Tag Archives: Dagny

Humour and Humanity

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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.

Not German(e)

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A short week this week because Thursday was Ascension Day or as it is amusingly known in Norway, (assuming you have a mental age of six, as I do) Himmelfartsdag. I started out the morning anaesthetising a dog for a cruciate operation. For those who don’t know, the cruciate ligament is within the knee joint and it can rupture on occasion causing instability of the joint. The operation replaces the ligament, thus re-establishing normal movement. Kari Anna thought she would test me out by asking whether I had remembered to take the Gentamycin injection into theatre, and with a triumphant smile I was able to wave the box at her. Not quite so jubilantly, an hour and a half later I slunk towards the fridge with the drug opened and drawn up into a syringe, presumably to be wasted. When I had offered it to Dagny, she had said “No thanks!” with a radiant smile. I felt a little vindicated when I told Kari Anna I was placing the labelled syringe into the fridge. Like me, she had believed the official Spraying of the Gentamycin was a routine part of the operation.

Dagny has been talking on-and-off about the possibility that I might begin to consult on an official basis. The only spanner in the works (and admittedly it’s quite a hefty spanner) is that on the days I am working, there is no spare consulting room. Often they already have a vet in all three rooms as well as one taking up space in the prep-room. This time, for the first time, she mentioned something about the idea of building another room. Personally I think they should build it of brick and designate it the British Wing. Given the Norwegian love of DIY and my current observations of practice protocol, I expect Dagny will begin construction herself as Magne skulks around, unobtrusive but observing carefully, and he will smile to himself as she fails to line up the bricks correctly before stepping in and… getting me to fix it.

As well as the cruciate operation, I assisted with another two cherry-eyes. For some reason Magne has started to ask me for his surgical gloves in German, as if it wasn’t complicated enough working in Norwegian. “Do you speak German?” he asked me. “Just enough to know that you are asking for gloves,” I might have replied. Actually that wouldn’t be entirely true. I know three other very useful things in German (I won’t count the phrase, “That is a lamp” which was the very first thing I learned when I bought a German picture dictionary as a teenager). I know how to ask for beer of various kinds. And when I’ve had the beer, I know how to ask where the toilet is. But most importantly, I know the very useful word “scheiße” I always thing it is a very expressive word, and as my best friend when I was learning Norwegian was German, for me scheiße is a word that is screaming to be incorporated into the Norsk language. Anyway, back with the cherry-eyes, this time Magne encouraged me to sit at the end of the table instead of on the other side so that I could see better what he was doing. Perhaps having me sitting in the wrong place was a distraction however. He paused as he started to cut into the tissue and frowned. “What is it I have forgotten?” he asked, looking puzzled, but I couldn’t help. Then with a smile, he grabbed the head-piece with the magnifying lenses and placed them in front of his eyes. “I thought everything had suddenly got very small,” he said.

In all of this theatre work though, I feel I am seeing very little of Vivek, Guro and Jan-Arne which is sad. Perhaps if I begin to work sometimes on a Friday (the only day when there might be a room free) I will get to see them a bit more. In the meantime, I hope to spend some time with Jan-Arne at the weekend as he does some large animal work. Maybe if I’m really lucky, I may even get to bury my arm inside a cow. How about that for wallowing in nostalgia? Of course, at this time of year, with the cows just out on all that luscious new grass, nostalgia may not be the only thing I end up wallowing in. Only time will tell.

Blissful Ignorance

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Sunday this week: a lovely day, and the day I had arranged to go out and “see practice” with Jan-Arne. I had been hoping to do this for a while, but it had proved difficult to arrange. In the event I ended up seeing only one patient, though Jan-Arne did all that he could to drum up some additional business, first by telephoning the previous days clients to see if they needed a follow-up call, and secondly by driving me around the entire district in a vain attempt to run over an animal (or cyclist).

The single call was to a cow with mastitis. I walked into the barn and as with the small animal clinic, had an immediate feeling of coming home. I miss farm work so much. I love the sense of peace that I experience when I am in the presence of dairy cows. These large animals are so docile; they allow us to stand so close and rarely object to being handled, except now and then when they need to protect their calves and even that is mostly done with a doe-eyed gentleness. But there is also a sense of community in farming that is so very different from city life. Years ago in Scotland, working in a dairy practice, I felt almost (only almost) as if I belonged. I wasn’t born to it, and yet as a vet there was a sense of integration. I was wanted and needed within their society, and it is that feeling of belonging that appealed to me, almost as much as the animals themselves.

There were some interesting differences. Norwegian farms are strict on biosecurity. I was fascinated to see the gigantic pair of wellington boots that the farmer’s wife brought out from a cupboard. They fitted right over Jan-Arne’s trainers and he clomped around with feet like those of a yellow elephant. I had to make do with special plastic wellington boot covers. I had the tremendous feeling that I could just walk back into that lifestyle. It all felt so similar to the old days that I could almost see myself there.

Any delusions about that were shattered later when we visited a farm where Jan-Arne was friendly with the family. We looked at a couple of their bottle-fed lambs and all the time the conversation was rattling on around me. I couldn’t follow a word and the farmer couldn’t speak any English. They had a lovely young daughter though, who kept grinning at me conspiratorially. She wanted to show us her pet lambs and tried various methods to capture them, including an attempt to entice them with some food. Afterwards, she raced around the field chasing them, a streak of pink in a pair of purple wellingtons, childish hair flying everywhere. Finally she managed to catch one, a sturdy black lamb of a traditional Norwegian breed. My biggest regret of the day was that in my haste to leave the house I managed to forget my camera. Jan-Arne very kindly offered to take some shots of the field and the child and the sheep and here they are…

Jan-Arne's Sheep 1

Jan-Arne's Sheep 2

Jan-Arne's Sheep 3

Always difficult to get a good action shot, but it was a beautiful setting on a wonderful day.

The biggest revelation occurred when we got back to the practice where I had left my car. Jan-Arne pointed to the house next door.

‘I wonder if Magne and Gerd are in there, enjoying their day off,’ he said. ‘Did you know they lived there?’

Did I know they lived there? My mind was screaming.’Magne and Gerd are married?’ I managed to croak it out at last.

‘Didn’t you know?’ He was laughing at me.

Amazing the things I fail to register. Everyone else knows presumably and maybe they just forgot to tell me, but more likely I missed it. Perhaps they stand and chat at the desk about what they are going to have for dinner. I have no idea because after so long in Norway, my brain just switches off when other people are chatting to one another. They could be talking about me, and I would remain in a happy state of oblivion.

I realised recently that this was, in many ways, a blessing. When I return to Scotland, it always comes as a shock to overhear conversations which my mind automatically processes. There are so many preconceptions based around accent and word use, instant frustration at the banalities of life. Here I escape all of that. I wouldn’t change it, even if it means that occasionally things pass me by. I wondered recently whether this must be like for a young child, having a mind that passes over incomprehensible things that don’t really matter.

When I discovered Magne and Gerd were married, it leaped into my head that I should be worried about whether I had ever said anything reprehensible about one to the other, but of course I was able to dismiss that in an instant. I just don’t have those kinds of conversations. I would love to say I have never said anything offensive about anyone, but of course, there is Scary Boss Lady. Apparently the other staff found “All Change” so amusing that they had to tell her and she read it. Since then, she has tried to convince me she isn’t scary. She even appeared one day in a poncho with the words “Love Me” woven into it. I left no doubt, she told me over a mammary tumour, that it was her I referred to. In case there was any confusion, I had clearly stated “Dagny, the scary boss lady”. She tells me that it will follow her now. Even at the Christmas party, she is in no doubt that her name-tag will read “Scary Boss Lady”. Still, she can’t have been too offended. Apparently she told her friends in the cycling club about me on a train journey. I can imagine their wide-eyed shock as they asked her, “Did she know you would read it?” Of course, I didn’t know. But I was aware it was possible, because I had already friended some of the others on Facebook. Ah well, it’s always a good idea when starting in a new job to begin on good terms with your boss!

Always Wet in Norway

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And so we have returned from our wanderings in Denmark and the UK. I will upload some holiday photos shortly. We arrived home in a rain-storm very late on the 6th of August. Allegedly there had been warm weather the whole time we were away, but despite exhaustion from our journey, undisturbed sleep was impossible due to the most incredible thunderstorm I have ever (mostly) slept through. Periodically I was awoken by an explosion of thunder (it only rumbles when it’s a long way off; when the lightning is almost upon you the sound is like the crack of a shotgun) so loud and so brief that it felt the house was under siege. I was vaguely aware that it seemed to be going on for hours. The full extent of the attack only became visible in the morning when dawn dragged the world into some kind of daylight. The field behind our house was under water, and there was a river flowing through the farm that hadn’t been there before.

A new river.
A new river.

Remarkably the cellar was still dry, but as the water rose it started to fill. Unlike Noah we were unprepared, so instead of relaxing and gradually unpacking the car, we spent the day removing everything from the cellar that we could shift in time. The washing machine, freezer and fridge all had to go. Most of the food, the bottles of wine on the lower shelves, all the tools and batteries and drawers full of debris, and still the water was rising. The neighbouring village had been evacuated. We were told this when we went to ask the neighbour if we could move our car onto higher ground. We didn’t know if we should try to get out but most of the roads were blocked anyway. Eventually, some time in the afternoon (five o’clock came round while I thought it was about lunchtime) the fire-brigade arrived and started to pump the water out of the village, over the main road and down into the lagoon beside the beach. Later still, a small fire-service van made its way through the water at the side of the house and knocked on our front door. An unnamed neighbour had informed them our cellar was flooded. Could they pump it out for us? We were immensely grateful, both to them, and to the unknown neighbour who had bothered to let them know our plight.

The view from the front door.
The view from the front door.
The wonderful fire and emergency services.
The wonderful fire and emergency services.

Various things happened while I was away. Kari Anna has had a beautiful baby boy. That much I was expecting. After my return, on Facebook on Sunday there suddenly appeared photographs of Irene dressed mysteriously as a bride. Strange, I thought, because when I went away she had no holidays booked. Monday morning there were pictures of a champagne breakfast. I confess I was a little saddened that in the photographs of these events there was no sign of the chicken-head mask but obviously her plans must have changed while I was away and I concluded it could be a little busy at work as she would undoubtedly be on honeymoon.

By the time I returned to work on Tuesday I was, at least, fully rested, though as sometimes happens, the practice was going crazy. It’s always that way with veterinary work. Some days there are no emergencies and other days there are so many that it is impossible to fit everything in. As soon as I was in the door, Marvellous Magne, smiling (mostly I think with relief, possibly there was some pleasure there at my return but there was no time for chat) grabbed me and asked me to help him put a dog on a drip. For the next few hours I was in constant motion. All the bottles of Virkon for cleaning the tables needed to be refilled. I did them one at a time. Setting up the operating theatre, I noticed we were down to the last sterile surgical kit. As I held up the testicle that Magne was removing, my mind was working through my plan of campaign. From there I moved smoothly through to get the steriliser in action, set up the machine to distil some water, and then back to help with yet another case. It was an unusual case, a dog which probably has an insulinoma, and so it has chronically low blood sugar. It also seemed to be anaemic, and so we got permission to give the dog a small blood transfusion from a generous donor dog. Having added some blood into one vein, we set to and removed some from another to send into the laboratory to assess the dog’s insulin levels. In the meantime, Magne set up a programme of medical treatment to try to alleviate some of the dog’s clinical signs.

More cases followed, and for the first time since I have met him, Magne seemed weary. I offered to finish up his operations for him. Falling to his knees in gratitude (no not really, he’d only shatter his kneecaps which would be quite incapacitating) he thanked me and disappeared. A happy moment for me as I love surgery. To my amazement as I escaped from theatre at about one, Irene appeared, hair still tousled and highlighted as in her wedding photographs. She had got married, but for practical reasons she wasn’t going on honeymoon until next week. I was immensely glad to see her.

Thursday was much calmer and there was more time to ensure everything was up-to-date. Most of the afternoon was spent clearing some of the shelves in the Prep-Room as part of it is to be walled off to create my new consulting room (scary boss lady has declared that it is hers, but obviously it’s really for me). Every little corner that isn’t in constant use is now taken up with towels, uniforms, dog and cat food, reams of toilet paper, bottles of washing up-liquid, and some very strange unidentified instruments of torture including padded rings encased in (generally rather filthy) bandage with metal bars protruding out at strange angles and a special visor apparently for dogs. Maybe they need to be protected from the riots that regularly occur in the clinic on a Friday night. There was just one classic Irene moment. We had retrieved some boxes from the paper bin (this really is the most glamorous job anyone could devise), and stuck them back together, I was packing one box with huge soap and detergent bottles, and Irene was packing a smaller one with washing up-liquid. To fill up the remaining space, we piled in packets of toilet rolls and as she handed me a pack, she remarked, “You’ll have to stick it in yours, my hole isn’t big enough.” Luckily I didn’t quite wet myself laughing, so the rolls remained wrapped up.

At the end of the afternoon, Jan-Arne showed me his new baby: a Toyota Auris Hybrid Stasjonsvogn. It’s not quite as beautiful as Kari Anna’s new son, but I think Jan-Arne is almost as proud.Jan-Arne's car

Scary

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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.

All the Wrong Words

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Back to my normal two day week this week, and Tuesday was a good day. Irene’s working times had changed so that she was starting first thing in the morning with me. It was great to know, as I prepared theatre and assisted with the anaesthetics, that she was there for back-up, assisting the other vets and generally carrying out the other million little tasks that sometimes get pushed aside. Whenever I escaped from theatre I found her clearing and re-organising everything. I haven’t been able to find the scissors since, however this seems a small price to pay when everything looks so beautiful. Actually there is another downside to tidying things away. After Irene and I so carefully piled all the toilet rolls into boxes and put them in the cleaning cupboard a couple of weeks ago, someone else couldn’t find them. Assuming we had run out, a whole new enormous batch was ordered and now the clinic is swimming in them. Still, at least all our bottoms will be clean and shiny at all times and that is always important.

I’ve had two comments this week on my use of the Norwegian language and the first of them came on Tuesday. As I said, that day things were well under control. Free to pursue my aim of ensuring everything was perfect in the operating theatre, I felt I was entirely ready on Tuesday afternoon for the dog that was coming in for a major operation on its leg. The anaesthetic machine was on. I had investigated carefully and found the correct instruments, I had additional suture materials and extra swabs. I had pain-killers all worked out and drawn up, and I even had the gentamycin at the ready in case they wanted to use some antibiotics at the surgical site. Imagine my frustration then when Dagny looked through the window in the door and said, “Oh, there’s no cushion and pad.”

I confess I was annoyed at myself. All the complicated stuff complete and I had forgotten something utterly basic. I couldn’t help myself. ‘Unnskyld,’ I muttered as Dagny loaded herself up with the items and strode into theatre.

As she heard it, she turned round. ‘You shouldn’t say that,’ she said.

‘Um…. what?’

‘You don’t need to apologise. You’ve been busy all day.’ Ah! That old thing.

‘But I have to apologise all the time,’ I explained. ‘I’m British.’ She just laughed.

Thursday was an interesting day. For months there have been suggestions that I should start to consult, but frankly I’ve been putting it off. There’s something very freeing about not having ultimate responsibility for cases. I know when I became a vet, that was one of the hardest things to come to terms with. However Irene, in her new role as Scary Boss Lady Junior had decided that the appointments needed tidying up as well as the prep room, and so in order to allow for additional appointments, she made me my own list. Admittedly it had only two vaccinations on it but it’s a start.

And on Thursday afternoon, I had more feedback on my Norwegian usage, this time from Wivek. In my head, there is this enormous enthusiasm for helping people. And so when asked for assistance, instead of just saying ‘Yes,’ or ‘okay’, I often use the word ‘Sikker’. Now ‘Er du sikker?’ translates roughly as ‘Are you sure?’ and therefore, in my mind, when asked for help, I was enthusiastically agreeing. And so it was left to Wivek to very gently break it to me that when you say ‘Sikker’… it’s pretty much equivalent to rolling your eyes and saying ‘If I must.’ Obviously as I am beginning to see clients now, it is quite important that I don’t make such an error. But how excellent that for all this time I have been quite inadvertently rude to Dagny so often. And I wonder whether that is why Magne has so many little smiles when I agree to help him. I always thought it was just because he liked me. Still, from now on, at least I know the difference. And perhaps, so long as she doesn’t read this, I can go on saying it to Dagny for a while. And then I can have some little secret smiles of my own!

And finally, somehow or other, I managed to miss the fact that last week was Guro’s last before she went off on maternity leave. One of the sad things about not working on Fridays is that I don’t always realise when important things are happening. Anyway, I’ve missed you this week Guro, and I wish you all the best for the coming weeks and months.

Build

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This week has been dominated by the construction of the new consulting room. The prep room has been unusable, partly due to dust, but more because of the noise. The crack of the nail gun causes immediate heart failure; I was only affected once or twice, but Jan-Arne died on several occasions. Marita also kicked the bucket in the dental room and I pointed out that in English this would be funny. For some reason, by the time I had explained that “kick the bucket” is an irreverent euphemism for dying, the hilarity was lost. Some things just don’t translate.

There has also been a rash of flank cat spays. Both Jan-Arne and Wivek had a go and the results looked very neat. As usual, the bubbling enthusiasm for trying new things is infectious. Scary Boss Lady’s cat, to my relief, was quite okay after last weeks operation, however Dagny, despite sharing the enthusiasm for new things, feels that except for nursing mothers, she will continue to use the traditional method as she can operate so quickly and cleanly already.

Somehow or other, I won the Smil again, partly because I had helped people with cat spays, but also for my anaesthetic skills on exotic pets and my apparent ability to hold onto cats that aren’t so very keen on being injected. I would love to feel I was an expert at cat-wrangling, however having seen British Veterinary nurses undertake this most dangerous of sports, I know that my skills are only a pale imitation of the real masters.

Irene spent Thursday defrosting the fridge in the kitchen. At some point, without me really noticing, an iceberg about the size of Mont Blanc had appeared in the left hand corner. So smooth and shiny was its surface that somehow I had believed it was an unusual curved part of the back wall, though what that says about my powers of fridge observation I’m not really sure. Still, armed only with a hairdryer and an enormous pile of incontinence pads, the intrepid Irene set forth to crush this enemy of refrigerator space. There was a moment of mystery half-way through when a small yellow Tupperware tub hove into view. After a few moments of frenzied hot-air, it was recovered but its content was sadly unidentifiable.

As I’ve said before, it’s never boring working at the clinic. Thursday afternoon was spent building some Ikea shelves. Dagny told me during lunch that she wanted my help. This sounded hilarious to me, because the Norwegian verb for assembling furniture is “skruer”. Again I tried some of my merry British wit by suggesting that after lunch I would be screwing with the boss, but nobody noticed. It actually fell to Leah and me to put the cabinet together and she is obviously very handy with a screwdriver. Sadly this is her last week for this summer, though she will be back at Christmas. Dagny commented during this process that I was always very quiet. I explained politely that while my brain was working, my mouth stood still, meaning that the translation process exacerbates my usual quietness, but someone else in the room (I think it was Jan-Arne, but I would be happy to be corrected) pointed out that the reason I was so quiet was because Dagny was always talking so much that I couldn’t get a word in. Of course the real reason, as I have probably said somewhere before, is that I like to live by the traditional maxim “Better to remain silent and be thought a fool than to open your mouth and remove all doubt”. It’s definitely a good ploy when you are working in such a crazy environment.

Dagny preparing to spay a cat by the traditional Norwegian method.
Dagny preparing to spay a cat by the traditional Norwegian method.

Cute

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The first thing I saw on Thursday morning when I got in was Dagny. Officially it was her day off, but she had received a message in the early hours of the morning about a whelping bitch, or more accurately, about a bitch that was not whelping, and by nine in the morning, Ninja’s owners had decided that she required some veterinary assistance. For the record, Ninja is a sweet little Chihuahua with big eyes, though when she arrived at the clinic, those big eyes looked definitely troubled. Not surprising because when Dagny carried out a vaginal examination, there was a puppy stuck in the passage.  Using plenty of lubricant, Dagny managed to draw the pup out into the world. Sadly despite all her efforts, the pup never started to breathe. An x-ray showed that there was another puppy, and by measuring its skull, Dagny estimated that it might still be born normally, and so instead of spending her time off relaxing, she stayed in the clinic while Ninja’s owners gave their pet some time to try to give birth naturally.

For me this could be only viewed as an opportunity. Thursday is the day that Irene has designated that the dental room and laboratory should be cleaned and maintenance carried out. I think everything in the lab is jogging along fine, but it was only recently I realised that there were weekly and monthly services to be carried out on the dental machine and that they weren’t being done. There is a sheet on the wall of the dental room that I hadn’t noticed, and on that sheet were daily and weekly spaces for initials. Leah had been doing the checks, but in the weeks since she left, the boxes have all remained blank, and when I checked with Irene, it transpired that she didn’t know either. Most of the time in between I have been distracted by other things, but now and then my imagination would go into overdrive as I pictured the whole dental machine seizing up through lack of oiling.

Dagny had tried to call the maintenance rep, but there was no reply and so  she suggested phoning Kari Anna, who is still on maternity leave. ‘After all,’ she said with a laugh, ‘It’s not as if she will have anything else better to do.’

This proved to be incorrect. Dagny held the phone away from her ear for a moment, and even I could hear the wails of the baby from across the room. Still, the dental machine is VERY important, and Kari Anna is VERY patient, so with her help, we managed to oil the handsets. All that was left then was to oil the compressors down in the bowels of the appliance, and so, by ten a.m., Dagny and I were crawling around on the floor of the dental room, pointing a handily discovered ultra-violet light into the guts of the machine.

There was a horrible moment when Dagny thought she had been pouring oil into the air-compressor itself, but happily, it did turn out to be the correct orifice (obviously it’s very important for a vet to get the right orifice).  Finally, the oil levels were back to the right place. As we finished, I pushed myself up from the floor and stretched. I fully expected Dagny to do the same, but for some reason, she was still on the floor.

‘I’m not sure if I should get up,’ she said. ‘This is my day off. Maybe I should just lie here.’  I offered to get her one of the cushions we use for patients, but she turned it down. She checked the time on her phone. ‘Actually,’ she said, ‘I should be at the gym,’ and before I knew what was happening, she had started to wave her feet around in the air.

I was taken away from all this excitement by Wivek. Her daughter had hurt herself at school, and as Wivek had run to work (what a healthy lot of people I work with) she had no car. I drove her to the school, but happily it transpired that the injury was not as serious as had originally been thought. I arrived back at the surgery to see Ninja and her owners taking a walk down the road and I assumed all was well, but when I went back in, I discovered that they were still waiting for pup number two to arrive.

She returned from her walk, and still was making no progress, and so finally Dagny and Ninja’s owners decided  it was time to go ahead with a Caesarean.  Dagny is a quick and decisive surgeon, and so within a very short time, the gorgeous little pup in the photo at the top of the page was born. It’s always lovely to see how all the staff gather round to help when there is a newborn to be revived. Somehow, even after years in practice, there is always something magical about the gift of birth.

Ninja still sleeping while her pup begins to explore.
Ninja still sleeping while her pup begins to explore.

 

 

 

 

Metzenbaum Meltdown

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It’s been a week of instrument incidents this week, at least on Tuesday anyway. I didn’t sleep well on Monday night, and by nine o’clock on Tuesday morning, I confess I was wafting round the practice, trying to be all efficient. It wasn’t easy. Somehow the standard tasks of ensuring the rooms were well stocked with needles and syringes seemed unusually complicated. I thought I was finally getting into my stride though, as I emptied the instruments from the autoclave, put them away, and packed up a raft of new kits for sterilisation.

Irene came into the room at this point and started to chat. My brain being otherwise occupied (the routine tasks were taking up all of the limited space in my one cylinder brain) I looked at her vaguely and failed to answer to her satisfaction. She looked at me with narrowed eyes and her head on one side.

‘Are you tired this morning? You’re not usually this quiet. I went to a concert last night. I’m tired.’

I admitted that I wasn’t at my best. My inclination was to remain silent, but it seemed impolite. ‘What concert did you go to?’ I had to try to appear normal at least. She named a singer I had never heard of and I tried to carry on the discussion as I set up the autoclave to sterilise the instruments I had just packed.

The autoclave has something of a pre-set routine. When you first switch it on, it automatically says that the door is open, and the locking mechanism doesn’t work until the programs become available. So I meticulously emptied the outflow, ensured the distilled water was topped up and then, to pre-empt the frustrating period when the door won’t lock, I carefully pushed the door to and set the locking mechanism in place. With a sigh of relief that everything was beginning to settle down, I turned my back as the machine began to run through its program. Irene had continued chatting, but now she was looking at me with a very confused look in her eyes.

‘So what’s in the autoclave?’ she asked. I frowned at her for asking such a crazy question. Obviously the packs I had just set up so carefully, but her eyes weren’t looking at me. They were directed towards the neatly stacked rack with the kits all neatly packaged in their white paper parcels. I had just set the autoclave off on its hour long programme with nothing inside.

All day long, I seemed to be all fingers and thumbs. There had been a spell lately when it seemed I was unable to do the simplest task without dropping something on the floor, and on Tuesday the effect was magnified. Opening up some suture material while Dagny was operating, I thought that rather than risk handing it directly to her from the package, I would drop it on the instrument table. Of course, it flipped out of my hands and missed by several inches. Somehow, every needle I used became detached from the syringe. I spent so much time running in and out of theatre to get new ones that I began to worry that someone would comment. It was a relief therefore when Dagny, usually so efficient, managed to drop the straight scissors from her kit. I retrieved them and offered to get a new pair.

‘I’ll need some Metzenbaums anyway,’ she said ‘you can just get some of those and I can used the curved scissors for everything else.’ Metzenbaum scissors are long slim scissors designed to cut delicate tissue. I collected a pair from the instrument cupboard. Once again, Dagny being occupied with her operation, I decided to drop them directly onto the instrument table. I should have known better. They too slipped to the floor with a clatter that seemed so loud in the quiet operating room. Fortunately, Dagny was not in Scary mood (in fact, she has been so unscary lately, that if I didn’t know how much she loved her nickname, I might feel the need to change it) and she just laughed and asked if we had another pair. At this point, Magne, ever the gentleman obviously felt that he should join in with this game of throwing things on the floor and dropped the chuck-key of the drill. Really I didn’t feel so bad then. The final flourish occurred as Dagny was stitching up. As she went to set the scissors back on the table after cutting her suture material, she misjudged it and the last pair went toppling to the ground. She completed clipping the line of sutures using a scalpel blade. Obviously the idea of asking for yet another pair seemed too high a risk. After all, judging by earlier events, I probably would have stabbed her in the toe.

Thursday, thank goodness, was much more relaxed. Dagny’s sister-in-law brought in her lovely little dog (that’s him in the picture at the top of the page) to be castrated. In contrast to Tuesday, theatre was a hive of extreme efficiency. I’ve never seem Dagny operate so swiftly. So much so that I barely had time to stabilise the anaesthesia before it was time to switch the machine off. I spent the rest of the morning discussing some modification of the anaesthetic regimes with Wivek, who is thoroughly knowledgeable in this, as with so many other things. We want to be sure that the patients are as comfortable and as safe as possible during surgery, and so we are reviewing the analgesic (pain-relief) protocols. When all is said and done, however many times you throw your scissors on the floor, in a good veterinary practice the well-being of the animals always comes first.

A Little Bit Crudie?

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This week saw my return to work after three weeks off following my operation. I was delighted to be back. There is so much more humour at work than on the Jeremy Kyle Show. Having checked all the other rooms were stocked, I found myself in Magne’s, where as happens every now and then, he asked me a question about an English word he had come across.

‘What does crude mean?’ he asked.

I found myself wracking my brains over that one. It definitely depends on context. Crude oil and crude humour are rather different. Both imply that the things they describe are unrefined, but that word carries almost as many difficulties. We discussed crude oil (because that one was easy to explain) and of course, being me, I had also to try to explain crude humour. ‘A bit rude’ doesn’t really cover it. Finally I think I got through when I told him that farting jokes would be a good example.

Of course, none of this got us any further with translating his medical text. I asked him if he could clarify, but when he said ‘it said that the cells were crude or something,’ I was more confused than ever. Finally he found the text and it described the cell collection technique he had used as ‘a crude method for detecting oestrus’ so finally we were able to get to the bottom of it.  As ever though, Magne, when presented with a new word, and especially one attached to humour, was unable to drop the subject. He spent the rest of the morning asking me. ‘Is that a bit crudie?’ ‘Is this a bit crudie?’ Of course Scary Boss Lady then wanted to know what we were talking about. She asked me whether my humour in this blog was a bit crude, so I pointed out that mostly I wasn’t crude. I was just rude and mostly to her. She seemed happy with that.

Thursday morning’s computer check revealed that I had a patient coming in to see me at 9a.m. Lucy was to have her claws clipped under sedation. Her owner had asked to see me… the first time that has happened here. I was delighted, especially as Lucy is such a lovely dog.  It all went very well. My only failing was to forget to ask to photograph her before she went to sleep. She was just waking up when I took the photo at the top, but I think she’s gorgeous.

Despite being very happy to be back at work, there were some complications. I’m not supposed to lift anything for six weeks so I had to ask other people to do all my heavier tasks. Gerd carried the water distillation container, Marita carried the reagent box from the blood biochemistry analyser, Irene carried the big soap bottle and put away all the dog food. We have a new nurse as well who started on Monday, Jacqueline, and she helped too. She’s been in the practice before, and so she knows her way around. Really I was very well looked after. Despite all this, I found myself quite sore by lunchtime on Thursday. Realising this, Dagny sent me home. She keeps trying to pretend that she is only worried that I will take more time off, but really I can see through the disguise.  I was hugged by Marita and Jan-Arne too and Irene wished me ‘God bedring’ (Get well soon) before I left. Really it’s lovely to be back.