Lord God Made Them All (11 page)

It all started when a young representative from a pharmaceutical company called at the surgery and started to talk about a wonderful new treatment for foul of the foot in cattle.

This condition was a headache in those early days. Judging by its name, it had been going on for centuries, and it happened when the interdigital space between the cleats of the cloven-footed bovine was invaded by the organism
Fusiformis necrophorus,
usually through some small wound or abrasion.

This resulted in the actual death of an area of tissue in the region along with swelling of the foot and extreme lameness. A good cow could lose condition at an alarming rate due simply to the pain. The medieval-sounding name came from the fact that the dead tissue gave off a particularly offensive smell.

The treatment we used to employ ranged from the tedious to the heroic. Cows’ hind feet were never meant to be lifted up, and I was always relieved when it was a forefoot that was affected. With hind feet, even applying antiseptics was a chore. If that didn’t work, we bandaged on pads of cotton wool impregnated with caustics like copper sulphate, and a very popular treatment among the farmers was dressing the area with Stockholm tar and salt—a messy and unpleasant business with the feet whistling round the head of the operator.

So I couldn’t believe it when the representative told me that an injection of M & B 693 into the vein would rapidly clear up the condition.

I actually laughed at the young man. “I know you chaps have to make a living, but this sounds like one of your tallest stories.”

“It works, I tell you,” he said. “It has been well tested, and I promise you it really does the trick.”

“And you don’t have to touch the foot at all?”

“No, only for diagnosis. Then you can forget about it”

“How long does it take to have an effect?”

“Just a few days. And I give you my word, the cow is sometimes much better within twenty-four hours.”

It sounded like a beautiful dream. “Okay,” I said. “Send some on. We’ll give it a try.”

He made a note on his pad, then looked up. “There’s just one thing. This drug is very irritant. You must be sure you don’t get it subcutaneous, or it could cause an abscess.”

As he walked out of the door, I wondered if this really meant the end of one of our most disagreeable tasks. I had already had occasion to be thankful for the beneficent M
&
B tablets. They had wrought some minor miracles in our practice. But I found it hard to believe that an intravenous injection could cure a necrotic condition of the foot.

When the stuff arrived, I had the same trouble convincing the farmers. “What are you doin’, injectin’ the neck? You should be puttin’ it into t’bloody foot.” Or, “Is that all you’re goin’ to do? Aren’t you goin’ to give me summat to put on t’foot?” These were typical remarks, and my answers were halting because I had the same reservations as the stock owners.

But oh, how magically everybody’s attitude changed because it was just as the young man said. Very often within a single day the beast was walking sound, the swelling had gone down, the pain had vanished. It was like witchcraft.

It was a giant step forward and I was at the height of my euphoria when I saw Robert Maxwell’s cow. The reddened swollen foot, the agonised hopping, the stinking discharge—it was all there.

The fact is that it was so bad that I was delighted; I had found that the worst cases, with the acute lameness and the interdigital tissues pouting from toe or heel, were the ones that recovered quickest.

“We’ll have some work on with this ’un,” the farmer grunted. He was in his late forties, a dynamic little man and one of the bright farmers of the district. He was always to the fore in farmers’ discussion groups, always eager to learn and teach.

“Not a bit of it, Mr. Maxwell,” I said airily. “There’s a new injection for this now. No foot dressing—that’s gone for good.”

“Well, that would be a blessin’, anyway. It’s savage amusement, hangin’ onto cows’ feet.” He bent over the leg and looked down. “Where exactly do ye inject this new stuff, then?”

“In the neck.”

“In the neck!”

I grinned. I never seemed to get tired of the reaction. “That’s right. Into the jugular vein.”

“Well, there’s summat new every day now.” Robert Maxwell shrugged and smiled, but he accepted it. The intelligent farmers like him were the ones who didn’t argue. It was always the thickheads who knew everything.

“Just hold the nose,” I said. “That’s right, pull the head a little way round. Fine.” I raised the jugular with my finger, and it stood out like a hosepipe as I slipped the needle into it. The M & B solution ran into the blood stream in about two minutes, and I pulled the needle out.

“Well, that’s it,” I said with a trace of smugness.

“Nothing else?”

“Not a thing. Forget about it. That cow will be sound in a few days.”

“Well, I don’t know.” Robert Maxwell looked at me with a half-smile. “You young fellers keep surprising me. I’ve been in farmin’ all me life, but you do things I’ve never dreamed of.”

I saw him at a farmers’ meeting about a week later.

“How’s that cow?” I asked.

“Just like you said. Sound as a bell o’ brass. That stuff shifts foul, all right, there’s no doubt about it; it’s like magic.”

I was just expanding when his expression changed. “But there’s a heck of a swelling on ’er neck.”

“You mean, where I injected her?”

“Yes.”

My happy feeling evaporated. I didn’t like the sound of that. My first thought was that I must have got some of the solution under the skin, but I seemed to remember the blood still gushing from the needle when I pulled it out.

“That’s funny,” I said. “I can’t see any reason for that.”

Robert Maxwell shook his head. “I can’t, either. I did that cow over with fly spray right after you left. Could some of that have got in your needle wound?”

“No … surely not. I’ve never heard of such a thing. I’d better have a look at her tomorrow.”

I made it one of my first calls the next morning. The farmer had not been exaggerating. There was a marked swelling on the neck, but it was not confined to the injection site. It ran right along the course of the jugular. The vein itself had a solid, corded feel, and there was oedema around the swollen area.

“She’s got phlebitis,” I said. “The vein has somehow got infected through my injection.”

“How would that happen?”

“I just don’t know. I’m pretty sure none of the solution escaped, and my needle was clean.”

The farmer peered closely at the cow’s neck. “It’s not like an abscess, is it?”

“No,” I replied. “There’s no abscess.”

“And what’s that long, hard lump goin’ up to the jaw?”

“That’s a thrombus.”

“A what?”

“A thrombus. A big clot in the vein.” I wasn’t enjoying this little pathological lecture, considering that I had been responsible for the whole thing myself.

Robert Maxwell gave me a searching look. “Well, what’s going to happen? What do we do?”

“Usually, collateral circulation develops within a few weeks. That is, other veins take over the job. And, in the meantime, I’ll put her onto a course of mixed sulphonamide powders.”

“Aye, well, she doesn’t seem bothered,” the farmer said.

That was one gleam of light. The cow had been looking round at us contentedly as we spoke, and now I saw her pulling a little hay from her rack.

“No … no … She doesn’t look concerned at all. I’m sorry this has happened, but it should just be a question of time before she’s right.”

He scratched the root of the animal’s tail for a moment. “Would bathin’ with hot water do any good?”

I shook my head vigorously. “Please don’t touch that place at all. It would be dangerous if that clot broke down.”

I left the powders and drove away, but I had that nasty feeling I always have when I know I have boobed. I gripped the wheel and swore under my breath. What had I done wrong? The sterilised disposable needles and syringes which we take for granted now were unknown then, but Siegfried and I always boiled our hypodermics and carried them in cases where they were always immersed in surgical spirit. We could hardly do more. Had the farmer’s fly spray done something? Hard to believe.

In any case, I comforted myself with the thought that the cow didn’t look ill. These cases recovered in time. But the unpalatable fact remained. That animal had had a simple case of foul until James Herriot MRCVS took a hand, and now she had jugular phlebitis.

Helen had just put my breakfast in front of me on the following morning when the phone rang. It was Robert Maxwell.

“That cow’s dead,” he said.

I stared stupidly at the wall in front of me for several seconds before I could speak. “Dead … ?”

“Aye, found ’er laid in her stall this mornin’. Just as though she’d dropped down.”

“Mr. Maxwell … I … er.” I had to clear my throat more than once. “I’m terribly sorry. I never expected this.”

“What’s happened, then?” The farmer’s voice was strangely matter-of-fact.

“There’s only one explanation,” I said. “Embolism.”

“What’s that?”

“It’s when a piece of the clot breaks off and gets into the circulation. When an embolus reaches the heart, it usually means death.”

“I see. That would do it, then.”

I swallowed. “Let me say again, Mr. Maxwell, I’m very sorry.”

“Ah, well …” There was a pause. “These things happen in farmin’. I just thought I’d let you know. Good mornin’.”

I felt sick as I put the phone down, and the feeling persisted as I sat at the breakfast table, staring at my plate.

“Aren’t you going to eat, Jim?” Helen asked.

I looked down sadly at the nice slice of home-fed ham. “Sorry, Helen, it’s no good. I can’t tackle it.”

“Oh, come on.” My wife smiled and pushed the plate nearer to me. “I know you worry about your work, but I’ve never known it to put you off your food.”

I shrugged miserably. “But this is different. I’ve never killed a cow before.”

Of course, I didn’t know this for sure—I never will know—but the thing stayed with me for a long time. I am a great believer in Napoleon’s dictum, “Throw off your worries when you throw off your clothes,” and I had never known the meaning of insomnia, but for many nights, turgid jugular veins and floating emboli brought me gasping to wakefulness.

As time passed I continued to wonder at the farmer’s attitude on the phone. Most people would have been furious at a disaster like this, and it would have been natural enough if Robert Maxwell had blasted me at great length. But he hadn’t been rude, hadn’t even tried to blame me.

Of course, there was always the possibility that he might be going to sue me. He was a nice man, but, after all, he had suffered a financial loss, and it would not take a legal genius to make out a good case that I was the villain.

But the solicitor’s letter never arrived. In fact, I did not hear a word from the farmer for nearly a month, and since I had been a regular visitor on his place, I concluded that he had changed his veterinary surgeon. Well, I had lost the practice of a good client, and that was not a pleasant thought, either.

Then one afternoon the phone rang, and it was Robert Maxwell again, speaking in the same quiet voice. “I want you to come and look at one of me cows, Mr. Herriot. There’s somethin’ amiss with her.”

A wave of relief went through me. Not a mention of the other thing, just a call for assistance as if nothing had happened. There were a lot of charitable farmers in the Dales, and this man was one of them. I just hoped I could make it up to him in some way.

What I wanted was a case I could cure quickly and, if possible, in a spectacular manner. I had a lot of ground to make up on this farm.

Robert Maxwell received me with his usual quiet courtesy.

“That was a good rain last night, Mr. Herriot. The grass was gettin’ right parched.” It was as though my last unhappy visit had never occurred.

The cow was a big Friesian, and when I saw her my hopes of a cheap triumph vanished in an instant. She was standing, arch-backed and gaunt, staring at the wall in front of her. One thing I hate to see is a cow staring at the wall. As we approached she showed no interest, and I made a spot diagnosis. This was traumatic reticulitis. She had swallowed a wire. I would have to operate on her, and after my last experience in this byre the idea did not appeal.

Yet, when I began to examine her, I realised that things were not adding up. The rumen was working well, seething and bubbling under my stethoscope, and when I pinched her withers she did not grunt—just swivelled an anxiety-ridden eye in my direction before turning her attention to the wall again.

“She’s a bit thin,” I said.

“Aye, she is.” Robert Maxwell dug his hands into his pockets and surveyed the animal gloomily. “And I don’t know why. She’s had nobbut the best of stuff to eat, but she’s lost condition fast over the last few days.”

Pulse, respiration and temperature were normal. This was a funny one.

“At first I thought she had colic,” the farmer went on. “She kept tryin’ to kick at her belly.”

“Kicking at her belly?” Something was stirring at the back of my mind. Yes, that was often a symptom of nephritis. And as if to clinch my decision, the animal cocked her tail and sent a jet of bloody urine into the channel. I looked at the pool behind her. There were flecks of pus among the blood, and though I knew her trouble now, it did not make me happy.

I turned to the farmer. “It’s her kidneys, Mr. Maxwell.”

“Her kidneys? What’s the matter wi’ them?”

“Well, they’re inflamed. They’ve become infected in some way. It’s called pyelonephritis. Probably the bladder is affected, too.”

The farmer blew out his cheeks. “Is it serious?”

How I wished I could give him, of all people, a light answer, but there was no doubt that this was a usually fatal condition. I had a feeling of doom.

“I’m afraid so,” I replied. “It is very serious.”

“I had a feelin’ there was somethin’ far wrong. Can you do owt for her?”

“Yes,” I said. “I would like to try her with some mixed sulphonamides.”