Monday, 28 December 2009

The Youth in Asia Pt 2 - Christmas Clearout

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 :)

Tuesday, 10 November 2009

Just a quickie... 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.) 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!)

Sunday, 18 October 2009

Jim Morrison said it best

'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.

' 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.

Thursday, 1 October 2009 there anyone else working today?

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 :)

Saturday, 19 September 2009

Red in tooth and paw

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.

Thursday, 3 September 2009

The busy in business

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?

Wednesday, 19 August 2009

The Youth in Asia - part one

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

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!

Sunday, 9 August 2009

Jenner-ation Ex

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!

Tuesday, 28 July 2009

To cut is to cure? Medicine vs Surgery

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.

Tuesday, 21 July 2009

Happy Anniversary!

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.


Saturday, 18 July 2009

IV - or not IV?

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.