Vet Among the Pigeons (13 page)

‘Would you look, Eamon,’ said Gordon. ‘Doesn’t she look just like St Francis of Assisi there?’

‘She does, all right,’ agreed Eamon, ignoring my
murderous
looks. ‘I suppose you could call her the vet among the pigeons!’

A
fter my disastrous first effort at continued practice development courses in the equine world, I had resigned myself to the fact that I just really wasn’t the academic type. A few courses of interest came and went, but I didn’t avail of any of them. I carried on to the best of my ability, learning only from my own experience, with an inevitable amount of trial and error.

As time went on, though, I became increasingly aware of my limitations. For all the things I could now do with a little bit of competence, there were a hundred and one others that were still beyond my grasp.

Some days it bothered me. Others, it didn’t. At the Blue Cross clinic in Ballyfermot one night, one of the regulars berated me as I prescribed a course of steroid tablets for her cat that was suffering from a neurological disorder. It was, by a coincidence, the same medication I had
prescribed
three months previously for a skin condition in her little Westie, and likely to be equally effective.

‘Is that all yiz can do for me?’ she questioned, looking
disdainfully
at the medication envelope. ‘I was watchin’ de vets on de TV the udder evening. Doin’ cat scans and tings like dat, dey were. Bleedin’ real vets dey have over der, not like yous lot,’ she ended, casting a disparaging look over the crew. With that she stomped out of the clinic, carelessly throwing a two-euro coin in the box as she went – the sum total of her donation towards the treatment.

While working in Ballyfermot, I was more than happy to refer clients to the referral practices that worked with the Blue Cross, as only basic medical treatments were carried out at the clinic. But back at the practice in Wicklow,
referrals
seemed to me to epitomise failure. At the time, it didn’t occur to me that recognising your limitations and knowing when and where to send a patient was a skill in itself.

My main interest was in surgery and I had already studied, in some depth, the various techniques for a wide range of surgical procedures and, more specifically,
orthopaedic
procedures. With some knowledge, but very little practical experience, I itched to get my hands on each new fracture that presented, and became increasingly frustrated when I would have to refer a case to the veterinary college or, worse still, simply amputate the limb as the owner could not, or would not, pay for the cost of a referral to a specialist hospital.

When the brochure for an orthopaedic course,
consisting
of five weekends over a two-year period, arrived in the office, I booked immediately, despite my misgivings. As I went on my daily calls, every three-legged dog I passed on the road seemed to mock me, regardless of whether I or
one of my predecessors had been responsible.

The course itself, although exhausting, was a revelation. The first Friday evening began with each delegate having to introduce themselves to the group and recount the story of their worst orthopaedic disaster. To my embarrassment, I had nothing to say as I had never carried out any
orthopaedic
procedures other than a few salvage amputations! Nonetheless, the mood was set for the course as we all knew each other’s worst. Intensive lectures followed,
alternating
between two surgeons, both of whom, unlike their equine counterparts, skimmed quickly over their own impressive qualifications before carrying on with the
lectures
. Despite their obviously vast experience, neither seemed to take himself too seriously and spent a lot of time showing cases that had gone wrong, allowing us to learn by their experiences so we wouldn’t have to learn from our own mistakes. Although intensive, the sessions were well lightened by the slagging and banter that took place between both lecturers and delegates. Unlike my previous experience, all the information was very specific and totally geared towards enabling you to do the job when back in practice.

I drove home after the first session on a high of depth gauges and drill bits, screw diameters and sizes. The
Saturday
morning continued with lectures which led to an
afternoon
of ‘cadaver practicals’ – putting the lectures into practice on real, although sadly, deceased, canine bodies. By Saturday afternoon, I was delighted to find myself
happily
drilling a pin into a femur and wiring it in place with a series of orthopaedic wires.

The twenty delegates were a very mixed group, some totally green, like myself, but also including people who could probably have given the course themselves, but all with an interest in orthopaedics. The whole atmosphere was one of total enthusiasm, with the more experienced vets delighted to show ‘the youngsters’, like myself, their own little tips and techniques. The lunchtimes and tea-breaks ended up being just as informative as the
practical
sessions and lectures. By the first Sunday afternoon, I came away with one job offer – should I ever want to take it – and a few phone numbers of like-minded vets with whom I still keep in touch.

As usual, Seamus wasn’t overly enthusiastic with my new-found skills. He laughed when I displayed the new ‘toys’ that I had ordered while on the course – the basic tools to carry out some orthopaedic repairs. While I waited for a suitable case, it was noticeable that the queues in the evening clinics lengthened considerably as each patient was treated to a thorough orthopaedic examination, regardless of their presenting problem.

With the second part of the course not due until the
following
spring, my enthusiasm had waned somewhat by Christmas, when I still hadn’t had a chance to put any of my new skills to use. It seemed that the cats and dogs of Wicklow had developed an innate street sense that they had previously lacked. The lectures themselves were gradually becoming a bit of a blur.

However, one morning in January, a time of year when mixed practice is usually relatively quiet, Arthur rang to tell me that he had admitted a dog he thought might need to
have his leg pinned. I was ecstatic, hoping against all hope that the fracture would be a type that had been covered in the first course. Skipping lunch, I rushed back to the
practice
to find a handsome German Shepherd sitting
expectantly
in the kennels. His radiographs were on the viewing box and as I stared at the clear images on the screen, I tried to convince myself that this was the perfect case. The
fractured
bone in question was a femur, the long bone
running
from the hip to the knee. The fracture itself was oblique, spiraling from the top end to half way down the shaft. I tried to ignore a few jagged fragments and the sheer size of the bone and the weight of the dog himself.

A very first session of the now distant orthopaedic course had been spent discussing fracture scoring. This involved a thorough assessment of each particular fracture and how it might have happened, the nature of not only the patient in question, but also the owner. Carefully, I assessed the dog himself, his giant weight and athletic potential, the type of fracture, the fragments, and
reluctantly
acknowledged that a pin and wire repair wasn’t going to be the best option. The sheer size and activity of the dog and the obvious velocity of the impact that had created the fracture all pushed me towards a bone plate, although, sadly, I realised that bone plating would not be covered until the following course! Having carefully weighed up all the options, I picked up the phone to ring the owner. Mrs Devlin sounded very hesitant as I outlined my plans. Ideally, I explained, Boris would be sent to the veterinary college for a bone plate, but when I gave a rough estimate of cost, the sharp intake of breath
suggested that this was not going to happen. I continued to outline the option of a pin and wire, trying to emphasise that the repair would not be as stable as the first option and therefore, would be less likely to succeed. I gave what I thought was a fair quote, significantly cheaper than the first option, but Mrs Devlin didn’t sound a whole lot more enthusiastic. The only other option, I informed her, would be to have the dog put to sleep; amputating a hind leg in a large, active German Shepherd would be a disaster.

‘I’ll have a chat with Jimmy and get back to you,’ she told me quickly. ‘Although,’ she continued, ‘he does have a brother who is good with the auld hounds. We might give him a ring and see if he could do anything. His father had a dog once with a broken leg that healed up right well without any of them fancy things you’re talking about.’

I looked in despair from my shiny new tool box to the unfortunate Boris and wondered why I had bothered. ‘They just don’t get it, do they?’ I complained to Boris. He whimpered slightly as he shifted his weight onto his good limb and then lay down, head dejectedly between his broad paws.

It seemed that ‘the brother’ was losing his touch
somewhat
as no mention was made of him when Mrs Devlin’s other half arrived at the surgery later that day.

With only a passing glance at Boris, he wrung his hands, and leaning his massive weight against the consulting table said that they had decided the best option would be to put the dog to sleep. Although I wasn’t altogether
surprised
, I couldn’t believe that Boris wasn’t even going to be given a chance. What, I thought to myself, was the
point in going to courses and investing heavily in
specialised
surgical equipment when people didn’t want the treatment for their animals?

‘Well, I told you that, didn’t I?’ said Seamus as I relayed my tale of woe to him the next morning. ‘You were the one running off to do your course.’

A regular part of veterinary practice involves euthanasia of animals: some much-loved pets at the end of a long road, others following serious illness or injury but, sadly, too many for the simple reason that they are unwanted. Boris fell in between two categories, but it sickened me to think of such a magnificent animal not being given a chance.

Not long after Mr Devlin had left the surgery, I dialled the house number. Mrs Devlin sounded surprised to hear from me.

‘Oh, it’s yourself, is it?’ she said. ‘Ah the poor old dog, isn’t it a terrible pity? But there was nothing to be done for the brute,’ she added as though in defiance of my lengthy lecture earlier that day.

‘Well, the thing is, Mrs Devlin, I was wondering, as you want to have Boris put to sleep, would you mind if we were to take over his ownership? I will do the surgery myself at my own expense and re-home him afterwards if his leg heals.’

As I spoke to her, I tried to ignore not only Seamus’s
reaction
at what was probably quite an unprofessional
suggestion
and also Donal’s when he realised that we would be inheriting yet another dog for the recovery period and one that was going to involve a lot of time and aftercare.

Mrs Devlin didn’t take too much persuading. I realised
just how genuine she was in her declared affection for the dog when she magnanimously offered to take him back when he had made a full recovery, if all went well. ‘But only,’ she reiterated, ‘if he doesn’t have a limp or anything like that.’ She seemed unfazed when I told her she would have to legally sign the dog over to me.

Donal was delighted for me that at last I had succeeded in obtaining a real orthopaedic case, but not as
enthusiastic
when he realised that Boris would be coming to stay with us for a while after the surgery. Although, ideally, I would like to have kept Boris until he was fully recovered and ready for rehoming, the imminent arrival of Molly’s sibling meant that I would have to organise for one of the local welfare groups to take over his care a few weeks after the surgery.

For the next few days, while I ordered the correct size pins and wire, Boris stayed at the surgery where daily treatment helped to reduce the tissue swelling in
preparation
for his surgery.

The night before the surgery I slept amongst an array of surgical atlases, course notes and any other relevant
articles
I could get my hands on. The surgical kit was duly sterilised and the battery for the drill fully charged.

On the fateful morning, Boris lazily wagged his tail as I slowly injected the intravenous anaesthetic. He was, by now, quite fond of me.

Arthur had readily agreed to assist at the surgery. He was happy to observe the procedure without the
responsibility
of actually doing it, and I was glad to have a bit of ‘professional hand-holding’, even though he had never
done any orthopaedic work himself. With Boris sleeping peacefully, I suspended the entire hind leg from a hook in the ceiling and carefully clipped the leg until it resembled an over-sized, if somewhat bruised, chicken drumstick. I wrapped the paw in a sterile drape before draping the
surgical
site. Once Boris was prepared, I scrubbed and gowned, finally putting on the sterile gloves before taking a last look at the surgical atlas, reminding me somewhat of a recipe book, propped up on the shelf behind.

It was only as I started to prepare for my incision that I really noticed the amount of swelling and discolouration in the area over the shaft of the femur. My surgical atlas
displayed
, in simple line diagrams, the site of the incision which would expose the two main muscle bodies. The next page indicated the shaft of the femur which would lie directly underneath, once I had separated the muscle mass. Tentatively, I prodded the area, hesitating for a few moments, trying to decide where exactly to make the
incision
in the distorted limb. Finally, taking a few deep breaths, I sliced an incision over a ten-centimetre-long
section
of the leg. Dark, red, watery fluid oozed out along the full length. Arthur diligently swabbed the site with sterile gauze so that I would have a clear view of what lay beneath.

I glanced back at the picture in my atlas, feeling slightly disconcerted that it wasn’t looking terribly similar.
Cautiously
, I started to separate the edges of the skin and pick at bits of traumatised connective tissue or fasciae. I
suddenly
noticed I was feeling rather hot, although it was cold in the operating room in mid-winter and my knees had taken on a rather jelly-like consistency that had nothing to
do with my state of advanced pregnancy.