Love Is the Best Medicine (13 page)

“Look at you, all fresh and frisky,” I said, scratching her under the chin, impossible not to. When I let up, Cleo’s ears pricked, head canting to the right. I mirrored the maneuver, the puzzled expression. She paused and then tried to see if I made more sense with her head listing to the left.

“What is it? What are you after, little one?”

There was a giggle behind me and I turned to see a technician cleaning bowls in a sink stealing a glance over her shoulder, amused by my coquettish remarks. The snout rooting in the breast pocket of my shirt brought me back to the task at hand.

“Hey, stop that, you little rascal.”

Now I understood her confusion. Cleo was looking for food. She had assumed I was about to deliver her breakfast and, finding me empty-handed, planted her face in my shirt pocket like she was strapping on a feed bag.

“I’m sorry,” I said. “I’ll get you something to eat as soon as you wake up from anesthesia. But first of all we’ve got to fix that leg of yours, okay?”

Cleo appeared to listen, but it was obvious that Uncle Nick had lost most of his credibility with this indecent disruption of her gastronomic routine. I decided I would write Cleo up as B.A.R.—bright, alert, and responsive (accurate, if unimaginative)—and moved on to the
O
part of the proceedings.

Objective
refers to all the hands-on stuff and the numbers it generates. Cleo’s heart rate said she was calm and, more importantly, not in pain, as did her breathing. Her belly felt fine and she stood quietly, if a little self-consciously, for her rectal temperature, which was in the normal range.

“Good girl, Cleo,” I said, producing an enormous orange marking pen resembling a giant Popsicle, designed for tagging livestock. At first, I could tell all was forgiven. An ice lollipop might not have been the breakfast of champions but Cleo obviously thought it was better than nothing. One lick, an unpleasant aftertaste, and her confused expression told me I was right back in the doghouse.

Which of Cleo’s legs was broken was patently obvious, but in veterinary medicine, every patient has three right legs. This is why operating on limbs fills almost every surgeon with a degree of trepidation.
Forget about falling off a cliff or running down a crowded street in nothing but your underwear, my worst nightmare is the omnipresent possibility of taking a patient to surgery and operating on the wrong leg. My patient cannot sanction my decision or offer me any last-minute verbal reminders (“Remember, it’s this one, Doc”).

For surgery involving the right leg, I need to clarify between
right
front,
right
hind, and
right
meaning “correct.” In an attempt to avoid any mistakes we have a strict policy requiring the clinician responsible for the patient to label the leg with a swath of waxy orange paint or some other mark that categorically defines which limb will be going under the knife.

For Cleo, my orange daub was redundant but I still identified the broken leg. If I didn’t do it now, the anesthesia technicians would be all over me to do it sooner or later. Cleo watched me swipe the orange crayon in a safe zone, below her right knee, her gaze turning from my hand to my eyes, her expression suggesting I would have to do better than this to redeem myself.

A
stands for
assessment
, and though I might have touched upon Cleo’s charisma and stoicism, I kept my wording practical, pertinent, and informative for the other doctors or technicians who might interact with Cleo but not know the details of her case. She was a healthy young dog with a right femur fracture that was three days old. The fracture was at the site of a previous surgical repair. Her blood work and urinalysis were normal. Any concerns I had about some sort of a predisposition to fractures, an underlying pathology, did not fit here. They had no basis in fact. There was no section in the patient record for niggling doubts or the tingle of my “spider sense.”

P
stands for
plan
and this was easy. Take Cleo to surgery this afternoon for right femur fracture repair. I might have said more—leg heals, Cleo does great, daughter overcomes sense of guilt, and everyone lives happily ever after—but I still had to call Sonja and then I had a special case to see.

F
OR
a twentysomething, twenty-first-century woman, Sonja Rasmussen was guilty of an unimaginable communications faux pas. Lost, broken, or forgotten, whatever the reason, she was without a cell phone. In this throwback to the Dark Ages, the only available means of contact was the telephone number to her hotel room in downtown Boston.

She picked up the phone before the second ring, and I imagined her perched on the edge of the bed, ready to lunge, picked-over room-service food on a nearby silver platter, ordered because she had been afraid to go down to breakfast and miss my call.

“Hi, Ms. Rasmussen, this is Dr. Trout.”

“Please, call me Sonja, how’s Cleo?”

“She’s great. She’s funny.”

“What do you mean?”

I caught the stiffness in her reply, the silent tension between us, as though I had meant “funny peculiar” and had news for her.

“I mean she’s entertaining, quite the character, though she was less than pleased to be denied her breakfast this morning.”

“Oh, I see,” she said, her tone more measured. “When is she going to have her surgery?”

“Well, I have an urgent appointment coming in shortly and from what I’m told it might need to go first. So Cleo will be second in line.”

Silence gave away her disappointment.

“It will probably be first thing this afternoon,” I said.

“And how long do you think it will take?”

“I’m not sure,” I said. “Couple of hours, then I’ll need to take some X-rays to make sure everything looks good. I can’t imagine I’d be calling you later than five.”

An audible sigh crawled into my ear.

“I’ll go out of my mind waiting here all day for your call. Maybe
what I’ll do is go shopping this afternoon and then swing by the hospital around five o’clock. Would that be okay? That way I can speak to you in person.”

“That sounds great,” I said. “I can show you the postoperative X-rays when you arrive.” And then I added, “How’s your mother doing?”

It was really none of my business but I imagined they had spoken after Cleo’s consultation.

“She’s good,” said Sonja, clearly caught off guard by my question. “It should be the other way around, but she’s the one looking after
me
, helping
me
keep it together.”

There was a pause and for a moment I thought she was going to say more, but she didn’t. I wouldn’t want you to think I handle all my conversations with pet owners like a homicide detective interrogating a prime suspect, but once again I sensed an element of mystery shrouding what she said or rather what she didn’t say, omissions speaking louder than words.

“She sounds like a remarkable woman,” I said.

Another pause, as though my remark had taken her by surprise.

“Yes,” she said, “I guess you’re right.”

I
CALLED
the cat’s name, Henry, and a man wearing a black turtleneck sweater and suede jacket stood up. He made a deliberate adjustment to the parting of his neat black hair like a slow military salute, picked up his copy of the
Boston Globe
in one hand, and strutted toward me swinging a cardboard cat carrier in the other. The guy looked like a character from central casting, the wannabe author type. I was wondering where he had hidden the Starbucks Venti Chai and the laptop containing his unpublished novel.

“Sorry to keep you waiting, Mr. Sharpe.”

I gestured toward the open door of a nearby exam room.

“I’m not Mr. Sharpe,” said Dan Brown Jr., brushing past me,
rudely depositing Henry’s mode of transportation on the table between us. “Henry is my fiancée’s cat, not mine. I’m just the delivery boy.”

I checked the owner’s name on the patient record and read “Susan Sharpe.”

“I’m sorry about that,” I said, “but maybe you can still answer a few questions about …”

Without invitation, Henry’s chauffeur had taken a seat, unfolded his newspaper, and disappeared behind the pages of the business section.

“… about Henry’s problem.”

My words trailed away to a whisper and he appeared not to notice, turning a page, snapping the paper taut. He eased back in his seat, happy to let me get on with whatever it was I did when I admitted a patient, and I realized here was a man who would rather be stuck at home organizing his sock drawer on Super Bowl Sunday than talking to me about his fiancée’s cat.

I resolved to battle on.

“So, Susan would be the person who brought in Henry through the emergency service last night?”

His head remained level, eyes rolling up above the page to meet mine, transmitting a “you still here?” look before giving in to a reluctant nod.

“And I see from his record that Henry has a long history of urinary tract problems. Has there been blood in the urine, frequent visits to the litter box? Why did he need to be seen last night?”

Of course I already knew the answers to these questions. The intern who saw the case in our ER had briefed me on Henry’s predicament, his record having grown to encyclopedic proportions after years of difficulty going to the bathroom. Like many tomcats, regardless of whether or not they are neutered, Henry had a talent for growing microscopic crystals in his urine. Sometimes these crystals can form discrete stones, but oftentimes they produce a sandy,
gritty sludge that builds up in the narrowest part of his manly plumbing, which happens to be the penis. The result is a painful and potentially life-threatening blockage because of Henry’s habitual inability to pee.

“Look,” he said with the raised brows of a man losing his patience, “she brought him in, she discussed the surgery with the doctor, she was told to drop him off this morning, but she had to work so here I am. The only thing I know for sure is he’s costing me a fortune and he wakes me up growling in the night every time he takes a whiz.”

He tried a smile, like an off-the-rack suit, apparently didn’t like the way it felt, and put it right back as the hypnotic pull of the Dow Jones got the better of him. I let him drift, preferring to head over to the carrier and open the box.

Henry was an arresting orange tom with a tail that shot up like an antenna, a twitching feeler in search of attention. I lifted his twelve pounds onto the table and he was on me, head butting, pressing his flaming flanks into my chest, sidling to and fro as I reached for my stethoscope, deafened by the steady grinding purr of a flirtatious cat.

His head was broad, the head of a cat neutered later in life, and his ears and face bore the scars of a former street fighter. When you went to stroke him he pushed into your hand, hard, as though he objected to a delicate touch, his tough old skin longing to be roughed up.

“Hang on there little man, hang on,” I said, swinging him around so that his head was away from me. Only now did I notice the extra toes on his front feet, the polydactyl paws of so many New England cats.

“I just want to have a feel of your tummy.”

Henry stopped purring as soon as I moved my right hand under his abdomen, guarding with a defensive muscular crunch. I gave him a noogie and he relaxed enough for me to feel a bladder that had distended to the size of an orange.

“I know, Henry,” I said, picking up his tail and hunting for his penis, “this is not very dignified but it has to be done.”

Henry began dancing back and forth on his back legs and this time the purr had ripened into a grumble. He let me catch a glimpse, no more, but it was enough to confirm redness, swelling, and considerable soreness. Poor thing, his barbed feline tongue had rasped the tip of his penis raw trying to relieve the gritty impaction trapped inside.

“I’m sorry, little man,” I said, rubbing down his neck. All forgiven, Henry twisted his big head off to the side to make sure I worked a few good scratches into the base of his ear.

I put him down on the floor so he could explore the room and washed my hands in the sink.

“So,” I said, turning my swivel chair back to front, straddling it, and sidling up to the back of a newspaper, “according to his records, this is Henry’s third episode of getting blocked. And you know what they say: ‘Three strikes and you’re out!’”

I didn’t expect the baseball metaphor to get his attention but he angled the paper forward and down so I could meet his steely eyes.

“What are you saying?”

“I’m saying, I think you’re making the right decision. It’s about time Henry was plumbed a little differently, down below, if you know what I mean.”

My turn of phrase had the desired effect.

“No, I don’t know what you mean.”

“Really,” I said, feigning surprise. “Susan didn’t tell you all the details of the surgery?”

“No. Like I’ve been saying all along she just asked me to drop him off. What are you going to do to him?”

I wasn’t sure whether he was suddenly Henry’s advocate or begrudged being left out of any decision that might affect his checkbook.