Humour and Humanity

I have seen a lot of SBL and Magmatic Magne this week: a lot of time in theatre, though I also endured some sessions with Mr Ikea, trying to follow the instructions for putting together a small and inoffensive chest of drawers. The thing had been undergoing assembly over several weeks now and the already-completed drawers had been huddling on a table in the corner, minding their own business except for the odd occasion when it was necessary to squeeze past them to get to the dog food. As is the tradition with Ikea furniture, a small error had been made at a crucial point about half-way through, thereafter it followed that everything else was just far enough out of place that the finished product wouldn’t go together. Dagny, active in this, as in all things was the perpetrator of this tiny error, and Magne had seized upon the opportunity to remind her of this fact, every time anyone went near. Still finally the thing was done, and all the drawers were in place. My first achievement of the week.

About an hour later, I found myself managing the anaesthetic for a mammary tumour operation. Dagny asked me to get theatre ready, and when she asked “Are we all set,” I replied (with the honesty and diligent self-confidence I try to maintain at all times) “I hope so.” In fact I wasn’t. I had failed to check if she wanted to use gaseous anaesthesia (a lot of the operations are carried out with a combination of deep sedation, local anaesthesia and propofol infusion) so she went and switched the machine on herself. A few minutes later, with the dog prepped and installed, I noticed the ominous stillness of the patient’s chest. She wasn’t breathing. The usual sense of consternation kicked in. Just work through it logically, I told myself, trying to remain calm. I checked the dog’s colour. It was pale, but it had been pale before we began. That meant that it was even more urgent though to discover what was wrong. I checked the level of anaesthesia. The eye was rotated down. Fine. I grabbed a stethoscope and listened for the heart because the heart-rate monitor wasn’t detecting anything. The heart was racing, as at this point was my own. It was at that point that Dagny quite casually pointed out that the rebreathing bag had filled up completely because the pressure valve hadn’t been reopened after testing. She hadn’t been aware that the dog was not breathing, and in her calm assessment, had just noticed what I was failing to pick up. Panic is a terrible thing. I can recall a time in the emergency clinic when whatever life threw at me, I knew I could handle it but five years off has sent me tumbling back into “starting out” mode.

Dagny talked a bit about her life during the operation. She told me that she was only six years old when she decided that she wanted to be a vet. Despite discouragement from those around her, who thought that as a woman she should do something less ambitious, more feminine, she planned out her life with ruthless efficiency and finally achieved her aim. No wonder then that with such determination to succeed, she ultimately went on to become a partner in the very first dedicated small-animal clinic in Norway.

By Thursday, I started to feel everything was more under control. I assisted Magne with a cherry-eye operation. It’s amazing to see him putting in the tiny sutures, ensuring that nothing is left to irritate the eye. Just before lunch a dog came in which was in respiratory distress. To my amazement my self-confidence suddenly kicked in and I was easily able to help out and even offer guidance. At one point, I suggested the possibility of draining the chest and Magne and Irene looked at me as if I had suddenly sprouted green bushy eyebrows. How odd it seemed, and yet it brought it home to me that despite the irony of the situation, I am much better with a frank emergency than with anything routine, and perhaps that shouldn’t be surprising given my history of working in an emergency and critical care setting for the last few years of my career in Scotland.

Later I found myself back in theatre once more, as Dagny and Magne, without even the benefit of Ikea instructions, set out to fix a fractured humerus in a young dog. After the lunchtime emergency, I managed to impress Magne once more with my astonishing ability to intubate a dog without a laparoscope. This has never seemed like any great achievement for me. I started out, all those years ago, in a small animal practice where everything was on gas, and everything was intubated and I don’t think I ever even saw a laparoscope. As with everything else, a good nurse and the correct positioning is essential, so thanks to Irene for that. When Magne returned from the hunt for the missing laporoscope, he found to his amazement that the dog was already in theatre, fully hooked up to the machine and almost ready to go.

“You know,” he said to me as he walked to the table, “you’re really quite useful to have around. I think you should work more hours!”
I felt rather diffident about this. I actually like just working two days a week and keeping my options open for overtime. “Well maybe I could come in and work Fridays as well,” I offered.
He just shook his head. “That would be no good at all,” he said with a twinkle in his eye. “I don’t work Fridays,” and with that, he turned away and started to cut.

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