Special Treat for 2011: Excerpt from The Lord God Made Them All
The Lord God Made Them All
By James Herriot
Chapter Eight
"It was Hemingway who said that, wasn't it?"
Norman Beaumont shook his head "No, Scott Fitzgerald."
I didn't argue because Norman usually knew. In fact, it was one of the attractive things about him I enjoyed having veterinary students seeing practice with us. They helped with fetching and carrying, they opened gates and they were company on our lonely rounds. In return, they absorbed a lot of knowledge from us in our discussions in the car, and it was priceless experience for them to be involved in the practical side of their education.
Since the war, however, my relationships with these young men had undergone a distinct change. I found I was learning from them just about as much as they were learning from me.
The reason, of course, was that veterinary teaching had taken a leap forward. The authorities seemed to have suddenly discovered that we weren't just horse doctors and that the vast new field of small-animal work was opening up dramatically. Advanced surgical procedures were being carried out on farm animals, too, and the students had the great advantage of being able to see such things done in the new veterinary schools with their modern clinics and operating theaters.
New specialist textbooks were being written that made my own thumbed volumes with everything related to the horse seem like museum pieces. I was still a young man, but all the bursting knowledge I had nurtured so proudly was becoming irrelevant. Quittor, fistubus withers, poll evil, bog spavin, stringhalt—they didn't seem to matter much anymore.
Norman Beaumont was in his final year and was a deep well of information at which I drank greedily. But apart from the veterinary side we had a common love of books and reading.
When we weren't talking shop the conversation was usually on literary lines, and Norman's companionship lightened my days and made the journeys between farms seem short.
He was immensely likable, with a personality that was formal and dignified beyond his twenty-two years and which was only just saved from pomposity by a gentle humour. He was a solid citizen in the making if ever I saw one, and this impression was strengthened by his slightly pearshaped physique and the fact that he was determinedly trying to cultivate a pipe.
He was having a little trouble with the pipe, but I felt sure he would win through. I could see him plainly twenty years from now, definitely tubby, sitting around the fireside with his wife and children, puffing at that pipe which he had finally subjugated; an upright, dependable family man with a prosperous practice.
As the dry stone walls rolled past the car windows, I got back onto the topic of the new operations.
"And you say they are actually doing Caesarians on cows in the college clinics?"
"Good Lord, yes." Norman made an expansive gesture and applied a match to his pipe. "Doing them like hot cakes, it's a regular thing." His words would have carried more weight if he had been able to blow a puff of smoke out after them, but he had filled the bowl too tightly and, despite a fierce sucking which hollowed his cheeks and ballooned his eyeballs, he couldn't manage a draw.
"Gosh, you don't know how lucky you are," I said. "The number of hours I've slaved on byre floors calving cows. Sawing up calves with embryotomy wire, knocking my guts out trying to bring heads round or reach feet. I think I must have shortened my life. And if only I'd known how, I could have saved myself the trouble with a nice straightforward operation. What sort of a job is it, anyway?"
The student gave me a superior smile. "Nothing much to it, really." He relit his pipe, tamped the tobacco down and winced as he burned his finger.
He shook his hand vigorously for a moment, then turned towards me. "They never seem to have any trouble. Takes about an hour, and no hard labour."
"Sounds marvellous." I shook my head wistfully. "I'm beginning to think I was born too soon. I suppose it's the same with ewes?"
"Oh yes, yes, indeed," Norman murmured airily. "Ewes, cows, sows—they're in and out of the place every day. No problem at all. Nearly as easy as bitch spays."
"Ah, well, you young lads are lucky. It's so much easier to tackle these jobs when you've seen a lot of them done."
"True, true." The student spread his hands. "But, of course, most bovine parturitions don't need a Caesarian, and I'm always glad to have a calving for my case book."
I nodded in agreement. Norman's case book was something to see; a heavily bound volume with every scrap of interesting material meticulously entered under headings in red ink. The examiners always wanted to see these books, and this one would be worth a few extra marks to Norman in his finals.
It was August Bank Holiday Sunday, and Darrowby market place had been bustling all day with holiday makers and coach parties. Each time we passed through I looked at the laughing throngs with a tiny twinge of envy. Not many people seemed to work on Sundays.
I dropped the student at his digs in late afternoon and went back to Skeldale House for tea I had just finished when Helen got up to answer the phone.
"It's Mr. Bushell of Sycamore House," she said. "He has a cow calving."
"Oh damn. I thought we'd have Sunday evening to ourselves." I put down my cup. "Tell him I'll be right out, Helen, will you?" I smiled as she put down the receiver. "One thing, Norman will be pleased. He was just saying he wanted something for his case book."
I was right. The young man rubbed his hands in glee when I called for him, and he was in excellent humour as we drove to the farm.
"I was reading some poetry when you rang the bell," he said "I like poetry. You can always find something to apply to your life. How about now, when I'm expecting something interesting 'Hope springs eternal in the human breast' "
"Alexander Pope, Essay on Man, " I grunted I wasn't feeling so enthusiastic as Norman. You never knew what was ahead on these occasions.
"Jolly good." The young man laughed. "You aren't easy to catch out."
We drove through the farm gateway into the yard.
"You've made me think with your poetry," I said. "It keeps buzzing in my head 'Abandon hope all ye who enter here ' "
"Dante, of course, The Inferno. But don't be so pessimistic." He patted me on the shoulder as I put on my Wellingtons.
The farmer led us into the byre, and in a stall opposite the window a small cow looked up at us anxiously from her straw bed. Above her head, her name, Bella, was chalked on a board.
"She isn't very big, Mr. Bushell," I said.
"Eh?" he looked at me enquiringly, and I remembered that he was hard of hearing.
"She's a bit small," I shouted.
The farmer shrugged. "Aye, she allus was a poor doer. Had a rough time with her first calvin', but she milked well enough after it."
I looked thoughtfully at the cow as I stripped off my shirt and soaped my arms. I didn't like the look of that narrow pelvis, and I breathed the silent prayer of all vets that there might be a tiny calf inside.
The farmer poked at the light roan hairs of the rump with his foot and shouted at the animal to make her rise.
"She won't budge, Mr. Herriot," he said. "She's been painin' all day. Ah doubt she's about buggered."
I didn't like the sound of that either. There was always something far wrong when a cow strained for a long time without result. And the little animal did look utterly spent. Her head hung down and her eyelids drooped wearily.
Ah well, if she wouldn't get up, I had to get down. With my bare chest in contact with the ground, the thought occurred that cobbles didn't get any softer with the passage of the years. But when I slid my hand into the vagina, I forgot about my discomfort. The pelvic opening was villainously narrow, and beyond was something that froze my blood: two enormous hooves and, resting on their cloven surfaces, a huge expanse of muzzle with twitching nostrils. I didn't have to feel anymore, but with an extra effort I strained forward a few inches, and my fingers explored a bulging brow squeezing into the small space like a cork in a bottle. As I withdrew my hand, the rough surface of the calf's tongue flicked briefly against my palm.
I sat back on my heels and looked up at the farmer "There's an elephant in there, Mr. Bushell."
"Eh?"
I raised my voice. "A tremendous calf, and no room for it to come out."
"Can't ye cut it away?"
"Afraid not. The calf's alive and, anyway, there's nothing to get at. No room to work."
"Well, that's a beggar," Mr. Bushell said. "She's a good little milker. Ah don't want to send 'er to the butcher."
Neither did I. I hated the very thought of it, but a great light was breaking beyond a new horizon. It was a moment of decision, of history I turned to the student.
"This is it, Norman! The ideal indication for a Caesar. What a good job I've got you with me. You can keep me right."
I was slightly breathless with excitement, and I hardly noticed the flicker of anxiety in the young man's eyes.
I got to my feet and seized the farmer's arm. "Mr Bushell, I'd like to do a Caesarian operation on your cow."
"A what?"
"A Caesarian. Open her up and remove the calf surgically."
"Tek it out o' the side, d'ye mean? Like they do wi' women?"
"That's right."
"Well that's a rum' un." The farmer's eyebrows went up. "I never knew you could do that wi' cows."
"Oh, we can now," I said airily "Things have moved on a bit in the last few years."
He rubbed a hand slowly across his mouth. "Well, ah don't know. I reckon she'd die if you made a bloody great 'ole in her like that. Maybe she'd be better goin' for slaughter. I'd get a few quid for her and I allus think fust loss is best."
I could see my big moment slipping away from me. "But she's only a thin little thing. She wouldn't be worth much for meat, and with a bit of luck we might get a live calf out of her."
I was going against one of my steadfast rules—never to talk a farmer into doing something—but I was seized by a kind of madness. Mr. Bushell looked at me for a long time, then, without changing expression, he nodded.
"Awright, what do you want?"
"Two buckets of warm water, soap, towels," I replied. "And I'll bring some instruments into the house to boil, if I may."
When the farmer had departed, I thumped Norman on the shoulder "This is just right. Plenty of light, a live calf to aim for and it's just as well poor Mr. Bushell doesn't hear too well. If we keep our voices down, I'll be able to ask you things as we go along."
Norman didn't say anything. I told him to set up some straw bales for our equipment and had him scatter loose straw around the cow while I boiled the instruments in a pan in the farm kitchen.
Soon all was ready—syringes, suture materials, scalpels, scissors, local anaesthetic and cotton wool laid in a row on a clean towel draped over one of the bales. I added some antiseptic to the water and addressed the farmer.
"We'll roll her over and you can hold the head down, Mr. Bushell I think she's too tired to move much."
Norman and I pushed at the shoulder, and Bella flopped on her side without resistance. The farmer put his knee against her neck, and the long area of the left flank was exposed for our attention.
I nudged the student. "Where do I make the incision?" I whispered.
Norman cleared his throat. "Well, er, it's about…" he pointed vaguely.
I nodded. "Around the rumenotomy site, eh? But a bit lower, I suppose." I began to clip away the hair from a foot-long strip It would need a big opening for that calf to come through. Then I quickly infiltrated the area with local.
We do these jobs under a local anaesthetic and in most cases the cow lies quietly on her side or even stands during the operation. The animal can't feel anything, of course, but I have a few extra grey hairs round my ears that owe their presence to the occasional wild cow suddenly rearing up halfway through and taking off with me in desperate pursuit, trying to keep her internal organs from flopping on the ground.
But that was all in the future. On this first occasion I had no such fears. I cut through skin, muscle layers and peritoneum, and was confronted by a protruding pink and white mass of tissue.
I poked at it with my finger. There was something hard inside. Could it be the calf?
"What's that?" I hissed.
"Eh?" Norman, kneeling by my side, jumped convulsively. "What do you mean?"
"That thing. Is it the rumen or the uterus? It's pretty low down, it could be the uterus."
The student swallowed a couple of times. "Yes… yes… that's the uterus all right."
"Good." I smiled in relief and made a bold incision. A great gout of impacted grass welled out, followed by a burst of gas and an outflow of dirty brown fluid.
"Oh, Christ!" I gasped. "It's the rumen. Look at all that bloody mess!" I groaned aloud as the filthy tide surged away down and out of sight into the abdominal cavity. "What the hell are you playing at, Norman?"
I could feel the young man's body trembling against mine.
"Don't just sit there!" I shouted. "Thread me one of those needles. Quick! Quick!"
Norman bounded to his feet, rushed over to the bale and returned with a trailing length of catgut extended in shaking fingers. Wordlessly, drymouthed,
I stitched the gash I had made in the wrong organ. Then the two of us made frantic attempts to swab away the escaped rumenal contents with cotton wool and antiseptic, but much of it had run away beyond our reach. The contamination must be massive.
When we had done what we could, I sat back and looked at the student. My voice was a hoarse growl. "I thought you knew all about these operations."
He looked at me with frightened eyes. "They do quite a few of them at the clinic."
I glared back at him. "How many Caesarians have you seen?"
"Well… er… one, actually."
"One! To hear you speak I thought you were an expert! And, anyway, even if you'd seen only one, you should know a little bit about it."
"The thing is…" Norman shuffled his knees around on the cobbles. "You see… I was right at the back of the class."
I worked up a sarcastic snarl. "Oh, I understand. So you couldn't see very well?"
"That's about it." The young man hung his head.
"Well, you're a stupid young fool!" I said in a vicious whisper. "Dishing out your confident instructions when you know damn all. You realise you've killed this good cow. With all that contamination, she'll certainly develop peritonitis and die. All we can hope for now is to get the calf out alive." With an effort I turned my gaze from his stricken face. "Anyway, let's get on with it."
Apart from my first shouts of panic, the entire interchange had been carried out pianissimo, and Mr. Bushell kept shooting enquiring glances at us.
I gave him what I hoped was a reassuring smile and returned to the attack. Getting the calf out alive was easy to say, but it soon dawned on me that getting the calf out in any way whatsoever was going to be a mammoth task. Plunging my arm deep below what I now knew was the rumen, I encountered a smooth and mighty organ lying on the abdominal floor. It contained an enormous bulk with the hardness and immobility of a sack of coal.
I felt my way along the surface and came upon the unmistakable contours of a hock pushing against the slippery wall. That was the calf, all right, but it was far, far away.
I withdrew my arm and started on Norman again. "From your position at the back of the class," I enquired bitingly, "did you happen to notice what they did next?"
"Next? Ah, yes." He licked his lips, and I could see beads of sweat on his brow. "You are supposed to exteriorise the uterus."
"Exteriorise it? Bring it up to the wound, you mean?"
"That's right."
"Good God!" I said. "King Kong couldn't lift up that bloody uterus. In fact I can't move it an inch. Have a feel."
The student, who was stripped and soaped like myself, introduced his arm and for a few moments I watched his eyes pop and his face redden.
Then he withdrew and nodded sheepishly. "You're right. It won't move."
"Only one thing to do." I picked up a scalpel. "I'll have to cut into the uterus and grab that hock. There's nothing else to get hold of."
It was very nasty, fiddling about away out of sight down in the dark unknown, my arm buried to the shoulder in the cow, my tongue hanging out with anxiety. I was terrified I might slash into something vital but, in fact, it was my own fingers that I cut, several times, before I was able to draw the scalpel edge across the bulge made by the hock. A second later I had my hand round the hairy leg. Now I was getting somewhere.
Gingerly, I enlarged the incision, inch by inch. I hoped fervently I had made it big enough, but working blind is a terrible thing, and it was difficult to be sure.
At any rate, I couldn't wait to deliver that calf. I laid aside my knife, seized the leg and tried to lift it, and immediately I knew that another little nightmare lay ahead. The thing was a tremendous weight and it was going to take great strength to bring it up into the light of day. Nowadays when I do a Caesar, I take care to have a big strong farm lad stripped off, ready to help me with this lifting job, but today I had only Norman.
"Come on," I panted. "Give me a hand."
We reached down together and began to pull. I managed to repel the hock and bring the foot round, and that gave us greater purchase, but it was still agonisingly laborious to raise the mass to the level of the skin incision.
Teeth clenched, grunting with effort, we hauled upwards till at last I was able to grasp the other hind leg. Even then, with a foot apiece in our hands, nothing wanted to move. It was just like doing a tough calving except it was through the side. And as we lay back, panting and sweating, pulling with every vestige of our strength, I had the sudden wave of illumination which comes to all members of our profession at times. I wished with all my heart and soul that I had never started this ghastly job. If only I had followed Mr. Bushell's suggestion to send the cow for slaughter I would now be driving peacefully on my rounds. Instead, here I was, killing myself. And even worse than my physical torment was the piercing knowledge that I hadn't the slightest idea what was going to happen next.
But the calf was gradually coming through. The tail appeared, then an unbelievably massive rib cage and finally with a rush, the shoulders and head.
Norman and I sat down with a bump, the calf rolling over our knees. And like a gleam of light in the darkness, I saw that he was snorting and shaking his head.
"By gaw, he's a big 'un!" exclaimed the farmer. "And wick, too."
I nodded. "Yes, he's huge. One of the biggest I've ever seen." I felt between the hind legs. "A bull, as I thought. He'd never have come out the proper way."
My attention was whisked back to the cow. Where was the uterus? It had vanished. Again I started my frantic groping inside. My hand became entangled with yards of placenta. Oh hell, that wouldn't do any good floating around among the guts I pulled it out and dropped it on the floor, but I still couldn't find the uterus. For a palpitating moment I wondered what would happen if I never did locate it, then my fingers came upon the ragged edge of my incision.
I pulled as much as possible of the organ up to the light, and I noticed with sinking disquiet that my original opening had been enlarged by the passage of that enormous calf and there was a long tear disappearing out of sight towards the cervix.
"Sutures." I held my hand out, and Norman gave me a fresh needle. "Hold the lips of the wound," I said and began to stitch.
I worked as quickly as I could and was doing fine until the tear ran out of sight. The rest was a kind of martyrdom. Norman hung on grimly while I stabbed around at the invisible tissue far below. At times I pricked the young man's fingers, at others my own. And to my dismay, a further complication had arisen.
The calf was now on its feet, blundering unsteadily around. The speed with which newly born animals get onto their legs has always fascinated me, but at this moment it was an unmitigated nuisance.
The calf, looking for the udder with that instinct which nobody can explain, kept pushing his nose at the cow's flank and at times toppling headfirst into the gaping hole in her side.
"Reckon 'e wants back in again," Mr. Bushell said with a grin. "By 'eck, he is a wick 'un."
"Wick" is Yorkshire for lively, and the word was never more aptly applied. As I worked, eyes half-closed, jaws rigid, I had to keep nudging the wet muzzle away with my elbow, but as fast as I pushed him back the calf charged in again, and with sick resignation I saw that every time he nosed his way into the cavity, he brought particles of straw and dirt from the floor and spread them over the abdominal contents.
"Look at that," I moaned. "As if there wasn't enough muck in there."
Norman didn't reply. His mouth was hanging open and the sweat ran down his blood-streaked face as he grappled with that unseen wound. And in his fixed stare I seemed to read a growing doubt as to his wisdom in deciding to be a veterinary surgeon.
I would rather not go into any more details. The memory is too painful. Sufficient to say that, after an eternity, I got as far down the uterine tear as I could, then we cleared away a lot of rubbish from the cow's abdomen and covered everything with antiseptic dusting powder. I stitched up the muscle and skin layers, with the calf trying all the time to get in on the act, and at last the thing was finished.
Norman and I got to our feet very slowly, like two old, old men. It took me a long time to straighten my back, and I saw the young man rubbing tenderly at his lumbar region. Then, since we were both plastered with caked blood and filth, we began the slow process of scrubbing and scraping ourselves clean.
Mr. Bushell left his position by the head and looked at the row of skin stitches. "Nice neat job," he said. "And a grand calf, too."
Yes, that was something. The little creature had dried off now, and he was a beauty, his body swaying on unsteady legs, his wide-set eyes filled with gentle curiosity But that "neat job" hid things I didn't dare think about.
Antibiotics were still not in general use, but, in any case, I knew there was no hope for the cow. More as a gesture than anything else, I left the farmer some sulpha powders to give her three times a day. Then I got off the farm as quickly as I could.
We drove away in silence. I rounded a couple of corners, then stopped the car under a tree and sank my head against the steering wheel.
"Oh hell," I groaned. "What a bloody balls-up."
Norman replied only with a long sigh and I continued, "Did you ever see such a performance? All that straw and dirt and rumenal muck in among that poor cow's bowels. Do you know what I was thinking about towards the end? I was remembering the story of that human surgeon of olden times who left his hat inside his patient. It was as bad as that."
"I know." The student spoke in a strangled undertone. "And it was all my fault."
"Oh no, it wasn't," I replied. "I made a right bollocks of the whole thing all by myself, and I tried to blame you because I got in a panic I shouted and nagged at you and I owe you an apology. "
"Oh no, no…"
"Yes, I do. I am supposed to be a qualified veterinary surgeon, and I did nearly everything wrong." I groaned again. "And on top of it all, I behaved like an absolute swine towards you, and I'm sorry."
"You didn't really, you didn't… I…"
"Anyway, Norman," I broke in. "I'm going to thank you now. You were a tremendous help to me You worked like a Trojan and I'd have got nowhere at all without you. Let's go and have a pint."
With the early-evening sunshine filtering into the bar parlour of the village inn, we dropped into a quiet corner and pulled deeply at our beer glasses.
We were both hot and weary and there didn't seem to be anything more to say.
It was Norman who broke the silence. "Do you think that cow has any chance?"
I examined the cuts and punctures on my fingers for a moment. "No, Norman. Peritonitis is inevitable, and I'm pretty sure I've left a good-sized hole in her uterus." I shuddered and slapped my brow at the memory.
I was sure I would never see Bella alive again, but first thing next morning a morbid curiosity made me lift the phone to find out if she had survived so far.
The "buzz-buzz" at the other end seemed to last a long time before Mr. Bushell answered.
"Oh, it's Mr. Herriot. Cow's up and eatin'." He didn't sound surprised.
It was several seconds before I was able to absorb his words.
"Doesn't she look a bit dull or uncomfortable?" I asked huskily.
"Nay, nay, she's bright as a cricket. Finished off a rackful of hay, and I got a couple o' gallons of milk from 'er."
As in a dream I heard his next question. "When'll you take them stitches out?"
"Stitches… Oh yes." I gave myself a shake. "In a fortnight, Mr. Bushell, in a fortnight."
After the horrors of the first visit, I was glad Norman was with me when I removed the sutures. There was no swelling round the wound, and Bella chewed her cud happily as I snipped away. In a pen nearby the calf gambolled and kicked his feet in the air.
I couldn't help asking, "Has she shown any symptoms at all, Mr. Bushell?"
"Nay." The farmer shook his head slowly. "She's been neither up nor down. You wouldn't know owt had happened to 'er."
That was the way it was at my first Caesarian. Over the years Bella went on to have eight more calves normally and unaided, a miracle which I can still hardly believe.
But Norman and I were not to know that all we felt then was an elation all the sweeter for being unexpected.
As we drove away I looked at the young man's smiling face. "Well, Norman," I said "That's veterinary practice for you. You get a lot of nasty shocks, but some lovely surprises, too. I've often heard of the wonderful resistance of the bovine peritoneum, and thank heavens it's true."
"The whole thing's marvellous, isn't it?" he murmured dreamily. "I can't describe the way I feel. My head seems to be full of quotations like 'Where there is life there's hope.' "
"Yes, indeed," I said. "John Gay, isn't it—The Sick Man and the Angel."
Norman clapped his hands. "Oh, well done."
"Let's see." I thought for a moment. "How about 'But't'was a famous victory' "
"Excellent," replied the young man "Southey, The Battle of Blenheim."
I nodded. "Quite correct."
"Here's a good one," the student said. " 'Out of this nettle, danger, we pluck this flower, safety.' "
"Splendid, splendid," I replied. "Shakespeare, Henry Fifth."
"No, Henry Fourth."
I opened my mouth to argue, but Norman held up a confident hand. "It's no good, I'm right. And this time I do know what I'm talking about."
By James Herriot
Chapter Eight
"It was Hemingway who said that, wasn't it?"
Norman Beaumont shook his head "No, Scott Fitzgerald."
I didn't argue because Norman usually knew. In fact, it was one of the attractive things about him I enjoyed having veterinary students seeing practice with us. They helped with fetching and carrying, they opened gates and they were company on our lonely rounds. In return, they absorbed a lot of knowledge from us in our discussions in the car, and it was priceless experience for them to be involved in the practical side of their education.
Since the war, however, my relationships with these young men had undergone a distinct change. I found I was learning from them just about as much as they were learning from me.
The reason, of course, was that veterinary teaching had taken a leap forward. The authorities seemed to have suddenly discovered that we weren't just horse doctors and that the vast new field of small-animal work was opening up dramatically. Advanced surgical procedures were being carried out on farm animals, too, and the students had the great advantage of being able to see such things done in the new veterinary schools with their modern clinics and operating theaters.
New specialist textbooks were being written that made my own thumbed volumes with everything related to the horse seem like museum pieces. I was still a young man, but all the bursting knowledge I had nurtured so proudly was becoming irrelevant. Quittor, fistubus withers, poll evil, bog spavin, stringhalt—they didn't seem to matter much anymore.
Norman Beaumont was in his final year and was a deep well of information at which I drank greedily. But apart from the veterinary side we had a common love of books and reading.
When we weren't talking shop the conversation was usually on literary lines, and Norman's companionship lightened my days and made the journeys between farms seem short.
He was immensely likable, with a personality that was formal and dignified beyond his twenty-two years and which was only just saved from pomposity by a gentle humour. He was a solid citizen in the making if ever I saw one, and this impression was strengthened by his slightly pearshaped physique and the fact that he was determinedly trying to cultivate a pipe.
He was having a little trouble with the pipe, but I felt sure he would win through. I could see him plainly twenty years from now, definitely tubby, sitting around the fireside with his wife and children, puffing at that pipe which he had finally subjugated; an upright, dependable family man with a prosperous practice.
As the dry stone walls rolled past the car windows, I got back onto the topic of the new operations.
"And you say they are actually doing Caesarians on cows in the college clinics?"
"Good Lord, yes." Norman made an expansive gesture and applied a match to his pipe. "Doing them like hot cakes, it's a regular thing." His words would have carried more weight if he had been able to blow a puff of smoke out after them, but he had filled the bowl too tightly and, despite a fierce sucking which hollowed his cheeks and ballooned his eyeballs, he couldn't manage a draw.
"Gosh, you don't know how lucky you are," I said. "The number of hours I've slaved on byre floors calving cows. Sawing up calves with embryotomy wire, knocking my guts out trying to bring heads round or reach feet. I think I must have shortened my life. And if only I'd known how, I could have saved myself the trouble with a nice straightforward operation. What sort of a job is it, anyway?"
The student gave me a superior smile. "Nothing much to it, really." He relit his pipe, tamped the tobacco down and winced as he burned his finger.
He shook his hand vigorously for a moment, then turned towards me. "They never seem to have any trouble. Takes about an hour, and no hard labour."
"Sounds marvellous." I shook my head wistfully. "I'm beginning to think I was born too soon. I suppose it's the same with ewes?"
"Oh yes, yes, indeed," Norman murmured airily. "Ewes, cows, sows—they're in and out of the place every day. No problem at all. Nearly as easy as bitch spays."
"Ah, well, you young lads are lucky. It's so much easier to tackle these jobs when you've seen a lot of them done."
"True, true." The student spread his hands. "But, of course, most bovine parturitions don't need a Caesarian, and I'm always glad to have a calving for my case book."
I nodded in agreement. Norman's case book was something to see; a heavily bound volume with every scrap of interesting material meticulously entered under headings in red ink. The examiners always wanted to see these books, and this one would be worth a few extra marks to Norman in his finals.
It was August Bank Holiday Sunday, and Darrowby market place had been bustling all day with holiday makers and coach parties. Each time we passed through I looked at the laughing throngs with a tiny twinge of envy. Not many people seemed to work on Sundays.
I dropped the student at his digs in late afternoon and went back to Skeldale House for tea I had just finished when Helen got up to answer the phone.
"It's Mr. Bushell of Sycamore House," she said. "He has a cow calving."
"Oh damn. I thought we'd have Sunday evening to ourselves." I put down my cup. "Tell him I'll be right out, Helen, will you?" I smiled as she put down the receiver. "One thing, Norman will be pleased. He was just saying he wanted something for his case book."
I was right. The young man rubbed his hands in glee when I called for him, and he was in excellent humour as we drove to the farm.
"I was reading some poetry when you rang the bell," he said "I like poetry. You can always find something to apply to your life. How about now, when I'm expecting something interesting 'Hope springs eternal in the human breast' "
"Alexander Pope, Essay on Man, " I grunted I wasn't feeling so enthusiastic as Norman. You never knew what was ahead on these occasions.
"Jolly good." The young man laughed. "You aren't easy to catch out."
We drove through the farm gateway into the yard.
"You've made me think with your poetry," I said. "It keeps buzzing in my head 'Abandon hope all ye who enter here ' "
"Dante, of course, The Inferno. But don't be so pessimistic." He patted me on the shoulder as I put on my Wellingtons.
The farmer led us into the byre, and in a stall opposite the window a small cow looked up at us anxiously from her straw bed. Above her head, her name, Bella, was chalked on a board.
"She isn't very big, Mr. Bushell," I said.
"Eh?" he looked at me enquiringly, and I remembered that he was hard of hearing.
"She's a bit small," I shouted.
The farmer shrugged. "Aye, she allus was a poor doer. Had a rough time with her first calvin', but she milked well enough after it."
I looked thoughtfully at the cow as I stripped off my shirt and soaped my arms. I didn't like the look of that narrow pelvis, and I breathed the silent prayer of all vets that there might be a tiny calf inside.
The farmer poked at the light roan hairs of the rump with his foot and shouted at the animal to make her rise.
"She won't budge, Mr. Herriot," he said. "She's been painin' all day. Ah doubt she's about buggered."
I didn't like the sound of that either. There was always something far wrong when a cow strained for a long time without result. And the little animal did look utterly spent. Her head hung down and her eyelids drooped wearily.
Ah well, if she wouldn't get up, I had to get down. With my bare chest in contact with the ground, the thought occurred that cobbles didn't get any softer with the passage of the years. But when I slid my hand into the vagina, I forgot about my discomfort. The pelvic opening was villainously narrow, and beyond was something that froze my blood: two enormous hooves and, resting on their cloven surfaces, a huge expanse of muzzle with twitching nostrils. I didn't have to feel anymore, but with an extra effort I strained forward a few inches, and my fingers explored a bulging brow squeezing into the small space like a cork in a bottle. As I withdrew my hand, the rough surface of the calf's tongue flicked briefly against my palm.
I sat back on my heels and looked up at the farmer "There's an elephant in there, Mr. Bushell."
"Eh?"
I raised my voice. "A tremendous calf, and no room for it to come out."
"Can't ye cut it away?"
"Afraid not. The calf's alive and, anyway, there's nothing to get at. No room to work."
"Well, that's a beggar," Mr. Bushell said. "She's a good little milker. Ah don't want to send 'er to the butcher."
Neither did I. I hated the very thought of it, but a great light was breaking beyond a new horizon. It was a moment of decision, of history I turned to the student.
"This is it, Norman! The ideal indication for a Caesar. What a good job I've got you with me. You can keep me right."
I was slightly breathless with excitement, and I hardly noticed the flicker of anxiety in the young man's eyes.
I got to my feet and seized the farmer's arm. "Mr Bushell, I'd like to do a Caesarian operation on your cow."
"A what?"
"A Caesarian. Open her up and remove the calf surgically."
"Tek it out o' the side, d'ye mean? Like they do wi' women?"
"That's right."
"Well that's a rum' un." The farmer's eyebrows went up. "I never knew you could do that wi' cows."
"Oh, we can now," I said airily "Things have moved on a bit in the last few years."
He rubbed a hand slowly across his mouth. "Well, ah don't know. I reckon she'd die if you made a bloody great 'ole in her like that. Maybe she'd be better goin' for slaughter. I'd get a few quid for her and I allus think fust loss is best."
I could see my big moment slipping away from me. "But she's only a thin little thing. She wouldn't be worth much for meat, and with a bit of luck we might get a live calf out of her."
I was going against one of my steadfast rules—never to talk a farmer into doing something—but I was seized by a kind of madness. Mr. Bushell looked at me for a long time, then, without changing expression, he nodded.
"Awright, what do you want?"
"Two buckets of warm water, soap, towels," I replied. "And I'll bring some instruments into the house to boil, if I may."
When the farmer had departed, I thumped Norman on the shoulder "This is just right. Plenty of light, a live calf to aim for and it's just as well poor Mr. Bushell doesn't hear too well. If we keep our voices down, I'll be able to ask you things as we go along."
Norman didn't say anything. I told him to set up some straw bales for our equipment and had him scatter loose straw around the cow while I boiled the instruments in a pan in the farm kitchen.
Soon all was ready—syringes, suture materials, scalpels, scissors, local anaesthetic and cotton wool laid in a row on a clean towel draped over one of the bales. I added some antiseptic to the water and addressed the farmer.
"We'll roll her over and you can hold the head down, Mr. Bushell I think she's too tired to move much."
Norman and I pushed at the shoulder, and Bella flopped on her side without resistance. The farmer put his knee against her neck, and the long area of the left flank was exposed for our attention.
I nudged the student. "Where do I make the incision?" I whispered.
Norman cleared his throat. "Well, er, it's about…" he pointed vaguely.
I nodded. "Around the rumenotomy site, eh? But a bit lower, I suppose." I began to clip away the hair from a foot-long strip It would need a big opening for that calf to come through. Then I quickly infiltrated the area with local.
We do these jobs under a local anaesthetic and in most cases the cow lies quietly on her side or even stands during the operation. The animal can't feel anything, of course, but I have a few extra grey hairs round my ears that owe their presence to the occasional wild cow suddenly rearing up halfway through and taking off with me in desperate pursuit, trying to keep her internal organs from flopping on the ground.
But that was all in the future. On this first occasion I had no such fears. I cut through skin, muscle layers and peritoneum, and was confronted by a protruding pink and white mass of tissue.
I poked at it with my finger. There was something hard inside. Could it be the calf?
"What's that?" I hissed.
"Eh?" Norman, kneeling by my side, jumped convulsively. "What do you mean?"
"That thing. Is it the rumen or the uterus? It's pretty low down, it could be the uterus."
The student swallowed a couple of times. "Yes… yes… that's the uterus all right."
"Good." I smiled in relief and made a bold incision. A great gout of impacted grass welled out, followed by a burst of gas and an outflow of dirty brown fluid.
"Oh, Christ!" I gasped. "It's the rumen. Look at all that bloody mess!" I groaned aloud as the filthy tide surged away down and out of sight into the abdominal cavity. "What the hell are you playing at, Norman?"
I could feel the young man's body trembling against mine.
"Don't just sit there!" I shouted. "Thread me one of those needles. Quick! Quick!"
Norman bounded to his feet, rushed over to the bale and returned with a trailing length of catgut extended in shaking fingers. Wordlessly, drymouthed,
I stitched the gash I had made in the wrong organ. Then the two of us made frantic attempts to swab away the escaped rumenal contents with cotton wool and antiseptic, but much of it had run away beyond our reach. The contamination must be massive.
When we had done what we could, I sat back and looked at the student. My voice was a hoarse growl. "I thought you knew all about these operations."
He looked at me with frightened eyes. "They do quite a few of them at the clinic."
I glared back at him. "How many Caesarians have you seen?"
"Well… er… one, actually."
"One! To hear you speak I thought you were an expert! And, anyway, even if you'd seen only one, you should know a little bit about it."
"The thing is…" Norman shuffled his knees around on the cobbles. "You see… I was right at the back of the class."
I worked up a sarcastic snarl. "Oh, I understand. So you couldn't see very well?"
"That's about it." The young man hung his head.
"Well, you're a stupid young fool!" I said in a vicious whisper. "Dishing out your confident instructions when you know damn all. You realise you've killed this good cow. With all that contamination, she'll certainly develop peritonitis and die. All we can hope for now is to get the calf out alive." With an effort I turned my gaze from his stricken face. "Anyway, let's get on with it."
Apart from my first shouts of panic, the entire interchange had been carried out pianissimo, and Mr. Bushell kept shooting enquiring glances at us.
I gave him what I hoped was a reassuring smile and returned to the attack. Getting the calf out alive was easy to say, but it soon dawned on me that getting the calf out in any way whatsoever was going to be a mammoth task. Plunging my arm deep below what I now knew was the rumen, I encountered a smooth and mighty organ lying on the abdominal floor. It contained an enormous bulk with the hardness and immobility of a sack of coal.
I felt my way along the surface and came upon the unmistakable contours of a hock pushing against the slippery wall. That was the calf, all right, but it was far, far away.
I withdrew my arm and started on Norman again. "From your position at the back of the class," I enquired bitingly, "did you happen to notice what they did next?"
"Next? Ah, yes." He licked his lips, and I could see beads of sweat on his brow. "You are supposed to exteriorise the uterus."
"Exteriorise it? Bring it up to the wound, you mean?"
"That's right."
"Good God!" I said. "King Kong couldn't lift up that bloody uterus. In fact I can't move it an inch. Have a feel."
The student, who was stripped and soaped like myself, introduced his arm and for a few moments I watched his eyes pop and his face redden.
Then he withdrew and nodded sheepishly. "You're right. It won't move."
"Only one thing to do." I picked up a scalpel. "I'll have to cut into the uterus and grab that hock. There's nothing else to get hold of."
It was very nasty, fiddling about away out of sight down in the dark unknown, my arm buried to the shoulder in the cow, my tongue hanging out with anxiety. I was terrified I might slash into something vital but, in fact, it was my own fingers that I cut, several times, before I was able to draw the scalpel edge across the bulge made by the hock. A second later I had my hand round the hairy leg. Now I was getting somewhere.
Gingerly, I enlarged the incision, inch by inch. I hoped fervently I had made it big enough, but working blind is a terrible thing, and it was difficult to be sure.
At any rate, I couldn't wait to deliver that calf. I laid aside my knife, seized the leg and tried to lift it, and immediately I knew that another little nightmare lay ahead. The thing was a tremendous weight and it was going to take great strength to bring it up into the light of day. Nowadays when I do a Caesar, I take care to have a big strong farm lad stripped off, ready to help me with this lifting job, but today I had only Norman.
"Come on," I panted. "Give me a hand."
We reached down together and began to pull. I managed to repel the hock and bring the foot round, and that gave us greater purchase, but it was still agonisingly laborious to raise the mass to the level of the skin incision.
Teeth clenched, grunting with effort, we hauled upwards till at last I was able to grasp the other hind leg. Even then, with a foot apiece in our hands, nothing wanted to move. It was just like doing a tough calving except it was through the side. And as we lay back, panting and sweating, pulling with every vestige of our strength, I had the sudden wave of illumination which comes to all members of our profession at times. I wished with all my heart and soul that I had never started this ghastly job. If only I had followed Mr. Bushell's suggestion to send the cow for slaughter I would now be driving peacefully on my rounds. Instead, here I was, killing myself. And even worse than my physical torment was the piercing knowledge that I hadn't the slightest idea what was going to happen next.
But the calf was gradually coming through. The tail appeared, then an unbelievably massive rib cage and finally with a rush, the shoulders and head.
Norman and I sat down with a bump, the calf rolling over our knees. And like a gleam of light in the darkness, I saw that he was snorting and shaking his head.
"By gaw, he's a big 'un!" exclaimed the farmer. "And wick, too."
I nodded. "Yes, he's huge. One of the biggest I've ever seen." I felt between the hind legs. "A bull, as I thought. He'd never have come out the proper way."
My attention was whisked back to the cow. Where was the uterus? It had vanished. Again I started my frantic groping inside. My hand became entangled with yards of placenta. Oh hell, that wouldn't do any good floating around among the guts I pulled it out and dropped it on the floor, but I still couldn't find the uterus. For a palpitating moment I wondered what would happen if I never did locate it, then my fingers came upon the ragged edge of my incision.
I pulled as much as possible of the organ up to the light, and I noticed with sinking disquiet that my original opening had been enlarged by the passage of that enormous calf and there was a long tear disappearing out of sight towards the cervix.
"Sutures." I held my hand out, and Norman gave me a fresh needle. "Hold the lips of the wound," I said and began to stitch.
I worked as quickly as I could and was doing fine until the tear ran out of sight. The rest was a kind of martyrdom. Norman hung on grimly while I stabbed around at the invisible tissue far below. At times I pricked the young man's fingers, at others my own. And to my dismay, a further complication had arisen.
The calf was now on its feet, blundering unsteadily around. The speed with which newly born animals get onto their legs has always fascinated me, but at this moment it was an unmitigated nuisance.
The calf, looking for the udder with that instinct which nobody can explain, kept pushing his nose at the cow's flank and at times toppling headfirst into the gaping hole in her side.
"Reckon 'e wants back in again," Mr. Bushell said with a grin. "By 'eck, he is a wick 'un."
"Wick" is Yorkshire for lively, and the word was never more aptly applied. As I worked, eyes half-closed, jaws rigid, I had to keep nudging the wet muzzle away with my elbow, but as fast as I pushed him back the calf charged in again, and with sick resignation I saw that every time he nosed his way into the cavity, he brought particles of straw and dirt from the floor and spread them over the abdominal contents.
"Look at that," I moaned. "As if there wasn't enough muck in there."
Norman didn't reply. His mouth was hanging open and the sweat ran down his blood-streaked face as he grappled with that unseen wound. And in his fixed stare I seemed to read a growing doubt as to his wisdom in deciding to be a veterinary surgeon.
I would rather not go into any more details. The memory is too painful. Sufficient to say that, after an eternity, I got as far down the uterine tear as I could, then we cleared away a lot of rubbish from the cow's abdomen and covered everything with antiseptic dusting powder. I stitched up the muscle and skin layers, with the calf trying all the time to get in on the act, and at last the thing was finished.
Norman and I got to our feet very slowly, like two old, old men. It took me a long time to straighten my back, and I saw the young man rubbing tenderly at his lumbar region. Then, since we were both plastered with caked blood and filth, we began the slow process of scrubbing and scraping ourselves clean.
Mr. Bushell left his position by the head and looked at the row of skin stitches. "Nice neat job," he said. "And a grand calf, too."
Yes, that was something. The little creature had dried off now, and he was a beauty, his body swaying on unsteady legs, his wide-set eyes filled with gentle curiosity But that "neat job" hid things I didn't dare think about.
Antibiotics were still not in general use, but, in any case, I knew there was no hope for the cow. More as a gesture than anything else, I left the farmer some sulpha powders to give her three times a day. Then I got off the farm as quickly as I could.
We drove away in silence. I rounded a couple of corners, then stopped the car under a tree and sank my head against the steering wheel.
"Oh hell," I groaned. "What a bloody balls-up."
Norman replied only with a long sigh and I continued, "Did you ever see such a performance? All that straw and dirt and rumenal muck in among that poor cow's bowels. Do you know what I was thinking about towards the end? I was remembering the story of that human surgeon of olden times who left his hat inside his patient. It was as bad as that."
"I know." The student spoke in a strangled undertone. "And it was all my fault."
"Oh no, it wasn't," I replied. "I made a right bollocks of the whole thing all by myself, and I tried to blame you because I got in a panic I shouted and nagged at you and I owe you an apology. "
"Oh no, no…"
"Yes, I do. I am supposed to be a qualified veterinary surgeon, and I did nearly everything wrong." I groaned again. "And on top of it all, I behaved like an absolute swine towards you, and I'm sorry."
"You didn't really, you didn't… I…"
"Anyway, Norman," I broke in. "I'm going to thank you now. You were a tremendous help to me You worked like a Trojan and I'd have got nowhere at all without you. Let's go and have a pint."
With the early-evening sunshine filtering into the bar parlour of the village inn, we dropped into a quiet corner and pulled deeply at our beer glasses.
We were both hot and weary and there didn't seem to be anything more to say.
It was Norman who broke the silence. "Do you think that cow has any chance?"
I examined the cuts and punctures on my fingers for a moment. "No, Norman. Peritonitis is inevitable, and I'm pretty sure I've left a good-sized hole in her uterus." I shuddered and slapped my brow at the memory.
I was sure I would never see Bella alive again, but first thing next morning a morbid curiosity made me lift the phone to find out if she had survived so far.
The "buzz-buzz" at the other end seemed to last a long time before Mr. Bushell answered.
"Oh, it's Mr. Herriot. Cow's up and eatin'." He didn't sound surprised.
It was several seconds before I was able to absorb his words.
"Doesn't she look a bit dull or uncomfortable?" I asked huskily.
"Nay, nay, she's bright as a cricket. Finished off a rackful of hay, and I got a couple o' gallons of milk from 'er."
As in a dream I heard his next question. "When'll you take them stitches out?"
"Stitches… Oh yes." I gave myself a shake. "In a fortnight, Mr. Bushell, in a fortnight."
After the horrors of the first visit, I was glad Norman was with me when I removed the sutures. There was no swelling round the wound, and Bella chewed her cud happily as I snipped away. In a pen nearby the calf gambolled and kicked his feet in the air.
I couldn't help asking, "Has she shown any symptoms at all, Mr. Bushell?"
"Nay." The farmer shook his head slowly. "She's been neither up nor down. You wouldn't know owt had happened to 'er."
That was the way it was at my first Caesarian. Over the years Bella went on to have eight more calves normally and unaided, a miracle which I can still hardly believe.
But Norman and I were not to know that all we felt then was an elation all the sweeter for being unexpected.
As we drove away I looked at the young man's smiling face. "Well, Norman," I said "That's veterinary practice for you. You get a lot of nasty shocks, but some lovely surprises, too. I've often heard of the wonderful resistance of the bovine peritoneum, and thank heavens it's true."
"The whole thing's marvellous, isn't it?" he murmured dreamily. "I can't describe the way I feel. My head seems to be full of quotations like 'Where there is life there's hope.' "
"Yes, indeed," I said. "John Gay, isn't it—The Sick Man and the Angel."
Norman clapped his hands. "Oh, well done."
"Let's see." I thought for a moment. "How about 'But't'was a famous victory' "
"Excellent," replied the young man "Southey, The Battle of Blenheim."
I nodded. "Quite correct."
"Here's a good one," the student said. " 'Out of this nettle, danger, we pluck this flower, safety.' "
"Splendid, splendid," I replied. "Shakespeare, Henry Fifth."
"No, Henry Fourth."
I opened my mouth to argue, but Norman held up a confident hand. "It's no good, I'm right. And this time I do know what I'm talking about."
还没人赞这篇日记
