If it drops below 70 millimeters of mercury, we’re in trouble and an alarm will go off. We should be safe between 80 and 90, where we are now. Watch that line there. And that counter, that’s the heart rate. If there’s any change in either of them, tell me immediately.”
“Right.”
“Write down the time, the heart rate and the blood pressure.”
I nodded, and wrote.
He went round to the other side of the table where Scott brought forward instruments on rolling carts and created what Ken called a sterile area in the room. He and Scott between them took disposable green cloths out of sterile packaging and laid them all over the horse’s abdomen, leaving visible only a narrow shaved section on top.
“All set?” Ken asked Scott, and Scott nodded.
It was the last moment that Ken could have drawn back, but the commitment in his mind had been made long before.
“Incision,” he said, dictating to me while he picked up a scalpel and with precision suited the deed to the word. “Ten inches, beside the umbilicus.”
I wrote fast what he’d said and switched my gaze back to what he was doing. Scott, meanwhile, went off to scrub.
“Watch the blood pressure,” Ken said fiercely, not even raising his eyes. “Don’t watch me, watch the monitor between writing.”
I watched the monitor, which remained steady. I still couldn’t help taking fascinated second-long glances at a process I’d expected to be horrifying, but wasn’t in the least. For one thing, there was little smell, when I’d somehow been prepared for stench, nor, with retractors, clamps, forceps and swabs, even a great deal of bleeding.
“Cutting along the linea alba,” Ken said, continuing his running commentary. “That’s the central fibrous ridge between muscle groups. If you cut through there into the abdominal cavity you get little bleeding.” He looked at Scott, who had returned, and without being asked Scott held out a long rubber sleeve-glove, which he pulled on over Ken’s right hand and arm up to the armpit. “Watertight,” Ken explained to me briefly, “and of course sterile, for going into the abdomen.”
What I hadn’t begun to envisage were the extraordinary contents of an equine tum. From out of the quite small incision popped a large ridged bit of intestine and in its wake Ken slowly began to pull a loop of vast tube ten or more inches in diameter, seemingly endless, pink, bulbous and glistening. My eyes, I suppose, were equally huge with astonishment.
“Watch the screen,” Ken said. “This is the colon, now distended by gas. The equine colon’s not held in place by connecting tissue like in humans, it just zigzags free. Half of all cases of twisted gut are colon trouble.” He pulled out at least another yard of the enormous tube and gave it to Scott to support in a green cloth while he felt around in the cavity it had come from.
“The mare’s less than a month from foaling,” he said. “It’s a good-sized foal.” He was silent for a moment or two, then said unemotionally, “If she collapses and I can’t save her, I’ll deliver the foal here and now by cesarean section. It might have a chance. It’s got a good strong heartbeat”
Scott glanced at him quickly and away, knowing, I thought, a good deal more than I did about the risks of such a procedure.
From time to time, as the drip bag emptied, Scott replaced it with a full one from the two-way cupboard, asking me to fetch it for him and to throw the empty one away.
“Screen?” Ken asked me after each change.
“Same,” I said.
He nodded, intent, slowly feeling his way round the internal organs, his eyes in his fingertips.
“Ah,” he said finally. “Here we are. God, what a twist” He brought some part I couldn’t see up into his own vision but still just inside the mare and made an instantaneous decision to cut out the tangled obstruction altogether.
“Eyes on the screen all the time,” he instructed me sharply.
I obeyed him, seeing
“Right.”
“Write down the time, the heart rate and the blood pressure.”
I nodded, and wrote.
He went round to the other side of the table where Scott brought forward instruments on rolling carts and created what Ken called a sterile area in the room. He and Scott between them took disposable green cloths out of sterile packaging and laid them all over the horse’s abdomen, leaving visible only a narrow shaved section on top.
“All set?” Ken asked Scott, and Scott nodded.
It was the last moment that Ken could have drawn back, but the commitment in his mind had been made long before.
“Incision,” he said, dictating to me while he picked up a scalpel and with precision suited the deed to the word. “Ten inches, beside the umbilicus.”
I wrote fast what he’d said and switched my gaze back to what he was doing. Scott, meanwhile, went off to scrub.
“Watch the blood pressure,” Ken said fiercely, not even raising his eyes. “Don’t watch me, watch the monitor between writing.”
I watched the monitor, which remained steady. I still couldn’t help taking fascinated second-long glances at a process I’d expected to be horrifying, but wasn’t in the least. For one thing, there was little smell, when I’d somehow been prepared for stench, nor, with retractors, clamps, forceps and swabs, even a great deal of bleeding.
“Cutting along the linea alba,” Ken said, continuing his running commentary. “That’s the central fibrous ridge between muscle groups. If you cut through there into the abdominal cavity you get little bleeding.” He looked at Scott, who had returned, and without being asked Scott held out a long rubber sleeve-glove, which he pulled on over Ken’s right hand and arm up to the armpit. “Watertight,” Ken explained to me briefly, “and of course sterile, for going into the abdomen.”
What I hadn’t begun to envisage were the extraordinary contents of an equine tum. From out of the quite small incision popped a large ridged bit of intestine and in its wake Ken slowly began to pull a loop of vast tube ten or more inches in diameter, seemingly endless, pink, bulbous and glistening. My eyes, I suppose, were equally huge with astonishment.
“Watch the screen,” Ken said. “This is the colon, now distended by gas. The equine colon’s not held in place by connecting tissue like in humans, it just zigzags free. Half of all cases of twisted gut are colon trouble.” He pulled out at least another yard of the enormous tube and gave it to Scott to support in a green cloth while he felt around in the cavity it had come from.
“The mare’s less than a month from foaling,” he said. “It’s a good-sized foal.” He was silent for a moment or two, then said unemotionally, “If she collapses and I can’t save her, I’ll deliver the foal here and now by cesarean section. It might have a chance. It’s got a good strong heartbeat”
Scott glanced at him quickly and away, knowing, I thought, a good deal more than I did about the risks of such a procedure.
From time to time, as the drip bag emptied, Scott replaced it with a full one from the two-way cupboard, asking me to fetch it for him and to throw the empty one away.
“Screen?” Ken asked me after each change.
“Same,” I said.
He nodded, intent, slowly feeling his way round the internal organs, his eyes in his fingertips.
“Ah,” he said finally. “Here we are. God, what a twist” He brought some part I couldn’t see up into his own vision but still just inside the mare and made an instantaneous decision to cut out the tangled obstruction altogether.
“Eyes on the screen all the time,” he instructed me sharply.
I obeyed him, seeing
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