Tag Archives: Veterinary

Carry that Weight

Sunrise/sunset: 09:52/ 13:14. Daylength: 3hr21min

I love being a veterinary surgeon. I am in the privileged position of having a career that is built around helping animals and in addition, I get to spend some of my days driving round in wonderful scenery and meeting farmers and their animals, and that’s something I value highly.

But there is a flip side to being a vet, which I discovered very early in my career, and that is that there is a lot of responsibility and that sometimes we find ourselves dealing with very heavy events.

I qualified when I was twenty two and started working at twenty three, and still have a stark memory from that time when I had been sent out to euthanase an old lady’s dog. I had driven out to her house and was still green enough to be worried about the process itself. Even when you’ve done it a thousand times, there’s still a risk that something untoward will happen, but you learn to navigate around potential difficulties, explain the possible issues beforehand and cope on the odd occasions when something unexpected does occur. On that day however, I was still completely green and very nervous. The old lady grabbed my hand and looked up at me from her chair. “I don’t want her to go,” she said. “Can’t you take me with her as well?”

I had no idea how to respond then and I probably still wouldn’t. Fortunately I had a wonderful nurse with me that day who did manage to say something and even after all these years, I remember how wise she was in comparison to me. Nowadays, when things get tough, I have more experienced people like Hilde and Thomas I can call on. Good colleagues are incredibly valuable in a crisis.

This week has had a couple of those moments when I have been reminded of how fragile everything can be. The first was the discovery on Monday that there had been a horrible event on Sunday in which a number of animals had died. I can’t give details: the investigation is still underway. But the quiet Monday I had planned, where I caught up with some overdue paperwork, was disrupted completely as I ended up driving to Tromsø with some of the animals that had died so that post-mortems could be carried out. There’s an extent to which, when tragedy hits, you have to act first and deal with the situation before you start to think too deeply about it, and that’s what I did. It wasn’t until I came home at the end of a twelve hour day, that I had time to process what had happened and what the animals had gone through, and then I cried briefly and hugged Andrew and Triar and then posted on Twitter, asking people for pictures of their pets and what they loved about them, so that if I woke in the night, I’d have something lovely and positive to read.

Our events here however, have been rather overshadowed by the news that Norway is experiencing its first ever outbreak of bird flu in domestic hens. Periodically last winter, there would be reports of bird flu being found in wild birds and Norwegian hen keepers have strict rules about outdoor access for their birds. When migration is happening, they all have to have a roof over them at all times. It had struck me, when doing our twice yearly emergency readiness exercise that if there was an outbreak of a serious illness in our area, that we would be in the front line and would be part of the team who had to go out and deal with the consequences. What hadn’t really struck me was that before we attended, there would likely be another vet who had been called out and might have been exposed first and a farmer too, and that they would be even more at risk, because they wouldn’t know beforehand that layers and layers of PPE were necessary.

This only came home to me when I read where the outbreak had occurred. It was (is) in Rogaland, where I used to live and work. Before I got the job here, I had applied for a job working with chickens down there, and it struck me that I could potentially have been that vet. Then it struck me further that the vet in question might be someone I know. It turns out the vet is indeed someone I know and they are still dealing with the possible fall out. So now I am hoping that there is nothing more serious to come, but the weight on them must be very heavy indeed.

But there was some lightness this week too. I have a busy few days planned, with lots of farm visits to different types of animal and with lots of different colleagues. Yesterday morning, I headed down to the fast boat in the dim pre-dawn November light. I was going up to Tromsø, where I would meet Birgit and we would visit a pig farm in the area. It was a routine visit, taking samples and carrying out a welfare inspection as part of Mattilsynet’s campaign to improve pig welfare.

The boat trip was a wonderful start to the day. The waters between Finnsnes and Tromsø are sheltered by islands and peninsulas and so it was a very smooth journey. It was getting lighter as we travelled and we went from farmland backed by low hills to much more sheer mountainsides, their peaks shrouded in snow and clouds. I had brought a book, but in the event, I couldn’t stop looking out of the window. The sunrise (picture at the top of the page) came when we were only a few minutes outside Tromsø. This is definitely a trip I want to repeat in my spare time.

The farmer was lovely. His pigs all looked in very good shape and he proudly showed us his sheep afterwards. Not all visits are like that, but it is great to see healthy animals being cared for well.

And it was fantastic to meet up with Birgit again. She had driven down from Storslett for a meeting the day before and had stayed overnight in Tromsø. She had her dogs with her and after the visit, we stopped briefly to give the dogs some fresh air. Kvaløya is beautiful. As I work in this area, I often look around me in wonder and think how lucky I am… as well as that I want to spend more leisure time exploring these different areas.

There was just time to stop for something to eat before I headed back on the boat. I ate a very tasty smoked salmon and cream cheese roll and was very pleased to see that the coffee shop were selling Senja Roasters‘ Christmas coffee. It was a good end to a very pleasant trip.

Concerning Welfare

Sunrise/sunset: 09:01/ 16:00. Daylength: 6hr58min

Back in June I wrote a post about complaints from animal rights organisations about Mattilsynet: Trouble in Paradise. Last weekend on my Facebook feed, I found a post from a colleague with a link to a new article from NRK, Norway’s public services broadcaster. It contained the stories of whistleblowers from within Mattilsynet regarding the distress its inspectors are feeling about their inability protect the welfare of the animals they are supposed to oversee.

Link to article in Norwegian: We have to close our eyes to suffering animals. *See note below for translation tips

One of the things I have noticed in my job is that almost every other week, changes are introduced to policies and protocols. There’s a lot to learn in any role and a year in, I feel I’m still picking things up, which would be enough already without the feeling that anything I learn might shift again next week. Then there’s the “paperwork”. Most of it is digitalised now, but there is a whole load of report writing, which often takes up far more time than the actual visit.

I am catching up gradually with some of the politics, and it seems that the current concentration on bureaucracy relates to criticism from the official Norwegian Auditor General in 2019 regarding the poor quality of case processing. It was stated that Mattilsynet lacked good tools and systems to deal with the animal welfare supervision it had to carry out, and that the result was that serious breaches of the animal welfare laws were not being followed up. It also said that Mattilsynet employees were not using the tools they had to penalise those who broke the law, and that it took too long for those who didn’t take proper care of their animals to be banned.

There’s a certain irony to what is happening now as a result of these accusations. I haven’t been here long, but one of the major constraints is the computer system we have to work with when processing cases. We use a system called MATS. I don’t know how old it is, but it is so complicated to use that it slows everything down. It sets out protocols and you have to work through the elements in order and tick off certain actions before you can proceed to the next. So if I receive a message from the public regarding a concern about animal welfare, it comes to me in MATS. I have to process that message and work through various stages on a list, and then at some point I will come to the end of that segment and have to move onto the next.

Once you click through to the new section, you can’t go back and change anything in the previous section if you’ve made an error. Thomas always tells me I have to be very careful before I click onwards, and I often check with him. But as I am trying to stand on my own feet a bit more, there have been cases where I have got as far as writing a report or a response to an animal owner who has asked for permission for something, and then had to go right back to the beginning as I realised I had linked the case to the animal owner’s personal file, and not to their business, or some other easily made system error that cannot be rectified.

MATS is also clunky in other ways. Almost nothing is automatic. Before we leave the farm or home, following an inspection, we have to write a “receipt” with a summary of what we have checked and what our assessments were. This used to be on paper, but now most of them are sent electronically. So we type our observations into an app. This would be very useful if there was an integrated system. If the observations we recorded in the receipt were transmitted automatically into MATS, and then perhaps used in the report, then it would be truly useful. As it is, we have to open MATS and the receipt and copy and paste all the information from one to the other.

The report itself has to comply with strict parameters in how it is set out and before I can send it to the owner, I have to run it past a colleague, and then afterwards past a control team, all the time making amendments, and then often sending it back and forth multiple times until everyone is satisfied.

Instead of rebuilding the system, they are adding things like the receipt system (and another system that allows us to add photo evidence) before the problem of MATS has been addressed. It seems to me, that they are trying to tweak something that is so fundamentally flawed that they are actually making the situation worse instead of better.

Of course all of this really comes back down to funding and monitoring. The argument is that they can’t afford a new system, though not affording it is probably costing millions. I have watched similar events in the public sector in the UK. The health service and school systems have both wandered into this territory where funding is reduced, then criticisms are made, and rather than improving the situation, new systems for monitoring are introduced, which increase the workload in ways that do nothing to correct the problems, but increase the cost of the operation. That the Norwegian government is paying veterinary surgeons to copy-paste long lists of observations and check and recheck whether the reports we write comply exactly with a template, which could presumably be automatically applied if the will and funding was there, seems brainless to me.

In addition, there are certain routine visits we carry out, for example those to check the farmers are following the rules with regard to ear-marks, disease control and traceability. Common sense would suggest that if no breaches of the rules are discovered, the feedback report could be generated automatically. Not only would that save direct work for the vet who did the inspection, but it would sidestep all the report-checks for compliance and would ensure their other aim – that everyone is dealt with the same way, wherever they are in Norway – was met without any effort whatsoever. Reducing the time it takes to process cases would free up time so that we could carry out more inspections. It seems like the system is set up in a way that prevents us from doing the most fundamental part of the job, which should be getting out and checking whether the animals are okay.

Anyway, I’m not going to comment any more on this for now. Our area is actually better off than those in the report, for which I am grateful. The report mentions an area where the inspectors have been told they can’t take on any more cases until the old ones are cleared up and we haven’t reached that stage. Thomas often tells me of his frustration that we are firefighting cases, rather than preventing problems before they start. Because I’ve only been here a short time, I can’t compare it with how things used to be, but he feels things have become more difficult. I am also aware of how much Thomas takes on, in comparison with what I can do at the moment. Though I help as much as I can, I know he is taking responsibility for the worst problems, as I work to follow what he’s doing and ensure the case timelines are kept in order. I am learning a lot about how cases should be handled, but even writing up the timelines shows me how frustrating the system is. There has been a change in government in Norway and the new government is more left-leaning, so I can only hope that some of the budget cuts, that have been happening forever, start to be reversed.

*****

Though the snow has gone for now, it was beautiful while it lasted. Triar and I followed the same trail last Saturday as we had the week before. There were amazing views as I reached the higher ground and I went a little further than last time, though I think I was still only about halfway along the trail to the peak. I need to find someone to go with me before attempting the whole walk.

Looking back at the snowy trail up to Kistefjellet

And on Tuesday evening, there was a snowstorm. Though it was windy, the temperature was around zero. When it’s really cold, the snow is powdery, and when the wind blows, it doesn’t stick to anything. But this snow stuck to everything. I went down into the town centre to get something, and had to stop to take photographs of the trees as they were so beautiful against the overcast sky and the streetlights.

I am looking forward to winter now. Though snow can be inconvenient, I still feel a childlike excitement when I wake up to find the world has turned white. And in a month, the polar night will be here. I hope you will follow and share it with me.

*If you want to read a Norwegian article in English (or any other language) you can paste the URL into Google Translate (set the languages at the top). A link will appear in the “Translation” side. If you click on the link, it should take you to a translated version of the article.

Sound and Salmonella

Sunrise/sunset: 05:47/ 18:06. Daylength: 12hr 19mins

For the first time this winter I have seen ice in Gisundet, the sound that runs between the island of Senja and the mainland. I had wondered whether it would freeze in winter, but this year it hasn’t been cold enough. I could ask someone local, of course, but it’s not the kind of thing that has come up in conversation so far.

Rather than being a sign of impending freezing, this ice appears to be what I have discovered is called brash ice. Brash ice is an accumulation of floating ice made up of smallish fragments, not more than two meters across. It appeared after a long warm day, when the sun was up for twelve hours and the temperature reached five degrees. The heat must have broken up some of the areas of ice that had formed in the bays around the edges of the sound, where the water moves less. Later in the day there was also wind, which was moving the ice along. You can see the the ice in these photographs, some caught along the shoreline in the first picture, and in the second, the flow right along the middle as it passes under the bridge.

Moving back to the topic of work, I have always had a weird fascination with infectious diseases and outbreaks. I confess that last year, when the pandemic began, that I spent far too much time searching the internet for the latest news from Wuhan, then later watching the spread across the world. I had always wondered what it would feel like to live through a pandemic, and though this one has been way less deadly than bubonic plague or Spanish flu, I would now say that living through one is periodically terrifying, with long periods of boredom and frustration. If I survive this one (and I realise my chances are relatively good) then I will be happy if there isn’t another in my lifetime.

That said, my interest remains and I have been watching the news recently as there has been an outbreak of salmonella in Norway. As Mattilsynet is Norway’s food safety authority, it has been involved in trying to trace the source of the infection. When it is a localised outbreak, it is often easy to trace the source. If all the affected people ate at the same hotel or restaurant, or bought food from the same shop, then the situation is generally clear.

This outbreak however, seemed to be spread across Norway and some other countries in Europe. This was confirmed by serotyping the bacteria – assessing the outside surface to check for distinctive structures that allow us to separate them into different groups.

When an outbreak is so widespread, it can be difficult to work out what food it was that caused it. The assessment is made more difficult with a bacterial infection such as salmonella as the time from eating the food to the time when infection causes illness can vary from six hours to six days. Trying to find out what a very sick patient ate almost a week ago can be nigh on impossible, however there can be some indication from examining which groups of people were affected. For example in another recent outbreak, most of the patients were children and that one was eventually narrowed down to chicken nuggets. Earlier outbreaks in Norway have related to chocolate bars, salad and black pepper so you can’t even concentrate only on meat products.

In this case, the infection has been found to come from a batch of beef imported from Germany and processed as mince. Now follows a process of trying to track down any remaining packs. Though they will by now be out of date, a few people might have taken them home and frozen them. Freezing will not kill the bacteria, though thorough heating would. As with any other outbreak, Mattilsynet must now also try to assess whether its internal procedures can be improved from the information collected. We will never stop all outbreaks of illness, but it is part of our job to try to ensure they occur as rarely as possible.

I will end on a more cheery note. It was lovely and sunny this week and I walked down to the little harbour on the edge of Gisundet below where we live. The water was wonderfully still and clear, as was the light and so I took a few photographs. I hope you enjoy them.

Goaty

Sunrise/sunset: Down all day.

Another interesting week at work. On Monday, Thomas and I made a visit in response to an anonymous “Concern Message”. I was nervous as we drove out. This was, in part, due to the nature of the visit. Obviously nobody wants to be reported and it’s quite possible that some of the recipients might be angry. But it was also because I was unsure whether Thomas would want me to lead the inspection and interview. He had shown me how to print out the point-by-point sheet which we use to guide us through and I went in clutching a clipboard. However, by the time I had struggled into my tissue-thin jumpsuit, huge white foot covers (tied with a bow) mask and gloves he had already begun and so I followed him round, listening carefully as he asked questions and noted down the replies.

I felt much more relaxed on the return journey. The presence of my clipboard was explained when he told me I should fill it in on our next time out as he pointed out having two separate records rather than one makes it less likely that anything will be missed. Next time out, I will also ask any questions that come into my head. There were some I thought of while we were out that I didn’t ask. With hindsight they were genuinely pertinent and could have been useful.

Back in the office, Thomas helped me through the next stage, which was writing a letter to the owner explaining the results of the inspection, and any actions considered necessary. This was another first for me, though I was aware of some of the rules we have to follow. These include all sorts of factors, such as ensuring that every action we ask the owner to take is backed up with the exact clause in Norwegian law that we are relying on, making sure the wording is simple to understand and perfectly clear, and ensuring the language we use is factual and not a value judgement. For example, we can note that an animal has been urinating and defaecating on the floor, but should never state that the house is disgustingly dirty.

I also discovered, as I worked through the response process, that there are many checks and balances in place to ensure we get things right. Once the letter was finished, we sent it to a Norwegian colleague to ensure the language was correct. After that it will be sent for official assessment by a dedicated group… and after that, it will be sent to Hilde, in whose name it will be sent out, assuming she also feels it passes muster. Though this sounds intimidating, I’m very glad that there will be plenty of help ensuring that I don’t make any errors due to the fact that Norwegian is not my mother tongue.

On Tuesday I drove out to meet Birgit, who works in the Storslett office. Our task was to blood sample forty goats to check for brucellosis as part of the annual OK Program. Brucellosis is a bacterial infection that can pass between animals and people and can cause long term fluctuations of fever, joint pain and various other nasty symptoms. As in Britain, there is currently no brucellosis in Norway and hopefully it will stay that way.

While I don’t think I have blood sampled many (any?) goats before, I spent several years in mixed practice in the UK. Back then, all mature cattle were tested for brucella every four years and I found myself quickly falling back into the rhythm of it. The test tubes we use come with a vacuum. If you push the needle through the rubber bung in the top and allow air to be sucked in instead of blood, then you waste the test tube. Brigit seemed very pleased with me as I managed to complete forty samples without losing a single one. On my part, I felt delighted that the skill I learned many years ago was finally being used again.

We are now almost at the end of the first week of the polar night. As you might have spotted in the windows in the picture above, it is not completely dark all day. Indeed for a short time between eleven and half-past one, it feels very much like full daylight. I stopped to take a photograph on the way back from the blood test to share here. This was taken at about 1pm, though a very short time afterwards it started to snow heavily, and the darkness drew back in.

On Thursday, we put up the Christmas decorations in the office and Andrew and I brought out a few of our decorations at home, though the tree will wait for Anna’s arrival on Monday. Most workplaces in Norway put up some decorations. Like the Danes, Norwegians take a lot of pride in encouraging comfort during the dark winter months.

I was struck afresh, when I looked at the photographs, that in some ways they are quite different from British decorations. Pigs play a big part here. A stocking is surely not complete without a marzipan pig. And the little hatted “nisse” are a regular feature. Nisse look a bit like garden gnomes and shouldn’t be confused with Santa. According to tradition, you have to feed the nisse creamed rice or other treats or they will play tricks on you.

On Friday I was on the early shift at the abattoir. We live close to the coast and even this far north, there is some warming effect from the gulf stream, but just a forty minute drive inland can mean a ten degree difference in temperature. I met John in the evening after work and we went out for a pizza, but as the restaurants didn’t open for an hour after we finished, I stopped to fill the car up with diesel and was struck by the beauty of the ice formations that the frost had etched onto the car. And so, being me, I grabbed my phone and took a photo to share with you. Have a lovely weekend.

Out and About

Sunrise/sunset: 09:12/ 13:51. Daylength: 4hr 38min

I’m sitting in my living room at three in the afternoon and it’s already dark outside, save for the streetlights on the bridge and along the shoreline across the water. The days are fast fading, but for now I am making the most of what daylight there is. It was wonderful to have a couple of days off at the beginning of the week and Charlie and I continued our exploration of local beaches and of Senja, the island that lies over the bridge from Finnsnes. The snow is coming and going, as you will see from the photos. Lots to see this week!

These photographs were taken on Sunday. This is one of our more regular haunts, though once the snow begins to lie, the track will become a ski-track. We won’t be able to walk along it until spring comes.

By Monday the snow was gone, and on Monday and Tuesday, we took Triar to different beaches, the first at Sørreisa (the site where you can light fires under shelter that I have written about before) and the next day on Senja near Vangsvik.

There were more fir trees as we walked down to the tiny beach at the southern end of Senja and it struck me that, twisted and stunted as they are, they remind me of bonsai trees. Not that they are anywhere near so small, but their growth is surely limited by the shallowness of the soil and the long, long winters.

I returned to work on Wednesday and was delighted to be invited out on a farm visit. Both Ammar and Thomas had compiled lists of possible farms to collect samples for the OK Program. The OK Program is an official project, carried out annually, where various samples are taken from different animals or herds to check for contamination. This can be in the form of heavy metals, which can be present in the soil in certain areas, antibiotics which might have entered the food chain, radioactivity, or infections such as MRSA or salmonella. Some of the materials are collected at the slaughterhouse, but we were looking for urine and milk samples. In the end, we visited four farms. One had no milk because the tanker had already collected it (and a herd sample was needed, rather than one from a single animal) and on another, there was no farmer to be found. But the other two were more productive. One had milk in the tank still. The other was the best for me. We had to collect a urine sample, and for that, we had to go and stand behind a row of cows in a byre and wait until one of the cows obliged. They were lovely cows – a little herd of Aberdeen Angus cattle that would have been equally at home in Scotland. They looked healthy and well fed and the farmer very generously let me take a couple of photos (including the sweet little cat at the top of the page).

And so I carried out my first farm visit in the north of Norway. Here’s hoping there will be many, many more!

Manic Meat-inspector

Sunrise/sunset: 08:36/ 16:26. Daylength: 7hr 50min

The slaughter season for lamb is almost over. I can’t pretend to be unhappy about that. With three technicians out of action and a vet colleague limited to inspection of live animals, I’ve ended up working in the abattoir every day for the past couple of weeks and it will continue for a week and a half more. I’ve decided to write a bit more about what I do… though it will be tongue in cheek. I have the typical dark humour about my job that I think many vets share. The life of a vet has some grim moments alongside the joy that working with animals often brings, and so it pays to laugh about it all now and then. So if you’re squeamish, you could just look at the photos and ignore the text altogether… otherwise, feel free to join me.

I’ve said before that the abattoir is a dangerous place. We have to wear a lot of PPE ( I no longer have to explain what that means – thanks Covid!). I generally work for an hour, then have half an hour off, but during the break, I have to strip off the outer layers of protective clothing, then put them back on again, which takes five minutes or so off each end.

Everyone in my section wears white trousers and a T-shirt as standard, and as I go into the sluice to get ready, I add a hair net, a white cotton short sleeved shirt, some rather fetching chain mail, a blue plastic apron, a helmet with ear protectors, a Kevlar glove on my left hand, a cotton one on my right, and finally a pair of waterproof latex gloves on top of the first pair. It’s important to put it all on in the right order. It’s hard to get a chain mail shirt over your helmet and harder still to tie your apron behind your back with two pairs of gloves taking away most of the fine sensation. I’ve managed to arrive in the hall missing every single item, including one head-scratching moment* when I reached up a hand to grasp something and realised that although my right hand was fully gloved, on the left I was wearing only the Kevlar glove. Goodness knows how I managed to remember the first and not the second, but there it is.

The line often stops while we are working. There’s a long succession of people, each one playing a small part in the process, and if any stage a problem occurs, then it is possible to stop the line while it is overcome. Most of the time, I have no idea why everything has come to a standstill as much of it is out of sight. I imagine generally, it is something mundane: one of the shearers hasn’t completed the job, or some item of equipment has lost power. But the other day, as I was leaving the hall for my break, I heard loud yelling. When I turned round, someone was running to stop the line. With a sense of shock, I saw one of the engineers was up in the rafters. His shirt was entangled in one of the meathooks and he was being dragged towards the edge of the inspection platform. Luckily the line stopped in time and someone else began to climb up the ladder to free him. Which is fortunate for me as if it had ended differently, I would definitely not be including this part of the story.

As I said earlier, I will be glad when the season is over. There are good things about the work. I could wax lyrical about my wonderful colleagues and the simple pleasure of a really good sharp knife, or even the unexpectedly entrancing swirl of a chainmail shirt as you stride across the floor. But as I walked back into the hall on Wednesday, checked to see that nobody was hanging from the roof, then dodged between a pair of swinging pig carcasses, both decorated with one of the big red tags that means the vet has seen something dodgy that needs attention, it struck me** that you could make the most wonderful platform game based on the production line.

If you’re young, you probably won’t remember Manic Miner, who rushed around underground trying to avoid spiders, slime and at one point being pursued by angry toilets with flapping seats that I could never get past as I was laughing too hard. But for those of us old enough to remember the pleasures of a good platform game, I hope you’ll agree that the slaughterhouse holds loads of possibilities. As well as pork dodging, there could be ladders up to the ceiling with moving hooks to avoid, a run through the flaming hot section where the hair is burned off the pigs, and a section with slippery bits of fat lying on the floor, just waiting for you to put your heel on them and slide into oblivion.

Anyway, enough of that. Back to the real world. It did snow a little, as you can see from the pictures of the frozen pond halfway up the page. But before that there were a few days when the temperature dropped fifteen degrees overnight. The resulting hoar frost was the best I have ever seen. Everything was sparkling, each blade of grass and tree branch wonderfully decorated: white on blue. I stopped half way home to take some pictures, one of which is at the top of the page. The rest I will add below. So while work is less than perfect, I am still marvelling every day about the fact that I get to live somewhere so beautiful. And as the winter arrives in full, I very much hope to share it all with you.

* Head-scratching is neither advisable with gloved hands, nor really possible with a helmet on. ‘Twas only a figure of speech.

**It was the thought that struck me, not a lump of pivoting pork. Just so we’re clear!

All Change

Things have changed since I last posted. So much so that this is the first time I have been able to sit down and record it. On the calendar downstairs, back on the 24th March, written in pink felt-tip pen, is the name of my nearest veterinary clinic. To distract my mind from my echoing e-mail box, I had wandered in off the street and asked (in my best Norwegian) whether I could come in and “see practice”, just for a week or two. The smiling receptionist, looking bemused promised to get the boss to call me, and I left, feeling, to be honest, like a bit of a tit. After all, I could have made that contact over the phone couldn’t I? Still, later that day, I received the call, and at 9a.m. on Monday morning, I presented myself.

I confess that the first question confused me somewhat. Peering into a cupboard filled with uniforms, Kari Anna (practice nurse) asked me whether I was a small or a medium. How to reply? I was obviously neither. Promising me that the medium was VERY stretchy round the waist (yes but what about the bum?) she handed over the medium overalls and commanded me to change. Shovelling me into a pair of green clogs (more on those later) she started to show me things on the computer. Obviously it was all written in Greek… or maybe Latin. Actually I might have understood those bits, but the rest was a mystery. Being me, I set out to solve it, and armed with a trusty pen and a post-it note, I gradually began over the course of a fortnight to decipher the runes.

I also made some new friends. So much for the much-fabled Norwegian stand-offishness; we spent the next two weeks laughing. And on the Thursday of the second week, I was offered a job. Dagny, the scary boss lady said I should talk to my husband… who of course said “What are you waiting for. Get signed up immediately!” So I did, setting out to work two days a week. The past fortnight has been a whirlwind of bank accounts and tax office visits ( yup, I didn’t have the former and have never paid the latter here) and getting the paperwork together to try to get myself authorised to carry out veterinary work in Norway. Currently I’m working as an assistant, which suits me down to the ground as I am helping out without having to consult (without knowing all those crucial anatomical words) and in the meantime, I am gradually picking up more Norwegian, though there is the terrible temptation to revert to English, especially as some of the clients immediately start to chat to me when they find out where I am from.

It’s a wonderful feeling, picking up the reins of something I used to be good at. Some things come back so quickly. Others are filled with fog. I suspect that when it comes to real knowledge, I have always been very reliant on books, and for the moment, I don’t have the right ones to hand. The BSAVA Manual of Emergency and Critical Care was my constant companion for all the years working in the emergency clinics. It’s at the top of my shopping list as even though there aren’t so many emergency cases during the day, I seem to recall it had a lot of fantastic tips on how to work cases up in the first instance. I’m slowly regaining knowledge, refilling the blanks, remembering the things I was never good at (I can take a mean x-ray, but I have never been on a course to learn to use ultrasound). I am learning new things as well. Who knew that it was illegal to castrate a dog or spay a bitch in Norway without good clinical reason? Apparently they have to be allowed freedom to explore their wild-side, though how that works when using drugs to prevent ovulation I have no idea. Bang goes the idea of opening a spay clinic in my nearest city!

This week started badly. I tried to anaesthetise a dog without having the machine fully switched on. Never a good idea. Worse still, it transpired that the green clogs actually belonged to the boss lady. Well I always did like to walk in shoes that were hard to fill. I’ve bought my own now. And Dagny has not yet used the whip on me that I took in for Irene (fabulous receptionist) to use on Jan-Arne (crazy vet).

Been out walking (the picture at the top is taken from south of our village, looking up the coast) and skiing, both downhill and cross-country. I would like to say that I didn’t fall over once, but sadly I can’t. Still things are looking up on all fronts. There might even be some movement on the book, but I don’t want to get ahead of myself so I’ll leave that for next time.

003

Bodies

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.

Shameless

So life is going on and work is getting better and better. Tuesday was a bit mad because Kari Anna is on holiday this week. She’s the clinic’s resident veterinary nurse, and like most veterinary nurses, when she is there, she flits calmly around the practice and suddenly all the mess has disappeared and everything is under control. On Tuesday morning there was just Gerd (a veterinær assistent like me … well actually not much like me because she is sensible and mature and… well you get the picture) and me there, and Gerd was busy on reception where the phone was ringing madly and about a thousand people were waiting to be helped. So I found myself rushing around, trying to make sure everything was reasonably tidy. Unlike Kari Anna, I was unable to do this invisibly and just in case I thought I was doing rather well, mid-morning Jan-Arne came up to me with a look of confusion and asked why I was doing so much cleaning up today.

Anyway into the midst of all this came scary-boss lady herself [hei Dagny!!!!] and demanded asked very kindly that I should get theatre ready for two cat sterilisation operations. Despite the fact that I had done it before under the steady eye of Kari Anna, immediate panic set in. I knew which surgical kit it was, but which size of drape had I been told again? And which suture materials? What size was the pack of gauze swabs, two or five? So many things to go wrong. Worse still, as I commandeered the last two surgical kits from the shelf, I realised that very probably I should have put the other kits that I had so carefully sorted out into the steriliser, because if any other operations were coming in immediately afterwards…

AAAAAAAaaaaaaaaaargh!

So with my head spinning round on its axis like the child from the Exorcist, I started to hunt around for everything I needed. At that moment, Magnanimous Magne (the other boss) stuck his head round the door and asked whether I could help him with a blood sample. I’m sure I snapped “No” rather rudely, but he didn’t seem to notice anything untoward, and a few minutes later, fortunately I found a spare minute to set up the haematology analyser and run his test for him. The operations went smoothly and there were no screams from outside theatre, so presumably nobody needed another kit during the time we were busy. It was with relief that I finished with the surgery and was left to sort out the two patients and clean up the theatre while Dagny went to get on with other vetty things.

As soon as that was all clear, I rushed to the autoclave. Now what was it I had to do again? I had to drain some water out of one of those little tubes but was it the water from the tube on the left or the right? I thought it was probably the left, but when I tried to open the tube up for emptying, I couldn’t get the rubber bung off the end. Was it meant to come off, or was it attached and needing to be twisted or opened somehow? I didn’t want to rip it off and then find I’d broken it. And was it the left tube? There didn’t seem to be anything in that one. So it was probably the right. Gerd was still stuck with her three million clients, and there was nobody else around, so taking my life in my hands, I approached my scary lovely boss and asked her if she knew. Very helpfully she came through. She hadn’t used the machine for three years, but she would try to remember. Within moments she had successfully removed the bung from the right tube as I had asked. With a triumphant nod she left me to it.

It was only when I was still standing there, with about a gallon of water in the bucket at my feet that I began to have some disquiet over whether it really was the right tube. When Kari Anna showed me, surely there had only been a little drainage? Now there was something approaching a flood threatening to overwhelm the bucket. Shoving the bung back into the tube, I rushed through, and happily Gerd was able to spare me a moment. I had, she confirmed, as I had suspected, made a brave attempt at emptying the entre autoclave, but fortunately all was not lost. There was enough distilled water to refill it and no harm done. Better still, she even showed me how to make more distilled water. Lets face it, by the time I have to do it, I’ll probably have forgotten, but I’ll deal with that when it happens!

Thursday and Friday weren’t so fraught thank goodness. This afternoon I even had a brief period when I wasn’t sure what to do. Irene was being terribly efficient, and there is another girl doing work experience who was rushing round after everyone tidying up, and as I don’t like to sit around doing nothing, I went in to see if Jan-Arne needed a hand. He was examining a cat with mastitis so I helped him to sedate her. As he was cleaning out her wound, Irene put her head around the door. Was I available, she wanted to know, to help with a dental? Her question was directed at Jan-Arne. Did he really need me?

Jan-Arne looked up with a grin. “No,” he said, “I don’t really need her, it’s just more fun when she’s here.” ** And really, when all is said and done, that’s good enough for me.

Here he is:

Jan Arne and pig

That’s him on the right….

And what is it that is shameless? Well I shamelessly stole Jan-Arne’s beautiful photograph of a foal for the top of my page. Who could possibly resist?

**Technically he said it in Norwegian, but it’s a near enough translation.

Humour and Humanity

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

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

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

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

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

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