Anyway, it had all changed for me and my work consisted now of driving
from farm to farm across the roof of England with a growing conviction
that I was a privileged person.
I got back into the car and looked at my list of visits; it was good to
be back and the day passed quickly. It was about seven o'clock in the
evening, when I thought I had finished, that I had a call from Terry
Watson, a young farm worker who kept two cows of his own. One of them,
he said, had summer mastitis. Mid-July was a bit early for this but in
the later summer months we saw literally hundreds of these cases; in
fact a lot of the farmers called it "August Bag'. It was an unpleasant
condition because it was just about incurable and usually resulted in
the cow losing a quarter (the area of the udder which supplies each teat
with milk) and sometimes even her life.
Terry Watson's cow looked very sick. She had limped in from the field at
milking time, swinging her right hind leg wide to keep it away from the
painful udder, and now she stood trembling in her stall, her eyes
staring anxiously in front of her. I drew gently at the affected teat
and, instead of milk, a stream of dark, foul-smelling serum spurted into
the tin can I was holding.
"No mistaking that stink, Terry," I said. "It's the real summer type all
right." I felt my way over the hot, swollen quarter and the cow lifted
her leg quickly as I touched the tender tissue. "Pretty hard, too. It
looks bad, I'm afraid."
Terry's face was grim as he ran his hand along the cow's back. He was in
his early twenties, had a wife and a small baby and was one of the breed
who was prepared to labour all day for somebody else and then come home
and start work on his own few stock. His two cows, his few pigs and hens
made a big difference to somebody who had to live on thirty shillings a
week.
"Ah can't understand it," he muttered. "It's usually dry cows that get
it and this 'uns still giving two gallons a day. I'd have been on with
tar if only she'd been dry." (The farmers used to dab the teats of the
dry cows with Stockholm tar to keep off the flies which were blamed for
carrying the infection.)
"No, I'm afraid all cows can get it, especially the ones that are
beginning to dry off." I pulled the thermometer from the rectum - it
said a hundred and six.
l i .:1 "What's going to happen, then? Can you do owl for her."
"I'll do what I can, Terry. I'll give her an injection and you must
strip the teat out as often as you can, but you know as well as I do
that it's a poor outlook with these jobs."
"Aye, ah know all about it." He watched me gloomily as I injected the
Coryne pyogenes toxoid into the cow's neck. (Even now we are still doing
this for summer mastitis because it is a sad fact none of the modern
range of antibiotics has much effect on it.) "She'll lose her quarter,
won't she, and maybe she'll even peg out."
I tried to be cheerful. "Well, I don't think she'll die, and even if the
quarter goes she'll make it up on the other three." But there was the
feeling of helplessness I always had when I could do little about
something which mattered a great deal. Because I knew what a blow this
was to the young man; a three-teated cow has lost a lot of her market
value and this was about the best outcome I could see. I didn't like to
think about the possibility of the animal dying.
"Look, is there nowt at all I can do myself? Is the job a bed 'un do you
think?" Terry Watson's thin cheeks were pale and as I looked at the
slender figure with the slightly stooping shoulders I thought, not for
the first time, that he didn't look robust enough for his hard trade.
"I can't guarantee anything," 1 said. "But the cases that do best are
the ones that get the most stripping. So work away at it this evening
every half hour if you can manage it. That rubbish in her quarter can't
do any harm if you draw it out as soon as it is formed. And I think you
ought to bathe the udder with warm water and massage it well."
"What'll I rub it with."
"Oh, it doesn't matter what you use. The main thing is to move the
tissue about so that you can get more of that stinking stuff out.
Vaseline would do nicely."
"Ah've got a bowl of goose grease."
"O.K. use that." I reflected that there must be a bowl of goose grease
on most farms; it was the all-purpose lubricant and liniment for man and
beast.
Terry seemed relieved at the opportunity to do something. He fished out
an old bucket, tucked the milking stool between his legs and crouched
down against the cow. He looked up at me with a strangely defiant
expression. "Right," he said. "I'm startin' now."
As it happened, I was called out early the next morning to a milk fever
and on the way home I decided to look in at the Watsons' cottage. It was
about eight o'clock and when I entered the little two-stalled shed,
Terry was in the same position as I had left him on the previous night.
He was pulling at the infected teat, eyes closed, cheek resting against
the cow's flank. He started as though roused from sleep when I spoke.
"Hello, you're having another go, I see."
The cow looked round, too, at my words and I saw immediately, with a
thrill of pleasure that she was immeasurably improved. She had lost her
blank stare and was looking at me with the casual interest of the
healthy bovine and best of all, her jaws were moving with that slow,
regular, lateral grind that every vet loves to see.
"My God, Terry, she looks a lot better. She isn't like the same cow."
The young man seemed to have difficulty in keeping his eyes open but he
smiled. "Aye, and come and have a look at this end." He rose slowly from
the stool, straightened his back a little bit at a time and leaned his
elbow on the cow's rump.
I bent down by the udder, feeling carefully for the painful swelling of
last night, but my hand came up against a smooth, yielding surface and,
in disbelief, I kneaded the tissue between my fingers. The animal showed
no sign of discomfort. With a feeling of bewilderment I drew on the teat
with thumb and forefinger; the quarter was nearly empty but I did manage
to squeeze a single jet of pure white milk on to my palm.
"What's going on here, Terry? You must have switched cows on me. You're
having me on, aren't you."
"Nay, guvnor," the young man said with his slow smile. "It's same cow
all right - she's better, that's all."
"But it's impossible! What the devil have you done to her."
"Just what you told me to do. Rub and strip."
I scratched my head. "But she's back to normal. I've never seen anything
like it."
"Aye, I know you haven't." It was a woman's voice and I turned and saw
young Mrs. Watson standing at the door holding her baby. "You've never
seen a man that would rub and strip a cow right round the clock, have
you."
"Round the clock?" I said.
She looked at her husband with a mixture of concern and exasperation.
"Yes, he's been there o
n that stool since you left last night. Never
been to bed, never been in for a meal. I've been bringing him bits and
pieces and cups of tea. Great fool - it's enough to kill anybody."
I looked at Terry and my eyes moved from the pallid face over the thin,
slightly swaying body to the nearly empty bowl of goose grease at his
feet. "Good Lord, man," I said. "You've done the impossible but you must
be about all in. Anyway, your cow is as good as new - you don't need to
do another thing to her, so you can go in and have a bit of rest."
"Nay, I can't do that." He shook his head and straightened his
shoulders. "I've got me work to go to and I'm late as it is."
Chapter Six.
I couldn't help feeling just a little bit smug as I squeezed the bright
red rubber ball out through the incision in the dog's stomach. We got
enough small animal work in Darrowby to make a pleasant break from our
normal life around the farms but not enough to make us blase. No doubt
the man with an intensive town practice looks on a gastrotomy as a
fairly routine and unexciting event but as I watched the little red ball
roll along the table and bounce on the surgery floor a glow of
achievement filled me.
The big, lolloping Red Setter pup had been brought in that morning; his
mistress said that he had been trembling, miserable and occasionally
vomiting for two days - ever since their little girl's ball had
mysteriously disappeared. Diagnosis had not been difficult.
I inverted the lips of the stomach wound and began to close it with a
continuous suture. I was feeling pleasantly relaxed unlike Tristan who
had been unable to light a Woodbine because of the ether which bubbled
in the glass bottle behind him and out through the anaesthetic mask
which he held over the dog's face; he stared moodily down at the patient
and the fingers of his free hand drummed on the table.
.
., :~:
.
But it was soon my turn to be tense because the door of the operating
room burst open and Siegfried strode in. I don't know why it was but
whenever Siegfried watched me do anything I started to go to pieces;
great waves seemed to billow from him - impatience, frustration,
criticism, irritation. I could feel the waves buffeting me now although
my employer's face was expressionless; he was standing quietly at the
end of the table but as the minutes passed I had the growing impression
of a volcano on the bubble. The eruption came when I began to stitch the
deep layer of the abdominal muscle. I was pulling a length of catgut
from a glass jar when I heard a sharp intake of breath.
"God help us, James!" cried Siegfried. "Stop pulling at that bloody gut!
Do you know how much that stuff costs per foot ? Well it's a good job
you don't or you'd faint dead away. And that expensive dusting powder
you've been chucking about - there must be about half a pound of it
inside that dog right now." He paused and breathed heavily for a few
moments. "Another thing, if you want to swab, a little bit of cotton
wool is enough - you don't need a square foot at a time like you've been
using. Here, give me that needle. Let me show you."
He hastily scrubbed his hands and took over. First he took a minute
pinch of the iodoform powder and sprinkled it daintily into the wound
rather like an old lady feeding her goldfish, then he cut off a tiny
piece of gut and inserted a continuous suture in the muscle; he had
hardly left himself enough to tie the knot at the end and it was touch
and go, but he just made it after a few moments of intense
concentration.
This process was repeated about ten times as he closed the skin wound
with interrupted silk sutures, his nose almost touching the patient as
he laboriously tied off each little short end with forceps. When he had
finished he was slightly pop-eyed.
"Right, turn off the ether, Tristan," he said as he pulled off half an
inch of wool and primly wiped the wound down.
He turned to me and smiled gently. With dismay I saw that his patient
look was spreading over his face. "James, please don't misunderstand me.
You've made a grand job of this dog but you've got to keep one eye on
the economic side of things. I know it doesn't matter a hoot to you just
now but some day, no doubt, you'll have your own practice and then
you'll realise some of the worries I have on my shoulders." He patted my
arm and I steeled myself as he put his head on one side and a hint of
roguishness crept into his smile.
"After all, James, you'll agree it is desirable to make some sort of
profit in the end."
It was a week later and I was kneeling on the neck of a sleeping colt in
the middle of a field, the sun was hot on the back of my neck as I
looked down at the peacefully closed eyes, the narrow face disappearing
into the canvas chloroform muzzle. I tipped a few more drops of the
anaesthetic on to the sponge and screwed the cap on to the bottle. He
had had about enough now.
I couldn't count the number of times Siegfried and I have enacted this
scene; the horse on his grassy bed, my employer cutting away at one end
while I watched the head. Siegfried was a unique combination of born
horseman and dexterous surgeon with which I couldn't compete, so I had
inevitably developed into an anaesthetist. We liked to do the operations
in the open; it was cleaner and if the horse was wild he stood less
chance of injuring himself. We just hoped for a fine morning and today
we were lucky. In the early haze I looked over the countless buttercups;
the field was filled with them and it was like sitting in a shimmering
yellow ocean. Their pollen had powdered my shoes and the neck of the
horse beneath me.
Everything had gone off more or less as it usually did. I had gone into
the box l l i with the colt, buckled on the muzzle underneath his head
collar then walked him quietly out to a soft, level spot in the field. I
left a man at the head holding a long shank on the head collar and
poured the first half ounce of chloroform on to the sponge, watching the
colt snuffling and shaking his head at the strange scent. As the man
walked him slowly round I kept adding a little more chloroform till the
colt began to stagger and sway; this stage always took a few minutes and
I waited confidently for Siegfried's little speech which always came
about now. I was not disappointed.
"He isn't going to go down, you know, James. Don't you think we should
tie a foreleg up?
I adopted my usual policy of feigning deafness and a few seconds later
the colt gave a final lurch and collapsed on his side. Siegfried,
released from his enforced inactivity, sprang into action. "Sit on his
head!" he yelled. "Get a rope on that upper hind leg and pull it
forward! Bring me that bucket of water over here! Come on - move."
It was a violent transition. Just moments ago, peace and silence and now
men scurrying in all directions, bumping into each other, urged on by
Siegfried's cries.
Thirty years later I am still dropping h
orses for Siegfried and he is
still saying "He isn't going to go down, James'.
These days I mostly use an intravenous injection of Thiopentone and it
puts a horse out in about ten seconds. It doesn't give Siegfried much
time to say his piece but he usually gets it in somewhere between the
seventh and tenth seconds.
This morning's case was an injury. But it was a pretty dramatic one,
justifying general anaesthetic to repair it. The colt, bred from a fine
hunter mare, had been galloping round his paddock and had felt the urge
to visit the outside world. He had chosen the only sharp fence post to
try to jump over and had been impaled between the forelegs; in his
efforts to escape he had caused so much damage in the breast region that
it looked like something from a butcher's shop with the skin extensively
lacerated and the big sternal muscles hanging out, chopped through as
though by a cleaver.
"Roll him on his back," said Siegfried. "That's better." He took a probe
from the tray which lay on the grass near by and carefully explored the
wound. "No damage to the bone," he grunted, still peering into the
depths. Then he took a pair of forceps and fished out all the loose
debris he could find before turning to me.
"It's just a big stitching job. You can carry on if you like."
As we changed places it occurred to me that he was disappointed it was
not something more interesting. I couldn't see him asking me to take
over in a rig operation or something like that. Then, as I picked up the
needle, my mind clicked back to that gastrotomy on the dog. Maybe I was
on trial for my wasteful ways. This time I would be on my guard.
I threaded the needle with a minute length of gut, took a bite at the
severed muscle and, with an effort, stitched it back into place. But it
was a laborious business tying the little short ends - it was taking me
at least three times as long as it should. However, I stuck to it
doggedly. I had been warned and I didn't want another lecture.
I had put in half a dozen sutures in this way when I began to feel the
waves. My employer was kneeling close to me on the horse's neck and the
foaming breakers of disapproval were crashing into me from close range.
I held out for another two sutures then Siegfried exploded in a fierce
whisper.
"What the hell are you playing at, James."
"Well, just stitching. What do you mean."
:
~1
,Y I I :3 i , "But why are you buggering about with those little bits of
gut?
We'll be here all bloody day."
I fumbled another knot into the muscle. "For reasons of economy." I
whispered back virtuously.
Siegfried leaped from the neck as though the horse had bitten him. "I
can't stand any more of this! Here, let me have a go."
He strode over to the tray, selected a needle and caught hold of the
free end of the catgut protruding from the jar. With a scything sweep of
his arm he pulled forth an enormous coil of gut, setting the bobbin
inside the jar whirring wildly like a salmon reel with a big fish on the
line. He returned to the horse, stumbling slightly as the gut caught
round his ankles and began to stitch. It wasn't easy because even at the
full stretch of his arm he was unable to pull the suture tight and had
to keep getting up and down; by the time he had tacked the muscles back
into their original positions he was puffing and I could see a faint dew
of perspiration on his forehead.
"Drop of blood seeping from somewhere down there," he muttered and
visited the tray again where he tore savagely at a huge roll of cotton
wool. Trailing untidy white streamers over the buttercups he returned
and swabbed out the wound with one corner of the mass.