Monday July 26, 2010
Dr. Jones was our family physician. He made house calls. I suppose that in and of itself is enough to date my childhood to an entirely different era. One more factoid about our doctor – he was obese. Really obese. You know, the kind of obese that means he would have lost his trousers with a good sneeze. At age eight, the prospect of your doctor involuntarily dropping his pants right there in the living room of your house triggered an uncontrollable snicker. But the sneeze never happened. The pants stayed in place.
Today, we would never even imagine a physician coming by the house. Maybe in an old Norman Rockwell scene – a cute little girl bundled up in a bed covered with fluffy quilts and propped up on a down pillow or two and a glass thermometer positioned just so in her mouth as a concerned mother looks on, worried, hands folded. The doctor stands over the little girl making his assessment and preparing to propose a treatment. Those days are gone for good.
But out here in the central valley, Stanislaus County, there are doctors who make house calls. There are several growing cities, university towns, mainly around agriculture. They grow peaches and grapes and lots of almonds. There are chickens and eggs and milk and cheese. The Dutch and the Portuguese run dairy farms, some of the biggest and best in the world.
The doctors who make the house calls are veterinarians. There are small animal vets and big animal vets. This week, I made the rounds with a veteran veterinarian. Dr. Ed Fisher specializes in the big animals.
When trouble strikes any one of a herd of holsteins, those familiar white and black patched cows first imported some hundred and fifty years ago from Holland, the call goes in. The doctor jumps in his specially equipped pick up truck and heads out to the scene. Dairy herdsmen prepare the ailing cow for the vet’s arrival.
Over an early breakfast, we talked about the life of a veterinarian out here in the country. It occurs to me that many of the issues Ed encounters in the animals are very similar to human health issues. I mean, the Holstein has a heart, lungs, esophagus, intestinal tract, bowels, eyes, ears, teeth, etc., etc. It’s still an anatomy course, right Doc? Ed laughs.
Yep, he says. “You know, what we do out there in the field is similar, but the conditions we work under and procedures we follow are vastly different than the sterile controlled environments of the hospital room or surgical suite.”
Now I laugh. “I guess so,” I respond,
Ed continues. “What we do is more like third world medicine, without the stainless steel and the sterile hallways. It appears to be much more primitive. We just take care of business. Every case is a new challenge. I assess. I diagnose. I treat. Sometimes with a scalpel.”
Ed could have been a human doctor, a physician. He would be a good one. He was a science whiz. Top grades. High scores. But I can tell, he loves what he does.
“Medicine is a science and an art. I like both: the science and the art.”
So after breakfast and a tour of the clinic, the phone rings. Ed takes the message from the morning’s dispatcher. “Looks like you might get to watch a surgery,” Ed says as we climb into the Ford pickup.
And I did. I’ll spare you the detail. After confirming the “twisted stomach” or gastric dilatation-volvulus, sometimes called bloat, and prepping the ailing cow with an anesthetic drug and shaving a large spot where the ten inch incision would be made, Ed turned to me and asked, “Are you OK with blood?”
“Uh, I think so,” I answered. “I guess we’ll soon find out.” I forced a smile.
Ed gave me instructions on what to do if I felt in any way queasy, suggesting that it would be better to sit down than to fall, especially considering the slop at my feet. “Check,” I said. And Ed took scalpel to the sterilized spot, just behind the rib cage as I observed.
The cow was conscious during the entire procedure in which Dr. Fisher rearranged the animal’s organs, reaching deep into the abdominal cavity up to his shoulder, his arm covered in clear plastic. He poked a thick needle in just the right place as a release valve providing a way of escape for trapped, noxious gas. With another needle and line, he tied the end of the stomach to a chord which he poked through the cow’s belly and in a precision, carefully choreographed motion pushed and pulled until that twisted stomach unravelled and set back where it belonged. To finish he job, he fastened a plastic button to the line on the exterior of the leathery skin, just to keep the digestive organ from disastrously slipping away and twisting up again. A button and a bow.
The ranch hand holding the tail as Ed worked breathed a sigh of relief, knowing that this cow’s life had been spared and would return to the herd again as a producing milker.
And as the good doctor finished the procedure, with the skill of a surgeon, which he is, Ed sewed back the muscle tissue and the exterior leather so that the patient would would heal nicely. He took pride in the stitching.
And me? I gave the assist.
Copyright Kenneth E. Kemp 2010