Extracts from ‘Podiatrist on a Mission’ due for publication in 2021
Podiatrist on a Mission is a true story..
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The metallic smell of blood tainted the air.
‘Hold the balls, I need to tie them off,’ he said.
The cold tap in the farmyard relieved me of the taught sensation across the palm of my hand. Blood clotting, tightening and then flaking from my skin left an unpleasant sensation. Nonetheless, my sights were set on something that appealed to me; to become a veterinary surgeon. Nothing could put me off.
Hugh Russell, my mentor, and a vet with many years’ experience, had strongly suggested that I take a job on a farm to see what it was all about and to work with large animals. Today I was assisting him castrate a bull.
We threw our rubber boots into the back of the dirt encrusted Hillman Hunter estate and headed back to the surgery on the edge of town. The characteristic aroma of canine fur betrayed the four dogs that often accompanied Hugh to work. The rear of the car was stuffed with stained cardboard boxes from the accoutrements of a country vet. The dark mustard coloured and lustreless paintwork on the vehicle looked a sorry state as much outside, as inside, and suffered from the lack of a good wash. The suspension rattled around the narrow lanes.
Back at the surgery, the green drape laid across the subject. The square aperture revealed recently shaved pink flesh. The metal surgical instruments, shiny and still hot from boiling heat, lay on the surgical table. The knife contacted the skin and parted, the bleeding absorbed by a swab. Hugh wore no gloves. He put another instrument in and spread the wound so it was wider and he could see the greyish colour of the ovaries. Once removed, he pulled some catgut off the roll. The suture was in a special container with a sterilising liquid so it came out ready disinfected. He closed the layers of tissue and pulled the skin together unceremoniously so that it bunched up. The ovaries hit the kidney dish with a soft squelch.
I worked with Hugh as much as I could, which usually meant holidays. We cut toenails, applied plaster of Paris, cut, sewed, spayed and killed…
Patrick’s leg was raised on a ratchet rest. This supported his leg. I’d been here before; Miss Wilson. Hitchin. Arcade.
‘You had to be careful not to let your skin get caught between the jagged edges,’
I had been warned by one of the hovering class tutors. The clinic was long and thin and had opaque coloured partitions of glass above the wood. Horse boxes came to mind in a stable. Fabric curtains hung down of horizontal running poles. Yep, just the same – memories of Miss Wilson.To my right I had a metal framed dressing trolley unit with glass top and a metal shelf below this. The trolley ran on castor wheels as did my chair. An angle poise with a regular 60W bulb provided illumination and swung toward Patrick’s foot. The trolley had to be prepared 20 minutes prior to clinic commencing with disinfectant and those ever so little glass bottles easily recognisable with their different colours, pink, white, dark brown, light yellow and another colour than had an ochre colouring. They still numbered five. I now knew the secrets of chlorhexidine, hydrogen peroxide, iodine tincture, ferric perchloride and tincture of benzoin compound.
The jar of cotton wool had a stainless steel lid weather by years of handling and bleaching under the light. My instruments, self purchased for £80 were disinfected and lay in a butter dish propped up with cotton wool upon which the sharp blades rested. Scalpel blades were issued under sufferance. These sterile Gillette blades had numbers, depending which shape you selected. The most common used at this hospital were No. 11 and 15’s. We also had solid blades requiring honing and stropping on leather. One student departed from the norm and sported a number 10 blade. All these numbered blades sounded more like a set of gold clubs. Belly shaped in appearance a number 10 gave him the sobriquet of slasher although this was the weapon of surgeons.
As we were handed out our Gillette’s, not to be confused with a face razor, the tutor would give us that certain look,
‘now make it last these can only be given out when they are blunt.’
It was not unusual for the blade not to last and one felt like Oliver Twist going back for more, only to be chastised for not using the right skin tension technique. My first year patient sat in his chair. Heavy dark leather, cracked and pitted with time, it had a thick frame and the patient had to climb onto the platform. Memories came back again. I was now in London. It all had been a bit of a mess really.
Wallace Miller lived with his wife in a small cul de sac off the main Kettering Road in a semi-detached house, replicating others along the same row. Like a taxi driver I had now acquired knowledge of numerous road names so I could plan how best to set up my house calls. As I traversed Northampton rural and urban areas I chocked up the miles.
‘Well it’s a fine day out there but I see you are as cold as ever.’
A low lit fire emitted red embers adding to the warm day, only the room was too hot. Born in 1898 he had fought in the trenches in northern France and had a spell in Gallipoli in 1915. While he missed the big Somme push he took a shrapnel wound to his leg at Ypres and still carried the metal. Medical care had been primitive and antibiotics not as yet discovered. A lingering infection would break out every now and again through a sinus, a medical term for a hole connecting the inside with the outside.
Mr Miller had chronic osteomyelitis and every now and again some small pieces of bone could break through.
‘How’s that leg of yours today Mr Miller?
‘Can’t complain,’ he would always tell me. I would visit him every 6 weeks and had done so for a year now.
‘And Mrs Miller, is she not around?’
Doris Miller was always there so I was quite surprised. I looked into his sad eyes.
‘Aw Doris has gone to hospital for a spell. Got taken ill last week.’ He stopped to blow his nose with a large worn out handkerchief. A large snort sounded behind his covered face.
‘She’ll be back soon, always a fighter that girl.’ His eyes looked watery.
‘But who’s looking after you?’ I knew he had no children as Doris and he married late. Getting back from the war after being hospitalised delayed matters.
‘Oh, Bessy our neighbour is very good and I get ‘Meals on Wheels’ from the voluntary service.’ I knew the good work they did as my own mother was one of the same kind souls who made lonely people’s lives just that little be less lonely.
Wallace enthralled me with his tales of the war. Most men who returned from the bitter conflict chose to forget and few recounted the horrors bestowed by the carnage of the Great War. Today as I write my own memoires there is no living person left who fought in the trenches as a British citizen. My visits to Wallace were a delight.
I tapped the brass artillery cartridge case sitting as a memento sitting in his hearth.
‘I see you still have this Mr Miller; you haven’t told me how you came by it?’
‘Nothing to tell really son. I went back to Ypres with some of the lads ten year ago. The cases were literally popping up, especially where farmers had been tilling their land. The place still crawls with the flotsam of that war.’
‘I bet that was painful revisiting the battlefields.’
The January morning was warm contrasting with the cold weather I had left behind in Britain. Eddy Street turned out to be much longer than I had reckoned on. It soon became obvious that American roads seemed to go on for ever and their house numbers ran into more than three digits long. The college or CCPM as we would refer to it was at the end and I was to be reliably informed that such buildings could be found in the less expensive parts of cities. It was Sunday and I had nothing better to do than explore. Rather than be late the next day I wanted to ensure I knew exactly how and where to go. Punctuality had been drummed into me by my father.
Having located the building which looked deserted this day I had back down a distance of 2 miles. Passing high rise tenements these edifices seemed foreboding when I was suddenly aware of being shadowed. A careful glance back revealed two boys aged around 13. I carried on aware that I was in a neighbourhood. I felt a sudden concern that came to full reality when I was kicked in the back. My young assailant backed away as I turned around. I was faced with the concern that the locals might be less friendly and saw me as ‘white’ and hostile. Now I confess that I was also naïve and less aware of local ethnic politics in this country. I reasoned it was better ‘to turn the other cheek’ than provoke any over wrought response. I walked away. I was later informed by a third year student as we drove to play soft ball, a form of squash, that never walk out alone. He flipped open his glove compartment.
‘I always carry this with me Dave!’
Staring out of the small car inset lay a silver coloured revolver. I was now ingratiated with the realities of America and the Second Amendment. ‘…the right of the people to keep and bear Arms, shall not be infringed.’
Mrs Silitoe had the door open before I could knock. Their house was constructed during the Second World War and had a ‘Prefab’ construction. Now a museum piece these kit like buildings can be found in museums like Avoncroft in the West Midlands. Such temporary structures were not expected to last and resulted from the effects of air raids and bombing runs in 1940-45, where so many people had to be rehoused from the cities and buildings destroyed in the Blitz, which of course was not exclusive to London alone. Fast to erect and highly functional, the arrangement seemed to have lasted for forty years.
Mr and Mrs Silitoe had nothing to do with the war but had been rehoused for different reasons. The accommodation had a kitchen, a living-dining area, two bedrooms and a bathroom. One had to marvel that these hastily constructed units had stood the test of time. On the other hand, it could be considered appalling that modern accommodation had not been exchanged. The furnishings and kitchen were basic. I found Ted sitting in the living room with his foot up.
‘Hello soldier,’ I said, knowing he had been in the army around the time of the Korean war in the fifties.
‘Ah Mr Tollafield. My foot’s been bad and I can’t take Trousers for a walk and he misses it so.’
‘Who’s ‘Trousers’ Mr Silitoe
‘Why the dog. My Bassett hound.’
‘Okay, so why’s he called Trousers?’
Ted called out.
‘Trousers, Trousers come here.’
The door pushed open and the long eared brown coloured dog entered. His coat appeared strange until I realised that he had a pair of flannel trousers wrapped around his middle as a coat. Puzzled I asked what on earth he had around his middle.
‘Trousers’ they answered together.
It seems that when he was a puppy Trousers found one of Mr Silitoe’s old suits and rather favoured it until it fell to pieces. Mrs Silitoe retrieved what was left of the material and tidied it up and placed the remnants back in his basket because he wouldn’t settle. As a puppy still he appeared with a trouser leg over his head one day and could not shake it off. However, when relieved of this obstruction he seemed to favour it and managed to find a way of getting it back over his head again. In the end she made him a vest of the remaining trouser leg inserting some elastic for easy removal and hence the hound has been called Trousers ever since.
I turned to Mr Silitoe’s foot.
‘What’s happened?’ I asked
Don’t know, Misses reckons I’ve got something in it.’
Bertie looked over at me and seemed annoyed. I did not like driving into Derby but I had been summoned.
‘Now, look David, you’ve upset the orthopaedic department’
‘And, Bertie?’ I said. Perhaps being a little petulant!
‘Well, look I know you are keen on all this surgery stuff. Afterall we talk you know and Luuk has mentioned you. No, don’t think it bad, it wasn’t. But look, we can’t go stirring things up with orthopaedics you see.’
‘What Bertie you’re telling me we can’t refer to them to help our patients?’
‘No, no, its not quite like that. Channels. Channels, they have to be followed. You’ve got to do it through the right channels.’
‘Well, all I can say is that I was taught to write a professional letter as part of my training directly to medical people.’
‘I know,’ he seemed to be agreeing. He continued,
That’s not the issue. You see it’s got to go through the patient’s GP.
A 28-year-old man was now talking to a 63-year-old man. The 63-year-old knew he was right and the 28-year-old knew the other was wrong. The 28-year-old man had to be wrong because there were rules. The 28-year-old man looked to the 63-year-old man for support, wisdom and seeing that the profession needed to make a statement.
‘So, you rely on a GP to make a sensible referral to a consultant in a manner that might not convey the problem on behalf of the patient in a sensitive and assertive manner?’
‘It’s not your place,’ with some annoyance.
‘Well I’m disappointed to hear you say that because I am here for the patient and as a professional I know my knowledge, experience and training have value in the healthcare market and I am disappointed that you take the orthopaedic surgeon’s view’
‘Damn it David, this is not coming from the orthopaedic surgeons but the Chief Medical Officer! You will not repeat this again, do you hear me?’
The next time we met I said goodbye, only this was goodbye for good.
Thank you for reading Extracts from ‘Podiatrist on a Mission’ authored by David R Tollafield
Publication set for early 2021
Busypencilcase Reflective Communications Est. 2015
Issued July 2020