A Christmas morality tale

A post without pictures.
A cautionary tale.
A day in the life of a companion animal veterinarian.  James Herriot eat your heart out.

Or something like that.

A couple of interesting things to report today, beginning with a death at 5.30 this morning, in the laundry at home.  I’d taken a patient home last night after an extended surgery to remove a large bone from her thoracic oesophagus that had kept me and my long-suffering wife and my diligent practice manager locked up in the operating room until well past bed time.  Well, past *my* bed time, anyway.  Some of you reading this post may well stay up past 9pm, but not this little black duck.

As the old saying goes, the operation was a success, but the patient died.  Kind of.  Not that the dog kind of died, of course.  Even in the hands of the most skilled of practitioners death is still very much an absolute kind of thing.  What I meant was that the operation was kind of a success.  Obviously the death of the patient reduced the glow a bit.  But I didn’t come here today to talk about death and sadness, nor to give you the impression that we’re in the business of being anything less than successful in the operation department, or even (even?) in the after-care department.  Actually, perhaps I shouldn’t have mentioned the dead patient at all, except that it was how the day began, so it kind of set the tone for the day, and I thought maybe it might set the right tone as I relate some of what followed.

Later in the morning we were visited by a lovely man and his lovely cat.  The man, let’s call him Lindsay, has been a client for many a long year, and is just about one of the nicest, friendliest and most interesting men around.  Just ask any of his three previous wives with whom he retains lasting friendships, apparently without upsetting his current one.

Lindsay first appeared on our doorstep way back at the turn of the century with two cats he’d brought back with him from his previous life in Pakistan and other exotic locations.  We cared for those two cats on and off until their deaths as very old cats.  One died in our care with liver failure, the other faded away more slowly from kidney failure.  As is the way in veterinary medicine, neither of then ‘died’.  Both were ‘euthanased’.   The first euthanasia took place here in hospital, the second at Lindsay’s house.

Obviously that was a memorable occasion, as is any death that comes at the end of a long and drawn out period of disease.  Two of us went to visit Lindsay and his wife and their last remaining cat, and we sat on the floor of their sitting room in front of the heater and talked about old times and cats and companionship and the kind of stuff one talks about as one dances around the subject of death.  Then we quietly and gently and nicely gave the cat that nudge into the next life that only vets can give, and we stayed and we sat and we talked for a while longer, and came back to the clinic and got on with our lives.

Today he came with one of his new cats, a good looking Balinese chap with a bit of a limp.  The cat, let’s call him Rafferty, was here a couple of months ago, also with a limp.  On that occasion he had some short term nerve damage, most probably the result of having his leg jerked by grabbing at something as he fell from a fence or a tree.  The result is called radial paralysis, or partial paralysis as was the case with Rafferty, and assessing the amount of damage required a bit of poking and prodding.

One of the things one wants to do in this regard is to find out if the cat has what is termed conscious perception of pain.  In other words does he say OUCH when it hurts?  The standard test in this regard is to pinch the toes.  If you pinch them only lightly the cat (or dog, or person) will likely withdraw the foot, but this is a mere reflex, relying only on local nerves.  To really know if it hurts you have to make it hurt.  So the toes are pinched quite hard, with a pair of haemostats.  (A bit like a pair of pliers, only more syllables.)

As expected, Rafferty *did* say OUCH, and this was a Good Thing, as it indicated intact nerve pathways all the way from the toes to the brain.  A cat that doesn’t say OUCH when you pinch his toes quite hard has a big problem.  So it was a Good Thing to hear that OUCH, but not so good that it was accompanied by a little nip.  Rafferty was so displeased to have his toes pinched, so discomfited by the ordeal, that he lashed out and bit the nearest thing, which in this case was Lindsay’s hand.

Oh dear, I said.  That could be nasty.   You should wash that bite right now with this disinfectant. Here.  Now.   I think I also suggested that cat bites are worth taking to the doctor, but Lindsay doesn’t recall me offering this critical piece of advice.  He seemed happy enough that his cat was more or less OK, and his hand didn’t trouble him at all.  Off he went, and we didn’t hear from him again.

Until today.

Lindsay came in today, again with Rafferty, again with a bit of a leg problem, although different legs this time.  And as he walked in the door he began our discourse by exclaiming “boy, have I got a story for you!”  I’ll precis it for you:

He left with his cat 2 months ago and went home, not at all bothered about his hand and his apparently tiny cat bite wound.  She’ll be right is probably how he felt, if not the exact words he used in his inner dialogue.  Four or five days later his hand began to swell, and to hurt, so he took it to the doctor, and the oral antibiotics began.  A couple of days of tablets and things were getting worse, so the doctor was revisited and a hospital visit was ordered.  The hospital staff began by saying they would admit him, then contradicted themselves and sent him home with different antibiotics.  When another day or two had elapsed and his hand was no better his now grumpy GP sent him back to the hospital where he was duly admitted.  IV antibiotics every 6 hours was the deal.  Scans were made, xrays were taken and consultants were consulted.  Amongst the consultants were the members of the Plastics Team at the Alfred, who expressed some alarm.  “This man may lose function of part or all of his hand” they said.  Send him to us immediately.

A period of hospitalisation in the Alfred followed, during which he was prepped for surgery not once but three times, but in the end no surgery was done.  I don’t want to cut you, was what the Irish surgeon said repeatedly in his gentle lilting brogue.

In the end the hand began to improve and the patient was discharged to the care of his wife and the comfort of his home, and he picked up his life again.  Which is where it gets interesting.  A while ago Lindsay found himself at a party.  A 50th birthday, with many guests.  As the big hours or the evening morphed into the small hours of the morning our cat-owning protagonist found himself the centre of attention, re-telling the story of his visit to the vet and the many, many, many subsequent visits to the many, many, many members of the (human-oriented) medical profession that followed.  Given his verbal skills, his personal skills and his self-professed penchant for a drink or two, I suspect Lindsay feels pretty much at home being the centre of attention, relating some tale of derring-do.

What he didn’t know was that amongst his audience was not one, not two, but a healthy handful of lawyers, and each of these lawyers, without exception started using words like “probable cause”, “duty of care”, “breach”, and of course “sue”.  Sue the vet, of course!

My blood went cold for a moment as I contemplated what might have been.  But of course people like Lindsay don’t sue over such trifles!  His response?  He proceeded to tell those assembled a story about how that very same vet, that breach-of-care, probable-cause vet, that culpable vet, that alleged vet, had visited his house a year ago and kindly and lovingly helped his ailing, failing cat to die.  Lindsay is obviously quite the raconteur, because by the end of it all there was not one, not two, but a healthy handful of lawyers wiping the tears from their eyes as they agreed that this was a vet who should most definitely not be sued!

There may well be a moral or two to this story.  Perhaps you could suggest one…


2 Comments (+add yours?)

  1. Heidi
    Dec 14, 2011 @ 21:05:51

    What a lovely story…? At least it was told very skillfully!

    The moral of the story, from what I can gather, is that even lawyers have hearts, and that maybe karma works like it should sometimes after all. Good on you John. (Sorry to hear about oesophagus obstruction though)


  2. scottsabode
    Jan 04, 2012 @ 23:30:57

    The moral is nice guys don’t finish last.
    I still have scars on my hand from the dear departed Orlando when he objected strenuously to being helped out of the one-legged dangling position in which he found himself when he got caught in the brackets of a fold-out washing line. I responded better to the antibiotics than your client but it still wasn’t pleasant. I remember watching as Orlando’s incisors pierced the flesh on my hand between thumb and forefinger. He got me on a couple of other fingers too. The doctor told me that the only bite with more bacteria in it than a cat bite was a human bite.
    Merry Christmas and a Happy New Year to you Dr John!


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