Tag Archives: Jan-Arne

Happy Birthday

Tomorrow is Jan-Arne’s birthday and at nine o’clock this morning, I received a message from Wivek to say that she and Marita were planning a special lunch for him at the clinic. I immediately wondered how I could contribute, and after some careful questioning, I managed to ascertain that whilst the savoury food was all planned, they were lacking a coherent cake strategy. Armed with only butter, eggs, flour sugar and cocoa powder, I began to throw something together. Luckily I also found some decorations hiding in my cupboard and so with only moments to spare, I made it in on time to join in. The other food was delicious. Marita had baked the most fantastic focaccia and aioli, and Wivek had provided a wonderful chicken salad. Somehow or other, I failed to take a decent photo of either, which is not like me at all. Like many food worshippers, usually I can’t resist taking photos of beautiful meals. Still Jan-Arne certainly looks happy.

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Last weekend, Tu Klinikk held its first CPD weekend on the subject of anaesthesia. CPD is vetspeak for Continuing Professional Development and in the UK, all vets are required under their agreement with the Royal College of Veterinary Surgeons to do an average of thirty five hours each year. The requirement in Norway is not quite so stringent I understand. More a recommendation rather than a requirement, as it was in the UK until only a few years ago.

Anyway, the subject of the weekend was anaesthesia. I confess I was delighted by this as I have spent a good part of the year working as anaesthetist for Dagny and Magne. It is unusual outside of the universities for vet practices to have a dedicated anaesthetist who is a fully qualified vet. Generally the vet who is carrying out the surgery also technically oversees the anaesthetic as well, and the patient is monitored by a nurse (or more rarely, an assistant). I find it very rewarding to have a ‘specialisation’. The lectures were in Norwegian (the lecturer came from Oslo). In the morning this was fine. I found I could follow quite easily, though my one-cylinder brain stopped translating as soon as I tried to write anything down so I had to make do with listening very carefully and plucking at Wivek’s sleeve at the end of each section for the bits that I knew I should have noted down, but didn’t manage.

I also managed to answer some questions that the lecturer posed about anaesthetic circuits, though slightly to my chagrin, I had to answer in English. I still don’t actually know how to say “one-way valve” in Norwegian, though as Wivek already laughed at me for my translation of “gas-flow rate” on my poster in theatre, I should have remembered that I really didn’t have to translate that one, other than adding an extra “s” onto the word gas. Just to make it more Norwegian you understand.

On my return to the practice on Tuesday morning, I discovered that Dagny and Magne had invested in some lovely new kit in the form of a drip driver, an infusion pump and a new oxygenation unit, so we will be able to make some positive changes to our anaesthetic regime. Whilst I fumbled through the set-up on my first run-through, it was obvious that Tornado Tawse already had everything running as smoothly as a weir in high summer. I only wish I could make everything look so effortless.

Infusion pump and syringe driver.
Infusion pump and syringe driver.

Wivek, true to form, was the first to use the new anaesthetic kit, putting her first heart-murmur dog on a propofol infusion. Like Jacqueline, she too seemed perfectly calm and utterly self-contained. I must say I was relieved when she confessed to me later that she thought that her own heart was hammering away far more rapidly than the happily anaesthetised patient.

Feeling that I had to make some contribution to this wonderful new era, I managed to create two pages of flow rates for ordinary surgical patients and shock patients, but the final task I set myself on Thursday afternoon was the rather complicated calculation required to work out the flow rate for post-operative patients where we won’t be using the drip driver. To give a brief oversight, you first have to work out how much fluid the patient will need in an hour. From that, you have to calculate how many millilitres will have to pass through in a minute. Then you have to work out how many drops that will be… and finally you have to split the minute into that number of drops so you can give a “time between drops” specification. Given that there are also two types of giving sets: one that gives 20 drops per millilitre, and one that gives 60, it is perhaps unsurprising that my brain came unstuck somewhere in this process and exploded messily all over the computer screen. Fortunately Jacqueline was there to clean up the vetty mess before anyone noticed. Just as well she’s as patient as she is efficient.

Happy birthday Jan-Arne.

Cake worship.
All hail the chocolate cake..

 

 

Jan-Arne and the Well Preserved Eye

Intravenous catheters can be frustrating things. When I was working in the emergency clinic, almost every patient we admitted had to be put on a drip, so back then I got quite good at inserting them. Nowadays it seems a bit more hit and miss. There’s a definite pattern though. If I’m on my own, generally I can get them in without too much problem. Under the benevolent gaze of Magnificent Magne or Jan-Arne, it’s usually not too difficult. But both Dagny and Wivek make the thing look so simple that I seem to go to pieces whenever they are watching. Dagny doesn’t even have to be watching. She only has to be in the room for the difficulties to take effect.

Early on Tuesday morning, Dagny had all her kit laid out for an operation and (tactfully) wasn’t watching me in my attempts, but stood chatting to one of the other staff. The dog was a dachshund, and its legs were so short, that even after I had shaved quite an extensive area of its foreleg, its body hair was so long that it obscured almost everything. With shoulders that were becoming decidedly tense already, I selected the smallest possible catheter and took aim. Slipping the stylet through the skin, I was encouraged by seeing a tiny droplet of blood moving up into the breach. Quickly, I slid the needle a nanometer further in… and the bleeding stopped. I had gone right through. Trying to keep my breathing steady, I withdrew a little, but it wasn’t to be.

I decided at that point upon a tactical withdrawal. Often it is better to start again with a fresh catheter, which can’t be blocked and hasn’t been blunted by its first traverse through the skin. Selecting a slightly bigger catheter (sometimes this works better as they are less flexible) I set the tourniquet back in place to raise the vein and once again tried heroically to keep the hair out of the way with the final two fingers of my left hand whilst still stabilising the vein between my finger and thumb. This time, the catheter went into the vein, but when I tried to slide the sheath down off the stylet, it just bent. Through all of this, Dagny had been carefully not watching, but I could tell she wanted to get on. I confess I was relieved as she finally elbowed me out of the way and did it herself. A few moments later, with the catheter triumphantly in place, she looked around for the laryngoscope so that she could put the tube into the trachea for the gaseous anaesthetic but it wasn’t there. Ever efficient with her cleaning, Irene had already tidied it away.

A little later, and another dog, this time a little pug dog (or mops, as they are called here). This one was having its corneas treated with the cryoscope. Marita came into the room and began to ask Dagny about the freezing effect, and how strong it was. Ever the scientist, Dagny thought it would be a good idea to try it on herself. She held it against the back of her hand for a moment.

‘It’s not sore,’ she announced airily, and moved the tip to a different place with a smile.

‘Ouch!’ A moment later, she was staring at a white mark on her skin- ‘Okay,’ she admitted ruefully, ‘Maybe it does hurt.’

Jan-Arne managed to injure himself this week as well.  On Wednesday, he had taken a biopsy and opened up the small container filled with formaldehyde that would preserve the sample while it was sent to the laboratory. With an aim that he presumably couldn’t recreate, even if he tried, he managed to drop the sample into the pot in such a way that some of the formalin splashed up into his eye. After much salt water washing, he was packed off to the doctor’s to get it checked over. Fortunately there was no permanent damage.

He has though, been evilly trying to tempt me with birthday cake all this week. He brought in the leftovers on Tuesday. Heroically I managed to resist. I’m not really sure how many birthday cakes one person needs, but he seems to have been very well supplied. Then again, he’s so generous to everyone that he deserves good things in return.

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The remnants of the cake were still there on Thursday, but I confess I found it much easier to abstain. Also, someone had brought in a pack of freshly baked boller. Boller are widely available in Norway. They are a kind of sweet bread roll or bun, often with raisins or chocolate chips inside. These ones had bits of Smash: chocolate with caramel and salt. After taking one and eating it, Irene announced that she had discovered a new taste sensation. Jan-Arne and I, both foodies, were looking at her very intently.

‘I had a piece of the boller with a bit of cucumber,’ she said, with wonder in her voice. ‘It was lovely.’

There was wonder in my head. Specifically I was wondering whether such a combination could possibly be delicious or whether Irene had finally lost the plot. I hadn’t come this far with my resistance to eating extraneous sweet things lightly however, and somehow I managed to curb my enthusiasm towards this idea.

‘You could design a new boller,’ Gerd offered. ‘An Agurk Boller.’ (Agurk being Norwegian for cucumber).

‘A Cucumboll?’ suggested Marita.

‘What’s English for boller?’ Irene asked.

‘Bun,’ came the reply.

And so the CucumBun was born. At least it will be, when someone takes the time to make it.

 

Todays picture is Chika who was in for her first vaccination.

Guts

It’s been a week for exploratory laparotomies. For those who don’t know, a laparotomy is a surgical cut into the abdomen, so an exploratory laparotomy is where that surgical cut is carried out to investigate what is going on. Despite the fact that we have many ways to explore inside animals without surgery such as x-rays, ultrasound, or even simple palpation (still a valuable tool) sometimes there is no way to be certain whether there is a serious problem without opening up the abdomen and having a look.

My photograph is of Anette, a seven year old Cavalier King Charles who was thought to have eaten part of a towel. Happily for Anette, the towel had already passed quite a long way through and Magne was able to manoeuvre what remained down towards her rectum. I was the happy person who went in to retrieve it.

It is much more complicated however when it is necessary to cut into the intestine to remove the foreign body. There is a risk of contamination of the abdomen (any leakage from the incision either during or after surgery leads to peritonitis). Hardest for me is when there has been damage to the intestine. It can be a difficult decision whether to open and remove the object or to remove the entire section of gut which has been damaged.

Removing a section is technically more difficult and there is more risk of contamination afterwards, but if the damage to the intestine is severe, it may never recover. For me, those kinds of decisions can be the hardest part of veterinary practice. There is always a tense period after such an operation before you can be sure that the animal is going to recover. I don’t know whether other vets spend so much time agonising over such decisions post-surgically. I suppose though, it is that which drives me to want to be as good as I possibly can.

Jan-Arne assisted me with two of the operations. The final one was on Wednesday and he had asked me on Tuesday whether I could come in specially for an hour or two to help him. I was delighted to do so. He is always so keen to learn new things. I was also happy because for the first time since I have been working at Tu, Charlie had taken a day off work and was able to come and see round the practice and join me in theatre.

He watched with interest and also chatted quite a lot to Jan-Arne during the process. Jan-Arne, as I have said before, works as a large animal vet sometimes, generally covering out-of-hours work such as nights and weekends. Charlie was impressed, as am I, by his unending enthusiasm. Having spent a number of years in large animal practice ourselves, it is hard to imagine relishing taking on additional out-of-hours work on top of working more full time already, but Jan-Arne genuinely loves these opportunities to work with farm animals.

I haven’t talked too much about his history, but I am genuinely in awe of the way he lives his life, making the most of everything that comes his way. He told me that in school, he always wanted to be a vet, but the careers advisor threw cold water over the idea, and his young self lacked the confidence to tackle the heavy requirements that are necessary for entry into the veterinary world.

He spent, therefore many years working in hotels, administration and marketing of telephones. In his thirties however, he was struck down by horrendous pain from a neck injury following a car-crash he had in his mid-twenties. Faced with life-threatening surgery, he made the decision that if he came through, he wanted to follow his childhood dream to become a healer of animals.

He became the first Norwegian man to qualify as a veterinary surgeon from the University of Veterinary and Pharmaceutical Studies in Brno in the Czech Republic. Continually inspired by his dedication and love for animals, I am very proud to work alongside him and the other vets, nurses and assistants who make such a wonderful team.

 

The Return of the Triumphant Polar Explorer

And so, the Scary Boss Lady returned triumphant from her travels in the cold, cold North. She had seen a polar bear, she told me. I presume she learned some stuff about eyes as well. I forgot to ask if the polar bear had healthy corneas, but I’m sure she would have mentioned it if it had needed treatment. She did bring back some pictures. This is my favourite.

polar 3

The hand belongs to Dagny’s husband Sondre, so that is a pretty big paw-print. The actual photos of the bear are very distant, but the place looks stunningly beautiful.

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And they did see some Svalbard reindeer.

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Meanwhile, back in the real world, the weather has been quite warm some days this week. So much so, that the first of this year’s flies appeared in the clinic. I couldn’t find the fly swat, so when the evil menace entered the operating theatre, I had to create a cunning fly opening by propping the doors outwards to encourage it to remove itself. Happily I didn’t make the same mistake I made last year when I announced to Dagny and Magne that there was ‘et fly’ in the room. They managed to keep straight faces, despite the fact that I had just told them there was an aeroplane buzzing around their heads. A fly in Norwegian is ‘en flue’. It’s an easy mistake to make.

Tuesday was a good day to forget my lunch. As sometimes happens, I remembered about five minutes into my journey that I had left it lying on the side in the kitchen at home, and as I never set out with more than five minutes to spare, there was no time to retrieve it. Fortunately there was a rep in from Bayer, who brought the usual inducements to buy their products in the shape of a few sandwiches and a bowl of chocolates. It’s good that big pharma likes to spend so much in bribes. Actually I had to laugh the other day when I realised the pen I had in my pocket was actually a Vets Now pen, presumably purloined from some conference or other. Those things get everywhere. It was a nice reminder of a happy past.

Thursday saw Wivek carrying out some major dental work on a dog. As we don’t have gaseous anaesthesia in the dental room, we often rely mostly on deep sedation for doing dental work, but as she was potentially going to be working on the animal for up to three hours, she wanted something that would remain reliably stable for much longer. She therefore used the new infusion and syringe driver to give a complex mixture of anaesthetic and pain-relieving drugs and we used the new oxygen pump for breathing. It all worked like a dream. I monitored the breathing and pulse for her and she achieved wonderful stability. I have always been a big fan of gas anaesthesia, but I could definitely be converted.

I had a slightly bizarre experience on Thursday. The washing machine and tumble drier are in the changing room area of the clinic, as is the toilet. As I stood unloading the machine and folding up the clean washing, Jan-Arne rushed in.

‘I have to go to the toilet,’ he said with obvious urgency. I took some of the uniforms through to fold them up in the next room as I had no great desire to listen, but the next moment, I heard the skirl of bagpipes emanating from behind the door. For a mind-blowing moment, I wondered whether Jan-Arne was actually Scottish. After all, only a true Scot could possibly blow that kind of noise from his bottom. But then it dawned on me.

‘Are you using your iPhone in there?’ I asked.

‘Oh yes,’ he said, obviously perfectly happy that I was there. Men are strange creatures.

Towards the end of the day, I was chatting to Dagny and she was trying to send me her is-bjørn photographs. It was taking ages (maybe Jan-Arne was on the toilet again). Marita walked in.

‘I just had a telephone call from a boy, wanting to know how long it would take for a rabbit to get pregnant if the boy rabbit and the girl rabbit got in together. I told him about five seconds,’ she said with a grin.

Dagny put her head on her side. ‘Oh no,’ she said. ‘I don’t think that’s right.’ She paused for a long moment for effect. ‘Not SO long as that,’ and we all laughed. It was the perfect end to a very pleasant day.

 

This week’s picture is of Jan-Arne’s dog Susii Because he chats to his clients enthusiastically about his own pets, those who have similar dogs tend to want to see him again. It always amazes me how many cute little brown dogs make their way onto his patient list.

 

Party Animals

“It’s a tough job being a vet, but you can never ruin our appetites.”

Wivek came up with this statement last week. I went in to join my colleagues for lunch on one of my days off and as I had arrived a bit early, Wivek collared me and dragged me off to her consulting room to show me a particularly unappealing case. We do get all sorts of unpleasant things in to deal with, from stinking abscesses to rabbits that are infested with maggots. Yet as soon as someone says “It’s time for lunch,” we can be immediately ready to eat. Of course, we would never leave an ongoing case that needed treatment. Sometimes, if it’s just too busy, we miss out on lunch completely. But there is almost nothing that occurs with animals that would put me off washing my hands and going off to devour whatever delight I have with me.

I do seem to have done more socialising this week than actual work. Tuesday was very quiet and Thursday was a day off for ascension day and on Wednesday night, Irene had a party. Not just any party, I might add. This was a Singstar party. If (like me about two weeks ago) you have no idea what Singstar is, it’s a PlayStation video game where two (or more) people compete by singing along to a music track. I confess that I found this concept almost as appealing as being poo’d on by an elephant with diarrhoea, but with promises of Jan-Arne’s sweet potato fries and Marita’s wonderful focaccia, I was finally convinced that there might be enough positives to make up for the potential trauma of making an absolute ass of myself.

I needn’t have worried. Having arrived unfashionably early (like about an hour before anyone else) to Jan-Arne’s party a few months back, I checked carefully with Irene what time things would be getting under way. Having been told I could get there from about seven (and help set things up) I finally managed to get out of my own front door at about eight-fifteen. Obviously I have a talent for arriving at the wrong time, whenever that might be. Still, there was much food preparation still taking place. Jan-Arne was rushing around dressed in shorts (and at one point a pair of blue light-up cats ears) trying to get three enormous trayfuls of sweet-potatoes to turn crispy. Wivek arrived with her dog Ida (pictured at the top of the page) clutching an enormous meringue base and a punnet of strawberries. Meanwhile Marita and Per Egil were bashing into the wine, presumably in a (very sensible) attempt to ensure their vocal cords were suitably lubricated to allow them to sing beautifully.

In the event, the food was wonderful. And I only managed to stay for three songs (none of them sung by me) as I had to dash off and collect Charlie from the airport. Despite my best efforts to convince him to return to the party with me, he politely declined. Obviously when it comes to being a party-animal, he’s more of a Scottish wildcat than a friendly lion.

Anyway, enough of the words. Time for some photos.

Not sure the screen was quite big enough.
Not sure the screen was quite big enough.
Mesmerising Marita. Focaccia queen.
Mesmerising Marita. Focaccia queen.
The nursing team: Kari-Anna and Jacqueline
The nursing team: Kari-Anna and Jacqueline
The Pussy Cat Doll (and Wivek)
The Pussy Cat Doll (and Wivek)
Ooooohhh... Young Maaaaan!
Ooooohhh… Young Maaaaan!
Turtally gorgeous
Turtally gorgeous
Jenny and her Australian friend (sorry, I can't remember your name)
Jenny and her Australian friend (sorry, I can’t remember your name)
Per Egil: Singing Legend
Per Egil: Singing Legend
Beautiful Ena wants to dance with somebody
Beautiful Ena wants to dance with somebody

 

The real stars of the show
The real stars of the show

 

 

 

Waltzing along

This week’s blog is going to be brief. Not only are we off to Scotland tomorrow for a wedding (Charlie has spent the last three hours on the computer writing his best-man speech) but also due to the impendingness of next week’s surgery, my brain has become as flaky as a West Highland White terrier with atopy.

Dagny’s neighbour Matilde has been in doing work experience this week. She has amazed me with the way she mucks in and helps with clearing up and holding things. I confess that when I was 14 or 15, I would probably have been too scared to touch anything without being specifically asked. She has also been with Dagny and me in the operating theatre watching some quite gory stuff. Again she impressed me by looking on with interest as Magne wielded his bone drill, rather than horror or faintness.

Of course, even my initial interaction with her showed signs of my erratic brain. I asked her on Tuesday morning what her name was, and completely forgot to tell her mine. Fortunately Dagny was there to remind me. I was trying to remember though, how introductions tended to occur back in Scotland. Here in Norway, it is a very set thing that when you meet someone new, you shake their hand and introduce yourself. Whilst this is probably very practical for most people, my available memory is now smaller than that of a fifteen year old laptop so within three seconds I have forgotten. Still, I suspect in Scotland that there might have been occasions when I could get through a whole week of work-experience student visits without them ever knowing what I was called. If they were lucky, the receptionist probably told them. Despite the readiness of the words “Sorry,” and “Thank you” on my lips, I fear that the reality is that I am just terribly rude sometimes.

Still I have been pleased to go into work this week. The (probably unwarranted) adrenaline flow over next week’s tonsillectomy has made me jumpy and there’s something reassuring about arriving in the morning and going through the consulting rooms to check the drawers whilst automatically assessing how many surgical kits are awaiting assembly and whether there is enough distilled water. Routine is my friend. As are Irene, who noticed I was quiet and gave me a hug, Wivek who is driving me to hospital next week, Marita who helped me with a dental this afternoon, Dagny, who told me to take the rest of Tuesday off after I have been for pre-op blood test and check-up, Jaqueline, who volunteered to speak to the owner of the dental so I could go home and Jan-Arne who made me laugh when I walked into the changing room and found a cuddly man there dressed only in a pair of stars-and-stripes boxer shorts. How lucky I am.

So I’m not sure whether there will be a blog next week. I will be in hospital overnight from Wednesday, hopefully home Thursday. Who knows, maybe something will happen on my ward that is so ridiculous that I can’t wait to share it with you. Au revoir mes amis. See you all soon.

 

This week’s photo is of Mika, who had been managing to lick his stitches. Hopefully his new, larger buster collar will discourage him. He is just as cute as he looks!

Touched (in the Head)

It seems like an age since I have written here. In my last post I was about to head off to Scotland. That weekend already feels like a distant memory. It was a wonderful wedding. I won’t share all the details, but just as a random sample of how great it was, here are some photos of the venue and the  wedding cake.

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The day after I returned was a whirlwind of hospital appointments and seeing Charlie off to the airport and then suddenly it was Wednesday and time for my operation. Wivek very kindly drove me to the hospital, and to my surprise (and relief) rather than dropping me in the car park, she accompanied me up to the ward, helped me find where I had to go and then waited with me until the nurse arrived. I was bundled into a bed and given some pain relief. I don’t know what it was, but somehow I managed to fall asleep and they had to wake me up to take me into theatre.

I came round a while later to be presented with some ice-cubes to suck. These were oddly soothing, but there was a horrible taste in my mouth and I remember a strange moment of overwhelming gratitude when the nurse came over to me proffering a lurid pink and yellow ice lolly.

At some point I was reunited with my mobile phone and it struck me that it might be a good idea to let my nearest and dearest know that I had survived. Having sent a boringly factual message to Charlie, I then concluded that I should also let Wivek know. I’m not sure what kind of madness seized my brain at this point. Rather than repeating the factual tone, my fingers sketched in the abstract statement ‘Ice-cubes are my friends.’ At least I think it was something like that. Having typed this gibberish, my clouded brain then decided it would be a good plan to include Dagny and Jan-Arne. To their credit, Dagny and Wivek just wrote back saying they were glad.

Jan-Arne however was obviously confused. Unlike the other two, I suspect that he didn’t have my number programmed into his phone, and faced with some random babble about ice-cubery, he rapidly texted back ‘Que?’ Followed by another message saying ‘Who is this?’ When I let him know it was me, he decided to call me. Goodness knows what I sounded like with a swollen throat and a brain filled with opiates, but it was lovely to hear his friendly voice.

At some point, the surgeon also very kindly visited to let me know that although they wouldn’t have the definitive pathology back for a week or so, there had been no sign of anything severely wrong with my tonsils. As the reason I skipped the waiting-list was that there was some concern over my history of melanoma, this was an enormous relief.

Anyway, my two weeks off raced past in a blur of writing (trying to get Ready. Vet, Go edited in time for a summer onslaught of literary agents) and Come Dine With Me on the TV. In defence of my (appalling) taste in TV programmes, I must say that I only watch such drivel when my brain and body are drained.

And so yesterday, I returned to work. I had been there less than an hour when I began to feel shaky and exhausted. Somehow, everyone but me was swamped with work and this was doubly frustrating as a vomiting cat had been booked in for me and left by the client, and despite having time to spare, without another pair of hands, I was unable to examine it. In between flurries of washing, topping up and resetting the haematology machine, I spent quite a while sitting in the lunch room feeling utterly drained, mentally and physically. I struggled most of the day, both with my veterinary work (thanks are due to Wivek and Marita, who very patiently helped me with each and every case) and with my Norwegian. At one point, I saw a very stressed owner whose dog had been hit by a car. Whilst my emergency-clinic primed brain was still ticking over well enough to asses the dog,  I struggled so much with explaining the concept of keeping an eye on the dog’s breathing that I was worried that I wasn’t managing to reassure the owner well enough that she could cope with monitoring the dog for the rest of the day.

I was also still horribly aware of the poor cat which was awaiting a full assessment. I had checked him out and put him in a comfortable kennel with some water so I knew his condition wasn’t critical, but as soon as Jacqueline had arrived, Magne had rushed her in to help him in theatre and I was beginning to wonder whether I was ever going to get a chance to examine and blood test him. I think the emotional roller coaster of the past few weeks was taking its toll, because there were moments when without logical reason, I found my eyes were suddenly threatening to overflow. It’s a long time since I have felt so oddly helpless.

Still there were a few lighter moments which kept me from being overwhelmed. Marita had two cats booked in for clipping and grooming under sedation. She appeared in the prep room clutching the wrong end of one of those evil plastic aprons that come in a roll and from the quizzical way she was examining one of the side tapes, I could tell that she had no idea which part of the thing she was gripping. It became apparent to me at this moment, that despite the fact that most of the logical and language sections of my brain were running on empty, spatial awareness was still fizzing away in a miasma of over-efficiency. I took it from her, tore away the throwaway sections and handed it back to her the correct way up.

‘What kind of IQ do you need to sort out one of those things?’ she asked, rolling her eyes.

‘Not very high,’ I responded. ‘After all I managed it.’

I think this probably demonstrates just how disconnected my brain was. Fortunately, instead of thumping me as I deserved, she just laughed and fixed me with a fake glare.

‘So are you saying my IQ is really low then?’ she demanded. In response, I just grinned rather weakly.

After the road-traffic-accident dog, I managed to snaffle Jacqueline to help me with the vomiting cat. Having tried unsuccessfully earlier to take his temperature on my own, I finally managed it with her there to help. Logic however, had deserted. Somehow I had forgotten  it might be better to blood test him first before winding him up by inserting an object up his bottom, however fortunately for me, despite turning into a wildcat with the thermometer, he reverted to sweet pussy cat while I wielded the syringe to take blood from his jugular.

Time was going on, and we were broaching the Thursday communal lunch hour. There was no meeting as Dagny was absent, but people kept urging me to come and get my lunch. Thinking that this was mainly out of concern for my health, I stubbornly sat and waited for the cat’s blood test results, and when they came through, I burrowed my head in a laboratory book to check the significance. I think I had been once or twice into the lunch room. I had started to prepare my lunch and was frankly oblivious to what was going on around me. Suddenly someone started to sing ‘Happy birthday’ and I finally looked up from my book.

‘Whose birthday is it?’ I asked.

‘We’re singing it for you,’ they replied.

I confess that, at this point, I was a million miles away, utterly disconnected from the clinic and wishing I could go home.

‘It’s not my birthday.’ I said in grumpy confusion. There was a rather long silence, filled with suppressed giggles and when I finally managed to reconnect my brain, I realised they were all  glancing between me and some stunning flowers rather obviously placed right in the middle of the table.

‘They’re for you,’ they said. The message on the card welcomed me back and said they had missed me and it was signed by Irene, Wivek, Jan-Arne, Jacqueline and Marita. Suddenly my eyes were filled with tears again, but happy ones this time. This was a gift from my friends, not an official token from the clinic and that meant a lot.

Finally, as I was leaving, Jan-Arne came up and gave me a huge hug.

‘I really missed you,’ he said. ‘It just isn’t the same when you’re not here.’

Magne appeared in the passage behind him and said something, at which point Jan-Arne went over and offered to give him a hug as well, but he was humorously rebuffed. For a moment, I considered giving Magne a hug as well as I suspected that might have been more to his taste, but somehow at the last minute, we both lost our nerve. Instead he patted me rather awkwardly on the shoulder and told me how glad he was to see me back. Despite the fact that yesterday was my worst day at work for a very long time, I am  very grateful to all my colleagues for their obstinate insistence (despite all the evidence) that I am lovely.