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: The Life of a Yorkshire Vet Page 3
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And so it started, my veterinary career at the most famous veterinary practice in the world – though first, I had a stint in Caithness to get through …
2
Anthrax and Appendicitis in Scotland
The day after graduation I was back in my reddish-orange Mini Metro, rushing up the A1 (the car could do that bit by itself), across the Pennines this time, to be the best man at the wedding that followed the aforementioned stag party in the Peak District. One of my best mates from university, Pete, was marrying Rachel, the girl he had met in our very first term at Pembroke, six years before. It was a great day and the first of many weddings that would punctuate my weekends, when not on call, over the first few years of life as a newly qualified vet. But there was no time for rest. I had less than twenty-four hours to get to the most remote and northerly part of the United Kingdom to my first job, as a locum veterinary surgeon, in Thurso, Caithness. I would be here for eight weeks before starting at the Skeldale practice in Thirsk.
I had been to the Scottish surgery several times as a student. I would spend three or four weeks at a time there, seeing practice, and I loved the people, the area and the way of life. The first time I visited this place, it was with my girlfriend, Anne. We saw practice there together for six fabulous weeks during the summer before Anne’s final year and my penultimate year at vet school. We stayed in a tiny tent in a cliff top campsite about half a mile from the practice, so it was really part work and part holiday. The staff at the practice thought it was a strange coincidence that two students from the same vet school should both arrive in this desolate part of the country at the same time. Not many students would venture to such a far-flung corner of the country, and initially they had no idea that we were an item. This misunderstanding was quickly rectified when, one evening after a meal in the local restaurant (there was only one restaurant in Thurso and it fitted all purposes – Italian on Monday, Indian on Tuesday, Chinese on Wednesday and Thursday and then ‘normal’ for the rest of the week), we were spotted entwined in a romantic embrace by the phone box. Eyebrows were raised over coffee the next morning and the record was set straight. There was also some astonishment that we were camping in Caithness, as there were generally horizontal winds, more often than not accompanied by horizontal rain. We were, however, blessed with the best summer there had been for many years. While it wasn’t exactly shorts weather, our tent on the cliff top remained dry, and didn’t disappear out to sea in a gale.
It was a wonderful place to learn the ropes. The vets there worked harder than any I have ever met. To calve five cows in an evening would not be unusual. I particularly admired a gruff veterinary surgeon called Frank. He was usually averse to taking students with him, maybe because of the danger of them dying of Benson & Hedges intoxication in his car, but he and I got on well. I asked him one evening, as we headed out on a visit to see a cow with a prolapsed uterus, how long the buzz associated with being on call would last? He pulled heavily on his Benson & Hedges before narrowing his eyes (as he always did before saying something – maybe to keep the smoke out), ‘Aye, it took me about twenty …’ and then he paused. I waited for the next word to be ‘weeks’ or ‘months’ but, as he puffed out smoke, ‘years’ was the next thing he said. I remember, at that point, thinking that this career was definitely going to be more of a way of life than a job.
Frank was an inspirational teacher and I admired him immensely. As a student he gave me my first opportunity to perform a caesarean section on a cow, and I remember every incision and every suture of that first epic piece of surgery. The cow was old, black and very thin, and she was heavily in calf. She was clearly at the point of calving but could not muster the energy to do it by herself. The prognosis was poor and she evidently needed a caesarean to have any chance of saving both her and her calf. The problem was that it seemed unreasonable to charge the farmer the full cost of the operation when the outlook was so gloomy.
As Frank drew heavily on his B&H, he pondered the options for the cow. He made a suggestion that made the hairs on the back of my neck rise. ‘I’ll tell you what,’ he proposed to the farmer, ‘we’ll let the student do it, and we won’t charge you for the operation.’
Frank instructed me from the comfort of a rusty gate while continuing to puff on his cigarette. I completed the surgery without complication and as I walked off the farm, I felt ten feet tall. Frank had given me this amazing first opportunity and I was, and still am, so grateful. I’m still not sure, though, if it was simply to give him a chance to finish his cigarette uninterrupted!
While I was at the practice as a student, I sometimes stayed with another of the vets, called Willy. Willy was a quiet and calm man who spoke slowly and gently and loved hill walking, and very old Scottish single malt whisky. He, too, was very hard working, and would punctuate his busy days by calling at a nearby beach to walk his spaniel, Gyp. The beaches around Thurso are spectacular and even a fifteen-minute walk would clear the mind like nothing else. In fact it was to this particular beach that I would return, six months later, as a newly qualified veterinary surgeon, to contemplate whether my embryonic career was about to come to a premature end.
It was the second week of my locum job in Thurso and I had thrown myself into the job with enthusiasm. Cattle and sheep were everywhere and it was the perfect place to start a veterinary career. I would get ample experience very quickly. I also reasoned that when I left after this short-term post, I could leave any early mistakes 600 miles behind me, when I got to Thirsk two months later. I had put my initials next to two visits in the day book on the morning in question (this was, and still is, the way to sign up to a job). The first call was to a cow with mastitis. The second was to a stirk (a young bovine somewhere between a calf and an adult), which had died suddenly. We had been taught at vet school that, in cases of sudden death, a tiny blood sample needed to be taken from the ear, avoiding any spillage or exposure to the air. The blood sample then had to be examined under a microscope, before a post mortem could be performed. This was to check for the presence of anthrax bacilli in the carcass. To do a full post mortem would inevitably cause anthrax to be exposed to the air, which would result in spores contaminating the environment, triggering a major disease outbreak. Although the practice had not seen any recent outbreaks of the disease, it was reasonably close to a place called Gruinyard Island, the site of secret testing of the deadly anthrax bacteria when it was being considered as an agent for ‘germ warfare’ in the Second World War. Anthrax was certainly something I needed to check for and this needed to be done on the farm before I could get on with a full post mortem.
As I packed the practice microscope and was about to head out of the door, a colleague, also very experienced and keen on dermatology, called me back. He needed the microscope to analyse a complicated skin case later that morning. He assured me that there would be no need to test for anthrax but, if I deemed it necessary when I had seen the dead beast, I should take a sample of blood and analyse it later at the practice. I bowed to his seniority and experience and was reassured by his advice not to worry about such a rare condition. I clambered into the practice van and was soon on my way.
I arrived at the farm to see the dead animal lying limp, next to a midden heap. It had a small amount of frothy blood at its nostrils. I chatted with the farmer who told me that it had been perfectly normal the previous evening. Keen to establish the cause of death, I set about a post mortem examination, closely inspecting all the body systems and taking numerous samples for analysis, which I put in a big plastic bag. ‘Blimey, that’s a large spleen,’ I remember thinking, as I explored the blood-filled abdomen. Before I left, I had a look at the other animals in the same group. Most of them had very high temperatures, but few other signs of illness. I was sure my thorough post mortem would give me the answers. As I drove back to the practice, my mind was racing with all the possible diagnoses and I started to wonder if I should, after all, have done that anthrax test.
I went past the b
each where Willy and I had walked his dog earlier that year, and pulled into the carpark nearby so I could collect my thoughts and check my textbook. I looked up the signs of anthrax: no rigor mortis, blood at the mouth, copious internal bleeding, large spleen, very high temperatures in other animals, and sudden death. I started to feel sick as I stared at the bag of bits, on the passenger seat next to me in my little van. As I flicked through the pages of the book, my face started to itch all over. I peered into the rearview mirror of the van to see angry, red wheals all over my forehead and cheeks. The final point on the list of signs of anthrax, which I read in horror, stated: ‘skin lesions in humans who have been exposed, followed by rapid and sudden death’. By now I was certain that not only my veterinary career but also my life was about to be cut short. I went for a brief walk along this lovely beach, thinking that, since it was probably my last, I may as well enjoy it.
Forty-five minutes later I was at the local veterinary laboratory. They cheerfully confirmed that the animal had died from acute pneumonia and there was not a trace of anthrax in the specimens. But what of my skin lesions – surely they were evidence that I had contracted the deadly disease? No – I had spent an hour stooped over the dead animal right next to a muck heap, swarming with infamous Scottish midges. They had enjoyed a feast on my juicy English skin!
So I lived to fight another day, a little the wiser.
The rest of my time at Thurso was less eventful. I developed a sound grounding for my new career and a healthy respect for the animals with which I would be dealing. On one occasion I went to see a cow, which the farmer described as simply being ‘off colour’. These cases are both easy and difficult. Easy because the farmer doesn’t know what is wrong with his animal, so I might have a better than average chance of impressing him with my diagnosis, but difficult because I would have no real clues to go on. Cows in this part of the world were not always amenable to a thorough examination. Luckily for me, I had enthusiasm and naïvity on my side. So, as the two farmers tried to catch the cow, which had not been handled for six months, I felt sure I would be able to ascertain its problems. Thirty minutes later, the cow had been lassoed. After a basic examination, during which I failed to elucidate the cause of its problems, I explained in detail to the two weather-worn Scots that I was intending to place a needle into the animal’s abdomen to take a sample of abdominal fluid. The farmers looked at each other with wry smiles, fully aware of what was going to happen next. I was blissfully unaware of what was going to happen. I can only imagine what did happen, because whatever it was, it left me ten feet away, lying on my back in the straw with stars spinning in front of my eyes, a bloodied nose and a very sore head. I had not succeeded in sampling the cow’s abdominal fluid and I decided that, on balance, it was probably not necessary, or indeed possible. I avoided a trip to hospital on that occasion, but not so the following week.
When the afternoon’s work had been completed, the staff at the practice all retired home for tea at about 5 p.m., before returning for evening surgery at half past six. We would often have tea at each other’s houses to chat about the day. Willy, a bachelor, and I would often have tea together but one day it was not as relaxing as it could have been. Poor Willy had been ill all day and had developed a severe bout of abdominal pain. In hindsight this was not altogether surprising because Willy’s diet consisted almost entirely of potatoes and meat pies. During my time in Thurso, sharing Willy’s house, I never once saw a vegetable nor a piece of salad pass his lips. He looked more and more pale and weak as the day wore on, so we decided he should go to the local hospital to see a doctor. It must have been pretty serious, because vets usually treat any minor ailments themselves.
I bundled him into the van and drove him the thirty minutes to the outpatients department at Wick Hospital. After a brief assessment, Willy was admitted to the ward. I was presumed to be a close relative, and was ushered to his bedside. A nurse came to put him on a drip. As vets, we do this all the time, and it is sometimes hard to stop our patients from chewing the catheter, but Willy was not in any position to object to his drip in any way. He looked very sick.
After about half an hour, a diminutive doctor appeared and carefully explained to Willy that he needed to perform an ‘internal examination’. As the doctor donned his rubber gloves, the look on Willy’s face changed from one of weak pallor to one of panic and fear, and I thought he was going to rip his drip line out and run out of the ward. Willy would have performed this procedure thousands of times on his patients, both canine and bovine, but suddenly it didn’t seem at all appropriate. He was on the receiving end! I could not stop fits of hysterical laughter welling up and, with tears streaming from my eyes, I rushed out to sit in the corridor. I must have looked distraught, as I sat convulsing in the corridor with tears in my eyes, holding my head in my hands. A helpful nurse was walking past. She had seen us when we arrived and she reassuringly patted me on the back. ‘Don’t worry,’ she soothed. ‘Your boyfriend is going to be fine.’
Soon afterwards, I left this desolate but beautiful area, armed with stories, experience and confidence and excited to be starting my new job in the equally beautiful North York Moors, in the market town of Thirsk.
3
‘Job’s a Bad Un’
After finishing in Thurso and before starting in Thirsk, my little reddish-orange Metro had one last mission. During my final year at vet school, I had received a bursary from the British Cattle Veterinary Association to undertake a research project, supported by the ever-calm and inspirational Dr Jackson. One of his areas of expertise was bovine obstetrics. We had devised a project to measure the oxygenation levels of calves during labour. This is done routinely in babies but veterinary medicine was lagging some way behind. During the project, I had been the first person to use this technique in calves and lambs and had written a paper setting out my findings. It was published in the Veterinary Record, our professional journal, while I was still a student. I had been invited to present my paper to a meeting of the BCVA in Exeter, Devon. I was in Thurso, Caithness. My little car had to make it pretty much from John O’Groats to Land’s End. I had to give my talk and then get back up to Yorkshire for the first day of my new job. My car and I made it, but only just.
Starting at Skeldale Veterinary Centre could not have been more straightforward. I already had some basic skills, which I had learnt in Scotland, and I was sharing a house with my university friend, Jon (he of the moustache). He had been at Skeldale as a student and, since two posts had arisen at about the same time, the partners had decided to employ both of us. Jon had started soon after graduation while I had been in Scotland, so he was familiar with some of the peculiarities of the area and the practice.
My first night on call was particularly memorable. It was also my very first night at the practice – there was no time for easing in gradually. After evening surgery had finished, I was sent out to see a ewe with orf. Orf is a viral infection that affects sheep, giving them painful, crusty swellings on the mouth and face. It can also affect the udder, so little lambs can catch it from their mothers and the sores make it painful for them when they try to suck. It is straightforward to diagnose and the treatment, while mainly symptomatic rather than curative, is simple. It was an easy first job for my first night on call. At about eight o’clock, the beeper went off again. In those days, mobile phones were not widely used so, when this happened, we had to find a telephone box, or borrow the phone of whichever farm we happened to be at or near. There was a cow to see with mastitis. The farmer had noticed it during evening milking. I took directions and went straight there. The farmer was a chap called Colin. He lived in the small village of Thirlby, which nestled in a very sheltered spot just below Sutton Bank. From his yard, you can see the white stone cliff from which the bigger village of Sutton-under-Whitestonecliffe gets its name. On this autumn evening, the bright limestone reflected the orange sunset and it looked spectacular. Colin came out to show me the cow. She had nasty mastitis. Her udder wa
s massively swollen and she had a very high temperature. Mastitis in cows can usually be treated with antibiotic injections and intra-mammary tubes (tubes of antibiotics which are instilled into the udder via the teat). However, in this case the infection was too severe for this simple remedy, in part because the teat was blocked. The skin of the udder was tight and purple and without aggressive treatment there was a high risk of necrosis and then gangrene. This is very serious and leaves an enormous messy and smelly problem for weeks. I decided that the proper course of action was to take my scalpel and lance the udder, as if it were a huge abscess. As I explained my plan to Colin, I could see he wasn’t convinced. ‘Can yer not give her an injection then, Vetnery?’ he asked.
I noticed that some of his family had arrived in the gloomy cow byre. It was as if the whole family had come to coerce me into a more benign course of treatment. The last to arrive was Colin’s striking daughter, who was about eighteen. She had a shock of red hair and a very short nightie, made somewhat incongruous by knee-high wellies. I was somewhat flummoxed at the arrival of this siren, who had surely come along to distract me from the task in hand. I regathered my thoughts and made preparations for my bold incision. Sure enough, a river of fetid pus came spewing out of the cow’s udder, all over the floor and all over my Wellington boots. I felt quite pleased that my actions had been justified, as there were gasps of awe from the onlookers. I finally returned home, well after dark, and recounted the tale of my first evening on call to my housemate and colleague Jon, including the arrival of the red-headed siren.
‘D’you know what?’ he said, as he opened a bottle of beer, ‘the very same thing happened to me on my first night on call!’ We both chuckled.