Tag Archives: Veterinary

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.

Not German(e)

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

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!