Читать книгу Tales from a Young Vet: Mad cows, crazy kittens, and all creatures big and small - Jo Hardy, Jo Hardy - Страница 6

Most people decide they want to be vets when they’re four years old and fall in love with their hamster, or kitten, or puppy. But for me the lightbulb moment didn’t come until I was sixteen. Until then I was pretty sure I wanted to be a forensic scientist – I loved the idea of solving mysteries – but when I was offered the chance to do a couple of weeks’ work experience with a local veterinary practice I realised how much people love and depend on their animals, and that if we help the animal, we help the owner, whether that’s an elderly person whose cat means the world to them or a farmer who depends on his cows for his income. Being a vet wasn’t just about animals; it was about people, too. There was also a forensic side to it. A vet has to examine all the available information to determine what’s wrong with an animal and while that’s sometimes obvious, it can also be a bit of a mystery.

I was sold.

I come from a family of animal-lovers, which helps. We’ve always had dogs, mostly springer spaniels; affectionate, loyal and energetic dogs. By the time I went to college we’d had Tosca for about eight years and Paddy, a little Yorkshire terrier, for four. Paddy came to us after his elderly owner died and the RSPCA discovered about 200 Yorkies in a squalid, windowless shed, all of them in a dreadful condition. Some of them died and the rest were farmed out to different rescue organisations. Paddy was only eight months old when we got him, a little brown ball of hair. He seemed to have survived the ordeal pretty well and he and Tosca soon bonded, she took him under her wing and they’d snuggle on the sofa together.

We also had my two horses, Elli and Tammy. I’d been mad about horses since I was five years old, when my friend started riding lessons and I begged my parents to let me learn, too. It was a huge financial commitment for my parents, but for Mum, being around horses was an unfulfilled childhood dream, and Dad just wanted to get as far away from his city job as possible at weekends. Only my younger brother Ross didn’t share the passion, having received a hoof in the groin during his first riding lesson when he was five. There was no way he was going near a horse again.

We bought Elli when I was twelve. She was a six-year-old bay, dark brown with a black mane and tail, chestnut dapples and huge dark eyes. She was my fun horse, so safe I could even ride her without a saddle. We won lots of rosettes together at local gymkhanas, but three years later she went badly lame. The vet told us she would never be a competition horse again and that she should be put down. The alternatives were to box-rest her in stables for a year or so, or to put her in a field, let her roam free and see what happened.

It was a huge blow to me. Elli was my world and there was no way I was going to let her be put to sleep. She’d always hated stables, so we chose to put her in the field and let her run loose. Two years later she was no longer lame but very unfit, so I began riding her to get her fit enough to enter competitions again.

While Elli was recovering I got Tammy, a four-year-old bay whose broad brown flanks have an orange glow in the sun. Tammy was much more highly strung than Elli. Nervous around other horses, she would bare her teeth if she got scared, but she was willing and bold and she learned new tricks really fast.

Tammy was so unpredictable that at competitions she would either come first or be disqualified after terrifying the audience by rearing or trashing the jumps. I was never scared with her because I’d been around horses for ten years when I got her, and I had a Saturday job in which I trained difficult and young horses. I also had a bum like glue, so I seldom fell off her, even when she was misbehaving. Elli became the one horse Tammy trusted, and by the time I left for college Tammy and Elli were sharing a field at the stables up the road from us and were happy in one another’s company. I knew I’d miss them dreadfully, but I planned to get home as often as possible, and I arranged to loan them out to other riders so that they’d be exercised.

Once I decided that I wanted to be a vet there was no stopping me. I worked incredibly hard to make the A-level grades I needed, and Dad and I went to look around potential vet schools.

There were seven veterinary colleges I could apply to (there are eight now), but the moment I saw it my heart was set on the Royal Veterinary College. With two campuses, in Camden and Hertfordshire, it has fantastic teaching facilities, including the Queen Mother Hospital for Animals, its own Equine Centre and its own first-opinion practice. So I was heartbroken when they turned me down. I decided to call them and find out why, and when I was told it was because I didn’t have physics GCSE I told them that there had been a mistake, because I did have it. I begged for an interview, but they said the interviews were almost over. Eventually they relented and said I could come on the last day of interviews, for the final appointment of the day.

I did and I was accepted. But as I was right at the end of the interviews, all the places had already been allocated for that September and so I was offered one for the following year. That was fine with me; I was prepared to wait and I decided to spend my gap year working and travelling.

A year later, when I walked through the doors of the RVC’s Camden campus to start my course, I felt ready to take on whatever the college was going to throw at me over the next five years. I knew that by the end I would need to know how to do everything – diagnosis, treatment and surgery – on any animal at any time, anywhere, from a well-equipped surgery to a grubby barn, and I couldn’t wait to get going.

For the first two years we were based in Camden before transferring to the Hawkshead campus in Potters Bar, Hertfordshire, for the final three years. And until the spring term of our fourth year everything went smoothly. My days were filled with lectures, essays and studying dry bones, specimens in bottles, X-rays, plastic models and charts. Everything, in fact, but live animal cases.

We knew that was coming, of course, but it didn’t seem real until, one bleak January day in 2013, all 250 of us in the year group were gathered together in the lecture theatre by our Vice Principal, David Church, a charismatic Australian who was passionate about getting the best out of his students. He was a genius, and incredibly intimidating for that reason, but we’d come to realise that ultimately he was on our side and always put the health and welfare of the students above everything else.

That January morning he looked around the auditorium at a sea of expectant faces. ‘This is the start of the rest of your lives. It’s time to put everything you’ve learned into practice,’ he announced. ‘You’re going to go out there and be vets, and you’ll be expected to know your stuff and get it right. You’re not students now, you’re colleagues of the vets you’ll be working with, part of the team, and you’ll be expected to know what to do.’

I was sitting to one side of the lecture theatre with my housemates, Andrew, James, Kevin and John, plus James’s girlfriend Hannah, who was a semi-permanent fixture in our house. Lucy was in the row behind. We always chose a spot well out of David Church’s direct eye line because he tended to pick on students and ask them alarming questions.

I turned to Lucy. ‘Are you feeling as nervous as I am?’ I whispered.

‘More,’ she replied. ‘I’m actually about to be sick.’

I looked over at the boys. Andrew looked cool and calm. He never seemed to get excited or nervous about anything, and was incredibly steady. Kevin looked worried and James even more so, but John looked excited. He couldn’t wait to get stuck in.

The five of us couldn’t have been more different. Goodness knows how we ended up sharing a house together, but after a year in student accommodation we’d opted to move into a small house in Camden in our second year, and we’d decided to stay together when we moved to Hertfordshire in our third. We’d been lucky with the house we found as the owners were going abroad and, amazingly, didn’t mind letting to students.

Being the only girl I’d bagged the best room. But for the boys the room that mattered was the kitchen, and this one had two ovens and six hobs. Food wasn’t a priority for me. I tried to keep my food budget to £10 a week and ate whatever was on offer at the supermarket so that I could save for other things, but the four boys were all big eaters.

James loved to cook and had an entire rack of spices. At weekends you’d find him creating gourmet dishes like pulled pork and fennel or Thai green curry to share with Hannah. He had a slow cooker and would put a casserole on in the morning to be ready for when he came back in the evening.

Andrew was stick thin but could pile away more food than anyone I’d ever seen; he liked substantial dishes like spaghetti with meatballs or big roasts. He’d eat a huge plateful and be back for more two hours later.

Kevin and John were both from the States, but that was all they had in common. Kevin was from South Carolina and was an outdoor, baseball and hiking kind of guy who loved his steak, burger and fries. Top of his list was grits, or ground corn; it was his staple diet and he’d bring back bags of the stuff every time he went to the States. We all thought it was just like Italian polenta that you can get in a lot of supermarkets, but Kevin insisted that they weren’t the same at all and he had to have the authentic Yankee version from home.

Every Halloween his parents would send over a bulk order of candy corn, which tastes like fudge, comes in the shape of sweetcorn and is orange and white. We loved it and dug into the huge jar every time we passed.

While Kevin missed the wide open spaces of America, John was a city guy from New York. Neat, clean and organised, he kept his room pristine and tidied up after all of us. John loved English culture, he thought the English were terribly polite and he loved traditions like afternoon tea. He shipped his Mini Cooper over from the States because he didn’t want to drive any other car, and he liked to make himself fancy dishes like chicken salad with pomegranate seeds and feta. He also made bread, enough for all of us, and on the days when I had no time or money for anything else his fresh bread kept me going.

All the boys were in different groups and on a different rotation schedule to mine, so I was grateful for Lucy. An hour after David Church’s talk we sat in the canteen, going through our rotations timetables. Altogether we would be going through sixteen different core rotations, some a week long, some two weeks. The essential ones would include farm animal medicine, first-opinion practice (which means being part of a local veterinary practice), equine medicine, and specialist areas such as neurology, surgery, anaesthesia and orthopaedics. In addition we would have three fortnights in which we could choose our own rotation electives, and sixteen weeks in which we were expected to carry out work experience, which we had to set up ourselves. We’d started writing to practices months earlier, asking if they would accept us for work experience, which had to fit into the gaps between the required college rotations. It was enough to make the most confident student’s head spin.

‘Horses first,’ I said. ‘That’s good for me.’

‘Not me,’ Lucy said gloomily. ‘I’m not keen on horses. I prefer cows, so give me a cowshed over a stable anytime.’

‘I’ll watch your back with the horses if you watch mine with the cows.’

She grinned. ‘Deal.’

Lucy and I were close, and there wasn’t much we didn’t tell each other. We had a lot of interests in common; we were both musical and also sporty, outdoor people. We played a lot of tennis together, but when it came to running our paths diverged; Lucy ran marathons while I was happy to settle for a mile or two with the dog.

Thank goodness we’d got into the same rotation group. I didn’t know the other three girls on our rotation – Grace, Jade and Katy – but soon after we’d been given our groups at the end of the autumn term, Lucy and I met Grace at the Christmas Ball. She bounced up, put an arm round each of us and said merrily, ‘Hello, girls, I think we’re going to be working together.’

Lucy and I laughed. ‘Nice to meet you, too. See you on Black Monday.’

‘Yup,’ Grace called, as her boyfriend Miles led her away, ‘it’s going to be a laugh.’

Black Monday was the first day of rotations. So-called, no doubt, because it was the day on which every single student was filled with unmitigated terror.

For us it fell on a bitterly cold day in early February, when the five of us gathered at 8am by the whiteboard in the RVC’s Equine Hospital, ready to begin large animal imaging, all of us pale with lack of sleep and visibly nervous. Grace, in total contrast to her appearance at the ball, was jittery and anxious. ‘Not good with horses,’ she muttered.

Jade had a bit of experience with horses but none of the others did, so I felt lucky. But liking horses and knowing how to treat them were two different things, and I’d spent the previous weekend cramming over my textbooks, trying to memorise every possible horse complaint.

For equine work we all had to wear green overalls with our name tags pinned to the front. Rumour had it that if you forgot your name tag you failed the rotation. I wasn’t absolutely sure that this was true, but just to be safe I’d had mine within sight all weekend. Underneath the overalls I had a thick fleece and, like the others, I was wearing sturdy boots padded out with warm socks.

The Equine Hospital was part of the Large Animal Clinical Centre. We’d been into the barn around the back during training, but until now we’d never entered the hallowed portals of the main building, which was a working hospital open to the public. Before starting we were given a tour by one of the more junior vets. It was an impressive place, with consultation rooms, an imaging centre offering bone-scanning, MRI, CT and X-rays, two surgical theatres, and three stable blocks, one of them the Intensive Care Unit. We would be back here again later in the year for equine medicine, surgery and orthopaedics, but this time our focus was the imaging suite.

Everything in it was large scale. It had to be. And, as we quickly discovered, imaging a horse was no mean feat. To take a CT (computerised tomography) scan, a human would be asked to lie on a flat bed while an X-ray tube rotates around their body. With horses, only the head and neck fit in the tube, so if any other part of the body needs to be imaged a standard X-ray has to be taken. The machine is suspended from the ceiling, with handles either side, while the radiographer moves it around the room like a submarine scope. It can be positioned anywhere around the horse, while someone holds a receptor plate on the end of a long wooden pole on the other side. Not easy, and it gets more complicated than that, because the angles have to be right so that the horse’s bones don’t get superimposed over each other.

Kitted up in lead gowns and gloves to protect us from the X-rays, we spent a lot of time learning the right angles to use, and then running out of the room while the image was taken (all bar the lucky two holding the horse and the plate) and back in again.

But our first job that grey February morning was to assist with bone-scanning, or to give it its technical name, scintigraphy, on a large grey Arab stallion. The clinician in charge that day was Jackie. In her mid-thirties and very friendly, she was aware of how nervous we all were and went out of her way to help us and make sure we were enjoying ourselves as well as learning.

The Arab stallion was lame, but there was no obvious reason why. Hence the bone scan, which is a good way of locating where the problem is when it’s not immediately obvious. Before the scan the horse is given an intravenous injection of a radioactive substance that spreads around its body, binding to areas where the bone is trying to heal itself and emitting radioactive rays that show up on the scans.

As one of the others stood holding the heavily sedated horse and stroking its nose, the scanner was moved around it, section by section. And, as we discovered, it takes absolutely ages. It’s not unusual to spend four hours scanning a horse, so we were taking it in shifts, holding the horse, observing the scans with the clinician or doing the other vital job – catching the horse’s radioactive pee in a bucket.

I was the lucky candidate first up for this job so, bucket in hand, I hovered around the horse’s rear end. I felt pretty silly and, to make matters worse, Lucy, who was holding the horse, kept catching my eye and making me laugh. As I lunged forward, just a moment too late to stop another waterfall of radioactive pee hitting the floor, Lucy snorted with laughter. ‘Just wait till it’s your turn,’ I mouthed at her.

It seemed like an age until we finished, but the end result showed that the horse had an inflammation in the pelvis. The only treatment, as Jackie the clinician explained, was rest and pain relief.

Over a brief lunch we chatted to the other three in our group. Now that we were underway, Grace had begun to get a little of her bounce back. Katy was quiet, but prone to cracking wicked jokes. And Jade was funny and very upfront – she said what she thought. They were all lovely, but I did wonder if, as we were going to be together so much, personality clashes would emerge.

Lucy and Jade were both trying out online dating, which led to a lot of laughter and discussion along the lines of, ‘Oh, look at him, what do you think? No, he’s definitely not my type, what about this one? That one looks like one of the horses, but here, take a look, this one’s quite hot.’

Grace, Katy and I weren’t in the market for dates, so we provided second opinions and back-up. Grace was living with her boyfriend, Miles, Katy wasn’t looking for a relationship and I had Jacques, the lovely South African I’d met during my gap year. By then we’d been dating long-distance for almost four years. We used Skype and our phones to stay in touch, but I missed him.

Apart from the horse pee/bucket challenge, things appeared to be pretty straightforward so far, but that afternoon we faced a much bigger test. An X-ray on the hock (the joint in the middle of the back leg) of a lame horse showed that a lot of things were wrong. This horse was elderly and the hock showed little bone protrusions, erosion, swelling and ankylosis, or bone fusion.

We had to stand round the X-ray and point out to Jackie what we saw, taking it in turns to come up with new things. This was a scene we would be repeating many times throughout rotations, in which students sweated and panicked, and clinicians looked patiently (or impatiently in a lot of cases) at them waiting for answers. If the person before you said the thing you had planned to say, you just had to come up with something else. The clinicians were never satisfied until they had squeezed multiple answers out of each of us.

Once we’d exhausted the list of visible irregularities, Jackie asked whether we thought the ankylosis was hurting the horse. My horse Elli had been through this, so I knew that once fused the bones in the two immobile hock joints no longer hurt because they had stopped moving. Feeling a touch smug, since everyone else had said yes, I said no, and was rewarded with a ‘Well done’ from Jackie, and ‘Just wait till we get to the cows’ and a wink from Lucy.

Next up was Honey, a lovely bay with a back problem. She had become unhappy with being ridden and an X-ray revealed that she had kissing spine; two of her vertebrae were touching each other, which must have been very painful for her. Luckily kissing spine is easy to treat; Honey would go for surgery, which could be done under local anaesthetic, and until then she’d be given pain relief via powder in her food.

By the end of the ten-hour day we were exhausted. Heady with relief that we’d made it through Black Monday, we raced each other around the imaging suite in the chairs on wheels, there for the infinitely more serious purpose of allowing clinicians to move around the horse while holding the scanner, but great for a little light relief before heading home.

Back at the house Andrew was cooking up a cauldron of pasta after his day in the QMH working on small animal imaging. Kevin, John and James were all away on their rotations.

‘How was your first day?’ I asked.

‘It was all right. Got pretty badly grilled over an X-ray image, though. They asked if it was an image from a dog or a cat. Surely I would know if I’ve just X-rayed a dog or a cat and I wouldn’t need to work it out from an image.’

‘So you couldn’t tell?’

‘Er, no.’

I laughed. Then it dawned on me I had no idea myself. ‘So when I get asked that question next week on small animal imaging, how exactly do I tell if it’s a dog or a cat?’

He looked at me and sighed, then went back to stirring the pasta. ‘You look at the vertebrae. Cats’ are long, dogs’ are short. Also the femur. Cats’ are straight, dogs’ are slightly curved.’

‘Thanks, appreciate it.’

I was grateful for the tip – at least that was one mistake I hoped to avoid. After four years of study there were still so many things to get wrong. Things we’d only realise we didn’t know when some gimlet-eyed senior vet put us on the spot. I could feel my cheeks burn just thinking about it. I hated messing up, but I was already beginning to realise that if the system of rotations was about anything, it was about making mistakes and then learning how to get it right, so that once we were let loose on the world as qualified vets we would know what we were doing.

I stuck a couple of pieces of cheese toast under the grill and went to Skype Jacques. At the end of March I would be heading to South Africa to see him and to do some work experience in the sun, and I couldn’t wait. Only six weeks to go. Six weeks of hard graft, endless grilling and a lot of wet noses.