by Lucy Daniels
It seemed like ages since Mandy had eaten Sunday lunch at Gran and Grandad’s house. Lilac Cottage had barely changed at all from her childhood. Sitting at the table, full of peach crumble and home-made custard, she could remember a time when she had sat on the same oak dining chair, swinging her legs because they were too short to reach the floor.
‘So what do you think of the plans for Hope Meadows?’ Tom Hope might be heading towards frailty now he was in his eighties, but the eyes that studied Simon were as shrewd as they ever had been.
‘Things are certainly moving fast,’ Simon replied. ‘Mandy’s done a brilliant job with Robbie Grimshaw’s animals. I’m very proud of her.’ Reaching out his hand, he patted Mandy’s knee under the table. Mandy made herself smile at him, though she wished he didn’t sound so condescending.
Gran put down her spoon. ‘Has everyone had enough to eat?’ There was a chorus of assent from around the table.
‘I’ll tidy up,’ Mandy announced. Standing up, she began to clear the dessert plates from the table.
‘And I’ll give you a hand.’ Tom Hope’s voice brooked no disagreement. ‘Maybe you’d like to have a look round the garden,’ he suggested to Simon. ‘Dorothy, will you show him?’
‘Of course I will.’ Gran’s eyes were twinkling. ‘He’s not as spry as he once was, and he doesn’t always hear everything, but he still loves his garden,’ she whispered once Tom had left the room. With a conspiratorial grin, Gran led Simon out through the back door. Sorting the glasses and cups onto a tray, Mandy followed her grandfather into the kitchen.
Tom Hope was standing at the sink. Despite the presence of an efficient dishwasher, he still liked to clean the cutlery by hand. Lifting a tea towel, Mandy walked over and stood beside him.
Looking up from the soapy water, her grandad studied her. ‘How are things?’
‘Fine, thanks,’ Mandy lied. She was sleepless with worry about James, and the situation with Simon seemed so overwhelming she could hardly bring herself to think about it.
Tom Hope was regarding her seriously, as if he could hear her thoughts rather than her words. ‘I don’t know exactly what’s going on,’ he said, ‘but I hope you’re not going to rush into anything so far as that young man is concerned. Tell me you’ll think carefully.’
Mandy stared at her grandad. ‘What do you mean?’ she said. How could he know anything? So far as she was aware, neither she nor Simon had breathed a word.
The old man shook his head. ‘Nothing more than that,’ he said. ‘Just don’t make any hasty decisions. You have lots of time.’
For a long moment, they gazed at one another and then Mandy reached out for a hug. She had to stoop to rest her head on Grandad’s shoulder now, but he could still comfort her better than anyone else. The only thing Mandy knew was absolutely right was that she was back in Welford with her family. She stayed in her grandfather’s arms for a long time, not wanting to let go.
It was getting dark. Mandy and Simon stood outside Animal Ark. Simon had packed everything into the car, combing the house carefully for all his possessions. He always hated leaving anything behind, even a sock or half a tube of toothpaste.
Mandy wondered if he’d mention his proposal again before he drove away. She had asked him for time to think, and so far he seemed to be willing to do that. Holding out his arms, he smiled into her eyes. Was there sadness in his gaze? Or was it a reflection of the melancholy she was feeling herself?
‘You will come and see me next weekend, won’t you?’ he asked.
‘Of course I will.’ She stretched up and kissed his cheek, hating herself for not wanting to hug him as usual.
Simon slid into the car. ‘Have a good week,’ he said. He wound down the window and looked up at her. ‘We are all right, aren’t we?’ Suddenly there was a note of doubt in his voice.
Mandy felt tears prick her eyes. This wasn’t the time or place for that conversation, she told herself. She patted his shoulder. ‘Everything’s going to be fine,’ she told him.
She watched as the car rolled up the drive. Next time she saw him, she would make him listen to her properly, show him just how far apart their plans and dreams had grown. Simon had to know that being in Welford had changed a lot for her: her priorities, her ambitions for the future. Her sense of who she wanted to have in her life.
With a sigh, Mandy turned her back on the empty driveway and walked inside.
Chapter Twenty-Seven
The whole Dhanjal family was waiting for Mandy on Monday afternoon, though Kiran was fast asleep. Mandy peered into the pram and smiled. He was almost as cute as the kittens she had brought.
‘We’ve got everything ready,’ Roo explained, her dark eyes earnest. ‘I want them to stay in this room at first, until they get used to us. We’ll be very careful with Herbie until the kittens are bigger.’
Mandy looked at the two-year-old. She was sitting on the floor, wide-eyed, rolling a ball and watching as first the tortoiseshell kitten and then the ginger and white batted it back and forth. Mandy had been impressed by the way Roo had talked to her little girl about the kittens. Why it was important for Herbie never to pick them up when Mummy or Daddy were not there. Not that they would be leaving her alone with them, Josh had murmured to Mandy. She felt a wave of satisfaction as she left the family with their new pets. Rehoming was one of the best parts of her job.
She glanced at her phone. It was three o’clock. Time to get back to Animal Ark. For once, Emily and Adam had agreed to go out and leave Mandy in charge. They were going to the theatre in York and had booked a table for dinner before the show. Mandy drove the short distance back to the cottage and went inside.
Adam was still reading his paper at the kitchen table. He looked up as Mandy entered. ‘How did it go?’
‘Perfect. It’s going to be a lovely match, I think.’
‘That’s good to hear.’ Adam folded his paper and laid it down on the table. ‘We had two calls while you were out. Another prospective owner for one of the adult cats.’
That was great news, Mandy thought. That would only leave the black cat and her kittens. Mum and Dad would be pleased to get their wildlife unit back.
‘The other was from the builder. He thinks he should be finishing his job in Walton a week tomorrow. After that, he’ll be able to make a start on the outbuildings here.’ He twinkled up at Mandy, obviously enjoying her reaction. That was even better news than the cat rehoming. She could hardly believe everything was happening so fast and so smoothly.
Adam stood up. ‘I’d better go and make myself look presentable.’ He grinned. ‘Otherwise your mother will roll up my newspaper and chase me round the table with it.’
Mandy laughed. ‘The way you run, she’d catch you easily,’ she teased.
It was quiet in the clinic once her parents had left for York. Helen was in the residential unit and Mandy had opened the new Hope Meadows website to check it once more before it went live.
There was a squeal of tyres on the driveway. She looked out of the window, half expecting it to be her parents coming back for something they had forgotten, but it was a car she didn’t recognise. A man jumped out of the passenger seat and ran for the surgery door. A woman climbed from the driver’s seat and dashed round to the boot. With her heart in her mouth, Mandy recognised Mr and Mrs Patchett, who had made it so clear to her that they would only see her parents. Standing up, she met Mr Patchett at the door.
‘It’s Isla,’ he panted. ‘She started whelping about four hours ago, she’s been straining the last half-hour and she isn’t making any progress. She’s really upset.’
Grabbing a pair of gloves and a bottle of lubricant, Mandy rushed out to the car. Isla stood in the back of the vehicle. She was panting heavily. Her eyes seemed to beg Mandy for help.
‘I’ll need to do an examination first,’ Mandy said.
‘You should fetch your parents.’ Even though she had been expecting some kind of objection, Mandy felt her anger rise, but Mrs Patche
tt went on, ‘This is an emergency. It needs someone with experience.’
‘I’m afraid they are both out.’ Mandy kept her voice calm and polite. ‘I believe I’m capable of handling this, if you’ll let me try.’ They could, of course, refuse. There was another vet in Walton. For a moment, she thought Mrs Patchett was going to slam the boot and leave, but Mr Patchett, who had followed Mandy out to the car, spoke firmly for the first time.
‘Please go ahead,’ he said. ‘Isla needs your help.’
Despite Mrs Patchett’s glare, Mandy didn’t wait for her to say anything else. Smearing plenty of lubricant onto her fingers, she inserted them into the dog’s vagina. It was obvious what was wrong.
‘A puppy has got stuck,’ she announced. ‘There’s just a tail presenting and the birth passage isn’t wide enough for the pup to come through. We need to do a Caesarean.’
Mrs Patchett drew in her breath. ‘Are you certain you’re competent to go ahead?’ she snapped. ‘You understand that Scottish deerhound anaesthesia is not straightforward?’
Mandy didn’t waste her time with a direct reply. ‘We need to get her inside,’ she said. ‘I want to do a Prothrombin Test to make sure her blood is clotting normally.’ Mrs Patchett looked as if she were about to speak, but Mandy held up her hand. ‘It won’t take any extra time,’ she said. ‘I’ll need to place a catheter anyway. I’ll run the test while the nurse gets everything set up in theatre.’ She paused, then spoke again. ‘I want to do routine biochemistry as well. Isla’s probably dehydrated. I’ll use minimal anaesthesia. I’m fully aware deerhounds don’t have much body fat, so it’s essential not to overdose. I’ll ensure her temperature is closely monitored, too. If necessary, we’ll use a high oxygen flow rate and other methods to cool her down.’
Mrs Patchett’s mouth had fallen open. Mandy caught Mr Patchett’s eye. Despite the fact he was obviously worried about Isla, he sent her an encouraging smile.
‘I can catheterise her in the car,’ Mandy said. ‘The less we stress her out, the better.’ Luckily the sun was shining. It should be easy enough to see the vein. Leaving the still silent Mrs Patchett, Mandy hurried back inside.
‘Can you set up in theatre, please?’ she called to Helen. ‘Scottish deerhound needing a Caesarean. Low dose fentanyl. And call Rachel, will you? See if she can come in and give us a hand.’
Helen shot off without comment, efficient as always. Gathering the things she would need for the blood test, Mandy ran back outside. Isla let out a low whine, her ears flat against her head.
Mandy sat down on the edge of the boot and spoke to her. ‘Poor Isla,’ she murmured. ‘It’s going to be okay.’ Reaching out, she ran her hand down the side of the deerhound’s neck. The dog’s muscles were trembling. ‘Can you sit down here and give her a cuddle?’ she asked Mr Patchett, who took Mandy’s place at once, holding Isla with one arm and putting her leg in the right position for the blood test.
‘I’ll get the test done and then I’ll come straight back,’ Mandy explained. ‘Keep her as calm as you can.’
The clotting test was normal. Biochemistry showed that Isla was indeed dehydrated. Mandy passed the information to Helen. Taking a deep breath, she went back out to the car. ‘I want to get her inside now. We’re ready to go ahead.’ Between them, she and Mr Patchett lifted Isla down from the boot of the car and guided her inside.
There was just the premedication to go, Mandy thought, and then she was going to have to have the most difficult part of the discussion. She had drawn up small doses of fentanyl and midazolam into syringes. With Isla still on the floor but with the stretcher table close by, she injected the fentanyl and followed with a small amount of midazolam into the vein. Helen had finished setting up in theatre.
‘We’re giving her additional oxygen before induction,’ Mandy explained to the Patchetts as Helen turned the machine on and applied the mask to Isla’s face. Though she looked confused, Isla stood still.
‘She’s so good.’ Helen rubbed the fluffy grey ear as she held the oxygen mask in place.
‘She is,’ Mandy agreed. She gave a further small dose of the sedative. Girding herself up for objections, she turned again to the Patchetts.
‘I’m going to give her an injection in a moment that will make her go to sleep. Then I’m going to place a tube in her trachea. Once that’s done, we’ll be taking her through to theatre. You can sit in here to wait. Once the puppies are breathing, we’ll bring them out to you to look after.’
Mandy wasn’t surprised when Mrs Patchett started to go red with fury. ‘Your father has always allowed us into theatre when he was carrying out a section.’ She drew herself up to her full height. ‘It’s essential you allow us in. Someone has to be there to revive the pups.’ To Mandy’s relief, she heard the door crash open.
‘I’m here!’ Rachel Farmer panted.
Mandy introduced her. ‘Mr and Mrs Patchett, this is Rachel Farmer. She will be in theatre with me. Along with Helen, she will revive the pups.’ Rachel had arrived in the nick of time, she thought. Although it was true her father allowed breeders to accompany him into theatre during Caesarean operations, it was something Mandy wasn’t happy to do. If something went wrong, either with the anaesthetic or the operation, Isla’s best chance of survival depended upon Mandy’s ability to remain calm. Cold as it seemed, the presence of the owners was likely to increase the risk.
‘I’m sorry.’ Mandy was firm. ‘I am happy for you to help look after the puppies in the waiting-room, but I can’t allow you to come into theatre.’
Mrs Patchett began to protest, but once again Mr Patchett came to Mandy’s aid. ‘We need to let Amanda get on,’ he said. ‘For Isla’s sake.’
Mandy felt weak with relief as, with bad grace, Mrs Patchett sat down. Breathing steadily, Mandy picked up the syringe with the ketamine. Attaching it to Isla’s catheter, she injected the drug in increments, with Rachel and Helen helping to keep the big dog steady until she was ready for intubation. The tube slid into the trachea without incident and, between them, they lifted the stretcher onto its wheeled trolley and rolled the sleeping dog into the prep room.
Helen was so thorough that Mandy felt confident enough to leave her in charge of the ongoing anaesthesia. Rachel helped clip and scrub the area on Isla’s abdomen. Once the patient was ready, they moved her to theatre. Helen began the complicated task of connecting up the anaesthetic tubing, the drip and the monitors.
‘Is everything stable?’ Mandy looked at Helen, who nodded. Picking up the plastic drape, Mandy laid it over Isla’s abdomen, clipping it into place. Lifting the scalpel handle, she pushed the blade into place and took a deep breath. The bright theatre light shone down as she reached out to make her incision, a firm stroke along the midline.
The shining bulge of one of the uterine horns pushed its way upwards. Lifting it out, Mandy surrounded it with gauze swabs before sliding the blade along the glossy surface. As always, the uterine wall was stretched and thin. It parted easily under Mandy’s blade. Reaching in, she drew forth the first pup, enveloped in its protective sac. She tore the membrane from the blunt little nose and handed the tiny body to Rachel, who was waiting with a towel. Readjusting the swabs, Mandy reached inside again. There was another pup. Working her fingers inside, she retrieved the second shining sac, splitting it open and passing the warm little bundle to her assistant. So far there had been no noise from the first pup.
Mandy forced herself to stay focussed and worked her way to the third. This was the one that was stuck. Chances were high it wouldn’t survive. As quickly as she could, she drew it forward into the light. As she had expected, the amniotic fluid had drained away, but she cleared the remaining membrane from the nostrils, and handed the pup over, this time to Helen.
A tiny squealing noise caught her ear. Turning her head, she could see Rachel rubbing away at the other two pups. A second squeal.
Rachel beamed. ‘Both breathing well.’
There was a pup in the other horn. Making sure
she did not cut into the placenta, Mandy made a second incision. She pulled the chunky little body out and, for the last time, broke through the membrane. A quick check showed her there were no more.
‘Last one,’ she said. Helen was still rubbing hard at the pup that had been stuck, so Mandy gave the final puppy to Rachel, who had put the first two in a box with a hot water bottle. ‘Any joy, Helen?’
The nurse sighed. ‘Sadly not,’ she said. ‘I’ve given dopram, but nothing so far. Isla’s doing well though.’
Mandy nodded and turned back to her final task. It was always fiddly, suturing the uterus. With tiny, painstaking stitches, Mandy brought the edges together. As she opened the last vicryl to begin stitching the abdominal muscles, she heard a tiny snuffling squeak. Whirling round, she looked at Helen. The nurse was grinning widely, holding up the stuck puppy, which was starting to wriggle.
‘Breathing!’ Helen confirmed, her voice triumphant. Still smiling, she handed the pup to Rachel, who put it with its littermates in the box.
‘Soon as you think they’re ready, you can take them out to Mr and Mrs Patchett,’ Mandy told her. Although she loved to hear the wonderful sound the puppies made in the corner of the theatre, Isla’s owners would want to help with the young litter. A few minutes later, both white line and skin were sutured. The stitches lay in a neat line along the centre of the abdomen.
‘You can switch her off now,’ she told Helen.
‘Already done,’ Helen reported. ‘I’ll just get her cleaned up.’ Together, they wiped away the blood and mess from the skin. It was important the pups could suckle as soon as possible. Moving Isla onto the trolley table, they wheeled her back through.
Mrs Patchett rushed over, leaving her husband in charge of the puppies. ‘How did it go?’
‘Everything was fine,’ Mandy assured her. She had half hoped the pups might have time to suckle before Isla woke, but the dog was already showing signs of waking. She coughed and lifted her head almost simultaneously. Mandy grabbed the tube, whipping it out of her mouth. To her pleasure, a moment later, the deerhound was wagging her tail and nuzzling Mandy’s ear.
