Kenny, our team’s MacGyver, uses rebar, barbed wire, and twine to set up a saline drip.
Back to Botswana. Both at the clinic and on the road we were working in less-than-ideal conditions, performing less-than-ideal surgeries. Weighing the risks against the benefits, particularly in communities where we knew we’d only be temporarily, with no option for aftercare or allowing a week or so to perk up prior to sterilization. I monitored more than a few hair-raising spays and neuters (and will never stop being in awe of the vets who not only performed those surgeries, but did so with a smile), but one that always sticks with me took place our last day of my first outreach, in Gumare. We had intended on only doing a quick morning there before hitting the road, but as anyone who’s ever worked in vet med knows (and with apologies to Robbie Burns), the best laid schemes o’ techs an’ vets gang aft agley. We met her in the late morning, one of those difficult cases of sterilization trips where one has to weigh lives in the balance and make a decision for the benefit of all. These are not easy decisions and these are not easy cases. But this is what we do.
I sit down to write, and I think — I don’t remember her name.
Of course, she might not have had one. Or she might have had a name but no one ever told us, or no one ever told me, or someone mentioned it in the moments between sedate-induce-prep-monitor-recover when my mind was scrambling between patients and drug dosages and trying not to get bit and it got dismissed as unimportant information, filed in short-term memory somewhere and dumped that night (drinking Savannah and Windhoek and wolfing down pizza at 10pm, still picking glass out of my hair laughing just a little bit hysterically, should we tell her tonight? — but that’s another story). Still, it feels strange to remember her so well and not have a name. All I have is her entry in the daily log: #9, F, shaggy brindle (pregnant)
Like several of our patients she’s brown brindle with a little white, long tail with a slight curl and half-pricked ears scarred and bloody with flystrike. A slightly longer, wiry coat that speaks to some kind of terrier ancestry. She comes in on the truck with a half-dozen other patients and I first see her through the welded metal grate, sitting slumped in a corner. She stares fixedly at the floor. She’s panting hard. They all are, hot and carsick and confused from what for most is their first vehicle ride. I don’t think twice about it until the back doors open and I see her half-jump half-fall onto the dirt, all skin and bone and an abdomen that looks to be twice as wide around as the length of her body. The buzzing activity in my head quiets for the space of a single thought: oh, crap.
She’s not the first pregnant bitch we’ve done and she’s not the last pregnant bitch we’ll do but there’s a difference between knowing that and seeing her, hipbones straining at the confines of her skin and ribs visible above the swollen mass of her belly. Underneath her teats hang pendulous; this is not her first litter. Even outside of the vehicle she stands head-down and focuses on breathing, ignoring the skittering fleas and ticks that layer her straggly coat.
There’s no time to dwell on it. A brief consultation with the vets and she’s sedated, drowsing in the sun. Vasco helps me lift her onto the table and I’m surprised by how light she is; running my fingers down her back I think about body condition scores. She’s maybe a two out of nine. Emaciated. Her gums might charitably called pale pink. When I shave for the IV catheter, I have to pick ticks out of the way. Stick-tight fleas litter her belly and crowd her swollen mammary glands; I can’t get them all and resort to soaking her in surgical scrub with the vague hope that it might make the little insects somewhat more sterile.
Ketamine and Valium drop her down to the surgical plane of anesthesia, eyes rolled towards her nose and breathing coming harsh but regular. Penicillin in the left hip, anti-inflammatories in the right. She’s vaccinated, given Ivomec against the parasites. Another scrub, a spray of alcohol and she’s ready for the quick carry over to the surgical table. My vet makes a face under her mask. “This is gonna be fun.” I get my top-up syringe of KetVal (the lesser of two evils, I’m not touching this girl with thiopental and our three precious vials of Propofol are long gone) ready, press my stethoscope to her chest, and give my vet the thumbs-up.
I don’t watch most of the surgery. Instead I watch her, counting off breaths and heartbeats and checking eye position, jaw tone, reflexes. She rides light a couple of times until my drugs steady her back down but for the most part she seems glad of the sleep. Kenny channels MacGyver and manages to set up an IV pole from rebar and twine and barbed wire; we hang a precious litre of saline and do our best to replace what’s trickling out of her with every move my vet makes. I’m only vaguely aware of the children and adults crowded around me. They watch curiously, make little comments, ask questions. Someone has a smartphone and films part of it. Somewhere in Botswana there’s shaky video of my veterinarian exteriorizing a 3.75kg uterus to the soundtrack of me cursing softly and monotonously, keeping calm for the audience while I vent my stress through every bloody oath I can string together. Occasionally I leave her to sedate another dog or prep as fast as I can, keeping one eye in her direction and trying to will her heart to stay steady until I can get back and listen to it. At home, I keep thinking. At home she’d have a dedicated tech, maybe two. At home I’d have monitors and Doppler and IV pumps and emergency drugs.
Let’s face it: at home we wouldn’t be doing this surgery.
She’s the longest surgery of the day. By the time my vet is closing it’s later than we’d planned and everyone else is recovering, sleepy piles of fur on dusty rugs. I’m monitoring with a leash wrapped around my ankle; on the other end a half-grown pup is single-mindedly attempting to stagger to freedom without realizing he’s attached to me. The prep table is already broken down. My drugs are back in the cooler. When the final suture is in we don’t even bother moving her, just settle her on a tattered blanket beneath her rebar IV pole and pull her a little further forward into the sun. She’s still ghost-pale, eyes rolled down, breathing slow. Her belly is strangely empty, flattened. She’s lost roughly a quarter of her bodyweight in the last thirty minutes. The nine lives we’ve taken out of her slip away from the world without ever drawing breath, the syringe in my hands ensuring that there is no pain in their passing.
None of us want to leave her during her slow recovery. We drain our water bottles and pass around lukewarm cans of Hansa. I run my fingers over scarred ears, scratch beneath her chin. She blinks drowsily up at us. My vets softly debate the merits of getting on the road now versus stopping for food. I tell her she’s a good girl, a brave girl, and I’m rewarded with a slowly wagging tail. Her heart beats steadily beneath her ribs, beneath my fingers.
I don’t know if she knows what has happened to her. I don’t know if she understands what she has lost. I don’t know if she will grieve, if she will experience confusion. What I do know is that she won’t die in labor, bleeding out into the dry dust. I know she won’t die of hypocalcemia as the pups suckle her dry. I know she won’t starve trying to feed them. I know she won’t be bred again for the whole vicious cycle to start anew.
We leave her there with an attentive audience while we go for food. At the restaurant we order and one of my vets disappears to check on her, returns fifteen minutes later to report that she’s still there, still alive, a little more awake. We stuff ourselves on chicken and chips and pretend not to notice the evening drawing closer. When we’re done and paid up and my vet is back behind the wheel, the rest of us stuffed into the bakkie and already drifting into that haze of exhaustion and fullness that comes from a long day and a good meal, he takes the road back into town. We drift past the empty lot where hours earlier a bustling surgery clinic filled the air with noise.
Our girl is still there. When she sees the vehicle she staggers to her feet, tail sweeping slowly back and forth. Her expression is already brighter. When I go to scratch her neck she ducks her head down and laps industrially at my fingers, cleaning whatever chicken residue remains with a pale tongue. The last of the onlookers are beginning to trickle away, so that only her people remain. She’s about ready to go home. We leave them with her vaccine information and our goodwishes, leave her with a few quick pets and scratches. As we pull out I turn to squint backwards out the dirty window. She’s standing there, watching us. And I don’t know what she’s thinking or what she’s feeling, but I know that no matter what, as the road peels away beneath us and we set our tires towards home — that no matter what, she’s got more of a chance at life now than she ever did before.
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