Small Things and Large — Vet Tech Week Bonus

[using an anesthetized Great Dane to warm up pediatric surgical patients in the MAWS clinic, Botswana]

During my time in veterinary medicine and animal care, I’ve worked with many sizes of patients; from elephants, cattle, and horses to hummingbirds, guinea pigs, and mice. There is something strange and special about the difference in their normal parameters, how a heart rate of 30 beats per minute is to be expected in the adult Asian elephant while the mouse’s can vary from 250 to almost 800 beats per minute. And yet, both are essentially the same — an evolutionary template of form and function that matches the one inside our own chests. And both need the same care under anesthetic. 

“Small Things and Large” tells the story of routine surgery on our smallest patients. 

She’s quite sweet. She arrives in a little carrying cage, with newspaper and a wicker basket and a soft fleece blanket, silky brown hair and a rotund little belly revealing themselves as she pokes her head out to say hello. She snuffles at the bars and watches with brightly intelligent eyes as we prepare the chamber where we’ll administer the anesthetic gas, a heated towel for her bed, an oxygen mask for keeping her asleep once we begin. One of the receptionists brings back the paperwork and hesitates before putting it on the table next to her. “Does she bite, do you think?” The rat peers at her for a brief moment before she begins grooming her face with her front paws, sitting daintily on her hindquarters. “Only, I don’t know, I always thought they bit. I don’t know,” she says again, “I don’t like them.”

“They make good pets,” one of the other techs says. She’s getting the anesthetic chamber ready, attaching the tubing with practiced hands. “Really smart.” The other techs murmur in agreement. “You can train them to pee in a litter box, you know.”

The receptionist raises her eyebrows. She reaches out towards the rat; the rat leans forward to sniff delicately at her fingers from between the slats of the cage. The receptionist makes a little noise that’s half shock and half delight as the rat inspects her, and in turn the rat twitches her whiskers and makes a firm study of the receptionist’s fingertips. “I’ve never touched one,” she tells me afterwards. And, grudgingly, “It wasn’t that bad.” For now, though, she hangs back and watches as we place the rat in the chamber and switch on the isoflurane.

It’s a quiet and easy anesthetic induction. Just a few twitches and the rat’s asleep, hairless tail curled around her as if she’s trying to stay warm. We tie the mask over her long nose and behind tiny ears, oxygen and anesthetic gases keeping her from waking. I have to leave to do x-rays as they’re shaving her belly and quietly trying to figure out what the best place is to scrub and prep; they’re not sure exactly where the incision will go. The rat breathes peacefully. I brush my fingers over the curve of her chest as I go; the beating of her heart vibrates against my fingers far too quickly to count her pulse.

A little while later the vet calls me over. He wants me to see the spay. I throw on a cap and mask, stand well back from the sterile drapes as I watch him cut expertly through the layers of skin and muscle. Fat wells from her abdomen as he digs for the uterus; patiently he replaces it each time it threatens to block his view.  The uterus is covered in pale greasy globules when he finally exteriorizes it, chuckling. “I thought she was pregnant,” he tells me. “Just big, I guess.” The uterus is surprisingly small and surprisingly large all at the same time, two thin ribbons of pink tissue with ovaries I can hardly see but somehow taking up more space than I ever would have thought. It seems like it takes the vet only moments to tie off the blood vessels, slice through, tuck the fat back in. Suddenly he’s closing. He’s a big man and his hands seem to dwarf the needle drivers as he patiently guides the suture through. I would have expected him to be clumsy. Instead, his fingers create suture knots almost too small to see.

The last stitch goes in, the monitoring technician switches off the anesthetic, and it’s done. “See?” he says, “Easy. Just like a cat, only smaller.” The rat blinks sleepily at me over the oxygen mask, already waking up. The vet strokes her chest with a finger that covers it completely. I don’t know if he’s comforting her or checking her heart. She is so tiny and he is so large and yet I can’t shake the feeling that they lay claim to the same dexterity of movement, the same grace in their limbs. She runs and climbs and lives her life with the same perfect sense of belonging that I see in surgery as my vet pins hollow bird-bones, turns gaping wounds into tiny lines of barely-visible knots, finds the hurting places and guides them back to health. As she begins to stir he picks her up and lets her curl into his palm, leans against the surgery table. They watch each other. The thrumming of her pulse fits perfectly into the space between his heartbeats.