a silage fork. The correct one was totally different to what the consultant had prescribed – in his blissful urban ignorance he didn’t know that silage was acidic. On another occasion, she rang about a child who had been bitten by a sheep and now had an unusual-looking growth on her finger. I was immediately able to diagnose orf – a common viral infection in sheep that is contagious to humans.
Once I rang her during one of our regular ‘salvage’ jobs to see what sort of pins and screws would be best to repair a shattered femur in a collie. Having got the necessary dimensions, I went off to Woodies to find a cheaper equivalent!
Sometimes, having access to the type of equipment used in human medicine would be a huge boon for vets. One night, my sister explained to me about the saws they used to remove plaster casts in children. The saw was like an ordinary saw but had the distinguishing feature of being sensitive to human tissue so the blade wouldn’t cut through flesh. This could be a great advancement in our attempts at cast removal, I thought, which
were generally slow and painstaking as we took great care not to cut into the delicate tissues of the animal’s leg. The job was so tedious that it often influenced how much casting material you would put on in the first place. Unless you knew that someone else was going to take it off, you held back on putting on too much.
‘No, believe me,’ I once explained to a farmer, whose bull calf needed an extra-large quantity. ‘The cast must come off on Wednesday the twelfth – not a day sooner or later.’ I knew that I was going to a conference in Dublin that day and so one of the others would have to carry out the tiresome procedure!
When I heard about my sister’s saw, I put in an order for one from her immediately. Luckily, there was a delay in getting it. She rang me from work one evening to tell me about a very small and frightened child who came in to have her cast removed from her arm. Every time the doctor turned the saw on, she shrieked and yelled and refused to let him near her. She clutched her Winnie the Pooh teddy bear and buried her head in her mother’s arms.
Eventually the doctor got frustrated, not wanting to have to put her through an anaesthetic for such a simple procedure. He fancied himself as being good with children and eventually managed to persuade her to hand over Winnie the Pooh to demonstrate that it didn’t hurt. As he ran the saw up and down the teddy bear’s arm, all was going well and the little girl was nearly ready to follow her brave bear’s example. Then one of the threads in the teddy’s arm caught in the saw and Winnie the Pooh was promptly shredded into dozens of tiny pieces, sending puffs of sawdust and red clothing in all directions. I never heard if they managed to get the plaster off the child but I decided that I would probably be safer not to experiment with the wonder saw because of the similarities of texture between many of our patients and that of Winnie the Pooh!
When I qualified as a veterinary surgeon my sister gave me a present of a hardback book, grandly titled An Atlas of Veterinary Surgery. Inside she inscribed it with words that just about summed up the differences in our jobs: ‘Best wishes in your future career!! Hope this is occasionally useful as an alternative to a bullet in the head.’
