I started this week with a farm visit with Thomas. We were collecting cow poo to check for paratuberculosis (Johne’s disease). I had arrived prepared with some of those long orange gloves I used to use years ago in practice for calvings and pregnancy diagnosis, but in the event, Thomas simply scooped up dung from behind the oldest cows in the herd with a green plastic spoon. Don’t tell me my job isn’t filled with glamour!
I also spent part of the week at the abattoir, where on Tuesday I stood on the pig line by myself for the first time, and yesterday when I stood in for a colleague on the sheep line. Meat inspection of pigs is more difficult than inspecting sheep. This is partly because they are prone to abscesses in unpredictable places and partly because of their thick skin which remains in place rather than being removed, as is the case with other species. I have never been particularly fond of pigs, though my biggest veterinary claim to fame is that I once helped one of the stars of Emmerdale Farm (as it was then) to give birth to a very fine litter of piglets. As I work in the abattoir though, they are starting to grow on me as I become more familiar with handling them.
Compared with cattle and sheep, pigs are both noisy and noisome. Unlike the others, pigs are omnivores, which means their dung smells way more unpleasant than the digested grass or hay that herbivores produce. They are also descended from forest dwelling foragers, rather than being herd animals living on grasslands. They have a tendency to squeal very loudly when you try to get them to do something they don’t want to and when I first started to examine them in their pre-slaughter check, I would often find them squealing at the top of their lungs as I encouraged them to stand up. They mostly come into the abattoir the afternoon before, and when I arrive to check them at about six thirty in the morning, most of them are sleeping.
To carry out a thorough check, I have to go into the pen and wake them. I want to see them all walking about and check them more thoroughly than I can if they are lying flat on their sides. Obviously waking them up is never going to be particularly popular. Indeed sometimes when the whole pen is deep in slumber, I will check the other pens first, where at least one or two of the pigs are already up and rooting around. But I have learned, from experience, that most of the squealing comes when I disturb them unexpectedly and they want to get up but can’t due to a lack of space, or because another pig stood on them in the flurry of rising. So now I go through very gently and try to ensure that when I start to nudge a pig to get up, it has space around its head so that it can do so without panic. There are still occasional squeals when they come up against each other, but more often I elicit a rather pleasant grunting.
Controversial though it might be, I have also found myself watching the slaughter process with increasing fascination. As a very young vet, I once shot a sheep and was so horrified that I have never done it since. I suppose it’s cowardly to have taken that path as there are times when it is necessary and somebody else had to do it, but I wanted to mention it in light of my monitoring the pigs at the abattoir. It’s part of my job to check that the stunning and bleeding process is done properly, so that the animals do not suffer. I had no choice in the beginning, but I no longer worry about what I might witness. I have discovered that they are so efficient with the pigs that I now see it as being close to an art form. They bring them in in small groups, manoeuvre an individual into position without stress (the slaughter men encourage them to wander around the pen until they end up in the right place) and then stun them with a carefully placed tong that sends an electric current through them. There is no squealing and no sign that they are distressed by the smells in the pen or anything they can see. I can’t speak for any other systems, but I genuinely believe that the pigs in the abattoir where I work meet their end in a way that doesn’t cause distress. I take no joy in killing, but in doing it humanely? That is of the foremost importance.
Just a quick warning that this post contains some details about meat inspection.
The days are getting longer so fast it’s difficult to keep up. From no sunlight a few weeks ago, to more than eight hours in a day is astonishing. It’s been beautiful weather for most of this week, and that’s very cheering.
Just as well for the good weather as there was a rather stressful incident at work on Tuesday. Regular readers will know that the tasks we have to carry out are many and varied and one of them is meat-control on elk.
It’s sadly not uncommon at this time of year for elk to be run over. This is the season when they migrate and unfortunately, despite all the warning signs, flashing lights and blue reflectors on the trees (which apparently help the elk to see when car headlights are coming) it still happens now and then. Once you have hit and injured an elk, there’s a phone number you call. Designated hunters are called in, who trace the animal, then shoot it humanely. They’re well trained and very efficient. Once they’ve taken it in and dressed the carcase, we are called in to carry out inspection of the meat. After all, it would be a waste to throw it away.
Anyway, back to my story. I went out to my first elk inspection on Monday with Ann. The stations where they are hung tend to be isolated places, so finding them isn’t always easy. But with most wild animals the meat inspection is straightforward. Other than their injuries, most are healthy. As well as checking the meat and organs, there is one routine test that has to be done. CWD is a disease that is similar to BSE (mad cow disease) and though it hasn’t been found here in northern Norway in elk, the decision has been taken to monitor the situation.
Thomas has trained the hunters to take the samples, and on Monday it had already been taken and sent off. The whole process seemed very straightforward. We had checked everything and marked the meat with the official stamp. So on Tuesday, when a second call out came in, Ann suggested I could go out on my own. I was working at the abattoir and it was on my way home. It wasn’t certain the sample had been taken, but Ann assured me it was similar to taking a BSE sample from a cow and I had done lots of those.
With a check of Google Map, I thought I had a good idea of where the station was situated. Despite that, I took a couple of wrong turns on the narrow snowy roads, but there was still plenty of time before dark. I felt a bit silly as Thomas had been at the abattoir and had offered to show me the way, but it was so beautiful that I couldn’t feel too upset about it.
I finally found the station, tucked away in a little clearing in the forest. It was minus twenty three, so I was glad when the key I had brought fitted and the door swung open. Inside, the elk was hanging. I checked the carcase without any problems and then walked over to examine the paperwork. The CWD sample had not been taken and so I made my way back to the tray where the organs and head had been placed.
For the first time since the start of my visit, I felt a quiver of doubt as I began to examine the head. To take the test, you need to get a sample of the brain. Though I could see a hole in the spinal column where the neck had been separated from the body, it didn’t look anything like the cattle I had sampled in the abattoir. There are different sized implements for taking the samples in different species and though I’d expected to use the cattle-sized tool, only the sheep-sized one seemed to fit.
Several minutes later, and despite the cold, I was starting to sweat. There was something far wrong. The sampling tool was going in way too deep: had been since my first attempt. I had tried to turn it as I had been taught, but it wouldn’t go. The knowledge was beating in my head; if I did it wrong, I could ruin the sample.
I took a deep breath. I wasn’t at all sure what the situation was in elk. In cattle over four years old that are taken for emergency slaughter it’s essential that the test is taken and a negative result received. Without one, the whole carcase has to be condemned. In sheep and reindeer it’s a bit different. A certain number of samples are taken each year, but if you can’t get one, you can sample another.
Stay calm, I told myself. I should try to call someone. Thomas had been at the abattoir. If I called him, he might still be there. But his phone rang out and there was no reply. I tried Ann. The same. In mounting frustration, I tried Ammar. He would be a couple of hours away in Tromsø and there was no way he could come out and help, but perhaps he could give some advice.
To my relief, after a few rings, he answered. As always, he was both helpful and upbeat. The sample you take is supposed to be nice and clean. There’s a specific area you are supposed to remove intact, but he told me it could be difficult in elk and to just take whatever material I could get. In addition to the brain sample, you also have to take some of the lymph nodes and he assured me that if I could take those and some of the brain, it would be fine. Call me back when you’ve done it, he said cheerfully, and then I was alone again.
I set to again with a feeling of determination. Many years ago, out on farms, I had learned that even if you think you can’t calve a cow, or return a displaced uterus, if you keep a calm head and persevere, you can achieve things you never thought possible. But despite all my efforts, I couldn’t retrieve much material. Nowhere near enough. In increasing desperation, I decided to find the lymph nodes. Ammar had told me ages ago with reindeer that if you can’t get a good enough segment of the brain, you should make sure the lymph nodes are there.
But when I started to look for lymph nodes, I felt equally out of my depth. The elg head looked completely different from anything I had seen before. I couldn’t even start to get my bearings. After several fruitless minutes, my determination had sped, replaced by a feeling of hopelessness. There was no way I was going to manage this.
Cleaning my hands again, I grabbed my mobile and rang Thomas again and this time, to my relief, he answered. He seemed astonished I was still working. He had assumed I was safely home by now. He was already back in the office. I felt my heart sink even further. I had been hoping against hope that I would catch him nearby so he could come and help. He talked to me for a few minutes about what was happening and then there was a long silence. I had the horrible feeling he was going to give me more advice and then I was going to have to try again, but I had no confidence left that I could achieve what I had set out to do.
When his voice came again, his words were wholly unexpected. “Do you have any rubbish bands there? Big ones?”
I walked around the corner into the little office area where there were shelves and a sink. There I saw what I had noticed earlier: a whole roll of black bin bags on the middle shelf. “There are,” I replied.
“In that case, pack up the head and bring it back here, and I’ll see what I can do.”
There was something rather surreal about driving several miles along snowy roads with a moose head in the car boot. I vaguely wondered what would happen if the police stopped me… but then as so many people hunt here, perhaps they’d think it completely normal!
I arrived back in the office with a feeling of huge relief. Even if I had messed the sample up in my attempts, at least I was doing something. Sometimes in those moments where you can’t see a way out of a situation, time extends and it’s hard to see an end.
I unpacked the head with Thomas’ help and he looked at it carefully. “No wonder you couldn’t get a sample,” he told me. “They haven’t taken enough of the neck away.” He reached out a gloved hand and grasped the section of spine from which I had been trying to take my sample. Wiggling it, he showed me a huge chunk of meat that moved easily up and down. “We have to take this whole piece off,” he said.
A few minutes and a very sharp knife later, he had managed it. Looking down at the head now, the anatomy was familiar, the sampling sites for both brain and lymph nodes were clear. Thomas went over the techniques again all the same. He has trained all the hunters and he made it really very clear.
As we filled in the paperwork, I suddenly remembered that in my desire to get help, I had forgotten to stamp the meat. It had been a very long day and there was no way I could go back tonight. With something of a sinking feeling – I had really messed everything up in a way I hadn’t for years – I headed home. Despite my awful day, there were still compensations. The sun was beginning to set as I stopped at the shop and so I took a photo.
Wednesday, despite all the finishing up I had to do, was much better. Having taken the sample to the post-office, returned the head, stamped the carcase and written the report (with help from Thomas) I was still finished just after lunch. I decided to use the flexitime I had gathered the day before to go back and take photographs of the places I had driven round. As you see above, it was a very beautiful day for it.
All’s well that ends well; though the sample Thomas had taken looked quite good, it hadn’t been possible to see the section that was meant to be intact. I had done too much probing around. There was still a worry that it might be rejected and if it was, then we would have to ring an expert to find out whether the meat could be used. So I was very relieved when the result came back clear on Thursday afternoon.
With a much lighter heart, I began to pack. We are away this weekend in a cabin, but more on that next week. For now I’m going to bank the fire up with logs and put my feet up. We’re not far from home, but this is the first time I’ve been away this year and I’m going to make the most of it.
Another week working from home. It was only to be expected as the coronavirus figures, though steady, hadn’t begun to drop. The Norwegian government announcement was made on Monday, but they have promised to review it again next week. Numbers are now falling, so I’m hoping that next week I will be able to join some of my colleagues in the office.
That said, working from home has its advantages. The drive to work is shorter and the coffee is better. Aside from that, for the past two days, Storm Frank has been battering the Norway coast and going out hasn’t been so appealing. Luckily our apartment was protected from the worst of the wind by the steep slope that rises up behind it, but minus ten gusting up to sixty miles an hour is really quite chilly!
There is now ice on everything. There is ice on this football field on Senja.
There is ice in the ditches and escaping from rocks.
Even the snow is covered in ice. It cracks as you step on it, the deep sound echoing through the air trapped in the underlying snow: very satisfying to jump into!
All this is treacherous of course, but going out is still sometimes necessary. As well as boots with spikes on the soles, we have a bucket of stones in the porch that we strew on the driveway. These are not like the mealy, red grit-mixed-with-salt that they use in the south. These are serious stones and at minus ten, salt has no benefits. With excellent foreplanning, Anna and I covered the driveway when there was something of a melt last week and now they are well embedded in the minus ten ice.
I had my five month assessment at work this week. It went well. In spite of coronavirus, Hilde is satisfied that I am picking things up quickly enough and working well. My ongoing aims are to start to take the lead when I go out on visits with colleagues and to put forward my opinions more in meetings. I am definitely guilty of not speaking up in meetings. This quotation from verse 27 of an old Norse poem, Hávamál, the Sayings of the High One is pertinent here:
Ósnotr maðr er með aldir kømr þat er bazt at hann þegi engi þat veit at hann ekki kann name hann mæli til mart veita maðr hinn er vætki veit þótt hann mæli til mart
For the unwise man who comes among men, it is best that be he silent. None know that he knows nothing, unless he should speak too much. * The man does not know it, he who knows nothing, whether he speaks too much.
Not that I am especially unwise, of course, but until I have a full understanding of what is going on, I always tend to listen more than speak. Silence among crowds comes naturally to me. But given that a few days back, I heard in a meeting that Anja would be conducting the visits to hens and chickens, and rather than speaking up at the time to say I was interested in chickens, I stayed silent and e-mailed her afterwards to ask if I could accompany her, there are definitely some changes I can make that shouldn’t be too difficult.
And I will leave you with two more pictures I took in the tail end of the storm (the first being at the top of this post). Removing my gloves to take them was painful, but definitely worth it.
Marian and I had a lovely walk up to Ognaheia on Tuesday. For once it wasn’t raining, snowing or blowing a gale, and for the first time in weeks we were able to have sandwiches and coffee overlooking the lake at the end of the track. How wonderful it is to be able to go out in company with a friend and walk in the fresh air amongst wonderful surroundings. We both agreed it was a far better way to get exercise than on a running machine in a gym. We saw the Highland Cows on the way home, so of course I had to ask Marian to stop so I could take a photograph.
And of course, yesterday was Valentine’s day. It’s not something we celebrate madly, but we did buy some food from the Thai Take-Away van in the village. It’s the only take-away for miles around, and only appeared relatively recently, so it’s quite a novelty. We’ve been once or twice before, but for some reason yesterday, the food was much spicier than it has been previously. It suited our tastes much better. Here’s hoping it continues. I also made a cake. Well any excuse really.
In addition to the cake and the take-away food, I bought Charlie some coffee beans from Steam, my favourite breakfast coffee shop in Stavanger. In return, he used the beans to make wonderful coffee to go with breakfast this morning. He makes breakfast every weekend, and brings it to me in bed. Delicious toast with a mixture of cheeses melted on top, along with slivers of onion and tomato and pieces of salami. And freshly ground coffee with frothed milk. It’s my favourite part of the week. I’m really very lucky.
Language is an odd thing. Now I am using Norwegian more often, I notice strange things occurring with greater frequency. For example, I sometimes have conversations with people and afterwards thinking back I can’t recall which language we used. More confusing still is the phenomenon which occasionally occurs when a sprinkling of “English” words are scattered amongst the Norsk. For example, I saw a headline in the newspaper the other day. “City løftet trofeet!” It said. Trofeet? I ran it through my mind. Not sure about that one. Something to do with three? Løftet meant lifted. I knew that. So something about a city being lifted? What could it mean? An earthquake? I was trying to work out how this incredible feat of tectonic activity had occurred without my being aware of it when I noticed the accompanying photograph of a bunch of football players and it suddenly crystallised in my mind. So much for earthquakes. I was halfway up the stairs before I registered that the Norwegian word for city is “by” Had I registered that City wasn’t even a Norsk word, I would have realised that this was all about the Norwegian obsession with English football. City had lifted the trophy.
So a day or two later, I should probably have been more alert to this phenomenon when I was looking for the soap. I found Irene and asked her where it was. “Det er I skapet der bodies holdes.” she told me. My mind worked that one out. It was in the cupboard where the bodies were stored. That much I registered. But really? The soap was in cold-storage with the bodies? It couldn’t be. Or did she just mean in the room? Was there another cupboard in there? I shook my head in confusion and she must have taken pity on me because instead of trying again, she led me into the prep-room, skirted round the piles of dog food that were sitting there and opened the cupboard where the clean laundry was stored. “There!” She pointed to the big container. I just stared at it. “What?” she asked, looking at me still. “But the bodies?” I asked her. She took out one of the “Bodies” a cute little item of clothing that we use on dogs when they’ve had an operation. It was again at that point that I realised that the Norwegian for body is “kropp”. When I told her, she just laughed.
I received my authorisation notice last Friday. So now I am allowed to do official vet things like operations. I love operating. The vets here are fascinated with the way I sterilise cats. I learned a really nifty method for castrating cats years ago that involves tying a knot in the blood vessel and vas deferens using only a pair of artery forceps. Once you’ve done it a few hundred times, it can be done in about ten seconds flat. And much to their interest, I have always spayed cats through a hole in the flank. Here they go in underneath through the midline. Guro, whose middle name is Moira because secretly she’s actually Scottish, decided to jump right in there and we spayed a cat together on Thursday. Apart from the classic first-time error we managed to make when we failed to go right through into the abdomen and found ourselves having one of those odd moments when it seems the cat had no abdominal organs, the whole thing went very well. I’m glad to work with such open minded people who are keen to try different things.
Another big event on Thursday, seeing my first patient alone. It was a dog with a broken claw. Not so much to go wrong I thought. But when I looked at the dog, it was hard to tell what I should do. Dim light from the window and a dog the colour of Yorkshire jet meant that I had only the faintest sight of the claw I was examining. Happily Magnificent Magne rode in to the rescue… and switched on the light. I felt just like a new graduate again: a mind so filled with uncertainty that common sense was as elusive as the light had been. The uncertainty was replaced by a booming knowledge, reflected in the client’s eyes… “Oh no. This one’s clueless.” Still, I managed to sedate the dog and the ring block around the claw worked perfectly. The patient never even twitched as Magne gouged away the outer layer of the claw using the dental instruments. The usual frustration entered my mind as I bandaged the foot without dressing or K-Band (how am I going to survive without K-Band????) but the finished product looked neat and tidy. And the next time could only be easier surely? And so I thought, that was my week over, but on Friday morning, as I sat in bed contemplating a lovely relaxing day, a message popped up on Facebook. “Are you there?” said Irene. Wondering whether she would be eaten alive by SBL for using Facebook at work, I replied that I was. “I didn’t have your telephone number,” she said. “Guro has rung to say she can’t come in. Could you come instead?”. I was tired from a midnight run to the airport, nevertheless I like working Fridays, so I wasn’t going to turn this down.
And so I found myself in a room examining my second patient. It was one of Guro’s and she has an interest in small pets such as rabbits and guinea pigs and this one was a hamster with a lump on its bottom. I was amazed when I took it out of its cage to find the “lump” was actually the most enormous pair of testicles that I have ever seen. If a bull had an equivalent pair, they’d be dragging on the ground. Aside from their massive size, everything seemed to be normal but as Madam Self-Confidence had still not installed herself in my head, I scurried off to get a second opinion. I found Vivek first. She was probably trying to hide, but there was no escape. Scouring the books in the back-room, we couldn’t find a thing, but happily Google Images came to the rescue. Apparently these gigantic appendages were completely normal. Of course, with the client now in “Oh no. This one’s clueless” mode, I couldn’t saunter back in and casually tell her that everything was quite in order, so happily this time Vivek came in to reassure her. One day perhaps I will manage to see a patient on my own again.
Later on I found myself helping out Jan-Arne. He was going to see a few more of Guro’s clients and so I examined a dog with him that was in for a biopsy of a lump beside her bottom. Obviously a day for it. It felt to me a bit like a lipoma, albeit in an awkward position, so I asked for permission to remove the whole thing, rather than doing the biopsy, if on inspection it turned out to be just that. And it was. It came away beautifully. My satisfaction was complete when I saw the owner’s face when I told her that it had been a benign fatty lump. To me, it was a small, if very satisfying operation. To her, it meant so much more. It is those moments that make life as a vet worthwhile.
I didn’t have time in my last entry, but in the car on Sunday Jan-Arne told me a bit more about Mystical Magne. As well as being married to Gerd, Magne is seventy-seven years old. I would never have guessed. According to Jan-Arne, Magne has said he will only retire when he doesn’t get up and look forward to coming to work every day.
Jan-Arne himself was off work on Tuesday… which just goes to show that large animal work can be bad for you. He told me on Sunday that he was hoping for a “small colic” in a horse. You should be careful what you wish for. Instead of the minor ailment he desired, he ended up dealing with a major incident. He carried out all kinds of treatment to try to alleviate the problem, including introducing a large-bore needle into the caecum to allow the gas to escape. At one point he was trying to get some liquid paraffin into the poor animal without much success. Rather than using a pump (which he felt would be unsafe for his patient) he tried to blow the solution down the tube… and landed up in a battle of rills where he couldn’t determine whether he or the horse ended up swallowing more. In addition he inhaled the stuff, and attributed the hideous cough he came down with the next day to this, as well as to a cold triggered by staying up half the night in his shirt-sleeves battling to save the horse. He is (as yet) not very experienced, but he is determined and innovative and shows a degree of dedication that I admire very much. Sadly this wasn’t a story with a happy ending. The poor horse was eventually put to sleep, but Jan-Arne tried all he could to resolve the problem and had done all that was possible to alleviate the animal’s distress. Sometimes that is all you can do.
On Thursday, still sounding like a rendition of the frog chorus, he turned up at work in a T-shirt and a pair of pyjama trousers. It is possible that he felt so ill that he didn’t have time to change, but more likely he thinks it is time to start a new trend. This is Norway after all, the land of cosmopolitan chic, and whatever you feel about maroon pyjama trousers, nothing could be worse than the hip-hugging, bum-crack showing jeans and white-socks-with-sandals look that has permeated the summer fashion parade here in recent years.
In the meantime Irrepressible Irene, short of veterinary work, had decided it was time to clean the windows. It would be more fun with two she told me, and so convincing was she with her foxy grin, that I found myself outside a few minutes later with a blade in one hand and a drying cloth in the other. Round the front of the building was easy enough, though there were a few girly screams as some spider’s webs came into contact with Irene’s hands. It must be said that she is a very attractive young woman, an opinion which must have been shared by two friendly spiders (both of them named Scott [after Sir Walter]) which felt so drawn to her that they began nesting in her hair and had to be removed.
Round the back of the building was a different matter. Not only were the windows higher off the ground, but there was a foot-deep runnel running along the side of the building that meant that the step-ladder Irene had fetched could not stand flat on the gravel. So with no discernible respect for Health and Safety* (yay for living in Norway) we mounted the precariously wobbling stairs and continued our perilous trip around the outside of the building. As we burnished the final window into glinting brightness, I thought we were finished, but with her usual thoroughness she insisted we should clean the inside as well. Unfortunately for her, there was some evil condensation in between the double glazing that even she was unable to banish. There was, however an interesting ritual that I observed. I can only assume that it is a Norwegian idiosyncrasy. At one point in the proceedings, Irene donned a rather natty chicken mask and continued to climb on swivelling chairs (*see earlier note on Health and Safety) to polish the glasswork. During this mysterious ritual, Gerd even came through to take a photograph. And so, dear reader, if you are really lucky and come back next week, I may be able to share some solid evidence of this fascinating local custom. Who could possibly resist that?
This week I spayed Dagny’s cat. She has asked several times before whether I would commit this terrifying act, but until now each query has been a false alarm. Not so this week when this cute, fluffy being arrived in the practice looking a little afraid… with her cat in a basket. But that was Friday, and as I like things neat and tidy we should return to the beginning.
I’ve worked four days this week, Tuesday through to Friday, and I confess that I have found it exhausting. Tuesday was particularly traumatic. I can only assume that on Monday they were short-staffed in terms of assistants because though for the clients everything was still running smoothly, from my point of view I arrived to chaos. There were four kits (I counted them!) in the sink waiting to be washed, dried and sterilised. There were no sterile kits in the cupboard. There was wet washing in the machine and dry washing in the tumble drier. Crazy. And of course my job as an assistant is to clear the backlog and ensure everything is in place so that the vets can perform their duties. Obviously I have to achieve this Herculean task invisibly, and sadly unlike Harry Potter, my cloak is faulty. And so it was that Dagny came upon me dithering in the autoclave room, trying urgently to get a sterile kit ready for the operation that had arrived at nine o’clock.
I was away on holiday for five weeks. Rather too long, I suspect, as my head still wasn’t quite back in its Norwegian groove. So much so that when Gerd told me it was a dog to be sterilised, I hadn’t picked up on the fact that in Norway, “sterilised” is only used for females. This then was a bitch spay. Not the much smaller castration I had been fondly imagining. So there she was. Dagny in full serious operation mode.
“What are you doing here Sarah? We need you in theatre. We need to get the dog onto Isofluorane.”
“I’m getting you a kit. You’ll need one.”
“There’s one in Magne’s room.”
There you go you see. Still so much I don’t know. My faulty cloak is slipping as Dagny disappears and I follow. Set up the anaesthetic machine. Turn on the oxygen generator. Connect the hoses and set the correct bag in place. Switch on the blood-gas and pulse monitor. Attach the mechanism that registers the breathing and measures the carbon dioxide levels. Then test the machine to make sure there are no leaks. Fine to do so with the oxygen on 0.2. I know this because Kari Anna told me. All the same as usual and now Magne has entered with the patient. We connect her up.
“Shouldn’t the oxygen be on 2?” I’m slightly surprised. It’s not like him to ask questions. The patient is on the border: close to needing 1.2 litres per second, just below the limit. I have her on 1. She definitely doesn’t need 2. To keep him happy I turn the knob slightly and now she’s on 1.2.
And then Dagny is there and the operation is underway and I realise that although everything is working fine, I haven’t printed off the form to record the gas levels. I’m swithering again. Do I leave the room to try to get one printed and leave the anaesthetic unattended or do I stay and monitor but not record? Happily Gerd passes the door at that moment and I rush out and ask her to print one. She’s busy though. it might take a few minutes. Dagny is speaking again. I brace myself. My performance this morning has not been faultless. She’s not unkind, but it can be difficult when everything is falling about your head and searching questions are asked.
“Did you check the anaesthetic machine this morning? Was the pressure stable?”
“Yes.” I’m on sure ground here at least. Perhaps she doesn’t understand that my fluster this morning has been caused by the fact that I am utterly aware of the consequences of not being thorough. I would not allow an operation using a faulty anaesthetic machine any more than I would allow them to go ahead with instruments which were not sterile.
“Are you sure? There wasn’t a leak. Did you have the oxygen switched off?” Still on relatively firm ground, though the 0.2 oxygen is a pulse in my head. Kari Anna said so but she isn’t here to defend me. I’m on my own.
“Well there was a small amount of leakage. I had the oxygen on 0.2. Kari Anna said that was okay.”
“Well we checked it yesterday and it was definitely leaking then. We can check it again at the end. If it’s leaking, the oxygen should be up at two.” She isn’t being mean, just practical, and yet I feel like a teenager caught in some act of defiance, faced with irrefutable proof of my guilt, even though I know I have done nothing wrong. Pah to my highly-disciplined, polite, British upbringing where nothing was direct and everything was couched in euphemism.
But I had checked that machine. I had. Everything had been normal: the same as all the other times I had used it and all those times it had functioned perfectly. Not only that but the bag is full now. I can see there is no leak. Despite my personal feelings of disquiet I stand my ground and the oxygen stays as it is. It’s not as if I’m not watching the monitors after all. And then the ultimate jab of the knife as my final weakness is uncovered.
“Do you have an anaesthetic form?” I quit my dithering and run.
The mood improves. Dagny is talking now about families, food, normal things. When the operation is over I check the anaesthetic machine instructions. The pressure check can be carried out with the oxygen up to 0.3. Feeling vindicated I rush out to find Dagny and tell her.
“Oh yes,” she says. “That was all explained. Magne told me that it was a different bag we checked yesterday. He saw you reaching far back on the shelf to get that one.” Magnific Magne riding to my aid again, even though I hadn’t exactly needed rescuing. The day progresses and chaos no longer reigns. Guro has told me she thinks I am efficient.
“I didn’t know you were in charge of the washing as well as everything else,” she says. So much work. All of it invisible. Until it is left undone and then everything falls apart. The life of a veterinary nurse or lay assistant. I had always helped them out when I saw they were busy, but never really understood what they might be going through.
Wednesday was a good day. It started with helping Jan-Arne to anaesthetise a parrot. Happily I had arrived to the relative tidiness I had left behind me by the end of Tuesday and therefore I had time to read up on bird anaesthesia. Just as well because I was undoubtedly rusty. The book was reassuring; Isofluorane was the drug of choice and that was the regime that had been proposed. In place of Gerd, Leah was there behind the front desk and generously she helped me set up the machine. The parrot didn’t like men apparently. I’m not sure it really approved of me either as I wrapped it in a towel and inserted its beak into the mask but there was not much it could do. It couldn’t have gone much better. Jan-Arne was able to drain the lump on the parrot’s face and clean it out and the bird was happily back in his cage, clicking and muttering to himself as we handed him back to his owner.
By Thursday everything was so much under control that I had time to clean down the cupboards and the walls in the consulting rooms. Goodness knows what Jan-Arne (or maybe it was Dagny) had been aiming at the bin in room A. I wiped it away, wondering whether anyone would ever notice and yet feeling good about doing it. Surely it must be reassuring for the clients when everything looks clean. To my delight, I won the “Weeks smile”. Two votes, only one of them written down. “To Sarah for her skills in clipping claws”. Oh yes, I’m a talented woman! And then Dagny told the room I would be spaying her cat tomorrow. “I’m going to be talking about this for days,” she said. “Everyone must know.” She should steady on, I thought. Otherwise I might have to start calling her Lovely Boss Lady, and that just wouldn’t have the same ring about it.
Friday morning arrived and I thought for a couple of hours that it just wasn’t going to happen. Then Dagny arrives looking glamorous as she does in her non-working clothes. The cat is glamorous too, with its basket all covered in bows. Actually it looks a little like Sophie, my cat from the UK, now residing with my mother whose cute photograph I included at the beginning of last week’s blog. Dagny’s cat is fluffier though, and much younger. “I’ll leave it up to you,” Dagny says. “I don’t want to hang over you.” And she disappears for a moment. I rush through and check with Marita for the dosage of the sedative in cats. I have it in my head for dogs now, but I haven’t anaesthetised so many cats. She and Jan-Arne help me. Thank goodness everyone is so patient with me this week. For some reason I have been asking for help all week and everyone has been fantastic. Seamlessly I return. As does Dagny. So much for leaving me to it.
And then the cat is on the table and I am gloved and capped. The scalpel blade is in place and suddenly everyone in the practice files into the room, fascinated by this incredible event. No pressure then! I start to cut. The hole is bigger than I intended but there’s no going back and happily as I cut through the peritoneum, the ovary pops into view, to audible amazement from the audience. It isn’t always so easy, but I try to look nonchalant, though I am given away slightly by my not-quite-steady hands.
“You don’t need to shake,” Dagny says with a laugh. She always knows just the right thing to say! Happily the operation goes smoothly and within a few minutes it’s all over. The room is empty again and after spraying the wound and applying some Mepore, slowly I begin to tidy the theatre and wash everything down. Well some things just never change.
And for those who can’t speak Norwegian, the banana featured at the top of the page says “Have a good day.” It was sitting on the table when I arrived on Friday and I couldn’t resist its smiling presence.
I have become obsessed this week with a song. It happens now and then, especially when I am trying to write (and this week, for the first time in ages I have found time to work on Ready, Vet, Go!). I’m currently writing a very downbeat section, but the song is quite the opposite (for those who would like to listen, it’s Laid by James). I have been listening when driving to and from work (which I have done a lot this week). I don’t know about anyone else, but when I listen to frenetic music, crazily loud in the car, I find it very difficult to drive slowly. Of course, in Norway that’s a disastrous concept. The speed limit on normal roads is 80km/hr (50mph) and you definitely don’t want to be stopped by the police. I failed to come to a complete halt once at a stop sign, and it cost me more than 5,000kr (£500 / 650USD). So instead of speeding, I have to beat the steering wheel in time to the music. Just as well no-one is watching.
Wivek too seems to have been singing a lot this week. On Monday, when she had to give a cat a barium meal (to show up the stomach and intestines on an x-ray) she mixed it in with some tasty food and left the cat in one of the kennels for a few minutes. When I commented that maybe, just maybe it would eat, she started humming a Norwegian song – Optimist by Jahn Teigen. I had never heard this song before, so she wrote it down and I Googled it to listen on YouTube. I confess I am less obsessively interested in that one. Deeply apathetic might be a better description, but maybe I’m just not giving it a fair hearing.
Of course the cat didn’t eat enough of the food for Wivek to be satisfied, so we had to try a little ‘encouragement’. This involved a towel, a wrapped up cat and a good bit of claw dodging, but we managed it in the end. Even after all that, we didn’t find anything significant, but a lot of veterinary practice is like that. A lot of people have commented to me over the years, that it must be hard being a vet because the animals can’t tell you what is wrong. I usually counter this by pointing out that although they can’t tell you what is wrong, they also never tell you any untruths. Still, I don’t suppose my GP very often gets bitten or scratched by his patients. Later on I remember Wivek singing Manic Monday… so that must have still been on Monday. It’s been a much longer week for me than usual because Irene and Gerd are both off, and so I’ve worked four days instead of my usual two.
In addition to all that driving back and forth, there was also a meeting in Bryne on Tuesday night. Dagny told me about it in theatre in the morning. I had been feeling vaguely uneasy because I had heard people talking about some meal out, and I had been wondering whether it was something exclusive that I wasn’t involved in, or whether it was something I had missed. I was invited though. Dagny told me I was already booked in. She berated me (humorously) for the fact that I had missed the information, which she told me had been given out on more than one occasion at the Thursday staff meeting.
‘Too busy eating and everything just going past you,’ she said. I fear there may be something in that. I asked Wivek if she was going, and she told me she was. When I said I hadn’t known about it, she said it had gone over her head too, though it was in her diary, so it must have been mentioned at some point. With Jan-Arne though, I hit the jackpot. When I asked if he was going to the meeting tonight, he said,
‘What meeting?’ I could have hugged him. (Actually, I often hug him, so it’s surprising I didn’t just take the opportunity to do it again).
My favourite Wivek song of the week however, was the Propofol song. Propofol is the intravenous anaesthetic we use most often. It’s very safe and quick acting and so as well as using it to produce deep enough anaesthesia to intubate animals before using gas, now and then we also use it when the sedative we have used just hasn’t worked well enough to allow us to treat the animal without pain. It’s so short acting that the dog or cat can still go home with its owner almost immediately. I used it today, for example, on a dog with a really painful anal-gland abscess. It was a tiny dog, and those are notoriously difficult to sedate. The normal dosages often don’t really work, and higher doses… well I don’t like to use those too much in case they are not safe. And so in order to treat the little animal without causing any unnecessary pain, I topped up my sedative with some propofol intravenously. Happily Wivek was there to help me. The whole practice has been working well together as a team lately, and as I got everything ready, Wivek started singing.
‘Propofol, propofol,, propofol,’ she sang, to the tune of ‘Here we go, here we go, here we go…’ Just as well sometimes that we ask the owners to go away when we do jobs which are going to be messy. Of course, there are times when veterinary work can be very sad. There are many more times when it is very rewarding. But I like best the fact that sometimes, we just have a lot of fun.
Finally, this week’s picture is of Cita who is seven years old. She is the kind of patient that makes all things worthwhile. Despite the fact that she had to have her eye removed after a cat scratched it, and has had both her hips operated on, still she comes in and is really kind and gentle towards us. I couldn’t resist taking her photo before Marita took her in to clean her teeth. I guess that if you’ve read this, you couldn’t resist her either. Have a great weekend.
I have been wondering whether I should talk about euthanasia for a little while now. As you can probably tell, working in the clinic is mostly a joyous experience, but there are times when veterinary work can be very sad. It seems to me, after twenty years working as a vet, that death is as much a part of life as birth, but outside the clinic it is more hidden, less talked about. When it is discussed, it is done in a hushed reverential way.
From what I understand from talking to people, I believe that I have something of an unusual view. To me, death seems a peaceful thing, rather than something to be afraid of. Except in exceptional circumstances, most of the animals we put to sleep are old or very ill. There are occasions when, from seeming terribly distressed, breathless, weary or in pain, you can see your patient relax. The strain disappears and it is obvious that they have found peace.
For the owner of course, it’s a sad time: sometimes devastating. Many people feel their pets are members of their family, and so the loss is intense. For me it has always seemed somehow very intimate and it is important not to intrude, but even after all this time, with each ending, I continue to share the sorrow . I have read other vets saying that they try to keep things brisk and professional, but I have never been able to do that. Usually there are tears in my eyes.
For the animal, I try to make sure that the experience is as peaceful as I can make it. Most animals don’t enjoy going to the vets. It’s important to take my time, to talk to both the owner and their pet. With dogs, I usually try to inject them without lifting them up onto the table. I always feel they are more comfortable on the floor: more secure, though of course smaller dogs can sit on their owner’s knee.
The process is different here in Norway and actually I prefer it. In Britain, it was the norm to give an overdose of anaesthetic directly into the vein. Personal experience has taught me that when being anaesthetised, it is like a light going out. It’s very rapid and I usually explained that before beginning, but sometimes I could see it was a shock to the owner that the whole thing was over so fast. There were difficulties sometimes in finding the vein and in making sure the injection went in correctly, as otherwise the whole experience could cause unnecessary pain.
At Tu, it is the norm to sedate the animal: deep sedation, so that he or she becomes unaware of the surroundings and is profoundly calm. Often we leave the room so the pet can go to sleep in peace alone with the people they know best. Once the animal is sleeping, we return. Generally we encourage the owner to leave the room, though they are welcome to return afterwards if they wish. The final injection is usually given into the heart, which isn’t the most pleasant thing to watch, but I am comforted by the fact that the pet is wholly unaware.
Whichever way it is carried out, I try to make sure that the owner is not too distressed by the procedure itself. Euthanasia is the last and kindest gift that an owner can give to their pet if they are in pain. The last thing I want is for their memory to be of my incompetence or of something frightening happening they did not expect. I try to ensure that I explain everything thoroughly and work as efficiently as possible. Experience has taught me that when things go wrong, it feels desperately traumatic, and if it is that way for me, then it must be even more so for the loving owner.
This week I carried out my first fully solo euthanasia in Norwegian. I was concerned that language might be a barrier. All the things that came so easily in English would be no longer second nature. I was worried I would be unable to properly offer comfort, but in the event it was obvious that body language counted for so much that it was not important that the words were not perfect or sufficiently profound. It was still a sad experience, and yet I find it somehow uplifting. It is such a generous act on the part of the owner. I am glad if I can help them carry that burden, even if only a little.
My week began (as it often seems to) with me assisting with a cruciate operation. I was quite pleased with myself and felt quite organised, and even remembered that I had to apply a bandage to the dog’s lower leg so as to keep the hair under wraps, so to speak. Dagny was on good form as she was heading off for some CPD in Svalbard. She hoped to see a polar bear, she told me, but when she saw my bandage she narrowed her eyes.
‘You do know you’ve put that bandage on inside out?’ she said.
I looked down at my handywork. The bandages we use are the flexible bandages that stick to themselves, and I invariably unroll them with the outer surface of the roll to the dog’s leg. Anyone who bandages often will be aware that it’s much easier to do that.
‘It’s not my bandage that’s inside out,’ I remarked. ‘They’ve just printed the pattern on the wrong side.’
‘I suppose they’re the other way out in Scotland,’ she said with a grin. The odd thing is that I seem to remember that for a while, we did have bandages with patterns on, and that the patterned side was inside the roll. I wonder whether now they sell these things online to the general public, whether they feel the need to put the pattern on the outside as a gimmick. Or whether my memory is just hopelessly faulty. Maybe there are some dino-vets in the UK who can set my mind at rest. Either way, I will continue to put the bandages on inside out. I don’t suppose the dogs will really mind. At least I’m no longer in the Glasgow PDSA, where you had to work out whether the owner was a Rangers or Celtic supporter so you could put on the wrong coloured bandage just to annoy them. Or better still, a bright pink bandage on their illegal male Pit-Bull. I wonder whether I could start a craze for blue, white and red bandages for Norway’s 17th May celebrations.
Thursday was much quieter. I confess I was really looking forward to lunchtime. Often, when Dagny isn’t coming in, Jan-Arne is asked to buy lunch for everyone on his way in at eleven o’clock. As well as the usual meats, bread and salad, he frequently brings pre-cooked burgers and I was so hungry I really fancied one. So it was with sadness that I discovered that everyone had been informed yesterday that there would be no lunch provided. Luckily, the ever-generous Wivek came to my assistance with some fibre-rich knekkebrød, (like Ryvita, only nicer for those in the UK) some smoked salmon spread and various salad items. Although there was no Thursday meeting, we still all had our lunch break at the same time and I was amused to look round and see what everyone was eating.
As you can probably tell from my list, Wivek’s lunch was very healthy. It suited her personality: conscientious and rather serious (though to be fair, she also confided in me afterwards that she had chocolate for breakfast, which just goes to show she has an underlying wicked streak). Marita had something not to dissimilar from Wivek: practical and organised. Irene wasn’t eating with us. She’s a woman of mystery. Jacqueline like me, had no lunch, but rather than steal from Wivek, she extracted an ice-lolly from the freezer. Of course she’s incredibly cool at all times, and just a little bit quirky and so that too was very suitable. And what about Jan-Arne? Well he had brought a couple of bread rolls, which he smothered in ketchup and mustard, filled with ham and cheese, then sprinkled liberally with Piffi, a spicy mix of salt, chilli, onion powder and other tasty stuff. He then proceeded to put this in the microwave and heated it up. So does this reflect his personality? Well it was warm and frivolous, cheesy and spicy and more than a little bit crazy. But somehow together it just works. Comfort food, comfort friend. I’ll take it. In fact, I’ll take them all.
Today’s photo is Pernille, who is having her blood pressure checked before an operation.