My Patients and Other Animals

A Veterinarian's Stories of Love, Loss, and Hope

About the Book

A moving memoir of a life spent in the company of animals—a veterinarian sheds light on the universal experience of loving, healing, and losing our beloved pets, and the many ways they change our lives.
 
The pursuit of a childhood dream has taken Suzy Fincham-Gray on a journey in veterinary medicine from pastoral farms on the English–Welsh border to emergency rooms in urban American animal hospitals, with thousands of stories collected along the way. In this unforgettable literary debut, she writes about some of the most emotionally challenging and rewarding cases of her career.
           
Like many physicians, Fincham-Gray tends to see her patients at often life-or-death moments. While dramatic, these stories expand into deeper explorations of our complex, profound relationships with the animals in our lives. She describes the satisfaction of diagnosing and treating difficult diseases and the universal experience of loving a pet, and—inevitably—raises questions about their end-of-life care. We meet Grayling, an Irish wolfhound in need of critical treatment; we learn about the fulfillment of caring for a chronically ill pet from the story of Zeke, a silver-brown tabby cat who likes to eat just a little too much; and we fall in love with Monty and Emma, Fincham-Gray’s own adopted cat and dog, who change her life in joyful and unexpected ways. Fincham-Gray depicts the sleepless nights she spends waiting for her pager to call her to the clinic, the cutthroat competition among residents, and what it’s really like to care for patients who can’t advocate for themselves.
           
Warm and humorous, Suzy Fincham-Gray is a rare breed—a clinician with an intimate, elegant literary style. She writes with the same tenderness she brings to her patients, whose needs she must meet with her mind, her hands, and her heart. 

“Suzy Fincham-Gray gives readers rare insight into the making of a compassionate doctor. Her passion for both science and the animals she cares for, combined with her eloquence as a writer, made me want Suzy as both my dogs’ veterinarian and my own friend.”—Teresa J. Rhyne, author of the #1 New York Times bestseller The Dog Lived (and So Will I)
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Praise for My Patients and Other Animals

“Suzy Fincham-Gray gives readers rare insight into the making of a compassionate doctor. Her passion for both science and the animals she cares for, combined with her eloquence as a writer, made me want Suzy as both my dogs’ veterinarian and my own friend.”—Teresa J. Rhyne, author of the #1 New York Times bestseller The Dog Lived (and So Will I)

“A beautifully written look at modern veterinary medicine . . . Fincham-Gray, who also has an MFA in creative writing, has created a wonderfully introspective look at the role of the veterinarian.”—Booklist (starred review)

“Written with candor, humility, and humor, this memoir tells of the professional evolution of a veterinary medicine graduate to a more seasoned internal medicine practitioner. This compelling read is highly recommended for anyone interested in veterinary medicine or who has a love of animals.”—Library Journal

“Affecting dispatches from the life of an animal doctor . . . In this affably written amalgam of pedagogic and heartwarming material, the author chronicles her early years as a medical professional . . . Pet fanatics and animal lovers in general will savor these bittersweet stories exploring the enduring human-animal bond. A fervent, anecdotal memoir infused with heart, compassion, and a natural love for animals on every page.”Kirkus Reviews

“Fincham-Gray explores in her candid debut the intricacies of her profession from inside the medical exam room. . . . The medical aspects of the narrative will likely draw future veterinarians to the book, but it’s the tales of Fincham-Gray’s patients that will keep general readers hooked.”Publishers Weekly

“Engrossing, visceral . . . My Patients and Other Animals is at its best when the author is at her nerviest, removing the romantic sheen from per profession and replacing it with a more realistic and complicated portrait. If it’s sometimes tragic, it’s also consistently rooted in compassion.”USA Today

“This beautiful, tender, and magnificent read isn’t just about one woman’s love and care for animals and the people who love them, or about this veterinarian’s big heart and deep intelligence. It’s also about the ethical complexity of caring for other living beings, and a clear-eyed look at what binds us to other creatures of the world and why that matters.”—Emily Rapp Black, New York Times bestselling author of The Still Point of the Turning World

“A gem of a book . . . Fincham-Gray’s nonstop life taking care of all sorts of nonhuman animals in need is a deeply inspirational and personal journey and a model for all, filled with joy, sorrow, tears, love, and loss.”—Marc Bekoff, author of Canine Confidential: Why Dogs Do What They Do

“Fincham-Gray writes extremely well, and her enthusiasm shines through on every page. I enjoyed reading this book, and while doing so I was made aware of the author’s absolute dedication to her work. Like James Herriot, she portrays her profession in a very good light.”—Jim Wight, author of The Real James Herriot: A Memoir of My Father
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Excerpt

My Patients and Other Animals

c h a p t e r   o n e
  
Peter and the Horse
  

Trees lining the country lane forced the air into an irregular rhythm that buffeted my eardrum through the Land Rover’s open window. Sunlight flitted through branches, splashing the wind- screen with unpredictable brilliance. The clean, savory perfume of the cow parsley clustered in the passing hedgerow mingled with the less subtle notes of manure clinging to my clothes. Beneath my stocking feet lay my lunch, along with empty syringe casings, odd scraps of paper with medical notes, and less identifiable detritus from our day’s farm calls in the Herefordshire countryside. And beside me, expertly guiding the SUV around the twists and turns of the narrow lane, sat Peter, the large-animal veterinarian with whom I was “seeing practice”—the UK term for gaining experience as a veterinary student by shadowing veterinarians in various settings.
We slowed, and Peter maneuvered the Land Rover into a gateway with a narrow dirt turnout that led to a long paddock running next to the road. There was one small gray pony in the field. We got out and walked to the back of the SUV, where I removed a pair of khaki Wellington boots and bottle-green coveralls from the boot. Peter was al- ready suited up and pulling on his wellies with practiced ease by the time I’d unfolded my outfit. I stuffed the too-long pant legs into my socks before stepping into my wellies, holding on to the car for balance.

Shuffling around in the boot, he located a black case the size of a laptop beneath the piles of syringes, rectal examination gloves, medication bottles, and shiny stainless steel implements that made me want to cross my legs. Peter opened the case to reveal what looked like an old-fashioned pistol. Made from blackened metal, it was small and sturdy with a brown wooden handle. The grip had the patina of age, cured by the skin oils embedded in its crosshatch. It was the sort of thing I imagined from back in the Wild West, thousands of miles from this English field. Alongside the gun was a box of ammunition that served one specific purpose. This was a single-shot pistol, and I was about to shoot my first horse.
 
I had been volunteering at the small-animal clinic in the veterinary practice that Peter co-owned since I was fourteen, when my determination to become a vet had driven me to make weekly visits to observe Peter’s small-animal partner, George, conducting his evening surgery.
The practice was a ten-minute walk from my childhood home in Hereford, a small cathedral city nestled on the Welsh border. In autumn, the short trek to the clinic was scented by delicious, yeasty apples fermenting at the cider factory across the street. During the spring, I was accompanied by the woolly odor and noise from trucks full of sheep and cattle on their way to market.

I’d logged hours upon hours in the small-animal clinic, watching vaccination after vaccination, cleaning hundreds of cages and walking every conceivable size of dog.

George was a Scotsman with a booming brogue and generous stature, both of which were barely contained by the thin walls of the consulting room. The clinic was in a converted Edwardian house, and the waiting area, which had presumably once been the drawing room, was always filled with eager owners and nervous pets awaiting their turn with the “Scottish vet.” After each appointment, George would stand in the doorway, his shoulders filling the frame, and call out for his next client in the high-pitched, slightly girlish tone he used to talk to his patients. Every consultation started the same way: “Hello, Mrs. Jones. How are you and Fluffy doing this lovely evening?” And he would narrate the entire visit: “Just a wee poke,” when administering a vaccine; “We’ll be in and out in a flash,” when de- scribing a surgery. Medications were prescribed by color and shape rather than their pharmacology. His parting words to every owner were “Take them home and love them.”

Over the years I’d heard all of George’s jokes and grown impatient at the unscientific language he used with his clients—I aspired to learn the precise name and clinical description of every disease—but I’d bided my time in anticipation of the moment Peter would invite me into the passenger seat of his Land Rover. And, finally, after four years of formal veterinary education, I had graduated from my unobtrusive corner of the exam room to the passenger seat, ready to visit horses, cows, sheep, and any other beast too big or messy to fit into a consulting room. Now it was my turn to entertain high school volunteers in the kennel room with tales of calving successes, hoof trimming, and cesarean sections—the same stories I had once listened to with rapt, jealous attention.

Although my upbringing was essentially urban—if a city with a one-screen cinema, a handful of shops, a nightclub called Marilyn’s, and a Pizza Hut was considered urban—the countryside Peter and I traveled through was familiar. It was where my family took walks through bluebell-carpeted woods in spring, picked strawberries in summer, and stomped through piles of crunchy autumn leaves. The gamboling lambs, grazing cattle, and hard, stiff earth of a plowed winter field had once been little more than fun distractions. But riding with Peter on large-animal calls, visiting farms for TB testing, calving, and managing herd healthcare, I had come to realize how integral farming was to my home.

Peter was well known in Herefordshire—with his muttonchops, and his cravat and collared shirt regardless of the day’s duties. He was no match for George in physical stature, but he occupied an equally substantial place in the practice and community. Peter’s energy was suited to the outdoors; his wiry forearms and strong grip were made for wrangling horses’ hooves, not tending to soft kittens’ paws. He carried the vaguely aloof brusqueness and rounded vowels of a country gentleman, and I felt naïve and weighed down by my need to prove myself in his presence. Over the prior two weeks of our working together we’d developed a good, if slightly distant, rapport. Com- pared to George and his jovial bedside manner, Peter had a more formal approach. But the rigor with which we discussed timely topics in veterinary medicine, and our meticulous daily reviews of clinical practice, more than made up for the lack of amiable banter.

We were visiting a pony who was no longer eating. Peter, who’d examined her before, suspected lymphosarcoma, a cancer of white blood cells. Her owners had declined further diagnostics and treatment—and to be present for this final visit. I didn’t remember the pony’s name. Peter had told me a few miles back, but it had instantly skidded from my mind. My thoughts were desperately clinging to the scientific and clinical aspects of the visit. I wanted to know her name, though, to gently whisper it under my breath once I stood in front of her. But more than that, I wanted to appear calm and com- posed. I couldn’t bring myself to ask.
 
My childhood was littered with mostly imaginary animals. Despite my best attempts to convince my parents that a dog was an essential family member, I had to make do with stuffed toys and wheeled suitcases as companions. On one summer family vacation in a remote, soggy corner of Wales, I even adopted a pet rock, complete with a collar and leash fashioned from long-abandoned red twine. Unfortunately my parents did not share my enthusiasm for my new pet, and I was forced to abandon her at the end of the trip, leaving only my dad’s endless apocryphal stories of his childhood puppy, Patch, to satisfy my dog-owning ambition.

Patch had been a black-and-white Border collie with a penchant for getting into trouble, and tales of him chewing through electrical cords, jumping out of a moving car’s window, and dining on the con- tents of the compost heap were part of our family lore. Patch had died of old age when my dad was a teenager, but even decades later, it often seemed like he was about to trot into the room.
My dad was a dog person and, for as long as I could remember, I had wanted to be like him, right down to wishing that his exuberant caterpillar eyebrows would one day meet in the middle of my fore- head. While my mum’s teaching career held no mystery—I went to school every day; I knew what teachers did—my dad was a microbiologist in a veterinary laboratory. And, because he wasn’t occupied with keeping two girls fed, clothed, and clean along with holding down a full-time job, he was the parent who taught me how to ride a bike, tell a joke, look down a microscope, and what the offside rule in football meant. He was also an eager amateur photographer, and for a time our attic contained not only the precisely-to-scale model rail- way he spent hours researching, painting, and setting up, but also the red-lit mystery of a darkroom. Once I was old enough to be trusted around the shallow trays of alchemical liquids, I would hover close to my dad in the small space, enthralled, while pictures developed on previously stark sheets of photographic paper.

Ultimately, it was a simple picture that my dad took of a laboratory sink, discolored with the residue of dyes he’d used to stain microscopic specimens, that illuminated my gateway into the world of science. I remember the first exhilarating instant I saw the image, the flat grayness of the once-white sink, the swirling blues, purples, and pinks curling around the drain in confusing whorls. I was fascinated, hooked. It was a visual representation of the days my dad spent culturing microscopic organisms on agar plates and in flasks of nutrient broth—the type of scientific life I wanted to be a part of.

When I was fourteen, my interest crystallized into a determination to join the world of veterinary medicine. The mystery of abdominal cavities revealed by a scalpel and the secrets of bones discovered on X-rays were calling to me. I was entranced by the science of physiology and disease—how bodies work, get broken, and are fixed again. I wasn’t inspired by a family pet saved from the brink of death by a  plucky veterinarian—my rock was indubitably resilient— and I couldn’t tell heartening stories of baby birds I’d nursed back to life from certain doom. My motivation came down to a picture of a dirty sink and a wonder at what lay beyond the plug hole.

Despite my uncommon inspiration, my dream of becoming a veterinarian was not unusual. The bucolic, very English portrayal of veterinary medicine in All Creatures Great and Small, a 1980s BBC series based on James Herriot’s books, inspired millions every Sunday evening to consider the same path. The show was set during the 1940s and ’50s in a fictional North Yorkshire village. The countryside was rolling and unspoiled, and the heroes—James and the younger Tristan Farnon—dashing and brave. It was a halcyon place of small, neat stone cottages with meticulously planted gardens, and a pub where the gents drank pints of local ale while the ladies sipped tea at the vicarage.

Herriot’s veterinarian was the center of a thriving agricultural community, driving from farm to farm delivering calves, treating lame horses, and performing the occasional house call for a rich landowner’s over-pampered Pekingese. Women were wives and assistants, and veterinary medicine, in Herriot’s time, was a male- dominated, large-animal-focused profession. It was, after all, only a few decades earlier, in 1922, that Aleen Cust, the first British female veterinarian, was finally permitted to practice, twenty-five years after she’d completed her studies.

The tide, however, was turning. And by the mid-1990s, when I began veterinary school, two-thirds of my classmates were female. Despite this shift, the majority of the veterinarians I met seeing practice, and the senior lecturers and clinicians at university, were male. When I went on farm calls with Peter, my presence and my introduction as a vet student were sometimes met with skepticism and out- right sexism. Peter and George showed no such prejudice, but I desperately wanted to avoid giving anyone proof that I couldn’t do a man’s job, especially when it came to holding a gun against a horse’s head and pulling the trigger.

When I started seeing practice with Peter—the summer before the final year of my veterinary education—I had not yet killed an animal. Although I’d stood a respectful distance from the cats and dogs I’d seen euthanized, passively witnessing their last breath, I had chosen not to look too closely at this aspect of my future career. I knew it was something I would do—would have to do—and I’d heard veterinarians talk about how it was the best decision for a suffering pet. But I’d never pictured myself administering the fatal bullet to a sick horse. I was so caught up in studying the factual, scientific nature of disease that I’d barely had time to consider the practical applications for my patients.

Four years of vet school separated the teenager who’d hovered in the corner of the examination room from the student who stood in that field. When I moved to London for my first year at university I’d just turned nineteen. I was staying in Commonwealth Hall, a large intercollegiate residence. My dad had driven me the three hours east from Hereford to London. As the view through the car window changed from the countryside of my childhood to the monotonous gray of the motorway, my excitement shifted into a tugging dread that made me want to beg him to turn the car around. Instead, I complained about his taste in music and argued with him about which cassette to put in the player.

After we’d decanted the contents of the boot and backseat into my cupboard of a room, I realized that the clod that had been slowly thickening in my throat all afternoon was going to make it difficult to say goodbye. A swift survey of my home for the next year had done little to raise my spirits—a single bed with institutional sheets and a thin, lumpy duvet; a radiator covered in multiple layers of peeling paint; a small wardrobe that smelled of other people’s clothes; a faux wood desk with the edges chipped and cracked; and, wedged in the corner, a tiny sink I preferred to think had been used only for washing hands and faces. My dad stood awkwardly in the only square foot of floor not occupied by suitcases or boxes.

“All right, you’ve got everything?” he said.

“I think so,” I replied, unable to look him in the eye. I knew his black caterpillar eyebrows were drawn into a continuous questioning line.

“I suppose I’ll be off, then, before the traffic gets too bad.” “Okay,” I paused. “Shall I come to the car with you?”

“No, no need, you get settled here.”

“Okay.” My small relief that I wouldn’t have to walk back from the car alone with a press of tears behind my eyelids was soon tempered by the realization that this was goodbye.

“Give us a call and let us know how you’re doing,” he said. “Will do.”

“Love you.”

“Love you, too,” I said. And then he was gone.

Sitting on my barely-twin bed, I listened to the excited bustle and chatter of other students moving in, making friends. I’d never quite fit in at high school; my peculiar dedication to academic excellence and rule following had branded me a “swot.” I didn’t have time for parties, illicit cigarettes behind the bike shed, or dating, which was just as well, because I was never invited. My extracurricular activities were more sedate—playing flute in the orchestra, singing in the school choir, and competing on the swim team. And my singular de- termination to get into vet school made it easier to ignore the whispered slights in the changing room after PE.

I’d harbored a shy hope that I would finally find my place at university, but not long after my arrival in London it became clear that my state-school education and just-about middle-class upbringing separated me from my classmates, the majority of whom had spent childhoods cantering around country estates while on holiday from private boarding school. I managed to find a small group of friends with backgrounds similar to my own to meet for meals in the dining hall—six girls who also lived in Commonwealth Hall and didn’t have pet ponies—but still, my need to spend one more hour revising bio- chemical pathways set me apart.

Even more alienating than my desire to study hard was my lack of horsemanship. At ten I’d gone through a horse-obsessed phase and had persuaded my parents that riding lessons were a necessary part of my childhood. In jeans and wellies, my sister and I spent every other Saturday morning at the cheaper of the two stables in town, which was more tolerant of our lack of jodhpurs and fancy riding boots.

However, it turned out that I was highly allergic to the beast I’d hoped to feed sugar lumps, and close contact with a horse resulted in instant sneezing and eye swelling. Still, this didn’t deter me. I continued taking riding lessons until I could no longer hide my blinding eye irritation from my parents.

Notwithstanding my persistence, I never found equilibrium in the saddle. When my steed went from a trot to a canter, my grip tightened on the reins and my biceps flexed. My white-knuckled hands would rise until they were uselessly hovering in midair, while my feet curled desperately around the stirrups and my frustrated instructor screeched “Keep your hands down!” If I’m honest, I always preferred my Sindy (the UK’s more realistic version of Barbie) horse to the real thing. I could plait and style its mane and tail for hours, brushing the man-made fibers until they shone. There was no risk of being stood on or bucked off, and I didn’t need to care about my lack of jodhpurs, because Sindy had the perfect outfit, complete with velvet hard hat and riding crop. But at vet school I couldn’t avoid horses or the “horsey set” that I’d once so desperately wanted to belong to.

My anatomy dissection class shared one horse—a pony, really— and one cow for the duration of the two-year preclinical course. The first day, they both hung from sturdy hooks through their backs, in disconcerting standing positions. Despite their posture, the nose- numbing tang of formaldehyde and the rubbery grayness of their muscles confirmed their lifelessness. The dissection room was in the basement of the veterinary school, and the only windows were high along one wall, lending a permanent fluorescent-lit austerity to our classes. It was cold and damp, and our white coats did little to protect us. If we didn’t roll our sleeves high enough, they slurped up the juices from the stainless steel dissection tables, the cuffs quickly turn- ing a dingy pinkish gray.

In addition to the two large animals at the front of the class, the headless body of a dog or goat lay on each of the tables positioned at precise intervals across the floor. A bucket hung beneath each one under the drain to catch escaping fluids. Trim, muscular ex-racing greyhounds lay stiffly on the cold metal surface, their legs extended and unbending.

There weren’t enough dogs to go around. Local shelters wouldn’t donate the bodies of euthanized stray dogs for what was considered experimentation, so goats were substituted. Their anatomy was significantly different, but they were of a similar size. We spent pains- taking hours in assigned groups of four, dissecting the nerves and blood vessels that were conveniently filled with blue latex for veins and red for arteries. One tiny part of anatomy was assigned each week; for example, the lower, lower half of the foreleg. Clustered around our dripping specimens, intently comparing the precise illustration in Miller’s Dissection of the Dog to the soggy mess of stringy tissues in front of us, I felt a camaraderie that I hadn’t discovered in the university bar. Dissecting the origin and insertion of a leg muscle and teasing apart its innervation was a more comfortable social engagement for me than enjoying a pint in the pub on the way home. Over two years, we gradually whittled down the bodies, with each diminishing carcass carefully restored to its preservative bath at the end of lab every week.

The hours we spent in the cavernous anatomy hall seemed far removed from the consulting room in Hereford and George’s warm, cheerful voice. And the cold, set specimens were so separate from the living animals they’d once been that it never crossed my mind to be upset.
That was until one Tuesday afternoon, toward the end of our first year, when we were assigned fresh horse’s feet from the local knacker’s yard. They had been severed above the fetlock, and the rim of skin and hair still attached to the foot made me wonder what the horse had looked like—an uncomfortable reminder that a short while earlier our specimen had been part of a living body. The flesh was petal pink and the cartilage glistening white, a stark contrast to the colors and textures we usually encountered in anatomy lab.

Despite my unfamiliar proximity to living flesh, foot dissection wasn’t bad. The inside of the hoof is secretly beautiful, with tiny pleats that resemble the underside of a mushroom cap perfectly interlinking with matching folds on the pedal bone, almost enough to make you forget the desperate prying needed to separate the two halves.

The knowledge we accumulated of the bones and joints, muscles, tendons, ligaments, and nerves of dogs and cats, goats, sheep, pigs, cows, and horses was tested in a qualifying anatomy examination at the end of our first academic year.

On entering the anatomy lab, we were handed a thin booklet of papers. An overwhelming array of specimens lay before us to be identified, and I barely noticed the now-familiar sour smell. Our anatomy professor stood at the front of the hollow room with a timer linked to a buzzer. He was a tall, slim man with a vertical face, who looked at us through his glasses as if we were samples on a microscope slide.

“Please choose a station and stand next to it,” he instructed.

Each table displayed a different-sized morsel of preserved flesh, a foot on one, a forelimb on another. Some had ropey nerves exposed with pieces of string tied around them; others were studded with colored pushpins inserted into a muscle, tendon, or ligament. Each was tagged with a small piece of soggy paper with a number written in black marker.

“Once you have selected a station, please find the corresponding page in your booklet,” the professor said. “You will see a question on the table next to the specimen. Please write the answer next to the appropriate number.” I glanced down nervously.

“You will have ninety seconds at each station, and the buzzer will sound when it’s time to move on to the next.” The professor gazed disinterestedly around the room, already looking bored by the prospect of moderating an exam for the next two hours.

“Any questions?” We stayed quiet.

The damp fabric of my shirt caught on my back; the basement room was uncomfortably chilly. I quickly checked my lab coat pocket for the pen I knew was there and moved to the table on my right, where the hind limb of a goat rested. The muscles had been removed, and a piece of grayish string encircled a delicate, white-plastic-looking nerve. The shallow pool of clear liquid surrounding the limb moved determinedly to the edge of the table and the sleeves of my freshly washed lab coat.

The buzzer sounded.
 
At times during those first two years of veterinary school, when the only living animals I encountered were the fearless, sooty mice who lived between the tracks at the Tube stations, the relevance of the cellular pathways, molecular structures, and biologic mechanisms we studied seemed impossible to realize. And I began to think that I preferred it that way.  My lack of horsemanship didn’t matter when the only horse I had to handle was fixed in formalin or on the pages of a textbook. The pain, suffering, and distress that disease caused animals were a long way from the frigid dampness of the dissection hall.

But, eventually, after years in the anatomy lab and countless qualifying examinations, it was time to move to the clinical campus in Hertfordshire, a thirty-minute train ride from London. Despite my apprehension about dealing with live patients, it was thrilling to be within sight of the goal I’d set so long ago. My clinical studies lay ahead before I would graduate with a veterinary degree, and I was determined to apply myself with the same commitment I’d given my books. Our stained lab coats were replaced with new, freshly starched ones. The lectures we attended advanced from slides of cells to pictures of the animals they composed. And, finally, we were introduced to the living embodiment of the anatomy, biochemistry, physiology, and pathophysiology we’d spent years studying.

I took to the small animals and their owners, but equine medicine and surgery was still my most dreaded clinical rotation. The patients, and the people who owned them, stirred a deep and uncomfortable confusion within me. My green country wellies, practical in the hospital setting, nevertheless set me apart from the horsey set and their sleek boots with the discreet “Hunter” logo. The university’s equine staff were similarly dressed, and significantly more terrifying. There was one particular equine medicine professional who appeared to enjoy making students, interns, residents, and likely other faculty members cry, usually from fear and humiliation. She was the only woman on faculty in the equine department—a hangover from the male dominance of veterinary medicine. Her voice had a gravelly, piercing quality, her confident stride could be heard from twenty paces, and her reputation was fierce.

My clinical duties on the equine rotation required me to jump out of bed at all hours, at the summons of my insistently bleeping pager, and rush to the hospital to “assist” with surgeries or administer medications. Medicating horses can be challenging, especially when you’re only half awake. Even instilling eyedrops was nearly impossible—the drops needed to be administered frequently, and a horse’s eye is in uncomfortable proximity to its surprisingly sharp teeth. Often we were forced to surgically implant elaborate catheters that tunneled underneath the reluctant horses’ strong eyelids to en- sure proper application of ocular medications.

The prospect of assisting with a surgery was barely more appealing. Surgery on horses can be difficult, and the risk of the procedure was terrifying. Before the patient arrived on the operating table there was anesthesia to administer. The sight of a sixteen-hand-tall horse crumpling to the ground was amazing, and we nervously hoped that no legs—human or equine—would be broken in the process. We used large padded boxes with mechanized lifting gear to anesthetize and then recover the huge animals. The anesthetists used endotracheal tubes thicker than my forearm to deliver oxygen and anesthetic gases to their enormous patients. Once the horses were asleep we would shackle and attach them to the overhead winch that lifted them into the operating theater. It could take a frenetic hour to get a horse anesthetized and delivered safely to the surgical table.
Horses are not designed to lie in one place for long periods. Blood supply and oxygen delivery to vital areas becomes quickly compromised in recumbent horses due to their large muscle mass and dense skeletons. Additionally, the weight of their organs can cause lung col- lapse after an hour or two under anesthesia. Every surgery was a race against the clock, since we knew that the longer it took, the more likely it was that the horse wouldn’t get up. My role during surgery was narrowly defined. Occasionally I would be asked to hand over an instrument or hold suction equipment, but generally these minor tasks were considered by some too expert. Consequently, standing still—not touching or breathing on the sterile field—was the typical extent of my duties.

However, I assumed it was unlikely that I would ever touch a horse in a medical capacity beyond my veterinary education. My passion did not lie in the surgical excavation of my patient’s tissues, and the diagnosis and treatment of disease in cats and dogs was further advanced than in large-animal medicine. This, combined with my ambivalence toward my larger patients, made it clear that my post- graduation interactions with hooved beasts would be limited. I knew that my future lay in small-animal medicine. I squirreled the information about equine, bovine, ovine, and porcine medicine away, tucking it into the sulci of my hippocampus, where it slowly faded, along with many of my memories of my years at veterinary school. There were some moments, though, that stayed with me long after my need for them had expired.
 
“You remember what you’re going to do?” Peter asked.

“Yes,” I answered, hoping he’d repeat the directions one last time. “You are going to draw an imaginary line from one ear to the opposite eye, and then repeat for the other ear and eye. The two lines will make an X. The spot where the lines cross is where you will place the gun. It’s going to be higher up than you think; remember that.” I nodded.

“Tell me what you’re going to do next,” he said.

“I’m going to position the gun’s muzzle flat against the horse’s head, at the same angle as the neck to the ground so the bullet goes directly into the cerebrum and cerebellum rather than across the top of the forehead.”

“All right, good. Now once you’ve got the positioning right, re- member that you want to squeeze the trigger gently; don’t jab at it with your finger, and whatever you do don’t step backward at the last moment. And don’t close your eyes. You’re only going to get one shot. It needs to be done right. We don’t want this horse to suffer.”

My anxiety ratcheted up. I was being entrusted with a huge responsibility, and whatever I did, I didn’t want to mess it up. I pictured myself firmly gripping the lead rope attached to the head collar. I silently recited a mantra: I will not close my eyes. I will not close my eyes. I will not close my eyes.

Peter loaded the gun, keeping the safety on, and we walked across the field. It wasn’t difficult to catch the pony. She was used to people, and we must have seemed like friendly visitors. We led her to the flat- test part of the field, not far from the road. A scrubby hedge only partially blocked the view of passing traffic. My hands were shaking. I took the gun. I wanted to give it back, but I knew I would not. Peter stood several feet behind me.

I reached up and gently patted the pony on her forehead. Up close I could see the sharp bones of her pelvis pushing against her skin. Brushing aside her wiry forelock, I silently calculated where to place my shot. Her gray hair softly bristled under my sweaty palm. I could smell her sweet, grassy horsiness.

I gripped the gun in my left hand and raised it to the spot on her forehead. It felt heavier and denser than I’d imagined. I’d seen guns only in movies, being waved around with relaxed nonchalance. With my right hand I grasped the lead rope. Placing the pistol to her head helped steady my hand. Her gaze was level with mine, and for a moment I stared into the black-brown liquid of her eyes.

I had one shot to get it right.

The sound ricocheted and reverberated off the trees that lined the road. Obliterating and unmistakably metallic, it bounced and spun inside my head. I could hear nothing else. Where, a second ago, there had been a smallish gray pony, now there was just a field. I looked down, and there she was, her eyes open but flat. There was a perfectly round, dark hole in the middle of the imaginary cross on her fore- head with red-black blood oozing out. I took my stethoscope out of my pocket and attempted to find her heart. My ears still deadened, I wondered if I would hear the slow thirty beats a minute even if a pulse was there. The noise and weight of my perfect shot lingered long after her last breath.

I handed the gun to Peter, my hands still shaking, and we walked back to the car to drive to our next call. The knacker’s van would pull in shortly to pick up the body.

“Well done,” Peter said. “Thanks.”

“Did you keep your eyes open?” he asked. “Yes,” I lied.

About the Author

Suzy Fincham-Gray
Suzy Fincham-Gray is a veterinarian and board-certified small-animal internal medicine specialist. She holds an MFA in creative writing from the University of California, Riverside–Palm Desert. She lives in San Diego with her husband, daughter, three cats, and two dogs. Her extended family still live in England, but they often visit with suitcases crammed with Marmite. My Patients and Other Animals is her first book. More by Suzy Fincham-Gray
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