Maybe it -should- happen to a vet

Snakes...why did it have to be snakes?

2012-01-31T09:52:00.001Z

The quote above, uttered by everyone's favourite archaeologist as he gazes into the Well of Souls and realises just why the floor appears to be moving, is often parodied, drunkenly recited or just plain copied amongst the geekier corners of the planet. However, the line, or something very much like it, will go through your average friendly veterinary surgeon's head when he or she clicks on the next consult on the list to discover that 'Freddy' is actually a boa constrictor, rather than a poodle, as they had previously been hoping.

A boa may have been a bad example there, because it suggests that the problem is that the animal is dangerous. Not so - or at least, not entirely so. The vet is probably going to feel just as disheartened by a grass snake, to be honest, because it is an 'exotic' - a word whispered with dread in prep rooms and dispensaries up and down the country.

You see, doctors have one species to deal with. It's an odd species, I'll grant you, and tends to talk your ear off before getting to the point of exactly what is wrong with it, plus it has a tendency to mislead or just plain lie to you about what it's symptoms are - but it's still just one. Vets have technically got all the others to worry about, from aardvarks to zebras, and the 8 million or so other species in between (that's a very rough guess, of course...have a look here for a slightly less rough one. But still a guess).

Technically. In practice, of course, it doesn't quite work like that. Back in Herriot's day, pretty much all vets saw pretty much everything that was thrown at them, from pets to farm animals, but nowadays it's very hard to be a true 'mixed practice' vet. Kerry and I gave up 'large animal' work (farm animals and horses) many years ago, and a lot of vets that graduated since our time (I was a millennium baby, veterinary-wise) have never set foot on a farm since they packed their wellies away after their final year viva.

This is not such a bad thing - at least for small animals, though it is getting increasingly difficult to find large animal vets at all any more, and even in 'mixed' practices, the work tends to be divvied up between small animal vets and large animal vets, rather than everyone doing everything. Small animal vets, like me, are nicely within their comfort zone seeing dogs and cats. It's when an 'exotic' walks through the door that we're catapulted right out of that zone into ignoranceville.

'Exotics' (a term that always makes me think of cocktails and hula skirts. Maybe if I was brought up in Honolulu it'd make me think of bowler hats and double decker buses?) is bascially the veterinary term for any animal that takes us out of that comfort zone. In Herriot's day, and even when I had just qualified, this included rabbits, but no longer. Rabbits are getting more common, and are edging closer to dogs as Britain's second favourite pet (after cats). In my first few years in practice, what we now call 'small furries' (but what would be more scientifically called rodents and mustelids - mice, rats, ferrets etc) could have been described as exotic (though this seems a very strange adjective to use about a gerbil) but, as with rabbits, this isn't really the case any more.

(In fact, I seem to be encountering a whole new breed of client, recently - the internet savvy rat owner. These people absolutely dote on their rats, and will likely have researched the problem for quite some time before coming to see you. This isn't a complaint - I actually find it quite helpful. There's (sadly) reams of research of rat ailments, because they are the classic lab animal (unlike guinea pigs, which are strangely very rarely used as guinea pigs) which is difficult to keep up with in practice. Plus, I like rats. I know some people aren't keen on them, but I don't know why. Contrary to what you might have heard, they don't carry any more diseases that your average wild beastie, they're highly intelligent and very sweet. I'm far far less likely to get bitten by a rat than just about any other species I examine, and when I have been bitten by them, I almost always deserved it.)

What we basically mean by 'exotic' is this - feathers or scales. A carapace would do it too, as well as whatever an amphibian is covered with (which might give you some idea of the extent of my amphibian knowledge). The appearance of a reptile or a bird in the waiting room will usually lead to some tense prep room negotiations between the consulting vets ('You do it, please!' 'I did that macaw yesterday, it's not my turn' 'But I saw that bloody chinese water dragon last week.' 'Tell you what, you see it, and I'll do the next five anal glands.')

It's not that we're afraid of them as animals (well, I'm not. My wife might have a different opinion on the matter) - I'm fortunate (considering my job) not to have a phobia about any animals at all. Take me to the top of the Eiffel Tower and I'll scream and cower shaking on the floor like Scooby Doo, but I'm not automatically terrified of critters. It's more the fear that you won't know what's wrong, and even if you can work it out you won't have the slightest idea what to do about it.

Though it may seem like rather an obvious statement, reptiles and birds are very different creatures to mammals. That's why they're in a whole different class (I mean this in the taxoniomical sense, though you can take that sentence any way you like and probably still get the right idea). Let's take a bit of a look at birds to make the point.

I don't know what it is about birds. I mean, they are fascinating creatures - they can fly, for heavens sake! An animal adapted to doing what mankind could only, until the last century, dream about. But, for some reason, they just don't float my boat. I can't find myself excited by, or even especially interested in, birds. I don't actively dislike them, because I don't really actively dislike any animal (except wasps. Bastards.) but they just don't interest me, and I'm not sure why because they really are quite amazingly different to mammals. On the face of it, they do seem similar - or rather, more similar to mammals that reptiles are - but sadly that isn't really the case. Let's just outline a few of the differences that really cause vets problems.

First (and foremost) - outward signs of disease, or lack thereof. Birds are really not good at looking ill, at least until they are so ill that they don't really have any choice. The practical upshot of this is that if a bird is taken to their local vet, they are normally very, very ill indeed. In the case of budgies, they are often so ill that merely the act of clinically examining them can be enough to get them to squawk off their mortal coil, which is an unfortunate experience for both vet and budgie.

The second problem is diagnosis. Birds have a vastly different anatomical and physiological set-up than mammals; although they do have lungs, they are tiny and don't expand, and the principle means of air flow is via air sacs. They don't have a stomach, instead they have a crop (well, some of them do), a proventriculus and a gizzard. They don't have external genitalia (well, most of them don't); checking the sex of a bird usually involves an anaesthetic and a laparoscope, except for budgies which have nicely colour-coded ceres (the bit just above the beak - blue for boys and pink for girls, satisfyingly. Except it's more brown than pink in girls, but let's not spoil it). They have a 'renal portal system', which means that anything you inject into the back legs ends up passing straight through the kidneys at much higher concentration that you would normally expect. I could go on, but I won't - there are many many more.

All of this means that it is often hard, if you're not experienced in looking at birds, to even know where to start. Is that poo normal? Are the eyes supposed to be that colour? Does that air sac sound unusual? This problem is compounded by the lack of interest in teaching about the exotic species at university. My lectures on birds were almost entirely about chickens, and the vast majority of them focused on the twenty different types of ventilation systems used for housed birds, as well as what lighting protocol you should follow to pump as many eggs as possible out of the poor things. Consequently, my notes of avian medicine consist largely of unhelpful tips like 'If there's something wrong with the birds, sacrifice one and send it for post mortem to find out what it is.' Rather callous, and unlikely to go down well in a consulting room.

Thirdly, their metabolism. Birds have quite a bit faster metabolism than mammals, and if you try and use your drugs at a normal dose scaled down, you'll likely be underdosing. Add to this that almost all medicines are not licensed for use in birds, and that different sources will tend to recommend different doses, plus the simple difficulty for an owner to get medicines into them, and you're having problems even if you do manage to work out what is wrong with them.

With reptiles, things only get harder. They are creatures that shed their skin, that only eat every third day or less, that don't bother with the trouble of keeping warm, just letting the environment do the job for them (which makes you wonder quite what a tortoises opinion of living in Britain in mid-January is). Another big problem with reptiles is...how can I put this delicately? The average reptile owner is, and I'm only saying generally, not perhaps the most well-to-do member of society. Because I'm a typical vet - i.e. a very poor businessman - I always cringe when I have to point out that people have to pay for our services, because we are a business, but the sad fact of the matter is that reptile owners quite often can't afford any tests or diagnostic aids that might help us work out what is going wrong, and certainly can't afford to be referred to a specialist reptile vet.

There is, however, one saving grace with exotics work, that I can sum up in one simple word; Baytril. Baytril is the trade name for enrofloxacin, an antibiotic that is licensed for just about any species that you can imagine would walk through the door, comes in a liquid formulation that can be mixed with drinking water, and is highly effective for many of the infections we see. It's also relatively cheap, and as a consequence of this, it becomes the back-up option for many a vet who otherwise doesn't really know what is going on. I'm not proud of this, but I guarantee many vets reading this will be nodding their heads, and possibly even getting down on their knees to thank Bayer for Baytril.

My personal approach to exotics work is be unashamedly honest with the owner's when they bring in their bearded dragons. 'I don't claim to be reptile specialist,' I'll say, 'But I'm happy to have a look!'. I also make no bones about the fact that I'm 'going to have a look in my exotics manual to see if it's got anything about this'. It might make me look a bit dumb, but I'd rather the owner knew where they stood than try and pretend I'm some sort of lizard magic-worker (a lizard wizard, if you will). As least they won't be too disappointed when the Baytril doesn't work.

This will be my last post for a couple of weeks - Kerry and I are off to Tanzania (if I can shake off this ruddy chest infection. Maybe I should take some enrofloxacin?) in a few days, to meet some exotics in person. I just hope we don't have to treat any of them...

The Express Diaries

2012-01-23T15:37:00.001Z

This is a writing post, not a veterinary post, so those that are turned off by such things may turn away now with a clear conscience (though now I'm a little worried I'm just left with those people who are turned on by such things. Er...hi.).

I wanted to tease you a little now that my latest project, the Express Diaries, is starting to come together. The Express Diaries is a pulpy-action/horror novel set in 1925 on (as the title suggests) the Orient Express. I'm very pleased with how it's going, and even more pleased now that Eric (Smith, Glimbit on Twitter) has agreed to do some artwork for me.

I'd like to share a few piccies with you now, partially to show you why I'm so happy Eric is working with me, and partially to be a tempting appetizer for what is to come...

Sirkeci Station, Istanbul - 1925
Our adventurers confront their fate at the terminus of the Simplon Orient Express

The redoubtable Mrs Betty Sunderland
'Widowed matriarch of the Yorkshire Sunderlands. An unusually enrepreneurial female of the age, having variously been an archaelogist, lecturer, and mother (of four). Currently owns a shop selling items of archaeological and occult interest in the Soho district of London

'I dreamed of a city in flames...on the high city walls, men and women hung from ropes, left to starve and rot in the baking sun'
Extract from the dream diary of Violet Davenport

As a further appetizer (though, I understand if you're a bit full after the piccies. Think of this as pudding), here's an extract from the London chapter, near the start of our story, where Professor Alfonse Moretti makes an expected and grisly discovery in the reading room of the British Museum, whilst investigating a mysterious artifact known as the Sedefkar Simulacrum...

'PersonalJournal of Professor Alfonse Moretti (trans. from Italian) October 24^th,1925.

I will not deny that mymovements and activities through the years always seem to have attracted morethan their fair share of interest by the police or related Government parties[1].On occasion this has been, shall we say, justifiedinterest. However, I was not expecting a simple research trip to the BritishMuseum Library to cause the furore that it did. Thankfully, I was notresponsible, nor even directly involved, in this gruesome incident. I think itis safe to say that I certainly hope not to get any more involved as time goes by.

I am fortunate enough to hold an invitation for the BritishMuseum Library Reading Room, open for several months, to aid in some researchwhich I have been conducting for a client of mine. This business with theSimulacrum intrigues me – an ancient artefact of which I knew nothing untilyesterday evening. An artefact that seems important enough to kill for (assuming,of course, that the colonel is wrong, and were are not merely chasing theramblings of a doddering old fool).

After ourgroup’s meeting at Brown’s, the afternoon turned grey, and cold. Rain filled upthe streets, but my spirits were lifted at the prospect of a trip acrossEurope, hopefully even a return home to Milan (provided that certain partiescan be avoided, of course).

It is only a mile or so from the hotel to the museum so Idecided to walk, despite the weather. Few others had been of similar mind, asit turned out, because as I entered the reading room (which never fails toimpress!) I was alone save for one other person; a thin man, still rudelywearing his heavy overcoat and a trilby, hunched over a document. I took up aseat a few desks away, and began my researches.

I like to think my skills in the use of libraries asexcellent, but after several hours all I had managed to do was confirm theexistence of the Simulacrum itself (a passing reference to it in von Juntz’s Unaussprechlichen Kulten), and uncoversome hints that there may be more pertinent documents in the BibliothéqueNationale in Paris. A breakthrough of sorts came in a detailed perusal ofBarbaro’s Giornale dell'Assedio di Costantinopoli, which suggests that a set ofdocuments known as the Sedefkar Scrolls werepresent in Constantinople in the mid-fifteenth Century. This may be the‘information’ that Smith refers to. Further sources suggest that the scrollsmay now be located at the Topkapi Museum in that great city.

Looking back now, my defence would be to say that I wasgreatly absorbed in these researches, which is why it took me so long torealise that the man in the hat, present since my arrival, had not moved oneinch in all the hours I had been there. I cleared my throat rather loudly, butthis produced no reaction from the figure. After several minutes of closeobservation, during which the man remained still as a statue, I called over anattendant and apprised him of the situation. Even then, fixated on my work, thegravity of the situation was not clear to me. The attendant nodded andapproached the man, and I returned to my studies. I was given little more timeto research, however, because a great shriek then filled the massive dome ofthe reading room.

I looked up to see the attendant standing horrified overthe man in the coat, who had toppled forward. His arms had spread out over thedesk, exposing his hands - or at least, what remained of his hands.

Even from my seat, it was obvious that the skin had beenremoved from both of them. Two dark streaks covered the desk where the bloodyappendages had smeared across the desk as the body slumped – for there could nodoubt now that the man was dead.

The attendant stood in shock as I approached. ‘Fetch thepolice,’ I said to him. He looked at me, then back at the body, and rushedtowards the door. I approached the body.

The man’s hat had slipped to one side as he had fallen,and underneath the trilby I caught a glimpse of red flesh. Carefully touchingonly the large overcoat, I took hold of the corpse’s shoulder and pulled itbackwards into the chair. The hat fell off and I did so, and I was greeted withthe sight of two wide, staring eyes in the midst of a red mass of muscle, teethand gore. The overcoat slipped open, and the further horrors within confirmedthat the unfortunate had been stripped of all his skin.

My shock (tempered, fortunately, by similar sights I haveseen) was mixed with puzzlement. To remove a man’s skin is no trivial thing. Todo it in the reading room of the British Library...?

I looked from the body to the document the man had beenstudying – or at least, positioned in such a way as to appear to be. It was asingle line of Arabic text, written on a leathery shrivelled sheet, roughly cutaround the edges, and one did not need to be a doctor to deduce what it wasmade from. I shivered.

Fortunately, my Arabic is as good as my English.Scratched across the grisly parchment was the following message –

THE SKINLESS ONEWILL NOT BE DENIED.

It is somewhatshamefully that I admit my next action was to search the coat of theunfortunate man. In my experience of such situations, time is of the essence,and events usually slow to a crawl when members of the police force becomeinvolved. It is often better to find such clues as may be helpful to solving acase without their interference.

In the pocket of the large coat, I found a small card.Taking it out and examing it, I was surprised to see that it was the businesscard of our troubled friend, Professor Smith. I inverted the card, and sureenough there was the message which the colonel had discovered. My firstthoughts were of fear for the colonel, but then I remembered that Goodenoughhad returned the card to Smith’s manservant when we visited him in Cheapside.

The corpse before me was of far too slight a build to beProfessor Smith himself, but the build and shape of the body, even the colourof the eyes, now that I had the idea in my mind, perfectly matched those ofBeddows.

Still considering this disturbing find, and the strangemessage regarding the ‘Skinless One’, I heard hurried footsteps indicating tome that the library assistant was returning. I quickly pocketed the card,although I decided against purloining the document on the table. The originalattendant, with two of his colleagues, rushed back into the room.

I agreed, against my better instincts, to wait with themwhilst the police arrived. After twenty minutes, two uniformed men accompanied asmall, shabby man, who introduced himself to me as Inspector Pike of ScotlandYard. One of the men began to calm thenow near-hysterical library attendants, whilst the inspector strode over to thegory scene. He examined the body still seated at the desk, making variousasides to one of the uniformed men with a notebook beside him.

‘Just like the others,’ the inspector commented at onepoint. The uniformed man wrote it down. After a long time, the inspector turnedto me. He at least managed to pronounce my name right, after which hequestioned me on what I had seen – which in truth, save for the body itself,had been almost nothing. Quickly realising this, the inspector allowed me toleave, but I would not until my curiosity was sated.

‘I am sorry, inspector, but I could not help overhearingsomething there. Have there been other cases such as this one?’

The policeman frowned and his eyes narrowed, as if hewere trying to work out whether to be annoyed with me or not. ‘Don’t you readthe papers? Triple murder, some Turkish fella. Well, three Turkish fellas, allwith the same name. Makrit or something.’

The uniformed man next to the inspector cleared histhroat rather loudly. I had read something of this in the morning’s paper, butnothing about the bodies being skinned. I said as much to Pike, whose frowngrew deeper.

‘Well,not totally. Not like this poor chap, but they all had patches...’

Thepoliceman cleared his throat again.

‘Ohblast it,’ the inspector said, and a look of comprehension and embarrassment slowlysettled upon his face. It was like watching a bulldog gradually realising thatit was being scolded by its master. ‘Erm,’ he said. ‘That’ll be all now, thankyou, professor. If we have further need of you, we shall be in contact.’

Ithink this ‘skinless one’ may be safe from the clutches of the law for a whileat least.

Uponmy return home I re-read the newspaper article. Mehmet Makryat. The name had nomeaning for me, and sadly there remains no more time for investigations, for weleave for Dover tomorrow. The incident today weights heavily upon me. I fear wehave been drawn into something bigger than any of us expected. I have decidedto tell the others nothing of my discovery today save the results of myresearches. We will be out of the country before it is mentioned in the papers,and it wouldn’t do at the moment to create unnecessary alarm. Better to let theothers think of this as something like a holiday, at least at first. I thinkthat leaving England may be the most sensible thing we can do at the moment,and it would be wise for us to keep our investigations as circumspect aspossible.

Ihope I have made the correct decision here. Time will tell.'

The Express Diaries will be out later this year, in several different formats including eBook and luxury hardcover edition. Watch this space! (Well, watch the blog, anyway)

In further writing news - my novel from last year, Past Tense, is now available as an an ebook for $5 from Smashwords.com - feel free to have a peek, as you can download the first 10% for free!

Past Tense at Smashwords

[1]Attempting to follow Professor Moretti’s web of past associations and dealingsis an exercise mired in misdirection, obfuscation, and more often than not,failure. It is probably better, ultimately, just not to know.

It's worse than that, he's dead Jim! - lazy TV medical matters

2012-01-12T15:53:00.000Z

I'm a big fan of zombies. Not entirely sure why, but I am. I'm well aware that they're very overused nowadays, and everyone else is starting to get sick of them, but I was a fan of them before everyone and his mother got into them, therefore I'm allowed to continue liking them (unfortunate typo on my first pass at that sentence - licking them. I'm not that keen on them, honest) long after everyone else is bored with them.

(I think I like them because the stories that they appear in are often the stories about ordinary people, forced into extraordinary circumstances. That's possibly because zombies are the z-listers of the undead ranks. I reckon I could take on a zombie. Frankenstein's monster would tear me limb from limb, and I wouldn't last five seconds against a vampire (except one of those Twilight vampires. I could probably take one of them, too. I don't want to join the general Twilight-knocking that geeks often indulge in, because a lot of people seem to enjoy it, and I'm well aware I'm not Twilight's target audience, because I'm not a teenage girl. What I will say is that when I was growing up, vampires didn't go sparkly when exposed to sunlight. They exploded.))

A consequence of this zombophilia (I nearly wrote necrophilia, but I think wisely stopped myself) is that I do enjoy AMC's zombie-apocalyptic themed show, 'The Walking Dead' (unlike Kerry, who refuses to watch it no matter how many times I try and tell her it's a comedy. Instead she's got hooked on Game of Thrones instead - so imagine my glee when a zombie turned up in it :) ) (and I'll spare you my boring lecture about how I was already a fan of the comic book that it's based on, as if that somehow makes me a more worthy fan. Just bear in mind that it does, okay?) - that is, I usually enjoy it. Until Rick(heroic and slightly dull sheriff, for those who don't watch it)'s son accidentally got shot early on in season two.

Rick pops his recently punctured son along to a conveniently local doctor, who takes a look at the wound. And this is where I start to get irritated. (Not, incidentally, because the 'doctor' turns out to be a vet. I'm all for vets cropping up in popular culture in unexpected places to big up the profession! Most surprising place so far - Terminator 3).

The doc (okay, vet, but Rick doesn't know that at the time) looks Rick deep in the eyes with his wise, sad and serious eyes, and tells him that those damn bullets have got to come out right now.

Sigh.

More than likely, the problem is with me, than the show. I'm quite happy to accept the possibilty of corpses wandering round desperate to eat flesh, but something like this brings the whole reality of the show crashing down around me, and diffuses all the tension that I should be feeling watching the show. Probably if I was a policeman I would already have been annoyed by the flagrant disregard of firearms law, but I'm a vet, and it's the medical errors that get to me. How many times have you seen a film or show where someone grits their teeth, pulls out a penknife and a metal bowl, and heroically fishes out a great slug of lead from their arm/leg/ear, which then clangs satisfyingly into the bowl?

Why has the bullet got to come out right away? What is it going to do, explode?

By the time a bullet has made it a significant way into your body, it's already done quite a lot of damage. Poking it back out again with a blunt knife is unlikely to do wonders for the already traumatised tissue. What you want to be doing is dealing the the damage the bullet has already done, not doing your best to cause more with your self-induced knife injury. Your biggest problem at this point is probably going to be bleeding - a condition not generally helped by a spot of DIY surgery.

Don't get me wrong, there are times - quite a few of them - when you do need to get the bullet out - there's a list of a few of them here, if you're interested. But initial gunshot wound first aid does not generally involve removing bullets unless they are very easy to get to.

So why do they do it every time on TV shows? Because it's cinematic, and it looks exciting having someone bite down on a wooden spoon whilst a flustered guy in a white coat pokes about in his back with a scary-looking pair of forceps.

It irritates me because it's lazy - only a modicum of medical knowledge is required to understand this, but still we're served it all the time. When I see something like this, it puts me in mind of the Mitchell and Webb sketch with the two scriptwriters who can't be arsed to do any research, and by disbelief, until that point happily suspended, comes crashing to the ground.

Defibrillators are the other overused medical item that usually have me frothing at the mouth. Defibrillator. Say it. Defibrillator. There's a clue in the name. It defibrillates - that is, it is ONLY useful when your heart is in fibrillation. Fibrillation is a technical term which basically means that your heart has gone mental. I've seen a heart in fibrillation, and rather than the smooth lub-dup beating that we're all familiar with, it looked bizarrely like a clump of worms, all twisting and writhing and squidging together. When your heart is doing that, it's about as efficient at pumping blood as the Daily Mail is at spreading calm and tranquility. Your cardiac output drops to zero, and without very prompt treatment you're going to die.

A defibrillator stops your heart, and you hope that when it starts up again the problem will have sorted itself out. It turns out even our bodies work on the 'turn it off and on again' principle beloved of IT technicians. The point being - this only works during fibrillation. Zapping a heart that had already stopped will do absolutely nothing other than a bit of burn damage.

So why am I repeatedly subjected to the sight, on TV, of people flatlining (zero electrical activity in the heart. Not fibrillation), to the glee of the attending doctor, who breaks out the paddles, rubs then together dramatically, and slaps them on the dead person's chest, shouting 'clear!'. The first time never works, either, but after (usually) three attempts, the casualty gives an immense gasp, and sits up.

Sigh.

I could go on - in fact, I did go on in an earlier blog about a similar issue with intravenous injections. But I suppose that is missing the point. The problem, as I said, is more with me than with the shows. I know it's supposed to be drama, not real life, but...it's lazy drama, and if a show does that to me, it makes me think they've got everything else wrong as well. And that reminds me that I'm watching a work of fiction, it never happened, and...and all my interest in the show fizzles away.

There's two solutions to my plight.

1 - Only ever watch shows that are meticulously, painstaking researched and so deeply invested with verisimilitude that I'll never be brought out of it again. But as they're not going to make any more episodes of The Wire I'm stuck with the second option, which is...

2 - Remain deeply ignorant in as many areas of knowledge as possible, so that I can't tell if the script writers got something wrong.

So, just remember, if you're talking to me, and I don't know something - that's deliberate, so I can sit back and watch The Walking Dead in blissful, uninformed insensibility.

Breeds Apart

2012-01-04T14:37:00.001Z

Imagine, if you will, I go to the doctors. There's nothing particularly wrong with me, I'd just like a check-up to make sure everything's tickety-boo. The doctor (I'm imagining an elderly distinguished chap, something like John Le Mesurier, but hey! It's your imagination, they can look however you like. So can I, now I think about it. Can I be handsome, please? More hair than that. Great, you've got it.) asks me about my family history, and at this point I break into a broad grin.

'Oh, no problems there, doc,' I say, reaching into my man bag (what? They're fashionable now, aren't they? Or was that the nineties?) and retrieving a document. 'Take a look at this!'

I then proceed, proudly, to show the doctor my family tree. 'All great specimens, doc! Champions, the lot of 'em.'

Doctor Le Mesurier, at this point, can't help but notice that three of my great-grandparents appear to be the same person. Not on that, it looks (to his increasingly concerned eyes) as if my grandfather also produced several other children from my own mum, and my dad has likewise done the nasty with with maternal grandmother. At this point, he could be forgiven for thinking that this particular family tree would not be out of place adorning the wall of a backwater redneck banjo-playing (and if you're reading this, Jon, I do apologise. I don't mean to drag the good name of banjos into the mud, but it's an easy stereotype, and I'm sticking with it) web-toed buck-toothed cannabalistic clan, and he's starting to wonder if it might be a good idea to page the nurse.

'What do you reckon, doc?' I say, proudly. 'Impressive stuff, eh?'

Now lets talk about dogs, and the concept of a 'pedigree'.

Canis lupus familiaris is a remarkable species - genetically speaking. Think of the smallest adult human in the world. What are they? Let's say two feet tall for the sake of argument and unnecessary googling. That'd be about twenty kilos in my money. Now think of the tallest. Shall we go crazy and say ten feet tall? Tiny bit of googling suggests this would give you a weight of about two hundred and fifty kilos. (I won't get into obesity, because I'm really thinking of body frame rather than fat, plus that's a far too depressing subject to get into this close to Christmas). So, quite a difference - the tallest human weighs about 12 x more than the tiniest.

Back to the dog. The smallest breed that springs immediately to mind (and there's probably smaller out there) can weigh in, as an adult, at as little as 1 kilo. (Sorry about metric weights, but I'm sorry to tell you it makes a hell of a lot more sense than pounds, and a lot easier to do in your head). Now, the largest dog that springs to mind that I see regularly is a great dane - and squashes the scales in our practice to the tune of 80 kilos. It doesn't take Stephen Hawking to work out there's an 80 fold difference between the teeny tiny yorkie and the great dane - and there's definitely bigger dogs than her out there.

The point of that slightly tedious maths exercise was to illustrate the amazing genetic variation that exists within the doggy gene pool. Remember, this is the same species. Tiny tim the yorkie could (with some mechanical aids probably best left only to the imagination) in theory mate and produced fertile offspring with Gerta the great dane (their names have been changed to protect them so don't go ringing the Daily Mail in disgust). I picked on body mass as it's the easiest to visualise, but just about any characteristic in dogs shows the same variation - tail length, hair thickness, nose size, ear shape - they're all incredibly variable. Astonishing, and fascinating, and unlike most other species on the planet.

Which is why it's upsetting to me, and to many vets, that this variation has been turned into a torture implement.

Now, I'm aware torture is an emotive word (certainly our governments seem to think so. Good job they don't do it, then, and thank heavens for these new-fangled advanced interrogation techniques that I'm hearing so much about. They sound terribly effective) but I use it quite seriously. The wondrous genetic variation within dogs has, in the hands of humanity, caused more profound suffering to this beautiful, loyal and trusting species than anything I can think of (and trust me, I can think of some pretty horrible diseases).

Y'see, the concept of breeding like animals together to get offspring that were similar to their parents has been around for a long time - long before Darwin (and Wallace) developed the elegant theory of evolution, people knew it happened. They just didn't know why. (The difference in evolution, of course, being -natural- rather than -artificial- selection, but let's not get into that now). Farm animals have long been interbred to produce more meat, more milk, more honey, more pencils (okay, not the last one). Even this form of breeding has it's problems - you select for one trait, and often get weaknesses in others - but at least you're trying to get something useful out of it (well, useful to you, anyway. Quite what the cows get out of it is another matter, for another blog). That is...you're breeding for a function. It's when you stop needing your animal to do anything, and you just want it to look a particular way (breeding for a form) that the problems really start.

Enter the dog.

Poor Canis lupus familiaris may be man's best friend, but I must say if any of my friends treated me like we have them, they'd be off my Christmas card list before you could say 'inbreeding'. Dogs, who are unlucky enough to have a very wide gene pool, have been moulded over the years into the craziest shapes since the invention of silly putty. The difference is, silly putty can't suffer. Dogs can. And 'pedigree' dogs most of all.

Roughly 50% of my canine consultations for ill animals (i.e. not vaccinations, neutering or check-ups) are to try and deal with pain and disease caused by inbreeding. In the practice right at this moment we have a bulldog on a drip because it can't stop projectile vomiting (due to a hiatal hernia - guess what? An inbred trait), a spaniel recovering from surgery to repair a condylar fracture (inbred weakness), and a labrador that can barely walk because of it's chronic severe hip arthritis (caused by hip dysplasia - you get the idea). This is not an unusual day for us.

The minute some idiot (sorry, did I say idiot? I meant the kennel club) that they'd like this particular breed's nose to be shorter than a certain length, or it's spine to be yea long, or even something relatively innocuous, like thinner, shorter hair, you're asking for trouble. Two dogs that look very similar on the outside are likely to share genes that affect more than their looks. Genes for a slight propensity to have malformed hips, for instance. You'll be fine the first time you do it. Probably the third. Possibly the tenth. But sooner or later, along with those genes for lovely silky coats, you'll have a whole load of crappy genes that you really didn't want.

All this is pretty basic genetics, and apologies if I'm patronizing my readership, but this fairly simple point seems lost on a large proportion of dog breeders, not to mention the Idiots (oh, oops, I did it again, sorry, I mean the Kennel Club). Of course, this happens when you're breeding for a function, too, but there comes a point where you have to breed out with a different stock, so your animal can still do what it was supposed to do in the first place. The problem with breeding for a form instead is that your animal doesn't need to be very healthy to do what you want it to do, which is just to sit there looking (according to Idiots) pretty.

This is a problem when the form you're breeding for is relatively sensible - you still get poor genes when you're inbreeding, hence my little doctor scenario above. It's a major problem when the form you are breeding for is actively, and obviously, deleterious to an animal's welfare - and it still blows my mind that there are so many breeds like this out there. Daschunds bred with legs so short and spines to elongated that you can almost hear their discs slip as they walk in the door (and it takes a deal of self control on my part to try and make that sound funny, considering the number of cases I have seen with dogs in absolute agony because of it. Thanks, Idiots), bulldogs bred with such short tails that they grow in upon themselves (and that's only one of many many anatomy problems I could suggest about a bulldog. More than 50% (in our practice, probably 75% of bulldogs are brought into this world via caesarian, because they can't give birth unaided. Doesn't that set any alarm bells ringing with the Idiots?), pugs bred with noses so short they can barely breathe (and if Hal or Lindsay are reading this - please don't take offence, Ruby is clearly one of the sweetest loveliest there ever was. But given the choice, she'd like to be able to breathe a bit easier, trust me).

The Idiots, when discussing Basset Hounds, like to talk about 'furniture' - which basically means the amount of skin folds they have on their stumpy legs. This is, apparently, a good thing. The fact that the majority of bassets suffer from chronic pain due to their malformed elbows seems not to matter very much to them (which makes me want to drop large pieces of furniture on them. Maybe that's where the term comes from?).

In bassets, as in other breeds where the genetic problems have reached crisis point (like West Highland White Terriers with skin disease, or Labrador Retrievers with hip dysplasia) the Idiots have instituted 'screening programs' to 'breed out' the unwanted traits. I have a very simple breeding program - stop breeding mother with grandparent, and your problems will go away.

All of which means, to me, that a 'pedigree' is simply a history of how inbred your dog is. The longer your pedigree, the less healthy you are likely to be, no matter how many bloody times your ancestors won at Crufts. These dogs cost hundreds, if not thousands, of pounds, are going to cost you a great deal of money in veterinary fees, and also, (and this is my key point, which is why I keep returning to it) they will suffer.

Things are changing a little. A few years ago all this information was news to my clients, but no more often than not they are well aware of the problems. I can't tell you how many westie puppies I've seen with the first hints of atopy which will likely mean they will be on steroids for the rest of their life, only for the owner to tell me 'Oh, I know they suffer from that, our last one did.' It depresses me and upsets me that they can't see that perhaps going out and purchasing another one will, ultimately, lead to more animals spending their whole lives in pain.

I'm aware my tone has shifted from flippant to angry, and that's the very reason I've avoided writing this blog for some time. The unfairness of life aside, it was probably the main reason I wanted to start a veterinary blog at all. Because I'm tired. I'm tired of seeing wonderful dogs in pain and chronic misery because some shithead decided his legs needed to be -this- short, or his eyes should bulge out just so. I'm sick and tired because our profession, the 'champions of animal welfare' have let this misery go on for far too long. It took a BBC documentary on the subject to bring it to peoples attention, and finally have the horror show that is Crufts taken off air.

Okay, I'm going to stop ranting. For those gluttons for punishment who want more of the same, here is a letter Kerry and I had published in the veterinary times several years ago. For everyone else - please reconsider buying that puppy with the long pedigree. I know it's nice to know exactly how big it will get, and you can buy a nice bumper sticker that looks like them - but remember Dr Le Mesurier, and try to consider what that means for the dog, and not you.

January blues - no problem!

2012-01-02T22:06:00.001Z

For you, my friends, the war is over. Well, okay, not the war, but the offer where you could get my new eBook, the Ancients, for free, is over, but that's got less of a poetic ring to it.

Do not collapse into a pit of woe, however, for I bring good tidings! The Ancients is still available at the low price of £1.50/$2/12 triganic pus, available from amazon.co.uk or amazon.com.

What, that's still not enough to keep the black dog from your door? Okay, how about this?

You can download the entire first half of Soul Purpose COMPLETELY FREE from smashwords.com - a modern SF/veterinary story, and the first part of the conduit sequence, written in a style much closer to my Blogging voice (which may or may not be a good thing for you to hear).

This is a permanent offer, so if you missed the January 3rd Ancients spectacular then I'd advise you console yourself with a lovely 50% of a novel. Enjoy!

The original offer text is below, for...well, for no good reason, really, other than to show you how generous I was once upon a time.

******

January is a depressing month, isn't it? The dogs have eaten the last mouldy bits of turkey, you've already played with the most exciting presents, and are down to that woolly hat and scarf from your auntie, and the house looks very bare without all those decorations. No wonder the papers are always repeating that spurious PR story that 'this day is officially the most grey, dismal and depressing day of the year'.

How could anyone possibly remain sane in such dark days? How?

By a free book giveaway, that's how!

That's right, for tomorrow only, my new eBook is available COMPLETELY FREE from amazon! You can spend that £1.53 you've saved on a nice warming cup of coffee instead, or even a mulled wine (oh, except that we're not allowed to drink that any more, are we? Never mind. Mulled wine is one of those drinks where the idea of it is nicer than the drink itself. Like those fruit teas that smell orgasmic but taste like sour lemsip).

So, on the 3rd of January, hightail down to your local amazon.co.uk or amazon.com, and pick up your copy of The Ancients absolutely free! You'd be craaaaaazy to miss it, and other such cliches!
(the offer lasts from 12 midnight January 3rd 2012 to 11.59pm Pacific Standard Time - this is GMT -8 hours (so from 8am Jan 3rd to 7.59am Jan 4th GMT). (The more astute amongst you may have realised that this date is now IN THE PAST. I'm sorry to say that unless you're Doctor Who you've missed the offer now. This offer remains here only for the interests of historians and time travellers)

Grab it quick while stocks last! (Except that stocks are effectively infinite so, y'know, you'll probably be okay). I'll be setting up a discussion group on Goodreads.com for anyone who wants to chat about it.

How do you find the time?

2011-12-29T18:04:00.003Z

Hello again, my blog-reading brethren. In the spirit of me opening the remit of my blog up a teeny bit to include my writing career, I thought I'd pop in a quick entry here to mention that Marc Schuster over at small press reviews has very kindly (and very gently) interviewed me about my new fantasy book, The Ancients. You can,if you are so inclined (for instance, you're having a masochistic day) read the interview here.

But that's not all! Oh no! Not by a long chalk! (I really should google how on Earth that expression came about. What's so great about a long chalk? It'd just snap). As a special not-Christmas-any-more-but-not-quite-new-year-either treat, I thought I'd include a short article that I wrote for the New Writer's UK newsletter. Hold on to your hats! (If it's windy. Or your hats are particularly valuable)

How do you find the time?

I am not, to my eternal regret, Doctor Who. The closest I have come to a sonic screwdriver when I accidentally dropped one in the dishwasher. I don‟t own a TARDIS and, probably the bitterest pill to swallow, I don't get to spend extended amounts of time in an enclosed space with Amelia Pond.
Time, therefore, is a problem – a problem familiar to many part-time writers. How do you hold down a full time job, talk to your spouse (there might not be so much of that after my Amy Pond comment, mind you), perform your domestic chores, eat, sleep, walk the dogs...and still find time to sit down and write?
It isn't just the writing, of course. There‟s a whole heap of procrastination to get over before you get anywhere near filling a page with your brain juice. Before I even started to write this essay, for instance, I‟d drunk three cups of coffee, checked my email, twitter and facebook feeds, read a random Wikipedia entry about how pencils are made, re-checked my email, twitter and facebook, and visited the toilet twice (largely thanks to the coffee). All that before I had even begun my titanic battle with the dreaded BLANK PAGE.
"How do you find the time?‟ - a question I am asked often by clients when they discover I'm an author (not that I mention it at every possible opportunity. Ahem). How do you find the time to hammer (or at least tap) out a novel in between all those petty mundanities that modern life throws at you?
The truth is disappointingly prosaic. We use the classic 'stolen hours'. Late in the evening. Early in the day. We find the time because we love it. We sneak those words out in the quiet watches of the night and the gentle hours of the morning because it's our escape, our breath, our passion. We make room in our lives for writing because without it there would be a hollow, empty shell where our souls would be, and we would shrivel away ghosts, almost-people, unable to express our one true love.A TARDIS would still be nice, though.
Just saying.

We need to talk

2011-12-22T13:26:00.000Z

Okay, blog, it's time to be honest. I know I haven't spent much time with you lately. I've taken you for granted, I know. Things have been crazy, I've been writing, I've been doing my certificate, and you just...well, you were always there, in the background. I just never found the time. And now I know we've grown apart. It's not you, blog, it's me. I just...I guess I felt you were holding me back, and I wanted to be free.

Can you forgive me, blog? I'm so sorry I haven't been around for you, but I can change, I promise!

There, I said it. I haven't written any blogs since...since May? And even that was a cheat, 'cos it was just an essay (if you're interest, I passed my 'A' unit for my CertAVP! Yay! Only B and C to go know...the ones where you have to know stuff, rather than waffle. Oh dear).

This blog started as a semi-anonymous musing from myself to vent my spleen about veterinary life. Turns out, my spleen didn't need quite so much venting as I thought. Perhaps it has it's own air-conditioning system? In any case, internal organs aside, the blog was really meant to be a veterinary-only chat about the work side of my life. The problem is, getting home from work and then writing about it has recently seemed about as welcome as watching a three-hour marathon of Animal ER - I just wanted a bit of a break from the work, rather than go on about it. Consequently, I'd got into the bad habit of only blogging when I was depressed or annoyed about something - and although I'm happy about all my blog posts, there's no denying the recent ones have had something of the black dog about them!

In the spirit of 'if you haven't got anything nice to say, then don't say anything', I took a bit of a break from blogging, to concentrate on my writing - which has worked very well, and I've got loads done. But I have missed blogging, and I'd like to get back to it - with a few changes.

I'm going to broaden out the scope of my blog! It's no longer just about veterinary life, you lucky people! I want to use my blog as a bit of a pimping point, to bling up my writing career though, innit (I think that's how people talk nowadays, anyway. Rofl.)

Brits are not generally very good at selling themselves or their work (well...actually, a lot of them are, but I'm using that as an excuse for why I'm not very good at it. I wouldn't do well on the Apprentice, anyway - though I must admit I'm still mystified as why Alan Sugar is regarded as some kind of business God when his products have been, and I'm trying to be generous here, almost uniformly second-rate) but from now on this blog is going to have a smattering (and hopefully just a smattering) of talk about my literary career, and possibly even the odd geeky post (though I'll try and keep these to a minimum as t'internet is littered with the blighters). I'm still going to keep blogging about veterinary life too, so don't/do despair, and though I'll try to keep them a bit more upbeat I'm not going to shy away from the less cheery aspects of the job, either.

So, there we are, blog? Our relationship has changed, but I think we can make it work.

Can you forgive me? I'll give you my last Rolo if you do...

Happy Christmas one and all! As something of a reward/punishment, I've done a whole two other blog posts today as well! They might provide a few moments blessed relief from the terrible Christmas telly!

Have a good one, and I'll see you all in the New Year

Always two there are...a master, and an apprentice

2011-12-22T13:08:00.000Z

It's been a pleasant few weeks at the practice.

Actually, now I come to think of it, that's a bit of a fib. It's been a teeny bit horrible, what with the pre-Christmas busyness and the usual set of 'clearout' euthanasias - but one of the things that has made it a little more enjoyable is the presence of a couple of vet students seeing practice with out.

Ah, vet students. They all look so young, fresh and excited. Makes me quite nostalgic for my student days, and all the things that will never come again - pound a pint nights, Oasis versus Blur, my hair...happy days. I can almost smell the formalin from the dissection room (if hte aforementioned formalin hadn't already sizzled most of my sense of smell away)

Vet students are nice to have around for a number of reasons. Firstly, they're a lot more interested than the typical stand in the corner and look bored work-experience types - probably because they're thinking 'Oh my God I actually have to do this job in a year or so and I have absolutely no idea what I'm doing!' (Don't worry, vet students. I've been doing it for ten years and I'm still not entirely sure either).

Secondly, it's nice to have some company in the consulting room, partly to share some of the strange experiences we have in there (see previous blogs for details), and party to be able to talk medically with someone. Maybe this sounds a bit feeble, but nice as it is to talk to clients and try and explain to them what you think is going on in simple terms, it's also nice to be able to talk to someone who can understand medical terminology, and follow your clinical reasoning. Well, if nothing else, it makes me feel clever (unless the student asks me a question that I don't know the answer too, but I usually brazen that out by telling them to clean my table, or put up some drugs, or as a last resort faking a fainting episode)

The enthusiasm they have is a little infectious too, and reminds me why I wanted to do this job in the first place. I genuinely do love animals, but I also love medicine, and am fascinated at what a complex, wonderful machine a living creature is. It's nice to be reminded of that from time to time, and to talk to someone who feels the same way, without the jaded cynicism that comes from ten years in (I suspect) any job.

For every Jedi, though there is a Sith, and the Yang to the Yin of having a vet student watching me consult is that I'm suddenly very aware of my own consulting skills. Fairly soon into the surgery, I hear myself saying for the fourth time in a row 'Now, the reason I gave that cat an injection of steroids is...'

Steroids are powerful anti-inflammatories, which probably relieve more suffering than any other drug I have in my arsenal. They also have many other effects upon the body, and so using them is a bit like the medical equivalent of using a cluster bomb. Lots of things other things will get hit, but you'll probably get the job done. They are regarded with horror, fear and loathing by veterinary colleges, and students (like me) have it drummed into them to avoid falling into the trap of using steroids at every available opportunity. They're a bit like the Dark Side of the force - quicker, easier, more seductive. And very cheap, to boot.

To me, however, and to many vets in practice, steroids' reputation amongst more academic members of our profession as the drugs of Satan himself is somewhat overstated. Yes, you get side-effects, but these effects are predictable and, for the most part, reversible. One of the more serious side effects, particularily in cats, can be diabetes - but this is rather rare, and I always explain the risk of this to clients. I can think of many cases of mine that would have had to have been euthanased years ago if it wasn't for the anti-inflammatory and itch-relieving power of steroids.

All this I can justify to myself...except when I have a vet student with me, who can't help but notice that I keep reaching for the same bottle on the shelf.

It's not just steroids of course. It's all the little things that you find yourself doing 'just to be on the safe side' - the things that you know probably aren't necessary but you just want to be sure. Things like giving antibiotics for diarrhoea in dogs, or for cystitis in cats. You know you probably don't need to, but...you don't want them coming back tomorrow, and another vet doing it, and you looking stupid for not doing it in the first place.

(The antibiotics issue is, actually to me, a more serious point that the steroids. Vets are as guilty as anyone else (well, more so than doctors, less so than farmers) of the overuse of antibiotics. Bacteria are getting wise to our antibiotics pretty fast, so we've got to try and be more responsible over their useage - but perhaps that's a topic for another blog)

So, I raised this as a bad thing about having vet students at the practice - but it isn't, really. It's a little like watching yourself on video - you're suddenly unpleasantly confronted with all the weird things you do that you weren't even aware you were doing.

As you get older as a vet, there's a certain arrogance that creeps over you - you've seen most things that can happen at least a few times before, and you've got a fair idea of what's going on with a patient within the first few minutes of a consultation. It's the common things occur commonly principle - sure, this animal that is presented to you after collapsing out on a walk -might- have myasthenia gravis...but it's probably just sprained its leg - because the leg sprainers will outnumber the myasthenia cases by tens of thousands to one.

The trick, when you reach my level of experience, is knowing when to listen to those little alarm bells ringing at the back of your head that tell you something isn't quite right here - it might appear to be a normal gastroenteritis, but it seems a little too pale, or a little too sore in it's abdomen, or just...just not right. It's the difference between giving a shot of steroids, or admitting immediately for a blood sample, x-ray and intravenous fluids. It's very easy just to slip into the steroids-every-time-because-you'll-be-right-nine-hundred-and-ninety-nine-times-out-of-a-thousand. I can feel myself of the brink of this 'old-vet' approach. teetering on the tightrope, ready to fall from experienced professional to, essentially, a knowledgeable amateur. It's my duty to my clients, and my animals, to avoid that slippery slope! This is part of the reason that I'm studying for my certificate in advanced veterinary practice.

Which is why vet students making me squirm as I reach for the steroid or antibiotic bottle once again is a good thing. It makes me question exactly what and why I am doing what I am doing, and what the consequences could be if I'm wrong. And, If nothing else, my excuses will get more finely honed!

So thank you, Laura and Jess, for making the last few weeks more enjoyable, if slightly harder on the brain!

The Ancients eBook now available

2011-12-22T12:00:00.003Z

I'll be the first to admit, that isn't the most subtle, clever, or punny of my blog titles. It's my way of flagging up that this post is largely one big (well, medium-sized) advert for my new book, The Ancients, which I am now going to attempt to sell to you - and if that makes you angry, feel free to screw this blog up, eat it, or flush it down the toilet.

(I should point out that this really only applies if you've printed the blog out, and are currently reading it on paper, because doing any of the above to you laptop/desktop/tablet/smartphone would likely invalidate your warranty, not to mention possibly cause internal bleeding)

And, if you have printed this blog out, then, like, what gives? Get with the program, daddy-o! All the cool stuff nowadays is made of electric - it's like all our dreams from the eighties have come true! Music, games, books - all of them are now essentially made of nothing! It's only a matter of time before E-food catches on. The point is - E-books are where it's at, man. Innit.

Which brings me to (I'd started to forget the point of this blog entry) my new book - The Ancients, now available as an eBook at the Amazon Kindle store.

The Ancients is a rollocking (that's a great word, isn't it? It's like swearing only without actually swearing! I'm going to say it again. Rollocking. Heehee.)

(Oh. I've just looked up rollocking in the online dictionary, and it turns out it doesn't mean quite what I thought it meant. Sigh. Okay, let's try again.)

The Ancients is a rip-roaring (better?) fantasy tale of betrayal, mystery, romance, war, kings and assassins. It starts with a young, embittered knight returning from a civil war that his ripped his country asunder. Here's a little excerpt to wet your collective whistles...

As he turned his face back to the road something in the darkness caught
his eye; a patch of light amidst the unrelenting black, lying by the side of the
road. It was impossible to make out any detail. He nearly ignored it. The last
thing he wanted was another delay, to have to spend all night in this accursed
weather, but something made him stop and look again. A smear of white, fuzzy
in the rain. Something was familiar about the shape. He approached it and as
he did so felt a peculiar feeling of having done this before - walking towards a
lonely shape in the rain. He tensed with expectation and dread, although he
didn’t know why. A brief image of the elven child flashed into his mind. Dazlar
ignored it, as he had learned to over the last few months, and reached the
shape, which finally became visible through the onslaught of water. He sighed.
So close to his home, must he be plagued here as well?

A body lay face down in the mud just off the road - a pathetic, crumpled
figure wearing scraps of soaked peasant clothing, silent and unmoving. Dazlar
rushed forwards and turned the body over, feeling the chill of the skin and
knowing even before he pressed his fingers into the neck that he would find no
lifebeat. He was right.
The corpse was that of a young woman with short, mousy brown hair
and a thin, pinched face. Dazlar suspected the girl had been starving for a time
before she came to this sad end. Her limbs had not stiffened yet but the skin
was cold. She couldn’t have been dead long. He sighed again and rubbed his
eyes with the back of his hand. He had seen so much death in the years he had
been away, but to find it now, almost on his doorstep, made the homecoming
even worse than the rain and wind had done. He looked down at the girl again,
searching for any sign of injury, any clue as to why she lay here. He could see
no blood around, no obvious wounds on her. It seemed as if she had collapsed
as she walked - or more likely thrown from her mount, the way she way been
lying when Dazlar had found her. She was not dressed for riding, though,
horse or drake. What to do now? Dazlar couldn't simply leave her here, not like
this. Burying her was not a prospect that he wanted to think about with the
weather the way it was. He really didn't have much choice, so close to Oldmeet.
He knelt down beside the body and with a grunt of effort hoisted her onto his
shoulders. The body was surprisingly light, despite the rain-sodden clothes.
Wondering if his homecoming could possibly get any worse, Dazlar stepped

back onto the road, such that it was, and continued towards the village he
hadn’t seen for three years.

A few miles down the road, Dazlar is picked up by a smelly, unpleasant farmer, Glanvic. After the sort of stilted conversation that normally occurs at parties where everyone is sober, Glanvic makes a surprising discovery...

The two sat silent for a time as the big shire pulled the wagon on
through the night. Then the small man broke the silence.
‘I'm Glanvic, by the way. Glanvic ap Glanver. I'd shake yer hand but...’
he grinned and wiggled his body to indicate he needed both his hands on the
reins.
‘Pleased to meet you.’ Dazlar said, not entirely truthfully. ‘So, how do
you come to be out on a night like this?’
‘Hah!’ said Glanvic, ‘Wouldn't believe it! I've 'ad worse bloody luck
tonight than the sodding Orc Empire, I ‘ave.’ He flashed his brown teeth at
Dazlar again. ‘I'm on my way into Oldmeet for the market tomorrow.’
‘Ah, yes,’ Dazlar said. Of course, there was always the market. It seemed
strange, but reassuring. The country was in chaos, ripped apart by civil war,
but they still held the weekly market in Oldmeet. Dazlar had been half
expecting everything to have changed. Perhaps it was because the homecoming
was turning out so differently than he had imagined. He took it as a good omen
that some things were still the same as they had always been.
‘Yeah,’ said Glanvic. ‘I'm a pig farmer, see.’ Dazlar nodded. He had
guessed as much from the smell. ‘Farm's a few miles from 'ere. Normally only
takes an hour or so to get in, only this bugger 'ere,’ he gestured one arm to the
shire driving the wagon, ‘only goes and throws a bloody shoe a mile into the
trip!’ He paused for the drama of this to sink in.
‘Oh dear,’ Dazlar said politely.
‘Oh bloody dear is right, my son!’ said Glanvic. Dazlar was hit with a
waft of Glanvic's breath, which was even worse than his general body odour.
He leaned back a little. ‘A bloody hour it took me to sort that out, and if that
wasn't enough a mile after that the wagon only bloody...’
Dazlar never found out what had happened next on Glanvic's ill-fated
journey. The pig farmer had stopped mid-flow and turned to look at the back of
the wagon. Dazlar had turned too. A loud spluttering noise was coming from
the covered section. Glanvic narrowed his eyes and brought the wagon to a
halt. He turned and his front half disappeared through the covered flap. When
he emerged he stared suspiciously at Dazlar.
‘I thought you said that girl was dead!’ Glanvic said, the tone of his voice
changed, accusing. ‘She's breathing!’

Ooh! Mysterious! What could possibly happen next?

All this and more can be yours for less than the price of a Starbucks Coffee! (probably...I haven't actually checked the coffee prices. Must be cheaper than of those frozen ones with raspberry juice poured on them, anyway - you need a mortgage to get one of those babies.)

The first few chapters can be read online at amazon, so why not hightail it to your local ebook store, if for no other reason than to check out the lovely cover designed by Eric Smith.

Amazon UK version here - The Ancients at Amazon.co.uk

Amazon US version here - The Ancients at Amazon.com

Thank you for listening! Normal blog service now resumed.

Oh, I say!

2011-05-29T14:31:00.003+01:00

Hm...the titles for my blogs seem to be getting camper every time. It's not deliberate, I promise you, it's just by terrible pun-ey way of telling you that I'm cheating with this one. It's not a blog post it's an essay I'm writing for my certificate (in medicine, of course. Kerry's the grunt with the scalpel, so she's doing surgery). (Oh, essay - geddit? No, I'm not proud of it either but let's stick with it (which sounds like something God said on the 7th day))

Don't worry it's not full of boring medical detail! Instead, it's full of tedious introspection and whining. Doesn't that sound more fun?

Anyway, for those of you still reading, part of my certificate is writing ten 'reflective' (i.e. personal rather than academic) essays of various parts of veterinary life. Initially horrified by the titles (of which the one waiting for you below is a classic), I finally realised a few essays in I was actually enjoying myself. Moreover, these essays seem to dropping the pressure on whatever release valve builds up in my brain and causes me to splurge blogs onto the interweb, which might explain why I haven't written a blog for yonks. (Now that's a word I haven't used for a long time...I'm sure there's a joke in there somewhere but I can't quite make it work and I want a pee so I'll have to leave it).

So, I've decided to cheat. Below is my first attempt at essay number 7 for my certificate. I probably won't actually submit it in this state, but as it is it feels -almost- suitable for the blog, so it's all your getting instead of a proper post. Nyah. (Except, of course, for this pre-amble, and I think we can all happily live without any more of it).

Ahem...

A key feature of a profession is “altruism” but much of the modern rhetoric around work relates to “balance”. Discuss the tension which exists between these concepts and how you have learnt to resolve it in your own life

An article on the BBC News Website from Wednesday 5th October 2005 reported a statistic that is already relatively well known in veterinary circles (see Bartram & Boniwell 2007 amongst others) – the suicide rate amongst veterinary surgeons in the UK is nearly four times the national average, and double that of other professions such as doctors and dentists. (Sustained well-being) suggests that such figures are only the tip of the iceberg and that for every suicide, there have been twenty attempted.
The BBC article quotes Professor Richard Halliwell of the BVA, who describes being a vet as ‘extremely stressful’. The research done by Professor Halliwell suggested a number of possible reasons for this worrying statistic, including the ready access of lethal injections for working vets, and the ‘culture of death’ the profession engenders by dint of vets’ use of euthanasia as an ultimate way to end suffering in animals. More relevant to this essay, though, are the contributions to stress from the long working hours of many vets, and difficulties in finding a balance between this and a ‘normal’ social life.
The work-life balance is a frequently discussed topic amongst employees and academics who study the psychology of work, and many articles (such as UNISON) discuss the disappointment felt by new employees who have high expectations of options to improve this balance, but find that their employers are either less enthusiastic than them or are simply unable to provide the flexibility their staff are hoping for.
The veterinary profession is particularly prone to pressures upon the work-life balance. As vets, we are seen (and often feel ourselves) to be part of a caring profession, so are driven to work longer and harder – unlike, say, a mechanic, our patients are capable of experiencing great suffering, and such suffering does not end at five o’clock on a Friday evening, which makes regular hours hard to stick to, even for those members of the profession who don’t have out of hours (OOH) duties to perform.
OOH work is also a large part of this tension – although perhaps less common than it was, many vets work a full time job with OOH work on top of it, which not only adds to stress and makes it harder to ‘switch off’ and relax after work, it also cuts down on time for social activities.
I have worked in practice for nearly eleven years now, and, like many others in our profession, found my first few years in practice extremely difficult, in large part because of long working hours, and especially because of OOH work.
In my first job (a mixed small/large veterinary hospital) I found the shock of the sudden change in my lifestyle almost overwhelming. As a student I had a large network of friends and acquaintances, and a very active, healthy social life. As I vet I found myself working sixty-plus hour weeks with frequent OOH duties on top, with almost no time for socialising (and no energy to do so even when I did find the time).
It helped that I remained somewhat connected to my old social scene, because my then-girlfriend was still in her final year at Langford vet school, but the change was still seismic, and something that I genuinely feel took me several years to overcome. As well as such a change in working life, I was attempting to learn a new profession, and deal with successes, failures, and more than anything the responsibility that comes with entering the profession.
Working on call was deeply stressful to me, for a number of reasons – firstly, the loneliness. It suddenly seems to be you (or, at best, you and your nurse) against the world. Secondly, I was called out from home, which meant that I found it harder to relax at home even when I wasn’t on duty – the lines between working and not working became blurred. I find it very difficult to relax, even now, when I’m on call, basically just wanting to sit in a darkened room and wait for the phone to ring.
I found myself taking solace in alcohol and, something which I had never done as a student, drinking when I was alone – it became a ‘reward’ for me when I didn’t have to work a night on call, a way to signify ‘I can relax now, I’m not at work’. My alcohol intake was not excessive (from a medical perspective) but it was much higher than previously and even now I have never lost that feeling of reward than comes from drinking.
My social life dwindled away until it consisted of visiting my girlfriend, and seeing my parents. Things became tenser when my girlfriend graduated, because we were both experiencing similar feelings, but now we lived much further apart.
After a few years, I left my job to be closer to her, and from then on we have always lived together (she is now my wife). This helped quickly and greatly with the balance, but it did not solve everything – we both worked long hours at that time, and both on different rotas, so that at any given moment one or the other of us was usually working, and therefore either absent or bad-tempered and difficult to live with! We realised that things would not improve until we worked less hours.
In the last five years or so, this has been achieved – we both found work in small animal practices (which we both found less stressful, even though it was probably harder work). My wife found a job with no on-call work at all, and I found one with less, but (more importantly to me) a day off per week – this day off gives me valuable ‘me’ time away from work, a time to remind myself that there’s more to my character than just being a vet.
Now, we both work in the same practice, and, having become a senior vet in my current practice, I work even less out of hours than I did before. As far as time goes, my work-life balance is now achieved, and I am much happier.
Just reducing working time by itself was not enough for me, though. I began writing about my experiences in my rare free time in those first years finding it cathartic to talk about how hard I was finding it, how distressing it was for me when cases ended badly or when deeply loved animals died. People began to comment upon my writing, and to my delight this began to develop in two separate ways – firstly as a blog, where I discuss many aspects of veterinary life, and secondly as novels. I was lucky and very pleased to find a publisher for my whimsical nonsense (which has become increasingly detached from veterinary work).
Forging a second (albeit small) career has been very useful in helping me to ‘switch off’ from veterinary work - and if I am stressed or upset about a difficult case or situation a can write about it, giving me an outlet and some measure of distance from it.
Both myself and my wife have taken active interest in old hobbies, ones that we left behind when we went to University. For her, it is riding. Concentrating on and caring for her horses brings her great pleasure and helps her to relax. For me, I have become a ‘geek’ again – reading science fiction, playing games, meeting up with new friends I have met through this hobby at conventions. In short, we have both developed full and active lives outside of work, sometimes with each other, sometimes with our own interests.
This has been quite a personal essay for me. There was a time, shortly after I qualified, that I felt there was nothing to me but a veterinary ‘machine’- diagnosing, treating, caring, killing (and at home, drinking) – but I’m happy to report that seems like a long time ago.
Thanks to the help of my wife, my writing, and my deep-seated nerdiness, I’ve found myself again.

OOH you are awful...

2011-01-14T11:41:00.008Z

Please excuse the terrible pun of a title, but...well, they're all like that, and if you're not used to them by now then I'm sorry to tell you that they are unlikely to get any better from here on in.

Some of you may be thinking 'Pun? What pun?' Well, sit still and I'll explain it to you. Still, I said. Don't fidget.

OOH is not a further sign of my rapid descent into campness (campdom? campicity?) but rather an acronym for the dread part of the job known as Out Of Hours. AKA On Call, AKA Duties, AKA stupid bastarding night work.

I am aware that the veterinary profession is not the only job blessed/blighted by out of hours work, but I'm afraid I can't speak for any other profession as I haven't worked in them, but this part of the job, more than any other, really puts the H,A,T and E in my love/hate relationship with my work. Between myself and my wife it has been responsible for one nervous breakdown, several tantrums, two resignations, a near-divorce and a broken remote control (which cost £20 to replace. Scandalous!)

(As to which of us had the nervous breakdown, well, I'll leave that hanging as an intriguing mystery. But ask yourself - which one of us has to write an introspective blog just to cope with the pressures of work, and which one of us just gets on with the job without moaning? (Mind you, it was me who had to pay for the bloody remote control, so we'll call it even))

I am, I like to think, generally cheerful and happy-go-lucky, a fairly relaxed kind of chap (I like to think that. I'm not, but for the purposes of this blog, lets go with it). On call, it's a different story. I turn into a strange Smeagol-esque creature, nervous of human contact, unloved and unlovely. All I want to do, when I'm on call, is sit in a darkened room next to the phone, and wait for it to ring. I can't stand to start doing anything that I couldn't drop at a moment's notice - not really a state of mind conducive to a good night's sleep.

Even more Gollum-like is my relationship with my phone (don't get me wrong, I love my iPhone with a passion that probably should be outlawed in decent, God-fearing countries, but that's because of all the other cool things it does, not because it's a phone. Take away the talky bit and I'd still be very happy with it. I suppose that's why they made an iPod touch, but you really don't want me to digress along these lines or we'll be here all day...) - I loathe loathe loathe talking on the phone even at the best of times. I'm with Stephen Fry on this one (yes, I mentioned Stephen Fry again. No apologies. He's my generation's Yoda. Apart from, y'know, Yoda) - how many other things do you have that will suddenly start shouting at you 'Talk to me! Talk to me! Talk to me!' and then get grumpy if you don't? I suspect I'm not alone in this sentiment, but my wife and mother-in-law seem to consider it a mortal sin if I don't immediately spring to attention and run for the phone. Why? That's what answerphones are for.

It's fair to say that my feelings about phones are mixed, at best. When I'm on call, my phone becomes this weird talisman. Much like our poor hobbits with the One Ring, I hate it, but am unable to part with it, and am constantly getting it out to check that it's working, that there's enough battery, that there's a signal, etc. If only it made me invisible, the analogy would be perfect (there's a suggestion for an iPhone app! I'd probably buy that one). I spend a lot of time on call sitting in my car, looking at my phone and occasionally muttering 'Gollum' to myself.

Why? What it is about OOH work that brings out the ringwraith in me?

It's hard to describe quite what's so horrible about being 'on call', so much so that it inspires in me, even now that I do less of it, a kind of deep, black terror. It's not the busyness - to be honest, I almost always work harder on an average 'normal' day than a day or night on call, and I don't feel the same dread of it (though tell me that on a Monday morning and you may get a different response. Like a punch in the nose).

I think it's a combination of a few things. First is the loneliness. When you're on call, it's you against the world. It's your responsibility, and anything that goes wrong is likely to be your fault. This is especially true of home or farm visits. First of all you've got to find the place - a job in itself before the days of SatNavs, and even then these won't help you too much if you're trying to find a remote paddock or cottage (I'm surprised I haven't heard of some poor young vet driving off a cliff in the middle of the night desperately looking for a farm. I did once nearly drive into the sea in Cornwall, but as that was whilst I was heading for a job interview, not an emergency call, so I don't think that counts. (Yes, somehow I got the job).

You're on someone else's territory, often dealing with a distressed owner and a distressed animal, your heart is racing and you're desperately trying to remember your notes from University. To me, as a new graduate, driving to a call at two in the morning, I felt like the loneliest person in the world (except, maybe, for that guy in the Omega man).

I'm lucky enough to have only ever worked in jobs where someone else took the calls, and then passed them on to me as required. My wife has only worked in jobs where she had the calls from the practice directly forwarded to her phone, so as well as being very annoying (Oh, you're not open at midnight? Well, can I make an appointment for tomorrow?) it adds to the feeling of isolation (and is really not good for the health of any remote controls within easy reach).

Aside from the crushing despair of solitude (I'm not laying this on too thick, am I? No? Good) there's the unpredictability. Always a factor as a vet - you never quite know what you're going to be faced, or when something is going to come through the door that derails your whole day) this effect is compounded out of hours, when there is not routine at all and the whole day is essentially unplanned. I think this part of the job is much tougher on new graduates, for whom every call is a new, unexpected scenario. I'm now old enough and long enough to have seen pretty much everything before (boy, am I going to regret writing that when my next night on call brings me a kangaroo with a lacerated penis) but I still find the fact that either I might make it through a full night's sleep, or I might have the most horrendous evening of my entire life difficult to deal with mentally.

This is especially hard when you are getting one call after another - before you've had a chance to deal with the first one. Nothing to me is more stressful than having emergencies stack up quicker than you can deal with them. The dangerous point to get to is the mental state of thinking 'If that phone rings one more time then my brains will explode!' because, Sod's law being the evil little git that it is, the phone always rings thirty seconds after that thought has passed through your brain.

Early in my career, I was called by the police to attend a horse lorry that had crashed, and fallen into a ditch, complete with horse. The fire brigade has requested the presence of a veterinary surgeon, and I drew the short straw. This call, as I remember, came whilst I was either stitching up a dog, or removing puppies from it. Something surgical, anyway. The terror I experienced upon receiving that call is like nothing I had ever felt before. Although I'm sure it can't compete with the feelings of the soldiers about to go over the top on the Somme, and although the actual call itself turned out to be fine (the horse just needed to be sedated to get it out of the trailer, plus there was a really cool bit where I was waved through a line of flashing police cars and ambulances like some sort of secret agent) an echo of that bowel-destroying fear has stayed with me every night on call I have ever done since.

The third problem with out of hours work is that it's on top of the normal job - you're expected to work a full day, work a night on call, then full day the following day as well. Same for weekends - full day Friday, work 48 hours over the weekend, then back to work Monday morning. Apparently, having a professional job means that things like the working time directive don't apply to vets. Here, at least, I feel I can help out the new graduates. When I was a lad, my rota was such that I worked thirteen days in a row, including four nights on call, for the prize of one day off (during which you slept). Nowadays, we get one day off a week, plus I've fought for giving the new graduates a half-day off in lieu of a night on call (which makes me sound like some Lord-Shaftesbury like crusader, which I'm not, I just didn't want to be one of those vets who said 'Well, I had it tough, so you can too.' Now I'm one of those vets who mutters 'Well, I had it worse, and I didn't bloody complain' whenever the young 'uns complain about anything at all)

It may be that it's just me; that my temperament is not best-suited for out of hours work - I know some vets who are more relaxed, and who will even (gasp!) go out for a meal, or down the pub with friends (not drinking, of course). I'm wound more tightly than a spring caught on a helicopter blade when I'm on call, and I suspect I would probably just shatter if I dared to venture into a public place. Still, I think a lot of vets who have spent much time working out of hours will find at least something to sympathise with in the above.

Well, that's probably enough soul-baring for this month. Please comment if this whole blog has made you rage at my self-indulgent weediness. Just don't do it when I'm on call, I don't think I could cope with it.

Working Relationship

2010-11-26T12:41:00.002Z

When I was a young slip of a lad (which is rapidly becoming far longer ago than I care to comfortably admit), love seemed a very long way away. This was no bad thing, because at the time I was dreaming of dragons, and swords, and all manner of things generally deemed unhealthy for a young chap to think about, but which never did me any harm. (Quiet! Who's blog is this, anyway?)

The years have passed, and I have achieved many things of which I am proud, some of which I am not proud at all, and some ambitions which have never come to pass (like never managing to get a 20th level magic-user. Bah. I suppose our dreams must surpass our reach, though). But, of all the things that bring me happiness and pleasure in my absurdly forrtunate life, the greatest is the happy series of accidents which allow me to hold a cat's small intestines out of the way so that the woman I love can stitch up its diaphragm.

My wife and I work together, which to some people would sound like a cruel and unusual punishment, or at least fodder for a crappy 'gentle' sitcom, but for me it is a source of pleasure and fun, and more than anything else makes my job an awful lot easier.

If I go on in this manner of how blessed and happy I am to have such a beautiful, loving and lovely wife I suspect you are likely to vomit all over your computer, so I'll try and explain why before too many electrical goods are wrecked. (Also, as I'm tapping away here it occurs to me that this particular entry seems to have more than a touch of 'luvviness' about it, rather than my usual alcohol-fueled misery. It can't be a coincidence that I've just finished reading Stephen Fry's autobiography, and if this torrent of sugary cheerfulness is too much for you to take, then please send Mr Fry an angry letter of complaint. It's definitely all this fault.)

My wife and I are fortunate to have a similar attitude to work. Fortunate because it prevents blazing rows in the practice, which would be awkward and embarrasing for our nurse and vet colleagues, and distressing for clients and their animals (although I can't help feeling that a blazing row would be closer to the 'family' atmosphere we like to promote at our practice than the more usual good-natured abuse). We like to get on with things - if there's an op on the board, or somone in the waiting room, we'd like to operate on them, or take them into our consulting room (hopefully not getting the two the wrong way round), and get the job done. If there's something outstanding, we find it difficult to sit down, relax, have a coffee, read a textbook, ponder our next move.

This isn't the only way or working, nor is it the best, but it's the way we like to work and so it means we don't get frustrated with each other. It also means that when a cat with its stomach herniated up into its thoracic cavity comes in as an emergency, as happened this week, we know each other well enough to get on with the job at hand with a minimum of panic and stress.

It leads to a more-or-less harmonius working relationship. There are some drawbacks to working closely to a loved one. The principle one that springs to mind is that if another vet does something which we would do differently ourselves, we generally keep quiet about it and don't say anything. There's no right or wrong way to do things, after all, and a lot of approaches to cases work as well as each other (unless you're doing it differently to me. In which case, you're just wrong. Okay?). If I or my wife do something that the other considers to be wrong, however, we'll generally point it out to each other. Forcefully. Often prefaced with the phrase 'You bloody moron! Don't you know that...'

It also makes for very tedious talking-shop evenings at home. If we were more diligent, perhaps we would have a 'no-vet-talk at home' rule, but neither of us can quite muster up the energy to enforce such a thing. Plus, there is then the dreadful danger that either my wife will start talking about horses, or I will start talking about zombies or the imminent rise of the machines, and I think that the veterinary world is a slightly less tedious solution for us in these cases (though I would like to once again pledge my allegience to our metallic masters. Just in case.)

So, a happy working relationship, and blog that is, on the whole, cheerful! The only problem I have with my wife's veterinary abilities is that she seems to believe that surgery is, is some way, clever. Well, I'm sorry to tell you it's not. It's not big, and it's not clever. You could literally train a monkey to do it. It is not brain surgery (unless, y'know, it is). I'm proud to be a medic, and my feelings on this matter in no way reflect my own ability with a scalpel. At all.

Ahem.

Cult of Personality

2010-10-24T13:12:00.003+01:00

Towards the end of a busy afternoon surgery last week, I had the following appointment waiting for me -

'New client, elderly dog. Check over.'

Sounds fairly innocuous, eh? Not the kind of consult to lose any sleep over the night before, trying to decide how to approach it? Not the kind of consult to worry a young and ruggedly handsome vet? (Or me, for that matter). Well, that's what I thought as well, dear reader.

Just shows you.

Disposing of my used syringes from the previous consult, and wiping my table with a practised swish (just writing that has made me wonder how many times I've done that in my career so far...a depressingly large amount, I suspect. Hence why it's a practised swish and not an amateurish smear. Anyway...) I walked out to call in the next client. Readers of previous blogs will be aware that this in itself can be a bit of a minefield, and has on occasion led to me being mortally insulted in front of a packed waiting room. Well, this isn't what happened to me this time. Quite the opposite, in fact. Disturbing, but definitely opposite.

As I called the name of the animal, I was met by the sight of a woman, who I had never met before, light up with a broad grin (a broad, gap-toothed grin at that. I wasn't going to mention that as it doesn't seem relevant but there, I've done it anyway, further confirming to the minds of any American readers that we Brits have the worst dental care in the developed world. Oops) and say (well, t was more of a shriek, really)

'Here he is! It's NICK! Nick's come to see you!' (This last was said to her dog, just to clear up any confusion. I was certainly confused by this point)

She jumped up as quickly as her new hips would allow, and rushed into the consulting room as if she was a teenage girl heading for the front row at the latest Twilight movie.

That was just how the consult started. By the end of it she was singing my praises to the heavens. When she made her appointment for the following week, she apparently told my receptionists (in front of my next, somewhat shell-shocked client) that she would 'always have time for Nick', and threatened something to the effect of taking me away on a leash.

And what had I done, this paragon of veterinary medicine, to receive such effusive praise? I expressed her dog's anal glands. Apparently she had taken a shine to me when I called the previous client through. Well, I have this effect on women (elderly, toothless women).

This may seem something of a mean-spirited blog. Why I am complaining that I'm liked? Well, (and I may have touched on this point before from a few other angles, but what the hell, I'm going to make it again) the problem is it was undeserved praise. Nothing I could have done it that situation would have made any difference, she would still have walked out of the room floating on air as if I was James Herriot reincarnated. It had nothing to do with my skills as a vet, or my ability to talk to people. She just liked me from the outset.

And here's the problem - I've been on the other end as well. The sort of consult where the client's face darkens like a thundery sky when you open your mouth to call them in. It just seems unfair that you're arbitrarily judged, when it's nothing to do with your clinical expertise.

Now, I can understand it. A few blogs ago I was talking about how much I hate going to mechanics, because I know less about car repair than Jane Austin, and all I have to go on is how nice they are to me. This is, of course, the same situation that a lot of clients find themselves in when they visit the vets. There's an old saying at vet school - People don't care what you know, they only want to know that you care. The reaction above, extreme though it was, I suspect comes about because it is quite a nerve-wracking thing taking your pet into the surgery, and it comes as such a relief that the man calling you into the room doesn't immediately have the bedside manner of Harold Shipman that some people sort of...over-compensate.

(Sorry, there was a brief pause there whilst I went to get my fingerless cycling gloves, because I'm bloody freezing. I'm now tapping away looking like an entrant in an Extreme Typing competition)

I'm not that keen on having personal appointments, myself. I get a little depressed when I see an evening surgery that is full of little 'NM' markers, that means the client will only see me. Partially because I slightly resent the implication to the other vets that they can't do the job, and partially because I feel a bit more pressured not to let people down when I am, shall we say, 'the man' (No? Okay, let's not say that).

(Incidentally, I don't want to give you the impression that this is something unique to me - everyone in the practice has a similar string of personal clients. My boss has at least twice as many as I do. It's true that I get more than my fair share, but that's largely because I've simply stayed in the same practice long enough for people to remember my name. The point I'm trying to make is that it's no reflection whatsoever on how good a vet you are)

Well, there you have it. The cult of personality that grows up around vets in their practices. I understand it from the client's point of view, and I'm all for it if it reduces the stress of going to the vets, but I'll never quite lose my tiny twinge of depression that it's nothing to do with your skill in the job. (I should be careful what I wish for - imagine if it was a true measure of my medical knowledge and skills? Not sure I could face looking at the list of consults every day!)

So it goes. Whatever else I leave you with from this blog, you can take one thing for definite.

There'll be at least one more little 'NM' in the consult lists from now on. She's back next Friday. I think I feel a sickie coming on...

Battle of the sexes

2010-10-18T20:34:00.002+01:00

It's just possible that, because of my profession, I have a slightly skewed view of humanity. In fact, I'm certain of it - and reason I'm certain of it is because of my answer to the question 'What is the main difference between men and women?'

My answer would be 'Women seems to like pus a lot more than men do.'

This is perhaps a surprising answer. AFter all, aren't the fairer sex made of sugar and spice and all things nice?

(Incidentally, what a horrible, sexist poem that is - so all boys are made of slugs and snails, eh? Might as well say that they're made of dog turd and have done with it. Imagine if the lines of that poem were reversed?)

Anyway, if that is true, then it must also be true that opposites attract because I have yet to work with a woman who didn't look upon the prospect of bursting a ripe cat bite abscess with a glee that would more normally be associated with a minor lottery windfall.

What is it about pus that is so exciting and endlessly fascinating to girls? To me it's a foul-smelling mix of white blood cells and bacteria that is better removed by necessity from an animal. To the ladies in my life it's like wine produced from God's own vineyard. They actually battle over who will get to lance the abscess when a particularily unfrotunate specimen comes in.

It seems to be quite specific to abscesses, too - I've yet to work with a female that will jump up and down with excitement at the prospect of picking maggots out of a rabbit's backside, or providing relief to an obstipated cat (obstipation is like constipation only much, much worse. Think of a cement mixer and you'll be in the right ball park). But thrust a juicy cat bite abscess towards them and they'll be charging for the scalpels quicker than you can say 'purulent'.

(I'm mostly talking about cats here for a few reasons. Dogs are less likely to get into a fight than cats - there's a reason for all that rolling on the back, submissive behaviour. Cats don't do that so much. If they don't get on, they'll generally settle it with physical violence - they're a bit like rednecks in that respect. Rabbits, on the other hand, simply have a problem with their pus. It's more like cottage cheese than anything else, and doesn't squirt satisfactorily out of a hole like lovely cat pus. You generally have to scrape it out with a curette. Apologies if you're eating, by the way.)

This may or may not be a surprise to you - I bet you are either a perpentrator or a victim of the lesser phenomenon, though - humans seem to be another source of endless fascination for daughters of Eve. Anyone who has ever sat through an evening having their spots squeezed (or squeezing the spots of) their siginificant other knows what I'm talking about here. In any case, I'm more than happy to hand the victims of feline violence to my female colleagues for rapid and gleeful lancing. Hey, it saves me a job.

Well, there you have it. The lesson for tonight - there's something in the feminine psyche which takes great delight in seeing nice fresh pus oozing from a gaping wound. Whether this lesson is of any use to anyone is another matter entirely. Hey, I don't make this stuff up, I just report it.

And please, next time your cat has a suspicious sweling on it's head two days after getting into a fight, ask for a female vet. They, and I, will be very grateful.

The Youth in Asia - part three mark 2. Once more, with feeling!

2010-09-23T10:59:00.005+01:00

Okay, here's the thing.

Kerry and I went out for a nice evening's gaming with a a friend last night, and also checked over his jack russell, Max. I've known Max for years. Lovely little dog, he sits under my legs when I'm playing games, and I absently tickle his ear when I'm rolling dice (Yes, yes, I know I'm a nerd! I'm fine with it, so there)

Anyway, Max has been ill for a while, and last night was also a 'check up'. It had been on the cards that he might be needing to be put to sleep, by friend had phoned me last night and told me that Max was doing much better, so Kerry and I took some wine, a nice board game, and looked forward to an evening's gaming.

When we got there, we checked Max over, and sadly, he was much worse. He needed to be put to sleep. And so that's what we did.

Then I came home and wrote the blog below. I was in a funny frame of mind - mentally, I'd been set up for relaxing, fun, gaming, and then suddenly had to shift the gears round in my head and turn into caring vet mode. I was sad, and upset that I'd in some way betrayed Max - all those times I'd been tickling his ear, or his belly, then one night I came round and killed him. Unfortunately, this seemed to warp my fragile little mind, and I'm sorry to say that the blog post that came out of it wasn't very good at all. I deleted it after I'd written it, for a number of reasons.

Firstly, it was intended to be an exploration of how performing euthanasia affects the person performing it. I wanted to explore the idea of what it might mean for human euthanasia, and how doctors may cope with it. Instead, it turned into a self-pitying 'poor me' polemic on how I don't like putting animals to sleep - fair enough, you might say, but it wasn't really what I was trying to say.

Secondly, it didn't feel very respectful to Max to be whinging about how unhappy -I- was.

Thirdly, I'm a bit of a drama queen. Anyone who follows me on twitter or facebook may be familiar with the intermittent angst-ridden 'waah! this happened' type of post that I like to squeeze in between puns just to throw everyone off track. What can I say? I wear my heart on my sleeve. If I'm miserable, I want everyone in the world to know! Thanks to the magic of the Internet, that is now possible. Ahh, technology :) This behaviour is not something I'm proud of, but it's part of me and there it is.

Fourthly, it made me sounds like a suicidal nut-job. This is not the case, honestly! I was just having a 'black dog' moment, if you'll pardon the pun (there I go again!)

So, I've decided this morning to reinstate the blog, in a slightly more rational, and hopefully light-hearted, frame of mind. I've chosen to do this for several reasons...

(Oh for God's sake! Get on with it!)

Firstly - well, the blog was at least partially successful in that it gives you an insight into the mind who has just put a well-loved dog to sleep. Well, my mind, anyway. Morbid chap that I am, I always find it slightly awkward meeting a friend's pet, because there's a little voice inside me that wonders if I will ultimately be the person who puts them to sleep. Yes, I'm a lot of fun at parties.

Secondly, I thought it might help to comment on some of the things I said in it. I'll add in some further thoughts in italics as we go - the great benefit of arguing with a past self is that they can't answer back. Take that, Nick from last night! Ha ha!

Thirdly, did I mention that I'm a bit of a drama queen? The blog from last night, poorly written and rambling though I feel it was, does reflect a piece of my personality that is, in it's own way, just as valid as the normal, handsome, well-adjusted fella that I am this this morning.

As you read the blog, especially the self-indulgent 'pity me!' parts of it, bear in mind that the guy below has got a pretty good life - a nice house, a lovely wife, great friends. How many people in this world have as much as him? Don't feel too sorry for him, he thrives on that sort of nonsense. Anyway, on with the show!

It's a hell of a thing, killing a man. Take away all he's got, and all he's gonna have. - Will Munny, Unforgiven

I'm not a cowboy. I've never held a gun, and I haven't really got the swaggering gait required. We do seem to have collected a number of horses here, but neither my wife nor myself use them to round up cattle, or escape from Red Indians (or Native Americans if you prefer...calling them that doesn't change what we did to them though...). I have never been part of a posse. But there's a part of my life that resonates with the gravelly-voiced Clint quote above. I've never taken the life of another human being, but by any definition, I am a killer.

This is a selfish post. It's selfish because it's about me - or, at least, about vets. I've talked about the act of putting an animal to sleep several times in this blog, but tonight I'm not thinking about them, for a change. I say for a change because during the process itself, it's all about them. The animal comes first, and rightly so. I feel guilty even writing this, because I am aware that I am alive, and all those many that I have seen, have killed, no longer have a voice for anything.

The more perceptive amongst you may have realised by now that this one isn't going to have many jokes in it. Sorry about that. Scroll down a few, I'm sure you'll find one. If you've all tuned out by now and I'm just talking to myself, well that's just fine too.

Most of these blogs are precipitated by an event in real life. Tonight, my wife and I went round to my friends house to play a board game, and check over his poorly dog, Max. Instead of playing the game, I put Max to sleep.

So tonight, I want to consider the effect this has upon me, upon the vet. Upon the instrument of the animal's destruction. I'm aware that to some of you - those of you who, mistakenly in my opinion, believe that humanity is something special, something quite apart from the rest of the natural world - may feel I am being melodramatic. They're only animals. All I can tell you is that this is how it makes me feel, and that, to me, the difference between humans and animals is not as great as is commonly regarded.

Except, young Nick from last night, it's not quite as simple as that, is it? I stand by my assertion that humans are animals, but, much as it pains me to admit it, a human leaves a much bigger hole behind them than an animal. This is probably because we're humans (well, most of us). What I'm trying to say is - human euthanasia, though I wholeheartedly agree with the idea in principle, would be much...well, messier, than animal. No-one's ever going to conspire to murder a dog in order to gain their inheritance, for instance. Humans leave a lot more clutter behind from their lives, which would makes things much more complicated that I suggest above.

Still, personally, and as an aside, I would be happier having the occasional person bumped off deliberately before their time than the current situation, where every single one of us is dragged on and on until our bodies litter ally stop working. Ugh. Anyway...

Early on in our career, vets learn (much as in many other professions with unpleasant tasks, I suspect) to suppress it, not to think about it, to joke about it, and to reassure ourselves that we are doing the right thing, that we are relieving suffering. Most of the time we are. Some of the time we aren't. We do it regardless, because we know the alternatives are not good.

Here is how the act of killing another animal makes me feel - a little sad. That's it. If it made me feel any worse, I wouldn't be able to function on a day to day basis. So, I feel sad, and usually professionally proud that it went well, that no more suffering was caused than was necessary.

At least, that's how it makes me feel most of the time. In my darker moments - moments like now, for instance, it makes me feel...well, it's a hell of a thing, to kill an animal. Taking away all those moments, for ever. In my very dark moments my mind conjures up a special hell for people who killed, who are confronted with all the lives that they have taken, and all the person can say is that they were doing their job, that they were relieving suffering. It's crazy, I know, because I'm pretty sure that there is nothing after death just as there was nothing before birth. Pretty sure. I think of the times when I haven't been entirely sure of the decision, and I have allowed the owner to influence the outcome. I think about the times when I knew it was the wrong thing, and I did it anyway, because there was 'no choice'. (Here I'm skirting around the issue that I sometimes do it because it is the easiest, and not the right, thing to do.) I think about the times when it was the right thing.

This may sound like I don't believe in euthanasia, but that's not true. I passionately believe that quantity of life is nothing if there is no quality. What is the point of continued existence, if all of that existence is pain? My wife once was peripherally involved with the case of a dog, rushed into emergency surgery, that was found to have a bleeding inoperable tumour on its liver. The vet in charge informed the owner, and sadly recommended euthanasia. The owner absolutely refused, and made the vet stitch the dog back up. He came and collected his dog, and took it home. It died overnight. That single case tells you all I rationally believe about the continuation of life. It is a concern to me that most of the patients I treat will have better deaths than my own.

No, this post is nothing more than a single, selfish lament. A long drawn out 'why me?', railing against the choices which have lead me to be the one responsible for the deaths of so many. I want to say that it isn't good for the soul, but I don't believe that such a thing exists so I'm stuck with simply saying that it doesn't feel good.

I'm running out of steam, (I think I mean 'wine' - I certainly found an empty bottle next to the laptop when I came down this morning!) and I think I'm glad for it. Other concepts flit through my mind - the idea of death as simply a loss of time. The process of dying. The culpability of the killer. But I find myself unwilling or unable to explore them as I thought I would.

I'm not sure I'll even publish this post - it seems very out of my normal writing style. Perhaps I'll re-read it in the morning. If I do, and if you're reading it, then rest assured, normal service will be restored soon.

I -did- mention that I was a drama queen, didn't I?

In the meantime, I can think of no better way to end this morose rambling than with the save words of Mr Eastwood, who says more with six words than I can manage with this whole blog. After the opening quote, his sidekick, the Schofield kid says 'Yeah, well, I guess they had it coming.

Clint looks into the middle distance.

We've all got it coming, kid.

The other side of the table

2010-07-24T16:41:00.008+01:00

I don't like mechanics.

Okay, that's not entirely true. I'm sure there are lots of mechanics who I'd really like if I met them socially. (Well, okay, even this is stretching the truth - being a socially-inept geek I don't really have a lot in common with the average grease monkey) What I'm trying to say is - I don't like taking my car to mechanics.

Part of the problem is that I'm a man (please don't take that quote out of context) and so it seems to be assumed that I was born with some deep underlying insight into how a carburettor works (or even what it does) and so the fact that I don't have the slightest clue already marks me out as a failure the second I step out of my car.

But how do they know you don't really understand the secrets of the internal combustion engine, I hear you cry? Don't try that with me. They know all right. They know the second they lay eyes on me, that I'm not the kind of man who takes pleasure in reading What Car magazine. They can tell just by looking that I used to get picked last in PE lessons. The bastards.

Once, taking my car in for a routine service, the guy behind the counter (with deep, ingrained oil around his fingernails - the kind that looks like it could never wash off even if he had his hands flayed0 asked me the mileage of my car. I had no idea. He looked quizzically at me like the cop in the Terminator when Kyle Reese grabs him by the lapels and demands to know what year it is. How could anyone not know what their mileage on their car is? I felt such a deep sense of masculine failure, I wanted to jump up on the desk and cry out 'I changed a tyre! I changed a tyre once, and it was raining, so there!'.

I didn't, of course. I was too humiliated, because his first question was 'What is your registration?' and I hadn't known that one, either. I had to go outside and check. Once, I was standing in a queue to pay for my fuel at a petrol station, and a woman in the shop was looking for oil for her car. She wasn't sure which one it needed, so she glanced around. It suddenly dawned on me that I was the only man in the whole building. The fact did not escape her either, for rather than ask at the counter she approached me, waving a tub of Castrol something-or-other, and asked me 'Is this the right one for my Peugeot?'

Everyone in the shop turned to look at me. I was so caught between umbrage at her sexist assumption and embarrassment that I didn't know the answer (of course!) that I just mumbled 'Don't know.' I couldn't leave the shop then, which would have been my preferred option, because I still had a car full of unpaid-for petrol, so I had to slowly wend my way up the queue of shame to pay, everyone there knowing that I had failed at some unwritten man-test.

You may get the impression from the above that I have something of a man-chip on my shoulder when it comes to mechanics, and you may well be right. You may also be wondering by now what the hell this has got to do with being a vet. Well, be patient (heh. Little medical joke there, see. Patient? No? Please yourselves.) Here is the tenuous link...

What I really don't like about going to the mechanics is that, basically, if something is wrong with my car, I don't have a clue what to do about it. I'm going to have to take it to someone else, who is going to look at it, tell me what's wrong with it, and then, hopefully, fix it. I will wait anxiously for the bill, really not having the slightest idea what it will be, and hoping that I haven't picked some cowboy who instead of fixing my car has just hastily Sellotaped in back together. I have no way of telling a good mechanic from a bad one, and all I can do is pick someone who seems vaguely nice and hope for the best - though whether being vaguely nice has anything to do with some one's skills in engine repair, I have no idea.

Sound familiar?

What I'm saying is - it is very easy to forget, as a Veterinary surgeon, what a depressing, stressful, expensive and scary experience it can be to take what is essential a family member, and leave them with a stranger for a day whilst they do unpleasant things to them, and charge you for the privilege. Now (and I cringe at saying this because I'm a thoroughly middle-class English person, and any hint of self-praise is usually enough to send me almost into a coma of embarrassment) I am, as it happens, fairly popular with clients, and they seem to quite like me. Part of the reason for this is that I'm a dreadful toady, and am almost unbearably nice to people because I don't like to cause a scene, but a lot of it is because that I do understand that it's not fun to take your animal to see a man in a green coat, and the more you can relax people, and explain as clearly as you can what you think, why you think things happening, and why you would like to stick sharp things into their beloved friend, the more they will trust you.

I do keep that in mind, but even so, a number of things have rather reminded me what it is like to be on the other side of the consulting room table. The first is that my own dog is not very well herself. Being vets, we thought that anything that happened to her we would probably sort out ourselves, but being the stubborn little so-and-so that she is, she decided to develop a condition that needs surgery, the success of which greatly depends on the experience of the surgeon with that particular op. And the experience we have with the op is zero, so we have had to refer her.

Which basically means we have had to ring round vets, getting appointments, getting (dare I say it) quotes for the operation, and generally worrying. Then we've had to sit in vets waiting rooms, trying to make small talk with other people whilst worrying about leaving our dog, and the bill, and whether the anaesthetic would go okay, and whether the vet would be nice to us, and so on. Karmically, it was probably some form of cosmic payback for the stress and misery I have unwittingly caused to other clients in a similar situation. Doctors, apparently, make the worst patients, but it's a fair bet that vets make the worst pet owners, because I was a blubbering mess the night before she went it.

(By the way, the operation has been delayed for the moment, because the condition - laryngeal paralysis - isn't quite bad enough for the surgery (a laryngeal tie-back) yet - some more stress ahead! Yay!)

The second thing that reminded me was talking to some friends a few weeks ago - they had taken their cats to see their local vet to get them vaccinated prior to a house move - and ended up feeling cheated and a little annoyed because the vet responsible gave a vaccine that they didn't feel was necessary without telling them, and generally not really explaining what they were doing. To use my mechanic analogy - it's like me being told that my flange nuts needed tightening, and it would cost me eighty quid. I've no idea whether they do or not, but if the mechanic doesn't take the time to tell me what a flange nut is, why its come loose and why it needs tightening again, I'm going to feel a bit ripped off even if my car would have exploded in a shower of oil and surprised vet had he not done so. It's not so much what they did, as how they did it, and this kind of thing contributes to the feeling amongst people that vets are money-grabbing bastards. We really don't do ourselves any favours on this front.

The third thing is the elephant in the room. Not literally (at least I don't think so - I'll go and check, Hang on....nope, no elephants) - but this week a programme was shown on BBC called 'It shouldn't happen -in- a vets' (very clever, see what they did there? I would never stoop so low to use a pun of a James Herriot title for my blog). Now, I have my fair share of issues with this programme, and I don't want them to turn into a rant, but I'll mention a few here. Panorama (which I think the program was - it wasn't clear from the opening credits. I do wonder if it was supposed to be a Panorama but was extended into it's own show? Anyhoo...), which used to be a paragon of impartial reporting, seems to have stooped to the lowest brand of journalistic mischief making. It always starts with the worry-maker-in-chief, Jeremy Vine, standing outside (see! This is an important issue, far too important to sit around behind a desk and tell you about), suddenly telling you that something you previously had no worries about at all may actually kill you/spend all your money/give you cancer. The programme then goes on to tell you, in no uncertain terms, exactly what you should think about this particular issue (which is always WORRY WORRY WORRY WHY AREN'T YOU WORRIED THIS PERSON/THESE PEOPLE IS/ARE OUT TO KILL YOU/STEAL YOUR MONEY/WORRY YOUR LIVESTOCK) - and the vet episode was no exception, right down to the freeze-framing the bad vets in black and white vaguely mugshot poses whilst apparently throttling cats, whereas depicting the nice vets in their living rooms, or in a lovely green field surrounded by nice cows.

I could write a whole blog on the show (which seemed to suggest you'd be far better taking your animal to a vet who has worked on his own for twenty years, than a large, well-supported practice with state of the art facilities. I don't work for one of the large franchise practices that seemed to be taking the brunt of the flak from this programme, but take it from me, I would rather have my own dog operated in one of them than in a single-vet practice.) but that isn't really what I want to waffle about. The thing that upset most of my clients, watching the show, was a brief image of the EVIL vet swinging a cat around the room holding it by the scruff of it's neck. Well, it may be a surprise, but this is a recognised restraint technique for cats if you're on your own - watch the video again and you may well notice that the cat itself doesn't look stressed or upset, and neither vet or cat were at risk from harm during the procedure. It's a technique I have used myself on many occasions (including on my own cat!) and in front of clients too - the point being, I have explained to the clients first what I am about to do, and why. Everything looks bad taken out of context (like my comment above, about it being a problem that I'm a man)

(Incidentally, don't get me wrong - there were a several rather upsetting things shown, like the dog which had it's leg amputated being -very forcibly- restrained post operatively, and a senior vet squeezing used blood back into a bag so it could be re-used on another dog, as well as a pretty depressing laissez-faire attitude amongst student nurses towards animals)

The point, for the purposes of this blog, was that scenes of animal restraint that look fairly routine to me, can be extremely shocking for people unused to such a thing - especially in the animal being restrained is their beloved pet. I'm sure those clients, with horrified looks on their faces, would understand a lot more if they weren't shown the footage of such by the pantomime Jeremy Vine, which accompanying operatic music, but were talked through the procedure by someone who actually knew what they were talking about.

Well, the torrent of words is slowly so I feel I need to creep towards a conclusion, which I suppose is this. If you're a vet, try and remember how horrible it is taking your pet in when you've been worrying about that cough he had all week. If you're not a vet (and really, why would you want to be?) - shop around! Find a vet that explains things to the level you want them explained. If they don't, you'll feel ripped-off whatever the bill, and it's a recipe for misunderstanding and all manner of Royal-college nastiness.

We're all human, you know. Well, except for mechanics, that is.

Seen and not heard...

2010-06-09T23:45:00.003+01:00

This will be a brief one, but it's a neat little illustration of...well, I've not really got the faintest clue what it illustrates, or why, but I'm pretty sure it illustrates something. When I work out what it is, I'll probably make some money out of it.

It wasn't the busiest surgery this evening - the waiting room wasn't packed, which in light of what was about to follow is probably a good thing. I walked out into the waiting room to call the name of the cat I was about to see (see my previous post for client-calling in strategies through the ages). I saw the woman sitting with a cat box, and standing next to her were her children, a little boy and a little girl. They were...oh, I don't know, I'm not good at estimating child ages. Puppies, kittens, I'm fine with, but kids...well, they were about yea high. Old enough to walk without dribbling, just about. They both looked cute to my untrained eye, anyway - the boy looked a little like a smaller version of Phil Mitchell's sprog in Eastenders.

So, I stood in the waiting room, patented vet-smile (TM) on my face, and called out the cat's name.

'Marny?'

The boy looked at me, caught my gaze, smiled, and shouted out 'You sound gay!'

Now, I've had a number of unusual responses in waiting rooms, but I'll be honest, this was a new one on me. I believe I might have lost control of my jaw for a moment, but years of practice left the smile on my face, so that my mouth lolled open like a sedated guppy's.

Okay, any of you who know me, it may have crossed your mind by now that our young Satan had a point. I have not been blessed with the deepest voice in the civilised world. I have, on occasion, been known to mince, and it's true that most practices I've worked at have been surprised to discover I had a girlfriend (or, as is now the case, wife). It's not the worst disability in the world, having a rather effeminate manner without actually being gay, and I genuinely don't mind it, but it can get a bit wearing at times. Still, old ladies seem to like it, and if works for the clients it works for me.

The lady uttered not one word of remonstration to my new arch-nemesis, but picked up the cat box and headed towards my consulting room. As I closed the door to the waiting room I could see the receptionists leaping to my defence by doubling up with laughter at the front desk.

The rest of the consult was, if possible, even less fun. The cat was fine, it was only a second vaccination, but Tiny Terror had decided that the next torment to inflict was to loudly repeat everything that I said, in a rather unflattering tone of voice. Whilst I longingly looked at the needles in my cupboard and wondered if it acutally might be worth doing some prison time, the mother decided to very quietly say to the monstrous spawn that she had produced 'Now, be quiet, the man's trying to work'.

Well, at least she said 'man'. Sigh. I managed to complete the consult without strangling anyone to death, or bursting into tears. As the woman left, she let her offspirng out before her, then turned to me and said in a conspiratorial tone 'He's autistic.'

Great, so not only had I been bullied by a child for my entire consultation, and ridiculed for it, I was now also a complete bastard for wishing various sharp unpleasant things to happen to the kid because he was disabled, rather than, say, an undisciplined little turd.

I was hoping to come to some great insight for having jotted this down, but thus far none has come to me. I'm no expert on autism, or children, or anything to be honest that doesn't involve animals (or science fiction), but it strikes me that children can get away with any behaviour they like so long as you put a label on it.

The label I have chosen for this paticular behaviour is 'bastard'. (I probably would have felt much better about the whole incident if the woman had turned to me at the end and said conspiratorialy 'He's a bastard.')

Anyway, if anyone wants me I'll be in the x-ray room, repeatedly radiographing my testicles until they couldn't produce a sperm if their life depended on it. Thankyou, and good night.

Really Wild Show

2010-05-29T17:00:00.002+01:00

Whilst we're on the subject (see my blog...okay, rant...below about natural things) let's talk about wildlife. Ah, wildlife. What to do. How can I best express my feelings about wildlife work?

Best place to start is read my previous blog, the one about natural oil. Yes, yes, I go on about that tea tree oil a lot, don't I? Sheesh, what's my problem with it? Never mind that. Keep reading. Get to the bit about pain and suffering. What do you mean you didn't get that far? Well go back and read it again! I haven't got all day.

All done? Okay. So now you know what I feel it's like to be in 'the wild'. It's bloody horrible. When I get creatures brought in from outside, you know what I think of them? They're not fluffy, cute animals. They're wounded soldiers. They're on the front line. It's war out there for them - literally, a life and death struggle every single day of their lives.

I once heard a story from an acquaintance of mine who just found out that I was a vet. She had found a wounded sparrow in the garden, attacked by a cat. It was very small, and weak. My friend and her daughter decided to take the sparrow in, and put it in the sink of their bathroom. They gave it a little water, tried to help it recover. It was too ill to drink. It was too ill to do anything. The sparrow died after a day or so.

So I asked why my friend had not taken the sparrow to the local vets, who were literally just up the road, and she said 'I was worried that they would put it to sleep.'

Stop and consider that for the moment. Stop and think about what that sparrow experienced from the moment it was injured, until the moment it died. Put yourself in that sparrow's position.

I'm spelling this out because, if I had been the vet on duty in that practice, then my friend's worst fears would have been confirmed. I would, absolutely, have put the sparrow to sleep. And you know what? I'd also do it for about 90% of the wildlife you would ever bring me. And if you can explain to me why doing that is worse than what that poor sparrow went through in my friend's sink, you have a different view of morals and ethics than I do.

So there, I've said it. All that preamble, so that I can reveal to you that I will, with a clear conscience, kill nine out of ten wildlife casualties that are brought in to me. As for the lucky 1 in 10, well, there's usually nothing wrong with them, and I'll tell you to take them back where you found them.

The animals that are brought to me are not pets. They don't behave like pets. They are scared of humans. They are scared of confinement. They are scared of just about everything in the world, because just about everything in the world is trying to kill them, directly or indirectly. If I see, for instance, a blackbird that has been attacked by a cat, I have a few choices. One is to say 'Let's just see how it goes overnight', give it a few jabs, and not worry about it until the morning. The other is to put it to sleep straight away. One of these choices is immediately very tempting for me, because (despite what you might believe after reading the above few paragraphs) I don't actually enjoying killing things. In fact, it would be fair to say that I bloody hate doing it.

But that won't stop me making choice number two. The overnight option is much easier, nicer for all concerned, and when I come in the next morning to find the blackbird has died overnight, then myself and my nurse can say 'Ah, well, we tried.'

Except that I can't do that. What I'm thinking about it that blackbird, alone in a cage. Terrified and dying. What kind of a night do you think it had? Any better than the sparrow in the sink?

What about the ones that wouldn't have died overnight? Well, firstly, it's less than you probably think. I didn't always adopt this attitude, you see. I've had my fair share of nocturnal deaths. It's not a good feeling. Secondly, remember what I said earlier - these are soldiers. I'm patching them up the get back in the fight. If I can't guarantee that this bird, or mouse, or whatever, won't be at the absolute top of it's game when I release it, then I am condemning that animal to die, either at the hands of a predator, or from starvation.

A lucky few of these wounded soldiers will be adopted by people, and become their pets. Well, that's fine. If they're never going back to war again, then I'll do all I can to help them. Some species also seem to cope better with captivity than others - hedgehogs, for instance, often cope a little better than some others once you've got them through the first few days (they bloody hurt to examine, though!) But that isn't the way for most of them.

And so I kill, or to use the polite term, euthanase, most of them. And I feel sorry about that, because I don't like doing it, and I don't like death, but I don't feel ashamed about it, because it's the right thing to do.

T'aint natural!

2010-05-29T16:22:00.003+01:00

There is a substance on Earth more ubiqitous than water, more precious than gold, and more magical than Harry Potter's pants. Apply it to any wound, scrape, blemish, graze or scald in existence and all ills and pains will melt away (like that cool bit in Indiana Jones and the Last Crusade, when Indy pours water from the Holy Grail onto his Dad's gunshot-wounded belly, and the wound is washed away). There is a name for this fabled mystical ointment, and it is spake thus - Tea Tree Oil.

I am daily reminded of the power of this wondrous elixir by clients of mine, who have invariably rubbed/poured/applied it on/to their faithful companion's skin. Well, let me pose the heretical question - if this stuff is so bloody good, why are you coming to see me now, eh?

Now, listen, I don't have a problem with tea tree oil (previous paragraphs to the contrary); I'm aware that it smells quite nice, and that your friend recommended it, y'know, the one who's son has got that terrible eczema, and the man in the health food shop said it worked for his irritable groin, and there's a nice picture of a leaf on the bottle. I would simply suggest that you can't go wrong with a nice bit of bathing in warm salty water, that's all. Pint of warm water, teaspoon full of salt, bit of cotton wool and bajinga! Robert's your mother's brother.

This may seem trivial (okay, okay, it is trival, but it segues me onto a wider point. What is the reason behind the supposed majestic power of tea tree oil? I know the answer. I get told it several times a day.

It's because it's natural, that's why. And natural has got to be good, hasn't it?

Sigh.

I really don't understand Joe and Jane public's obsession with things being 'natural'. In fact, I'm pretty sure they don't understand it either. Natural. What exactly does that word mean?

Here's the dictionary definition (according to Encarta, anyway) - present in or produced by nature; of, relating to or concerning nature.

Well, I don't know about you but I don't remember the last time I was walking through a forest and I was hit on the head by a bottle of tea-trea oil shampoo falling from a ripe tea-tree oil shampoo tree. I don't want to labour the point of this particular product, but my point is that tea trea oil, like any other product, must be produced - extracted from the tree (melaleuca alternifolia, of you must know. No, I'm not writing it again.) via a commercial and highly mechanised industrial process. It may be present in or produced by nature, but it's also produced by a lot of machines, manpower and energy, then put in a plastic bottle.

Good thing, too. You know what 'natural' means to me? It means dying alone from septicaemia contracted from an infection you got from a thorn in the foot. It means watching your baby cubs be mangled to death by the new male lion who's muscled his way into your pride. It means getting very nasty cramping diarrhoea and vomiting from taking tea tree oil internal, as it happens to be toxic.

'Natural' isn't great. It's horrible, because nature is horrible. It might look very nice having a picnic in a buttercup-strewn field on a summer's day, but try spending the same day in the same field as a field mouse and see how much you enjoy it. If you end the day with some food in your belly and not dead, then you're having a good day. Even then you'll probably get even by an owl overnight.

It's war out there. If there isn't at any one moment within a few hundred yards radius from where you are sitting now a large amount of creatures fearful, starving, killing or dying, then you're probably sitting on Pluto (in which case it's probably you doing the fearful and dying bit unless you're in a space suit or you're an alien - in which case I'd like to say - Greetings, my alien masters! Spare me, and I'll give you the rest of them! Ahem.)

Nature is pain, and death, and starvation. It necessarily follows from evolution - you're either the absolute best at extracting a particular kind of resources out of your enviroment, or your dead. So don't come to me with your 'natural'. Your arnica cream might be 'natural' (although it isn't), but so is getting your arm bitten off by a polar bear. Take your pills, and thank God for Western medicine. It's not perfect, but it's a bloody sight better than the alternative.

One of those days...

2010-05-14T17:32:00.002+01:00

It's been, as the cliche says, one of those days. It was one of those days, in fact, that made me start this blog in the first place. I don't know where those days come from, but wherever it is they can piss off back there, as far as I'm concerned.

It was the kind of day, in fact, that reminds me that we are, all of us (except for our mighty Robot Overlords, of course) basically fleshy machines, and that when something goes wrong with a bit of the machine that happens to house you, well, it's not great news.

Not a revelation to rival the Buddha's, perhaps - but it is a very obvious fact, the more you work in any kind of medicine. We're machines. Very complicated, self-repairing, self-aware and quite amazing machines, but machines. And machines break. And there's no reason behind this any more than there was a reason behind my Xbox breaking (THREE TIMES you bastards Microsoft! Ahem. Sorry.)

And that's the point of this blog. In fact, it's a bit of a cheat of a blog because it's really just an introduction to my very first blog, which I had to delete from my site (you'll find out later why. Just keep reading, you inpatient bugger. Or skip to the end. I'll put a joke there, I promise.)

So, the reason I'm in that kind of mood today - I came in this morning to find one of my inpatients, a very sweet cat called Humphrey (it really shouldn't matter whether he was sweet or not, should it? He didn't deserve what happened. But I'm getting ahead of myself, hang on...) feeling very poorly indeed. He'd been on intravenous fluids since Wednesday, and this morning his blood results were waiting for me from the lab. And they were not good news. Humphrey was very severely uraemic - that is, his blood urea and creatinine were something in the order of fifteen times the normal upper limit - that is, Humphrey's kidneys were buggered. He hadn't passed urine since he came in, despite all the fluids we were pouring into him, which meant his kidneys had pretty much shut down. Maybe better medics than me could save a cat like Humphrey, but I've never managed to get a cat in this state any better.

So, with a heavy heart, I phoned the owner (who must have seen the number calling, because she answered the phone with a hearty 'Hello! How are you?', which made me feel great. Humphrey was five years old, and I had no idea his kidneys would be in anything like the state they were. Fortunately, being the cautious chap I am, I had admitted him straight away for fluids, which was the right thing to do in such a situation. Unfortunately, for Humphrey especially, it hadn't made a blind bit of difference.

Now, there's not many things that can balls up a young cat's kidneys so severely and so quickly. A blocked bladder would do it, but Humphey had been peeing fine before this happened. Which leaves a rather short list, top of which would be poisonings. And top of that list would be antifreeze.

(which reminds me - please please don't use antifreeze in your nice water features in the garden. Cat's love running water. Antifreeze kills cat's kidneys, followed fairly quickly by the cat. Learn to love your frozen over water feature!)

But, talking it through with the owner, it wasn't antifreeze. Here comes the heartwarming part of the tale (I'm using a sarcastic voice here, if you wan't to read it to yourself like that. Ta.). The other poison that destroys cat's kidneys very quickly and irreperably is lilly pollen.

And as it turns out, Humphrey's owner's house had a lot of lillies in last week. On account of her father dying suddenly and unexpectedly the week before.

I put Humphrey to sleep today, because he licked a lilly plant last week. Because his owner's father died the week before.

I guess what I'm trying to say here is - there's no blame, there's no malice or hatred, or anything, behind any of these events. They just happened. Just like one day, they'll happen to us. I don't know why we seem to have this inate feeling, this need that life should be fair. To the point where if it isn't we tell each other its our fault that it isn't, because of what we like to do in the bedroom, or because we eat fish on the wrong day, or pray pointing in the wrong direction, or some other crap like that. I see, every day of my life, that life isn't fair, it isn't anything other than life, and it still surprises and upsets me when it isn't.

My wife has had a bad day too. A Staffordshire Bull Terrier that she operated on today, and removed an enormous tumour from it's spleen, died suddenly a few hours after it woke up, likely from a pulmonary embolism. It was less of a shock, because we already knew that the tumour had spread to the dog's liver (and possibly heart), and it almost cetainly wouldn't have lived more than a few months. They would have been comfortable and mostly normal months, though, at home with his owner, and he had them all snatched away in the space of a few seconds.

So, in the spirit of that, I'm re-instating my old first blog post, which was inspired by much the same sort of thing, and it expresses it better than I'm managing here. It might be grim, but keep reading! I promised that joke at the end, didn't I?

* * *

Life, death, and blogging.

As I walked into work today, I was immediately rushed downstairs by Chris, to help one of my vets. On the operating tablet was Maisie, an eighteen-month old Dogue du Bordeaux (if you don't know this breed, think of a slightly more canine version of Bungle from Rainbow and you won't be far wrong. Man, Bungle used to scare the crap out of me when I was a kid)

As I rushed into the theatre, wrestling the stethoscope from around my neck, Maisie gave a great shuddering cry, and vomited copious stinking bloody fluid all over the floor, and all over Jenny, one of our junior vets.

Several minutes later, despite much ER-alike injection, pumping, tubing and thumping, Maisie was dead. Not one of us could do a damn thing about it. When we opened up her abdomen, her guts were purple, and stinking. She had an intussuseption - where the intestines telescope into themselves, effectively causing a blockage - but this was likely secondary to the inflammation in the bowels.

Two hours earlier, Chris had walked Maisie out from the practice to go to the toilet - Jenny had admitted her the night before to keep in for observation for her vomiting - and she had wagged her tail, and walked (if slowly) out to the grass verge opposite the hospital, sniffing around in the way that dogs do to show they know more about the world than you do.

Jenny and I have both spent the rest of the day feeling miserable and useless. Partially because it's one of those cases where we feel there are no lessons to be learned - if we saw a case like Maisie's again tomorrow, we wouldn't have treated her case any differently. There was never any indication to operate before - Maisie's abdomen felt normal, her temperature was normal, she was bright and wanting to eat - but mostly because it was just so damn unfair. What did Maisie do to the world to deserve to die in such a terrible way? She wasn't even two years old.

Is there a point to this blog? I'm not sure. Nobody ever said the world was meant to be fair. I deal with death and suffering ever day of my life, but there's still some part of me that's hard-wired to thing that there should be some justice in the world. Today I had yet another reminder that life is fleeting, and precious.

So I'm starting this blog - to remind you all of this simple fact, possibly the hardest one for any human to digest. The blog is primarily about my work life. I'm hoping to show you what it's like being a vet in a world like this. Hey, it's a living.

Also to vent my spleen. Trust me, I'm a vet, spleens need to vented regularily or damage will ensue.

More tales from the front line to come.

* * *

Okay, you've made it to the end! Well done! Hopefully you don't need counselling at this point. The reason I deleted that post originally was because the case concerned, and both myself and Jenny, became the subject of a Royal College investigation at the request of the owners. This was sad, but not surprising - you've just read how I felt about the case, imagine how the owners felt. It was a senseless death, very depressing and very unexpected.

I can post it again because the investigation concluded that we had done nothing wrong, and there was no case for us to answer. The owners don't believe that of course, and without understanding, neither would I. The simple fact is, we did our best to save her, and she died anyway. It's a hard thing for our society to accept.

Right, you've made it through all the depressing stuff, now here's the joke....

There isn't one! It was a cruel literary subterfuge all along to further illustrate the point of life's unfairness. Except in this case it was a quite deliberate unfairness orchestrated by me. So it doesn't really make the point at all. Sorry.

Ah, never mind. I'm getting a drink. Anyone want one?

The Mutt's Nuts

2010-03-08T19:42:00.005Z

Just wanted to blog a quickie whilst a consult I did this evening was fresh in my mind. You could look upon the consult in two ways - either (if you're feeling charitable) it gave me an interesting perspective on how people view their animals, or (if you're not) it sent me into further despair about the future of humanity (maybe it's something of a relief that it doesn't look like we've got much of one)

I was seeing a dog out this evening after his castrate. The consult hadn't got off onto the best start when the owner (who I will refrain from describing because I don't want to predjudice anything. Let's just say she was 'dog rough', and leave it at that) was a bit aggrieved that I suggested we might have to charge her for the special shampoo I suggested to cure her dog of its potential fatal skin condition that I had diagnosed during the procedure (I didn't dare charge her for the skin scrape!)

'I haven't got that kind of money, what you doin', tryin' to rob me?' was the general gist of her reasons for not wanting the twenty-quid bottle of shampoo. (along with the polite 'Where the fuck did he get those fuckin' mites from, then?')

That's when we got onto the castrate. I explained that her puppy should have a light meal tonight, as he might feel a little sick after his anaesthetic.
(How the fuck am I supposed to cook fuckin' rice without a cooker, eh?)

Moving on, I explained where the wound was, and how although her dog's scrotum would look a bit peculiar now it was empty, it would all shrink down over the next few months.

Long pause.

'You what?'

'Erm...I'm just saying, it will all shrink down, and look very normal in a few months.'

'Are you telling me you've cut his bollocks off?'

(My turn with the long pause)

(slightly nervous at this point)'Well, he was in today to be castrated, wasn't he?'

'Yeah, but I didn't think you'd cut his balls off as well!'

Now, at this point, dear readers, I wasn't really sure what else to say. My gaze moved to the consent form for her dog, which she had signed, right under the words 'Dog Castrate'. The owner was now in a state of some consternation, huffing and swearing, and muttering 'I don't believe it.' I decided to go for the scientific approach.

'Erm...can I as you what you thin castration is?'

'It's the snip, innit? His tubes. Don't fuckin' believe it!'

'Um...no, I think you're thinking of a vasectomy. Castration is...well, removing the testicles.' Distressingly, I caught myself gesturing to my own crotch, as if this would somehow help to illustrate the procedure. Thankfully, the owner distracted me before I got too much further.

'Well, that's great, he's gonna attack all the other dogs now, isn't he?'

I didn't really follow the logic there, so I resorted to 'What?'

'He's gonna be jealous, isn't he? Lookin' at himself, and then seeing them with their balls hanging out, he's gonna kick right off, innee?'

It slowly dawned on me that the owner genuinely believed her dog was going to have such a self-image problem that he was going to take out it's anger and frustration on other dogs.

'I...um...dogs don't really think that way, to be honest.'

'Are you saying my dog is stupid?'

This is the point where my last, faint hope for humankind waved it's little white flag. Several minutes, and lots of swearing (only slightly on my part) finally convinced my owner that her poor puppy was not going to develop some kind of castrato-complex*, and that castrated dogs tended to be less aggressive than uncastrated. Somehow, I managed to survive the rest of the consultation without getting thumped, and even managed to get a 'Thanks' from the owner. We might even convince her to get her dog treated for that potentially fatal skin condition, if we're really lucky...

And that is my story. Bit too early to have much of a point to it, other than I wanted to write it down before my brain rejected it as too strange to be true. If there's a lesson to this tale, I suppose it might be this - if you need a surgical procedure, make sure you know what it is before you sign on the dotted line. Not much of a moral, I know, but what do you want from me? I'm a vet, not a philosopher (though I am occasionally a reluctant social worker too)

*(which, it occurs to me as I type, opens on to another issue, slightly less flippant and so not really belonging in this blog - is it justifiable to mutilate an individual of a species, for the good of the species as a whole? My honest answer is yes, I believe it is - I've seen too many unwanted puppies and kittens get euthanased or suffer to even slightly think otherwise - but I'm not blind to the fact that being neutered is a stressful and unpleasant thing to go through, and given the choice dogs and cats probably wouldn't go for it - I mean, a good way to add eight years to my own life would be to get castrated, but you don't see me lining up for it, do you? Anyway, I digress....maybe the subject for another blog, that one)

The art of veterinary medicine

2010-01-28T12:17:00.002Z

It is said, by some, that at University you learn the science of veterinary medicine, and then in practice, you learn the art. Well, I've always resisted this - I consider myself a scientist, and would like to think that I at least try to practice evidence-based medicine.

(I was surprised when I qualified to find this is not the view of all vets - possibly not even the majority. I know a few vets that would be almost offended to hear themselves described as scientists. But my degree says Bachelor of Veterinary Science, so I'm right and they're wrong. Nyah.)

(Okay, okay, not all veterinary degrees are BVSc - there's Bachelor of Veterinary Medicine, Bachelor of Veterinary Medicine and Science, etc... but I'm cheerfully going to ignore that point in the interests of brevity. Or I would have done if I hadn't rudely interrupted myself)

However, there is one aspect of being a vet that even I must admit has something of an art to it. Consulting (or convulsing, as my wife happily calls it). The (inexplicably named) surgeries, the part where we, the vet, actually meet the public.

The artistry begins in the waiting room, when you go out and call the client into the consulting room (unless you have a nurse do it for you. In which case you're lazy. Ahem.). This in itself is a bit of a minefield. Do you call out just the animal's name? The clients surname? The animal's name followed by the surname? All have their pitfalls.

In a full waiting room just calling out 'Tyson' generally leads to three different owners standing up at once (probably all bringing a Rottweiller in. I'll have to do a blog on animal names at some point...). Also, you run the risk of calling out 'Princess' or, worse, 'Honey', and having a large, hairy and slightly pissed off man stand up with a cat box, to the titters of the rest of the waiting clients.

Just calling out the surname, as my boss tends to do, strikes me as a little public school, and always makes me think of the Rowan Atkinson sketch where he is a teacher calling out increasingly bizarre and rude names from the register (Mydic? Has anyone seen Mydic?). It seems brusque and rude (though my boss is charming enough to pull it off effortlessly). It can also cause embarrassment when you fail to pronounce a surname correctly (especially if it's Greek - some real tongue twisters there), and it may well have got me into trouble last night when I saw someone with the unfortunate surname 'Fuchs'. (Other potential problem surnames - 'Cock', 'Uren' and, (honestly) 'Handaside-Dick').

A variant of this option is to call out 'Mr Smith' or 'Mrs Jones' or whatever. The problem here is that the person who registered the animal is not always the person who is bringing the animal in, often leading to you having to make a snap judgement of the marital status of the person in the waiting room. Getting in wrong risks a withering look and an 'It's Miss, actually.' (I once had this delivered not with a withering look, but infinitely more frighteningly, with a wink). Even worse (as has happened to me sadly often enough) is having to make a snap judgement of a person's sex. Bear in mind, if you get this basic fact wrong you will be spending at least ten minutes talking to them, and it's not the best way to start a conversation.

The third option, calling out the animal's name followed by the surname often leads to an exasperating reaction from the client of a puzzled look, and a giggle, and a comment like 'hee hee, 'Bilbo' Maclean, like he's one of the family!' - possibly funny at first, but when you've seen that reaction thirty times a day it does get a little wearing.

My personal preference is for option one, but scanning the list of names first to make sure we don't have duplicate animal names in, defaulting to option two with a particularly embarrassing animal name (a la Peaches Fru Fru...or for those bizarre times when the owner has seen fit to call their animal 'Mr' or 'Miss' (never 'Mrs'!) something - we saw a lot of mice called 'Mr Jingles' after The Green Mile came out. For the record, none of them lived quite so long as the one in the film) or option three with multiple-monikered mutts. (I don't mean mutts offensively, I just wanted an 'm' word for my alliteration. For what it's worth, if you've got a mutt, you've probably got the healthiest animal in the room. And that is definitely a subject for another blog)

One last point about waiting rooms - it happens to me about once a month, that I go out and call a clients name (with all the pitfalls mentioned above), and the client looks at me questioningly and says 'Yes?'

Now, I don't mean to be rude, but you are sitting in a WAITING room, in a veterinary surgery, with your animal, and a man in a green coat with a stethoscope sexily wrapped around his neck (okay, okay, just wrapped, then) walks towards you and calls your name. Is it possible you might have some contextual clues about what he wants?

Sigh. Okay, I know it's stressful taking your animal to the vets, so I apologise if that comes across a little mean-spirited. But really. Some people. I don't know.

Well, I was going to talk a little about the process of the consult itself, but I seem to have rambled on somewhat just about the waiting room, so I'll leave you in suspenders for the next exciting installment!

Happy new year, by the way :)

The Youth in Asia Pt 2 - Christmas Clearout

2009-12-28T11:44:00.006Z

The dust from the house move is slowly settling (like nuclear fallout, only slightly worse for my health), Christmas is fading away into the ether and the New Year looms menacingly in the darkness ahead, like a drunken thug with a sock full of stones.

All of which cheery preamble means that my life is starting to approach something of a routine once more, and the quiet but insistent voice that's been whispering in the back of my brain that I promised I'd do a blog in December has started shouting and poking me in the backs of my eyes as January approaches. So here it is! My Christmas blog, only slightly late.

I love Christmas. I'm aware that it's pretty much a made-up holiday, having very little to do with the birth of anyone any more, a holiday that was pinched off the Romans by the Christians (and almost cetainly stolen off someone else by the Romans before that) - fine by me! I have less religious conviction that Richard Dawkins.

I am also not blind to the fact that it is a tacky, tawdry, consumerist behemoth of a holdiay, all-consuming, all-devouring. But, it's so ubiquitous, that if you try and fight against it you'll go insane. Christmas is, and always has been (whatever it's been called down the centuries) a celebration that we've made it this far through life, and basically a party to cheer ourselves up that we've still got a very long winter left ahead of us.

And it works. Christmas is a bright spot in the dead of winter, a time for family and friends to get together, and forget about our otherwise boring lives. Yay for Christmas!

However...I hate being a vet at Christmas, and not because I usually have to be on duty for some of it - at least people tend to feel a little guilty if they call you in on Christmas Day, and you get less of the 'My cat can't sleep'-type call in the small hours of the night.

No, the reason I hate my particular job at Christmas is the phenomenon of the 'Christmas Clearout'. Christmas may be a time for family, friends and fun, but for various reasons it also seems to be a time when people finally decide to bump off their animals.

In the week leading up the Christmas (a three-day week), I personally performed seven euthanasias. Three of them were in a row, all lined up in reception waiting for me to call them in for their last ever appointment. As to why this happens around the festive season - well, I think it's a time when people stop and reassess their lives. The family is coming round, and suddenly that old doddery cat looks - well, very old, and very doddery. Suddenly that incontinent dog doesn't seem very easy to deal with. Suddenly the fact that your German Shepherd has nipped a few people in it's time looks a lot more worrying when the grandchildren are coming round.

Finances play into it too, of course. It's okay to keep the arthritis tablets going until you have to buy a Wii for the kids, and that thyroid operation looks a hell of a lot more expensive with the presents piled up under the tree.

Frustratingly, another reason - almost unbelievable to me now but sadly I see it every year - is to make room for the new pet that is being bought for someone as a present. Seriously - it's not big, it's not clever, and it's definitely not funny - please don't buy a pet, particularily and especially a puppy, as a present. I'm sure I don't need to tell you this, but it still happens every year.

This year has been especially bad because the practice has had several 'out of the blue' cases - nothing to do with Christmas, cases which suddenly get ill with no warning, but which turn out to have extremly serious problems such as liver cancer or kidney failure, and so need to be euthanased with little or no warning. These sad cases happen all year round, of course, but seem particularily poignant and sad just before the holidays, especially on top of the marked increase in euthanasia in general.

My thoughts at this time of year always turn towards the act of killing itself, and the effect it has upon me. I'm the kind of person who will always catch a spider and set it free rather than squash it - moving into this new house we found ourselves infested with flies, and the fact that I still feel guilty several weeks after the fact for losing my temper and swatting three or four of them in the middle of the night tells you something about my temperament. Nothing to do with high moral standards, of course, and everything to do with cowardice. I hate to feel responsible for the cutting off of another life.

Which might lead you to suspect that I have picked the wrong career. It certainly crossed my mind on Christmas Eve as I was injecting the third cat in a row with barbiturates, and watched it take its very last breath ever. It was made especially hard by an owner distressed almost to the point of hysteria in this last case, something I found rather annoying as once more I knew the cat could have been stabilised and had a normal life for several more years with tablets or a simple operation. Both of these had been refused by the owner who 'didn't want her to go through anything', as if taking a tablet a day was the equivalent of being subjected to what George Bush might politely call 'intensive interrogation'.

As the woman retched and cried and gurgled, heading for my sink, I tried to find it in my heart to feel some sympathy for her, but hten a looked at her dead cat and thought of what she had just made me do to make her Christmas a little easier. During the procedure, all I care about is the animal, making sure everything goes smoothly, and that there is as little fear and distress as possible. Afterwards, though, I wonder about myself, and what kind of effect this constant execution has on me.

You remain detached, of course, because you have to, but I find that as I get older, starting to worry about the loss of those dear to me, both humans and animals, it becomes harder to immunise yourself to it.

The actual process of killing has a demystifying effect upon death to those who deal it out daily - there is nothing taboo about it, nothing strange. It happens easily, sometimes quickly, sometimes slowly, but it is an inevitable, irrevocable end for us all. There is no 'special time', no warning, no clues that your story is about to come to an end. It just happens, without reason or purpose, just like your iPod fails to switch on one day or your car won't start in the morning. Life is fleeting, precious, and not at all sacred.

Okay, I'm laying it on a little thick here - It's not like I've just spent Christmas on the Somme. And I am far from the first person in the world to understand that death is no respecter of...well, of anything. But, as I sit here and reflect on the role of a vet during the Christmas holidays, knowing that there will be, more than likely, a large pile of black bags waiting in our freezer when I return to work tomorrow, it makes me wonder, just for a moment, what the suicide rates of doctors would be if human euthanasia were legal.

And, on that bombshell, I draw a close to my blogs for 2009. See you all in the new year with more cheerful news from the front line!

Eat, drink, and be merry, for tomorrow we go back to work :)

Just a quickie...

2009-11-10T20:35:00.005Z

...to promise that I have neither forgotten about nor given up on the blog, I've just got a few things going on in real life at the moment so I'm unlikely to make any posts during November. This may (or, more probably) may not be terrible news to you, but just think of my next post as a little Christmas present, just for you.

As a slight update to my last post, I suggested to a client that she needed to start putting a litter tray in the house try and reduce the bouts of cystitis her cat continually suffers from. Her response? 'My husband will divorce me if I put any litter trays down.'

Ooookaay. (Maybe he's just looking for an excuse, any excuse.)

Oh...one last thing. (That was my best Columbo impression? Did you like it? Please yourselves.) I generally keep this blog just for veterinary news, but on a slight side-issue and as a blatant plug, I submitted the (hopefully) final draft of my new novel Past Tense to my publisher today, and all being well should be out early next year. My first book, Soul Purpose, will very shortly be available as an eBook at a very reasonable $5 (Currently available in paper format on Amazon at a slightly-less-reasonable £13.99)

(NEWSFLASH! Soul Purpose is available at the excellent Smashwords site, for less than the price of Carp Fishing Monthly - how could you resist? Go on, give it a try! Your friends will love you (especially if I'm one of your friends :) )

View SOUL PURPOSE at Smashwords here

Right, plug over! Blog over! Back to real life! (I'll do a proper one in December I promise!)

Jim Morrison said it best

2009-10-18T11:48:00.008+01:00

'People are strange, when you're a stranger'

Quite right, Jim, they are. What the Doors lead singer neglected to mention, however, was they're strange when you're just about anything. They are especially strange, for some reason, when they are in a consulting room talking to me.

Now, the purpose of this post is not to make fun of anyone, or to suggest that I am in any way less strange than any of the rest of us - we're all human, aren't we? (Oh...except you at the back with the tentacles). It's more to jot these things down so that I don't forget them, as my life would be considerably less stressful but also greatly less amusing without the general public involved.

And what are 'these things' of which I speak? Well, they're all things that have said to me or a colleague at some time or another in a consulting room, usually with a straight face and an earnest expression. I'm not mocking any of the people involved. It's cruel to mock the afflicted. (Ooh no, stop it! Ooh.) (That was supposed to be a Frankie Howerd impression, if you're confused. It might not work so well via the medium of the written word)

(And we'll skip over the basic cliches that everyone is allowed to say, and in fact do say to me on a regular basis. I'm sure every profession has them - the comments that come straight out of people's mouths when they hear what it is you do for a living without way of their brains, but that somehow they seem to feel is original. You know what I mean - for doctors it would be to automatically list everything wrong with you at the current moment as if the doctor cares. For builders it's the same, only with houses. For archaeologists it's to make some highly amusing comment along the lines of 'oh, you'll have to come and dig up my garden, ho ho ho'

(Note - I am sadly not immune to this curse. Upon meeting a marine cartographer when I was slightly the worse for wear with drink, I am ashamed to report I honestly said 'Oh, that must be easy then, it's all blue.' Not only this, when he didn't laugh I assumed he hadn't heard my witticism, so I said it again, louder. I'm sorry.)

Well, for vets you get either one of two responses. Please avoid either of these, as they will make any vet to say it to want to sneak into your room at night and sterilise you sans anaesthetic. Firstly 'A licence to print money, that is.' No, you seem to have me confused with the Royal Mint. Now kindly drop dead.

Secondly, (and by far the most popular)....'Huhuh huh huh you put your hand up cow's bottoms heheheh hehe he huhuh huh'. Yes, yes I do. It's my job. I have also wanked off a dog for the same reason. Yes, rubber gloves and lubricant were involved. Are you over it now? Oh no, you're still laughing. Tee hee. Now drop dead.)

There is something about a consulting room which... you know, I was about to write something along the lines of 'turns otherwise sane people into gibbering lunatics' but I'm starting to question the usage of the phrase 'otherwise sane people', so I think I'll just leave it. Here are some situations I have been in whilst talking to the dreaded 'general public'.

- Once, not very long ago, whilst I was kneeling on the floor examining a dog for its vaccination, the owner asked me if I could have a check of its bladder. I felt it from the outside and it felt fine (not the easiest organ to check, the bladder, in fairness - you're much better going off clinical signs initially). The owner didn't seem entirely satisfied with my response that it all seemed okay, so like a good vet I proceeded to procure an anamnesis.

(That's 'get a history' to mere mortals who are not blessed with the wondrous Latin language of obfuscation so beloved of doctors and medics. My favourite word - Idiopathic. It means 'I don't know.' So idiopathic vestibular syndrome means that there's something wrong with your dog's brain, and I have no idea what that is. Fortunately, no-one else has any idea either so I can't comfortably, and quite officially, say 'I dunno' and still sound clever. The next best word is, of course, iatrogenic. That means 'caused by your dumb-ass vet'. an iatrogenic ruptured tympanic membrane would mean I poked my otoscope too far down your dog's ear)

I asked what the clinical signs were in this case to make the owner worried about her dog's bladder. There were none - the dog was peeing absolutely normally. However, the client told me, she knew there was something wrong there. I asked how, and looking slightly sheepish, she said 'Well this might sound a bit strange but...'

(Always a worrying phrase to hear!)

'...well, I have this horse whisperer comes round to see my horse, you see. And she told me that my horse had been speaking to my dog, and my dog told my horse that she's got a pea-sized lump in her urethra.'

Quite how this cross-species conversation got started, I do not know

('Alright Dobbin?'
'Yeah, not so bad. Yerself, Fido?'
'Well, now that you mention it....')

but I love the idea of them standing in the stable like old women waiting for their hair appointments, discussing their various ailments. I never found out how much Doctor Doolittle charged the client for her 'services', but I checked the dog's urethra rectally (hehe, yes yes. It's my job.) and funnily enough no such pea-like lump was found. The annoying thing is, I bet the client still believed her wondrous horse-whisperer over me. I wonder where the dog learned the horse word for 'urethra'?

- A colleague of mine recently saw a dog with a small slice wound in its paw, next to a little wart. When she asked how it happened, the owner told her that her daughter had been trimming the dog with scissors. Thinking that she had misheard, she suggested that the client would be better taking the dog to a grooming parlour to cut its hair.

No, the client said, she was trimming the dog, not the hair. She liked to cut warts off. The owner thought it would be okay, because she trimmed warts of her brother as well, and this usually turned out fine. It lead to the memorable line in the clinical notes 'Advise owner not to allow daughter to use scissors on dog in future.'

- My wife was on a house visit to examine a week-old litter of bulldogs (born via caesarian, of course). Aside from the owner not having a great grasp of basic maths...

(Five puppies, two boys. The repeated question (at least three times) 'So how many girls?')

...she soon demonstrated a rather limited understanding of genetics too. Whilst my wife was examining the pups, it became clear to her that the dog and the bitch who had produced this particular batch of dogs both had the same mother and father.

'Erm...you mean they're brother and sister?' My wife asked, nervously.
'No!', said the client, obviously taking some offense at the fact that anyone would be as stupid as to breed brothers and sisters together. 'They're from different litters!'

- I was once asked by a rather creepy looking gentleman whilst I examined his cat 'Would there be any problem with him eating a lot of human hair?'

- My wife called a client in to the consulting room, a rather large and somewhat hairy woman, who plonked the cat basket on the table, and then announced before she had said a word

'Just so you know, I'm a TS, all right. A trans sexual. I don't want there to be any question of that.'

Sadly, for comedic purposes, my wife did not then ask to examine the client's pussy. Oh what the hell, it's my blog, I can say what I like. She politely asked to examine the client's pussy.

- Just last week, I had a regular client of mine come in for an appointment for a vaccination of their cat. I was sure I had vaccinated it relatively recently, so was slightly confused. As she came in, she put the basket on the table, and said

'I hope you don't mind, there's nothing wrong with him, but I got a cotton bud stuck in my ear this morning, and the doctors was full. Can you get it out for me?'

- Not really the client's fault, this one, but I once did an unexptedly smelly fart during a consultation and succesfully blamed it one the dog's anal glands

- Honourable mentions must of course go to the numerous times I (and I'm sure every other vet) have had to examine dogs because they have developed two large lumps around their penis whilst playing with the owner (um... your dog has an erection, Mrs Smith) and the many many hamsters I have examined with a pair of large lumps just underneath their bottom (erm... your hamster has a pair of testicles, Mrs Jones)

Well, I think that'll do for a start. There are more, but they'll have to wait for another time. Thank you to all the weird, wonderful, and very ssstrange people who make my day job just a little more bearable, and certainly a whole lot funnier.

Erm...is there anyone else working today?

2009-10-01T19:37:00.006+01:00

I finished work today and confidently strolled out of the back door of the practice, whistling a merry tune and secure in the knowledge of another day's work done well.

(Okay, that's a lie. It was a horrible evening surgery, I was in a rotten mood, I'm struggling with man flu and one of my favourite vets to work with handed their notice in. But otherwise it's all true)

On my way to my car (a shiny newish red Fiesta of which I'm inexplicably proud, especially considering that it's a red Fiesta) I passed the clients (a nice young couple) who I had just finished seeing, waiting at the entrance of the practice with their cat, Peanut, presumably waiting for a taxi to come and take them home. I nodded and smiled at them, and they nodded and smiled back (expect for Peanut, who was in a mood with me on account of the fact that I had just stuck a needle into him) and approached my car.

Balancing an 8kg bag of dog food on my shoulder (it had just gone out of date. Nothing but the best for my pooches!) I manuevered the car keys from my pocket into my hand, and pressed the button which is supposed to open the boot.

(Or trunk, for my American readers. I would complain about the Americanism, except that, really, if you think about it - doesn't calling it a trunk make more sense than calling it a boot?)

Still pleased with the whole dog-food-balancing-on-shoulder thing, and glad that I hadn't dropped it and so made an idiot of myself in front of the clients, I failed to notice that the boot had not, in fact, unlocked. I only noticed when I tried to open the boot, was thwarted by it's still firmly locked state, and dropped the bag of dog food on the floor.

Undaunted (okay, a little daunted), I pressed the button again. No reaction from my car. Again. Nothing. Changing tack, I decided to press the button that unlocked the doors to the car, not just the boot. My Fiesta remained stubbornly inert.

Losing patience with the stupid car now, I pointed the key fob directly at it, and very very obviously pressed the 'unlock' button, not once, but twice, leaving my car in no doubt as to what I wanted it to do. Unbelievably, my car ignored me. I stared at it, angrily. The bag of dog food lay reproachfully on the ground at my feet, a constant reminder on the client's eyes boring into my back.

I couldn't resist it. I turned round to see if they were looking at me. As I did so, I pressed the unlock button three more times, just to show my car I meant business.

The clients were staring right at me. Why wouldn't they? What else would they look at in this car park other than a vet making a tit of himself? However, as I glanced, a flash from next to them caught my eye.

The flash came from the car that they were sitting next to. A Fiesta. A red Fiesta. My red Fiesta, that had been frantically flashing me to step away from the random person's car that I had somehow decided was mine.

Recovering my cool, and trying not to think about how many times I had pressed the button on my key fob to an answering click and flash from the car right next to the nice young couple and Peanut, I picked up the bag of food, approached my car, nodded and smiled once more, slid the bag into the by now very open boot, drove around the corner, and sank into a deep pit of embarrasment.

(On a side note - why is it you can remember embarrassing moments in your life with near-perfect clarity? Happiness, misery, depression all flit by in my mind as vague feelings, but I can remember perfectly when Sarah Hawkins turned me down in front of all of my mates in the first year of college. Thanks, brain.)

I suspect those clients probably won't want to see me again (and Peanut certainly won't) but the whole incident reminded me of something I've known for a little while. Which is this - clients really don't care how good a vet you are. They don't care how many textbooks you've read, or how much you know about the immune system, or kidney disease. If they like you, it's because they think you're a nice young man (and not the kind of idiot who can't even work out which car is his). And if they complain about you, it's not because you've made some major medical mistake. It's because you got off on the wrong foot with them.

I'm not blaming the clients for this at all. I mean, what else have they got to go off? All they know is whether they trust you or not. The sad thing is, this has got very little to do with how much you know about veterinary medicine, and everything to do with how charming you can be.

I have known absolutely terrible vets, with a client following that would eat their own pet's head if their hero vet told them to. I personally have made some dreadful mistakes medically, admitted them to the owner, and not been blamed for them because the owner trusted me. I (like most vets) have a string of clients that will 'only see me', despite the fact there are far better medics and surgeons than me in the practice I currently work in.

But, in all things there is a balance, and in this case, it's with the complaints. When someone complains about you, it's a fair bet it will have absolutely nothing to do with your skill as a veterinary surgeon. The astute amongst you may have noticed I have removed the first blog I ever wrote - this I because the case I talked about in it has been referred to the Royal College, a complaint of negligence against myself and a colleague. Now, I am normally phenomenally good at beating myself up about making mistakes (rivalled only, coincidentally, by my aforesaid colleague) but I can genuinely, wholeheartedly say that neither of us could have done more in that case. Royal College aside, this is not an unusual situation - complaints come from poor communication, or (rather more frequently since the credit crisis) from the bill.

So, there you have it. A brief rail against the vagaries of fortune, that reward undeservedly, then just when you start to celebrate, turn around and bite you in the ass without warning.

I can understand what it's like seeing a vet, and building up a trust - but please remember that all the other vets in the practice passed their exams and qualified too, and a small part of them dies when they call you through to their consult room and you say 'Oh, I only see Tim.'

And, most importantly, if you see a man struggling with a bag of food behind someone else's car, when he works out what he's done, just nod and smile as he walks past, and try and let him leave the scene with as much dignity as possible.

Thank you. Goodnight :)

Red in tooth and paw

2009-09-19T22:38:00.006+01:00

I'm writing this particular edition of my blog nursing a large bruise on my right forearm. I have this blemish on my otherwise pristine and perfect body because during a consulation on Wednesday with an especially bouncy springer spaniel, I managed to stab myself in the arm with a mixture of steroids and antibiotics. The needle plunged in right up to the hub, and when I pulled it out again it was enthuisiatically followed by a lot of surprisingly dark blood.

(Feel free to wince at this point. I did. Well, okay, I ran out of the consult room, and tried not to try. But manfully.)

As I stood over the sink washing my arm and wondering if I was brave enough to pour surgical spirit onto the wound to disinfect it...

(in case you're wondering, I did pluck up the courage. Stung like a bastard. And then my boss pointed out that I had stabbed myself with a sterile needle and antibiotics, so it was probably unecessary. I may have sworn a bit at that point)

...I started reflecting about the perils of the job, and in particular about difficult, or aggressive animals.

Now, before I say too much more, I would like to let you know that I am a fully subscribed member of the 'No bad dogs, but bad owners' school of belief - it really is true that owners who don't put any effort at all into controlling their animals are the ones that end up with the difficult to manage animals. Of course, it's usually not the owners that suffer for this, it's every other poor person that the animal meets, and ulitimately it's the animal itself, when it find itself on the wrong end of one of my needles for taking too many chunks out of the general public (but that's a whole different blog). It is not the dog that is to blame here!

However...(and I'd like to point out for the record that my wife has just read this blog, and would like to respectfulyl disagree with the 'no bad dogs' statement...)

There are some breeds of dog that, before you have taken too many steps along the road of veterinary medicine, you learn to dread setting paw in your consult room. Call it a pavlovian response. Once youve been attacked by several dogs of the same breed, it tends to put you off them a bit.

I'm looking at you, German shepherds! Though not directly in the eye, obviously, because I need all my fingers for my job.

(Y'know, when I was growing up, I'm sure German shepherds used to be called Alsations. Perhaps they've undergone a re-branding. Max Clifford was probably involved. Either way, I'm going to refer to them from now on with their veterinary abbreviation - GITS...sorry, GSDs)

My wife used to have several GSD's when she was growing up, and she loved them. She liked the breed right up until the point she faced a few in her consult room, and I can assure you she's gone right off them now. GSDs are a dog that's been traditionally bred for the same kind of temperament as a nightclub bouncer - short on temper, high on aggression. Add to the mix that GSDs are amongst the most nervous dogs you'll ever meet, and that their response to fear is generally to bite whatever they're scared off, then put that personality into a stressful, anxious environemnt, like, oh, I don't know, your friendly neighbourhood veterinary surgery, and you end up with a recipe for violence only rivalled by Tony Blair becoming a middle-East peace envoy.

I'm not saying all GSD's are horrible. There are several of them, patients of mine, that are lovely. There are many over which I have shed a tear when their hips have given out and I have done the only thing left to do for them. But what I am saying is, if a GSD walks into my room, and doesn't immediately cower in the corner, looking at me with trembling eyes and snarling lips, I breathe a deep sigh of a relief.

The sad thing is, we see a lot more of GSD's than we'd like to, on account of them being one of the least healthy breeds I can think on off them top of my head. If their chronic skin disease, vomiting, diarrhoea of eye problems haven't put it in a really bad mood by the time they come through my door, the hip arthritis and degenerative spinal condition probably will.

So, GSD's top my list of dogs to be nervous of. Bubbling under in my top of the chops are -
border collies (most are lovely, but they give you virtually no warning at all before attempting to remove your face with their incisors. Beware the ones thay lie on their back as soon as they come in the door!),
Rottweilers (again, in the main very nice, but you haven't lived until you've been pounced on by a nasty one. Oops, sorry, wrote that wrong - should say 'You won't live long once you've been pounced on),
Jack Russells (the bad ones are ornerier than a rattlesnake with it's tail trapped under a horses hoof, and twice as quick)
Skye Terriers (thankfully,its a rare occurence when one of these comes in you room. Really, just write your will when one does. There's no hope for you. I have never, and I am not exaggeratimg here, met a nice one. Never. One to contest the 'no bad dogs' saying, I think)

All the above said, I have never, so far, recieved any injuries from a dog anywhere near as nasty as those I've taken from the feline contingent of my clientelle. I would far, far rather be faced with a nasty dog than a nasty cat. Why? Because a dog has precisely one weapon - it's mouth, and you can stick a muzzle on it. A cat has five, - including four paws with claws as sharp as bloody hell. They've also got much faster reactions than me.

(Also, cat scratches and bites tend to have pus coming out of them a few days later. They're like the titular Rats in James Herbert's novel - get bitten by one, and you know in a day or so you're doomed...)

It's also partially a pride thing with cats. People don't tend to think any less of you if you're nervous of a 50 kilo slavering Cujo-alike. If you're scared of cat - well, that's a teeny bit wussy, isn't it? Owners tend to think so, anyway - even if they won't go near the feline horror themselves. Give me a violent GSD any day. Trying to extract a vicious cat from a box when it doesn't want to come is like sticking your hand into a blender, and about as good for you too...

(Which is why I favour the blitzkreig approach to vaccination fractious cats - in and out before they even know you've invaded their territory. Sadly, the owners of such cats tend to try and pet them during the procedure, something I tell them not to because if their cat bites them in my consult room, it's me that's liable for it. Another perk of the job that James Herriot neglected to mention to me in his books)

...Other animals can also do a fair bit of damage to my fair surgeon's fingers -Rabbits can prove surprisingly violent (well, surprising to anyone who hasn't seen General Woundwort in Watership Down) and do a fair bit of damage with a back leg stroke, and Gerbils/Hamsters (it's a terrible, terrible admission for a vet but I will be totalyl honest, I always always get them mixed up - even though they don't look anything like each other) can also chow down on fingers pretty effectively, and really, really painfully...

(Leading to the infamous-in-veterinary-circles 'hamster-flick' where rodent bites vet, and vet reflexively flicks said hamster off his finger, usually into a wall in front of horrified owner. I tend to adopt the grin and bear it approach, it's better for animal welfare, and you get sued less)

...So, at the end of this mammoth blog, and after a long string of ways to get injured by animals...

(and I haven't even started on sheep, cows, pigs, and (shudder) horses)

(Horses - here's a good idea. Let's get an 800 kilo animal that an already kick you through a wall, and nail iron shoes to its feet, so it can cut you in half whilst it does it)

...I would like to reiterate that, despite all this, I still love animals, and love working with them, and sometimes, just sometimes think that I'm in the right job. Yes, animals can be scared, and aggresive, and sometimes dangerous to the unwary veerinary surgeon.

But not nearly as dangerous as he can be to himself with a bouncy dog and a syringe full of steroids.

The busy in business

2009-09-03T15:06:00.004+01:00

It feels strange, indeed possibly downright rude, to be complaining about how busy we are at the practice given the global economic situation at the moment

(which, while we're on the subject, I'm heartily sick of being blamed for. The next time some smug newsreader tells me that its 'everybodys fault' that we're in this crisis when I don't even own a credit card, I'm going to throw my telly out of the window. (Don't worry, I'll get the next one on hire purchase))

...but man, we're busy. I mean don't get a chance to stop and phone people with lab results/come up with new plans for long-term cases/wonder whether you've just given the right injection/go for a pee kind of busy.

I've held off posting this for a while (partially because I've been to busy ha ha) but partially because it's stupid. Lots of people aren't lucky enough to be in work at the moment, and becuase I work in a business, the busier we are, the better we're doing, right?

My problem is I find it hard to see the connection between the amount of people I see, and my wages.

(Unlike most clients. I say this with sympathy - many of the people reading this blog will have spent ten minutes in a vets consulting room and then been in need of resucitation equipment when the invoice comes through. I can understand that. One thing I've learned over the years is that it always looks like someone is making more money than they actually are. Of that forty quid that you fork out for ten minutes with your friendly neighbourhood vet, about forty pence goes on paying their salary. The rest goes the nurses salary, the receptionists, the practice managers, the gardeners, the rent of the building, the phone and electricity, the syringes, the needles, the disposal of sharps bins, the ordering of drugs, and many other administrative charges that I won't bore you with further. But bear in mind there are two sides to every story.)

The work in the last few weeks has been relentless - unstoppable, like a time-travelling super-cyborg sent from the future, and about as damaging to my health and well being. The last weekend I worked on call, I was called out sixteen times on Saturday alone.

(a personal record! Call outs can range from lasting twnty minutes to two hours, and these calls ran the full gamut, including a call to put the dog belonging to an elderly lady to sleep. As I examined the dog, lying in it's own mess and no longer strong enough to howl in the pain from it's severe arthritis, trying to be polite about the fact that it had been like this for over a week, the lady told me that if I killed her dog she would then kill herself and all her other animals after I left. That was a fun one.)

It's been so busy that if you come in with your animal tomorrow and say to me 'Well, he's just not right. I don't really know what's wrong.' then I may well burst into tears on the spot. Pleasse ignore me if I begin beating the ground in frustration and misery, and politely turn away when I start howling 'Why, God? Whhhyy?' at the ceiling of my consulting room.

Thing is, I know I shouldn't be moaning. I'd be a hell of a lot more depressed if the practice went bankrupt and I was out of a job. The credit crunch has affected us a little - we're still busy, but there's a marked increase in the people who aren't paying their bills

(and despite my urgings, the practice probably won't go with the 'Do not ask for credit as having your animal taken off you and euthanased sometimes offends' sign above reception. Seriously, why do people take advantage of us especially? Try telling the lady at ASDA that you have forgotten your purse, and that you'll pay next week when your benefits cheque clears, and you'll be leaving the shop a hungry person.)

...but I find it hard to connect the horrible, vaguely organised chaos of another day where my brains feel like they have been put through a tumble drier, with the notion that the practice is doing 'well'. It has reduced better vets than me to tears. It has, on occasion, reduced me to tears.

So, what is this rambling blog about? It's about the fact that we are a business, not a public service, and we are in the unfortunate position of making money out of pain, and suffering. The bad side to this is that, however much we'd like not to, we care.

As vets, I think it's fair to say only a very few if any of us joined this profession to get rich, and as such we get very uncomfortable and awkward about asking for your money, in a way that a car mechanic is never going to, and behind the scences there's an awful lot of undercharging goes on because we either don't feel we're worth it, or we feel sympathy for your animal's condition, or we underquoted because it was too hectic to do a proper quote. We're never going to turn away an animal in distress because the owner cn't pay the bill, because we can't bear the thought of it. Yes, we're easy targets.

The plus side, if it can be called that, is that in the world we live in, there is a near-endless supply of pain and misery. There's certainly a lot of it about where I work.

So, perhaps you can see why I find the busyness of the business deeply conflicting. It leads to tired staff, stressed vets, bad decisions and poor client service, and it means more animals are suffering.

It means the practice is doing well.

I wonder if it's not too late for a career change?

The Youth in Asia - part one

2009-08-19T22:28:00.005+01:00

There I was, writing my last blog about drug reps - bit dull, wasn't it? I even bored myself, writing it. But a small part of it stuck with me.

It was the bit where I mentioned that people often say to me 'It must be the worst part of your job, putting things to sleep' - I followed this with a facetious comment about how seeing drug reps was really the worst part of my job.

That's a lie, of course. Never let the facts get in the way of a good blog, I say! (Or a crappy blog, in the case of my last entry). In fact, that isn't really the case.

I genuinely used to feel this. When people hear you're a vet, the first thing they tend to say (well, second thing - the first is 'Oh yeah, had your hand up a cow's arse, recently?' Look, if that's your first response, I would respectfully suggest that it's you that have got the bovine anus fetish, not me, okay? I just do it for a living, all right? Not for fun) is 'Oh, I couldn't do that. I couldn't put things to sleep.' And I used to think they were wrong. I used to feel that it wasn't that bad. Why? Because I was relieving suffering. Because there was nothing but misery left for the animal, and because it was probably the kindest thing I would do for that animal.

Now, ten years down the line, I'm not so sure. Not that I was wrong about it being kind, I still think that's true. In fact, I believe it's the greatest gift I have, to ease an animal's final moments. But nothing is ever quite as simple as it first appears, is it?

There are a number of problems associated with the act of killing. The first is this - the inappropriate euthanasia.

The most obvious case of this is - the healthy animal. The animal that would otherwise get better, but because the owner can't pay/won't pay/doesn't want the animal 'to suffer', they make you put their pet to sleep anyway.

The most blatant example of this that comes to mind is a cat that I saw with a fractured hip. The hip really needed an operation to heal properly. The owner couldn't afford the operation. I suggested that the owner telephone the RSPCA and the PDSA, two organisations that will readily help with financial problems. The owner didn't want to do this. Not having hearts entirely made of stone, we then offered to treat the cat at a cut price. The owner still couldn't afford to it.

Getting a sinking feeling of where this was going, I next offered to treat the cat for free. No. The owner didn't want the cat to go for surgery - it would be 'too much for it'. Okay. Deep breath. Y'know what, even without surgery, the cat would probably walk again. He would need 6 weeks rest in a cage, but he would be able to get back to a relatively normal life afterwards.

No. The owner didn't want the cat to 'go through' 6 weeks of cage rest. It wouldn't be fair. (This was, I may have neglected to mention, a two year old cat. It had, in all probability, ten to fourteen years of life left to it. Maybe it might have been prepared to spend 6 weeks in a cage.)

Would they consider rehoming the cat? No. It 'wouldn't be fair' on the cat. What they wanted was to have their cat put to sleep.

It was me that ended up doing it. I ended up with it because my colleague was hoping against hope that having someone else suggest to them they were doing the wrong thing might change their mind. It didn't. They were adamant. The owners, a young couple with two children, came in to speak to me one final time. Towards the end of the consultation I gave up any pretense of being polite and asked them if they wanted me to 'kill their cat.' They said that they did. I said that I would, hoping, secretly, and very illegally, that I would just be able to rehome the cat. They wanted to stay with it whilst I put the cat to sleep. So, my next plan was that I would sedate the cat whilst they were there, revive it and rehome it when it awoke. The owners wanted to take the cat home and bury it.

So, I did it. I killed a cat with a broken bone that would have healed in three weeks with surgery, and six weeks without. After I listened to the cat's heart beat its last with my stethoscope, the lady's daughter started crying over the dead body. The lady asked me 'Do you think we did the right thing?'

I could not speak, and I left the room.

The memory of that moment is with me strongly now as I write these words. I was the instrument of that cat's destruction. What good would it have done me to refuse? Vets have been struck off by the Royal College for refusing to perform euthanasia. I had no power to seize the cat - this would have been technically theft, and I could have gone to prison.

So I killed the cat.

I'm sure many vets have similar stories to this. Obviously hyperthyroid cats that the owner doesn't want to 'go through' being given tablets. Arthritic dogs that, instead of being given painkillers, the owner would rather that they 'didn't suffer'. Problem behaviour dogs that the owner has never given a thought to dog training, and that they are now scared of.

It always surprises me that people are arrogant enough to assume that they look after their pet so well, that rehoming can not be thought of even for a second - no one else could possibly look after this pet at all! Death is preferable than life without me!

Well, ask yourself - who are telling this lie to? And who is really going to come out worse because of it?

Okay, that's the first problem with euthanasia, and I have many more things to say on this subject. Part two in a few weeks. Stay happy!

Bad Rep-utation

2009-08-19T21:08:00.006+01:00

A Rep came to see me today (by this I mean a drug rep, not a holiday rep, or a repo-man, or a reptile) and commented that I must be very hard working, as of all the vets he knows, I am the most difficult to come and see.

Well....he's sort of right. In the sense that I will find any excuse not to see a rep. People always say to me that euthanasia must be the worst part of my job. They're wrong. It's drug Reps.

(What's that? An infected anal gland? Oh dear, we'd better cancel the Pfizer rep. A constipated cat, that needs the poo hand picked out of it's rectum? Better ring Bob and tell him I can't make my appointment.)

Why? I hear the cry echo across the internet! What could possibly be wrong with spending time with a nicely suited man (or woman) that often brings along with him (or her) doughnuts and free sandwiches?

Why? I'll tell you why. Because I didn't become a vet to prostitute myself to drug companies, that's why. What these sneaky well-manicured men (or women) (why are you always going on about women, Stan?) are doing with their sneaky free foodstuffs is bribing me to use whichever drug they think is in vogue at the minute.

Some vets love it. My boss loves it. My wife loves it. (It's free food! She's muttering at me. Are you mad?) I do not. I like to choose my drugs based on evidence, and there's nothing more likely to get my goat than a drug rep flashing a glossy piece of paper at me with an impressive looking graph showing that n number of dogs would rather be doused in cooking oil and set alight than be denied their latest wonder-drug (where n is usually < id="SPELLING_ERROR_2" class="blsp-spelling-corrected">privilege. The nature of my work is to make money out of pain and suffering. But I like to think I have some ethics, and prostituting myself for the sake of a drug company leaves a distinctly sour taste in my mouth (or maybe that's just the Rum & Raisin doughnuts I was fed by an enthusiastic rep recently)

Consider this - I can, off the top of my head, think of seven very effective flea products on the market for dogs and cats. There is no licenced painkiller for rabbits. Why? Because there's more money in selling flea products than there is selling painkillers to rabbits. (Ehh...what's up with that, Doc?)

(This is not that we don't have effective painkillers we can use in rabbits - they're just off-licence, that's all. Sooner or later some bright spark in a drug company will licence a painkiller that we already use, and charge is ten times the price for the privilege - as has happened recently with Zitac (Tagamet) and Atopica (Cyclosporin) in dogs and cats)

So, I don't like spending my afternoons with drug reps. In fact, I'd rather spend my afternoons arm-deep in pus than watch one more audio-visual presentation about why this NSAID is ever so slightly better than that one, so long you don't mind getting diarrhoea and stomach ulcers.

Drug reps? Bring on the anal glands!

Jenner-ation Ex

2009-08-09T11:02:00.004+01:00

I had a client in a few months ago who told me that she didn't need her papillon vaccinated. Why? Because she used homeopathic vaccines, that's why.

I took a deep breath. Now, I don't want to get particularly preachy with this blog - there's little more annoying in this world than being told what to do by someone who thinks they know better than you. But tough, I'm going to do it anyway.

Let's leave the whole subject of homeopathy for another blog, shall we? But homeopathic vaccinations? Really? The whole idea of a vaccination is to introduce something into the body that stimulates the immune system, and provokes a reaction that is protective against future infections. Now imagine giving a product which, if it were scaled up to a globe the size of the solar system, would contain one molecule of the active substance. (Which is equivalent to a 200c dilution, the standard I believe for homeopathic prophylaxis). Maybe it's just me, but I think my immune system might find that one a little tricky to find. In fact, if I had an immune system that tough, we could have simply sent my white blood cells into Afghanistan and saved the country a lot of money, lives, and ethical misery.

(In their defence, I believe that most homeopaths posit the theory that homeopathic vaccination works on a 'deeper' level than that of stimulating antibody production. If they ever feel like sharing this deeper understanding of the immune system with conventional medics, I'm sure we'd all be a lot happier and healthier. Whenever you're ready, guys!)

I'm sure you're all familiar with the story of vaccination. It is one of the greatest success stories of modern medicine. Edward Jenner was born into a world where 1 in 5 people who died, died of smallpox. He noted - it was probably common knowledge amongst agricultural families -that people who had been infected with cowpox tended not to get smallpox. Presumably being a silver-tongued devil, he somehow managed to convince a young boy - James Phipps - that it would be a good idea if he let Jenner scrape some pus from a milkmaid infected with cowpox, and inject it under Phipp's skin. (Accomplished with scratching his arms open with bits of wood).

Phipp's possibly received a lollipop for his troubles. He also received immunity to smallpox, probably a better present. 250 years later, smallpox is all but extinct (not counting the many samples held by various Evil Genius's in their Evil, Evil Lairs - but I'm sure James Bond will get round to them eventually).

Vaccines save lives. Remember the great MMR hoax a few years ago? Not much talked about now, is it? Somehow (nothing at all to do with Britain's wonderful newspaper journalists, I'm sure) we were convinced on the basis of no evidence whatsoever that the MMR jab could cause autism. Now let me be clear about this - people have died because of this hoax.

On the dog and cat front - I personally have never seen a single case of distemper, and for that I am grateful, because it sounds bloody horrible.

(This may not be very appropriate but it reminds me of a joke. One of the symptoms of distemper is that dogs get very thickened, hard pads. Vets used to treat this by applying lubricant to all the paws, but after that patients tended to go downhill very quickly. Aheh. Sorry.)

I have, however, sadly seen cases of leptospirosis, hepatitis, parvovirus, feline leukaemia, and many, many cases of cat flu. None of which I ever want to see again, thank you very much. For those who feel that as vets we over-vaccinate, bear in mind that the only disease your dog will be vaccinated against annually is leptospirosis - the rest are pretty much on a biannual or more usually triannual rotation. Leptospirosis immunity often only lasts for twelve months.

Are vaccines perfect? No. They don't always work. Cat flu vaccination in particular is often only partially effective - much like the human influenza vaccine. Very very rarely, you will get a vaccine reaction. If you think about it this is not unnatural considering what you are trying to do is stimulate the immune system.

In my career I have seen two fibrosarcomas develop on the back of cat's necks, one of which ended in the untimely euthanasia of that patient. These sarcomas were almost certainly due to vaccination against feline leukaemia virus. Has that shaken my faith in vaccinations? Not at all. Why? Because I have also seen more cases of feline leukaemia virus itself than I can sensibly count (but is definitely in excess of 100) - every single one of which ended in the premature euthanasia of the unfortunate animal concerned.

Right, preachy mode over. Does my story at the beginning have a coda? Yes, it does. I persuaded the said owner of the papillion to vaccinate her treasured pet, using similar arguments to above.

The papillion had a vaccine reaction. Thank you, sod's law. The back of the dog's neck swelled up, and was bruised for a few days. He needed three days worth of painkillers. The owner of the dog now refuses to see me, believing (I'm not quite sure why) that I injected her dog directly into it's spinal column. She probably thinks that I torture kittens for fun, too. (In reality, I only torture them as part of my day job, of course).

Hence this blog post, which has two morals. Firstly, you can't win 'em all. Secondly, vaccinate yourself, and vaccinate your animals!

To cut is to cure? Medicine vs Surgery

2009-07-28T20:23:00.005+01:00

My wife and I are both vets, which makes for some very boring discussions most eveings. We do like to have our own area of expertise, however. For instance, I consider myself a medic. My wife considers herself a surgeon.

(Not that either of us have officially specialized - neither of us have quite got round to it, somehow. It was so nice not having exams after taking them every year for the first twenty-three years of our lives that we're not in a hurry to get started again, though we both have plans in that direction at some point in the future... though this may be in the same way that I have vague plans to get bitten by a radioactive spider and develop superpowers)

The difference between medicine and surgery is relatively easy to define. Basically, pretty much anything up to the point where use a scalpel blade, and after you use suture material, is medicine. The bit in the middle is surgery.

(Incidentally, why do we call our consultations 'surgeries'? Surgery is, literally, the one thing you're pretty much guaranteed not to be doing when you are consulting, and considering that's really the fun bit of the job, it's kind of rubbing your nose in it, isn't it?)

Now, I can really see the appeal of being a surgeon. Surgery doesn't involve a lot of talking to owners. and life wound be so, so much easier without talking to owners. Surgey also has a much higher, shall we say - satisfaction quotient - than medicine. What I mean by that is, if you see a surgical problem (a broken leg, a ruptured diaphragm, lingerie stuck in a dogs abdomen (no, really!)), you knock the animal out, fix the problem, the animal wakes up. Job done. Instant healing work. (Incindentally, this satisfaction sometimes doesn't matter whether the animal actually recovers or not. It has not been unknown from me to hear phrases from surgical colleagues along the lines of 'The operation was a complete success. Unfortunately the pateint did not survive.')

Medicine is never quite as simple as that. If you work out the animal has diabetes, or Cushing's disease, lymphoid leukaemia or renal secondary hypoparathyroidism, you can't just magically fix it with a swish of the blade. You're then commited to a lifetime (well, the animal's lifetime) of tablets, or injections, or of which can go wrong at any time and need fresh blood-sampling, fresh jiggling.

So why be a medic? There are times (including right now, when I'm writing this blog) when I wonder that very same question. Surgery is fascinating. There are times during operations, when I experience one of those 'self' moments - I take a step back and look at who I am, what I am doing. What I am doing is standing with my gloved hand inside another living, breathing animal, one that will recover (hopefully) and be absolutely normal. That is a strange experience, and quite a fulfilling one, too. Medicine has no comparitive Godlike moments to offer.

I think what I like about medicine is the puzzle - piecing together the history, and blood results, the symptoms. Working out the problem has a lower key buzz, but one present nevertheless, that makes me feel a bit like a veterinary Sherlock Holmes, eliminating the impossible until the truth, however unlikely, shines through.

Of course, these are romantisized views of both disciplines. There are many medical cases (surgical too - see my first blog) which defy explanation and the textbooks, are are exercises in pure frustration (we don't get to call on Hugh Laurie to come and sort it all out, either). On the surgical side, there is a horrible, creeping sweaty feeling that only surgeons know - the feeling that something has just gone very, very badly wrong with your surgery.

(Which reminds me - a classic surgical euphamism is 'He lost a lot of blood.' What a lovely phrase. Kind of makes it sound like the animal's fault, doesn't it? Like he dropped it behind the sofa. Well, what the surgeon really means is 'I fucked up, and cut something that I shouldn't have, which was followed by twenty minutes of swearing and a whole lot fresh swabs.')

Still, at least I gives me and the wife something different to talk about of an evening. One fine day, you might see the fabled letters CertSAM printed after my name.

And one day, you might see me climbing a brick wall, and doing whatever a spider can.

Happy Anniversary!

2009-07-21T20:00:00.006+01:00

It was a momentous anniversary last week, as I'm sure you all know. No, not the forty years since mankind first walked on the moon. Something much more important. Well, to me at least.

It has been ten years since I became a Bachelor of Veterinary Science (decidely not hons) and a member of the Royal College of Veterinary Surgeons (which, I have just worked out, means that I have paid the Royal College so far roughly £3000 for the privelidge of being a vet. Yay.).

Ten years. Several ways of celebrating this anniversary spring to mind, but as I no longer have a firearms licence, and all the pentobarbitone is at the practice, I'll settle for a glass of beer and a Blog entry.

I've being trying to think today when the idea of being a vet first curdled it's way into the youthful cream that was my young mind. I'm fairly sure that I've narrowed it down to a holiday in Germany when I must have been about eight or nine. I always took several books to read with me, and one was a copy of 'Every Living Thing' by James Herriot...

(... and yes, I'm very aware that it's a massive cliche that I decided to be a vet because of James Herriot. What do you want me to do, lie? In retrospect, it's a shame I didn't base my career choice on one of the other books I took with me - Deathwing over Veynaa by Douglas Hill. I could have ended up as an intergalatic Legionnairy of Moros with an adamantium skeleton! Now that wold have been a fun job)

...and I loved that book. It all sounded som much fun, and the guy was helping animals! For a living! When I was a child, I loved animals (Not in that way, before you start, okay), and I loved Biology. When I read that book, it just made perfect sense to combine the two. Plus, it sounded really funny when James Herriot wrote about gruff Yorkshireman having to explain that their dog 'had a problem with his...with his pencil, Mr 'Erriot).

So I was very fortunate - from that time on, I had a sense of purpose. I knew exactly what I was going to do for the rest of my life. That nagging, insistent voice at the back of my mind, that was always telling me that I should try and make the world a better place, would be silenced! I would be making the world a better place with my day job! I could even spend my evenings playing rolepaying games and computer games, and not feel guilty about it!

The determination lasted through all the teachers, and all the careers advisors who told me that it was a waste of time (seriously, has anyone -ever- recieved one useful scrap of advice from a careers 'advisor'? My wife's told her she should be a florist. Though, considering my current feelings towards the profession, maybe we should have listened back then), it lasted through my GSCE's, through my A Levels, and right up to that final glowing day when I recieved my one (and only) offer to go to Bristol, to study being a vet.

I have now been a vet for twice as long as I studied to be one. I am older, arguably wiser, and a whole lot tireder. That nagging voice, the one that I hoped would finally shut up when I was doing good deeds and getting paid for them, is not fooled, and though it has grown quieter over the years, it has never been silenced. My job does not consist of doing good deeds, all day, every day, as I imagined it would. And though I may relieve some suffering, I also help to perpetuate it in the form of helping dog and cat breeders continue to spawn the various mutants that they seem to consider 'cute'. The best thing I do, the honest-to-goodness kindest act I generally perform, is euthanasia, and with the best will in the world, it's hard to feel good about oneself for repeatedly killing small animals.

Ten years gone. My attitude to my job is, and I suspect, always will be, mixed, but it has brought me the greatest thing in my life so far - my wife - and for all the wonderful years we've had together, I actually feel it was worth it all!

There are many more things I could write about, but I'll leave them for another time. For now, sit with me and raise a glass, for years gone by, and to absent friends.

Cheers.

IV - or not IV?

2009-07-18T21:48:00.003+01:00

I've been on call today and given six intravenous injections. I haven't missed a vein once.

Not that impressed? Well, I am here to tell, young reader, that you should, because giving an IV injection is not quite a simple as they make it look on the telly. It always really bugs me on some programme or other, when someone needs to be sedated really quickly, the hero/heroine just grabs an arm and fires away. Yeah, good luck with that buddy/buddess - you've just given a subcutaneous. Or an intramuscular if you pushed hard enough.

Okay, maybe I'm getting too worked up about this - but I've seen it too many times not to feel peeved that a skill which I acutally possess is so undersold by mass media. I am, in real life, what you might call a doofus. You might call me that, if you were being polite and didn't want to call me a clumsy idiot. No mug of coffee is safe from me. If you have red wine and white carpets, I would advise you never to let me into your house.

However, somehow, when I am in vet mode, I am pretty goshdarn good at getting an injection to go where I want it do go. To get an IV, you need a steady hand, and a gentle touch. A client of mine who was a nurse told me that they practiced their IV on cats - because if you can get a cat's vein, you can get anything.

Now imagine that cat would like to eat your eyeballs. Now further imagine that said Corinthian-cat's owner would not allow you to clip any fur from its leg, because 'it's going to a show at the weekend' (For some reason, show judges, who actively encourage producing animals which look they have repeatedly been hit in the face with a cricket bat, and are so deformed that if they sneeze hard their eyes can prolapse, feel that a clipped patch on a foreleg looks unsightly) and perhaps you will understand why I'm a little proud of the fact that I can hit a vein fairly often.

I am, of course, not on my own amongst the veterinary profession at being able to perform this particular task, but I must fight against my natural modesty and immense charm to bring you the news that I am actually better than quite a few others I have worked with. It is not unusual for other vets to ask me to come and try and get blood/fit an IV catheter for them. As you can imagine, when I get that lovely flush of blood back in my syringe, I make no fuss about it. There may be a little dancing involved. There may be some asking of the nurses 'Who's the Daddy?' (They never seem to know who the Daddy is, though.)

You might call it my super-power. I could be Vein Man! (Though now I think about it I'd have to spell it prominently on my mighty chest or people might think I just really loved myself)

(NB - I may have near-legendary vein-hitting skills, but a chimpanzee with no arms and a stitched up mouth could bandage an IV catheter better than me. Hey, a guy's got to have some limits to his power, hasn't he? I've got to leave some jobs for other people)

So, the next time you see someone stabbed in the arm aimlessly with a syringe, and thereupon fall instantly to the ground in sedated stupor, stand up and shout at your television set 'We demand realism! Don't devalue a skill that people are proud to attain!'

Go on. Please. At least think it a bit? Thank you.