The flight to Boston was delayed. This was turning into a late-night affair. I looked around the waiting area and wondered if they were hoping for additional people. There were three of us GIs and one businessman.
When final boarding was called, only the four of us boarded. Our arrival time in Boston was now scheduled for midnight. The only good thing was I had most of the plane to myself. I settled into a seat near the front of economy class. I hope to get some sleep on this four-hour flight. We had one stop in Providence and then just a hop to Boston.
Once we were in the air, I loosened my tie and jacket. We could fly at half price as long as we were in uniform. That was fine, but the dress greens were not designed for comfort.
I was close to a deep sleep when I felt a slight shake on my shoulder. I looked up into the pretty face of one of the flight attendants.
“Oh, I’m sorry to wake you up,” she said. “Since we only have you three soldiers on board, we are going to play cards in the back of the plane. Do you want to join us?”
How could I refuse such an offer?
“Cards,” I said. “What kind of cards are we playing? Strip poker or regular poker.”
“Arn’t you a funny one,” She said. “I think we are going to play hearts. It’s an easy game to learn if you haven’t played it before.”
“Sure, I’m game,” I said. “Maybe it will make the time go faster.”
I got up and started to retrieve my overnight bag from the rack above the seats.
“Don’t bother with that,” the attendant said. “We have a stop in Providence, but no new passengers are expected. My name is Sharon, by the way.”
So I followed Sharon to the rear. Sharon was beautiful. Short and petite, with nice curves and a suggestive walk.
We all squeezed in around a small bench, and Judy started dealing out the cards. I was careful to sit next to Sharon, even though I knew it would be to no avail.
“Are any of you guys headed to Vietnam?” Charlotte asked. I waited for the other two guys to respond. Their sleeves were blank. I assumed they were privates heading to a training assignment.
“We are flying east,” I said. “Vietnam is the other direction. But talk to us next year, and it might be a different story.”
We played hearts. I didn’t follow the game and was more interested in Sharon. But the time flew. Every twenty or thirty minutes, one of the girls would check on the businessman sitting in the front of the plane.
The conversation was just chit-chat. Something I was not very good at. Judy put up the cards as we approached Providence, and everyone returned to our seats. The fantasies were over, and Boston loomed shortly.
At Boston, we taxied up to an open gate. Exiting the plane into the open air of the Northeast in December was a shock. It was cold, very cold. My lungs hurt when I took a deep breath. My nose and ears were instantly stinging from the cold. I hurried and almost ran to the terminal door. Any thoughts of Sharon were gone.
I retrieved my duffle bag from the baggage carousel and headed for a taxi. Finally, when I settled into the cab’s back seat, I started to warm up. The driver had his heater going full blast.
At the bus station, the ticket clerk chuckled at my question about when the next bus was leaving for Fort Devens.
“I can sell you a ticket tonight, but the next bus isn’t until ten in the morning,” the clerk said. “You can get a cheap room at the hotel next door. They save some rooms for you GIs. They also serve a pretty good breakfast.”
I took the clerk’s advice and made the short walk to the hotel as fast as possible. After checking in, I had the hotel give me a wake-up call at eight in the morning. I wished I had slept on the plane rather than getting excited about a card game with the girls.
Once I arrived at Fort Devens, I took stock of my clothes. My uniform was okay. My civilian clothes fit the Oregon climate fine, but I was not prepared for this cold weather in Massachusetts.
I had one hundred seven dollars left from my travel pay. On my first chance, I caught a base bus to downtown Ayer, which was not much larger than Myrtle Point.
I found the leather jacket in the only Men’s Store in town. Its price tag read one hundred twelve dollars. I tried it on, and it fit perfectly.
The clerk was anxious to sell it.
“The only problem is I only have a hundred and seven dollars,” I said.
“That’s close enough,” the clerk said. “We like doing business with you boys.”
I handed him the money.
“Do you want me to put it in a box for you?” the clerk asked.
“You have to be kidding,” I said. “I need to wear this jacket.”
So, in December of 1965, I owned the leather jacket. This jacket served me well for the remainder of the Massachusetts winter. When I went to Korea, we couldn’t take civilian clothes, so the jacket stayed home. It did go to Germany with me and again served me well.
I wore this jacket for many years after my time in the Army. It fit me well until time caught up with my belly. For the last decade or two, it has hung in the closet.
Stephanie, my son’s wife, looked at it the other day. We were downsizing.
“I bought that jacket in 1965,” I said.
“Really, it looks almost new,” Stephanie said. “I think Anya would love it.” “I’m not sure it will fit her, but she can have it,” I said. “It has followed me halfway around the world. Not to Korea, but to Germany.”
So, after sixty years, the jacket has a new life. It will last another sixty years with little problem.
My first learning experience after arriving in Sweet Home was how the schedule worked in the construction industry. The clinic was initially scheduled for completion in August of 1976. It was late August before it got started.
After leaving Enumclaw in July, I had six mouths to feed, if I included mine. It was evident that I would have to generate some income while I waited for the clinic to be completed.
The telephone started ringing even before my equipment and supplies arrived. Word of my presence in the small community spread fast. There had never been a veterinarian in Sweet Home before, and getting services from Lebanon or Albany was difficult.
As soon as I had some basic equipment, I started doing farm calls out of the back of our car. It was no time before a house call service for dogs and cats was in demand.
And that is when my second learning experience occurred. This learning experience was of a professional nature. I was the first veterinarian to practice in Sweet Home, and before my arrival, veterinary services were not convenient. One consequence of that was the poor vaccination status of the pet population.
Kirby was a walking ball of fluff. A twelve-week-old Shih Tau, he was Emma’s pride and joy. Emma had called for me to stop by to look at Kirby. He was doing okay, but he had a slight cough.
Emma was outside with Kirby when I pulled into her driveway. Kirby was playing on the lawn and did not seem bothered by a slight cough that would stop him momentarily.
“How long has Kirby been coughing?” I asked.
“I noticed it last night,” Emma said. “It wasn’t bad, but today it has been getting worse this afternoon.”
I did an exam on Kirby. His temperature was just slightly elevated, and his lung sounds were normal. I could induce a cough with the slightest pressure on his trachea.
“Is he eating?” I asked.
“Yes, you wouldn’t know anything was wrong with him except for the cough,” Emma said. “I felt a little odd calling you for what looks like such a minor thing.”
“When was his last vaccination?” I asked.
“He hasn’t had any vaccinations, Doctor Larsen,” Emma said. “We have never vaccinated our dogs before.”
“You should be vaccinating him pretty soon,” I said. “Canine distemper is rare, but they say it sneaks up on you.”
“What do you mean by rare, Doctor?” Emma asked.
“I have never seen a dog with distemper,” I said. “I don’t think I have ever talked with another veterinarian who has seen the disease. Of course, counting school, I have only been in this profession for six years. But, I would count that as rare.”
“But this is just a little cough, Doctor Larsen,” Emma said.
“Distemper is a pan-tropic virus,” I said. “That means it attacks most of the systems in the body. It comes in stages, usually separated by days or weeks. The first stage is sometimes just a cough. Then, the second stage might be pneumonia or diarrhea and vomiting. The final stage is usually neurological, where the pup will seize, sometimes uncontrollably. Many pups this age will not survive the second or third stage. Dogs that survive the disease will usually have lasting neurological signs. That might be a twitch or seizures like epilepsy. It is not a good disease.”
“Maybe we should vaccinate Kirby now,” Emma said.
“That’s a thought, but I would rather put him on antibiotics for a few days first and see if we can get this cough under control,” I said. “And Emma, if this were to be distemper, vaccinating him now would not help with the course of the disease.”
So, I dispensed antibiotics and a cough suppressant for Kirby and sent him home with instructions to recheck him the first of the week. And like I would also learn, those recheck appointments are often not kept.
It was over two weeks later when Emma called. She was frantic on the phone.
“Kirby has been having seizures all morning, Doctor,” Emma cried into the phone. “What am I going to do. My husband wouldn’t let me have you come back to recheck him because of the expense. What should I do now.”
“It sounds like he may have canine distemper,” I said. “I could look at him and see if we can get the seizures under control. At his age, if this is distemper, his odds are not good. And Emma, if this is distemper, my recheck would not have changed things one bit.”
“I have you back,” Emma said. “Can I pick up some medication?”
I called Karl at Groves Drug Store and prescribed some phenobarbital for Kirby’s seizures. But I had little hope that it would be helpful under the circumstances.
Emma called the next day with news of Kirby passing. I was unsure from the conversation if Kirby died or if her husband put him out of his misery. Either way, it was a sad outcome for my first case of canine distemper.
Kirby was the first case in Sweet Home, but he was far from the last. I saw more cases of distemper than probably any veterinarian in the state.
It changed the way we conducted practice in Sweet Home. In my clinic, vaccinations were not elective. No elective procedures were performed in the clinic without the dog being current on vaccines. If they were not current, we would vaccinate them and wait for two weeks before admitting them to the clinic for their procedure.
We were the only local veterinarian with that requirement. Did it lose us a few clients? I am sure that it did. But I could sleep easy at night, knowing that it was the right thing to do.
The lack of convenient access to veterinary care played a significant role in Sweet Home’s canine distemper epidemic. However, a couple of years later, we were able to identify the source of many of the cases of distemper. The City run dog pound, was sending out unvaccinated dogs into the community, and many of those dogs would come down with distemper.
With the help of the humane society, we got the City to clean up its facilities and change its policies. After five or six years of work, distemper in Sweet Home became the rare disease it should have been all along.
By the time I entered the exam room, Callie was already unhappy. She was actually a nice cat; she just didn’t like the clinic. When Ruth got all her vitals, she was disgusted by the invasion of her privacy.
She perched herself in the middle of the exam table and glared at me, just daring me to be the next one to touch me.
Rebecca attempted to soothe Callie, but Callie raised her paw as a warning for Rebecca not to touch her.
“She’s just a little upset right now, Doctor Larsen,” Rebecca said. “She doesn’t like leaving the house, and the thermometer thing really gets on the fight.”
“She doesn’t like leaving the house because she usually comes to the clinic,” I said. “But I know Callie, and she is basically good. She just doesn’t like to have anything to do with me.”
“I don’t think it is you, Doc,” Rebecca said. “She just doesn’t like her routine disrupted.”
“You are just here for Callie’s annual exam and vaccines, I see,” I said. “But Callie looks a little unkept to me this year if I remember correctly. Has she been feeling okay?”
“She is doing pretty well, I think,” Rebecca said. “Now that you mention it, she is a bit thinner this year. Ruth said she had lost a couple of pounds. And unkept; maybe I just haven’t noticed since I see her every day. I guess we just attributed it to her getting older. But looking at her now, she has seemed to have lost that slick hair coat.”
I reached my hand out to pet Callie on the back, avoiding her head for now. She instantly swirled and hissed. And swatted me on my wrist, drawing blood.
Cat scratches could be serious, but bite wounds from a cat are much more serious. Cat bites account for the largest number of State Industrial Accident claims in the veterinary field. And a cat is the only animal to put me in the hospital from a bite wound on my hand.
“Callie, you and I are going to have to come to terms with each other if we are going to do an exam,” I said.
Then, with a distracting motion with my left hand, I grabbed Callie by the nape of her neck with my right hand. Even old cats are usually easily controlled with such a grip. I always felt it to be a learned response from when they were moved about by their mothers.
Once I had a hold of Callie, I could calm her enough for a thorough exam. After listening to her chest and abdomen with a stethoscope, I briefly peeked into her mouth. Then, I switched hands on my grip on her neck and palpated her abdomen with my right hand.
Her anterior abdomen was not normal. I finished palpating the rest of the abdomen and then returned to her anterior abdomen. I switched hands again and palpated with my left hand. I had been trained to use my left hand for rectal palpations, and I could almost see with my left fingertips. I could feel a mass projection from the lever. It was not painful, but it had a very irregular surface. It was the size of a large lemon.
I released my grip on Callie’s neck, and she settled on the exam table. I patted her head and thought I could hear a slight purr. She was calm, feeling that her torture was over. Rebecca could tell that I had spent much longer on the exam than was normal.
“What did you find, Doc?” Rebecca asked.
“Callie has a mass in her anterior abdomen,” I said. “It is probably a liver tumor. It is not painful, but based on Callie’s weight loss and rough hair coat, it is causing her some problems. We need some x-rays and blood work to better define things.”
“Doc, you know we love Callie,” Rebecca said. “But things are slow right now in Gavin’s construction business. And Doc, I am four months pregnant. There is no way we can spend much money on Callie right now.”
Rebecca and Gavin had been good clients for over five years. I would have no problem carrying an account for them. I knew that Rebecca had managed their finances carefully and that they were not going to overextend themselves.
“I could carry an account for you guys with no problem,” I said.
“Doc, it’s not that we couldn’t come up with the money or that we couldn’t make payments; it’s that we just can’t put ourselves in a position of uncertainty at this time,” Rebecca said. “Are there any lessor options available?”
“We need to talk frankly right now,” I said. “Rebecca, I don’t have any success stories to tell you about liver tumors in my hands. It’s almost a death sentence. And from what I can tell, that is probably the case for you and I.”
“Are you saying we should put her to sleep?” Rebecca asked.
“The only shortcut we could make would be to go right to surgery with no diagnostics,” I said. “I would do that for you if you understand that if there is nothing I can do, we put Callie to sleep instead of recovering her from the surgery. That way, we give Callie a chance. If things go well, she wakes up and gets a new lease on life. How much time we buy for her depends on what kind of tumor she has.”
“That sounds like a good plan,” Rebecca said. “At least I will feel like we did the best we could, one way or the other.”
“There will be several bridges to cross,” I said. “The first one will be for Callie to survive the surgery. Then, we will have to wait to see if the liver still works. And finally, her survival will depend on the malignancy of the tumor and what kind of metastasis are present.”
“I guess we better schedule it as soon as possible,” Rebecca said.
***
Callie seemed much more at ease with the clinic when Rebecca brought her in for surgery early the following week. The girls took her back and started the prep routine while I spoke with Rebecca.
“I just want to make sure you understand what is going to happen today,” I said.
“Yes, Gavin and I discussed it again last night,” Rebecca said. “We have the utmost confidence in you, Dr. Larsen. And we trust your judgment. If there is a chance your hands can save Callie, that would be great. But if it is not to be, we are prepared for that also. Will you give me a call when surgery is over?”
“Yes, I will call as soon as we are done,” I said. “If it looks like I can’t do anything, I will call before we euthanize Callie. But I don’t plan to wake her up. I just want to make sure that is clear.”
“We wouldn’t want to put her through any more than what is necessary,” Rebecca said. “I guess I need to sign that little form in case you need it.”
Rebecca signed all the papers and went back to say goodbye to Callie one last time.
“I will be waiting for your call, Doc,” Rebecca said with tears in her eyes. “I am guessing that the longer I have to wait for a call, the better the chances are for Callie.”
“That’s right, Rebecca,” I said. “A lot of times, if things are bad, the decision is made shortly after the initial incision. Maybe I’ll have Sandy give you an early call for a progress report. That way, you won’t be completely in the dark.”
Once Rebecca left, we took Callie right into surgery. Once she was under anesthesia, we clipped her entire abdomen. We extended the clipped area to include some of her rib cage.
“Why do you want such a large area clipped?” Ruth asked.
“Hopefully, this will be a four or five-inch incision, starting at her rib cage and extending toward her umbilicus,” I said. “But we really don’t know what we will find when opening her up, so if we need to go longer, we will be ready.”
When Callie was all prepped and draped, I took a deep breath and made a four-inch skin incision. Then, I extended the incision through the abdominal wall through the linea alba. Once the abdomen was opened, I removed the falciform ligament to provide more room and visibility.
I placed retractors on each end of the incision and carefully reached into the abdomen with my left hand. The mass almost jumped into my hand. I moved some intestines out of the way and pulled the mass up to the incision.
This was an ugly mass. I worked it through the incision. The only good thing I could see was it was on a thin stalk of liver tissue extending from the left lateral liver lobe. That meant I could remove it. But looking at it, I don’t know how much time this would buy Callie.
This tumor was made of a mass of nodules. Each nodule was a centimeter in diameter, and the color was a pale red. There was a distinct demarcation between the tumor and normal liver tissue on the stalk. This stalk of liver tissue was almost an inch wide and less than a centimeter thick.
“Are you going to be able to remove that thing?” Ruth asked.
“That’s the good thing,” I said. “This looks like a snap to remove. The problem will be if this is malignant. It has likely already metastasized. We might not be buying much time for Callie. But we are here, and this is coming out. Time will tell us the rest of the story.”
“I will have Sandy give Rebecca a call and tell her the tumor is removable and we are going ahead with the surgery,” Ruth said.
“Yes, that is all we can say right now,” I said.
I placed six overlapping mattresses across the stalk to the liver tissue connecting the mass. When I tied these, crushing through the liver tissue, they ligated all the vessels and biliary tree going to the tumor. Then I incised through the stalk on the mass side of the ligatures. There was no bleeding. I sat the tumor on the tray and released the stalk of tissue back into the abdomen.
I carefully explored the rest of the liver and the anterior abdomen for a few minutes. I could find no other tumors and no evidence of metastasis. I had done all I could do.
I did a three-layer closure with Maxon, and we moved Callie to the recovery kennel. Then I went to my office to call Rebecca.
“Surgery went well and things were the best we could hope for,” I said as soon as Rebecca answered the phone. “The good thing is this tumor was on a small stalk of liver tissue and it was easy to remove. The bad thing is it is one ugly mass of tissue.”
“Do you think Callie is going to be okay?” Rebecca asked.
“She is doing well right now and recovering well,” I said. “I think she will better with the mass out of her belly, but as to what kind of survival time we have bought her, only time will tell. We could know a little more if we send this tumor over to the diagnostic lab and find out what it is and how malignant it might be.”
“If we spend the money to know a little more, does that allow us to do anything to change the outcome?” Rebecca asked.
“No, Rebecca, we have done all there is to do,” I said. “At this point in time, there is nothing left to do. All it will do is allow us to put a name on this tumor. What is going to happen will happen, and all the money in the world will not change the outcome.”
“I think we can live without putting a name on that tumor,” Rebecca said. “We will just take things as they come and love every day we have, Callie.”
Callie went home at the end of the day. She looked like she was feeling well and purred loudly when she saw Rebecca.
***
When Rebecca was in for suture removal two weeks later, Callie had already gained a pound.
“We are so pleased, Doctor Larsen,” Rebecca said. “Callie feels so much better since her surgery. She is eating better and almost plays a kitten at times.”
“Her attitude hasn’t changed much,” I said as we wrestled Callie to remove her sutures.
“I am a little embarrassed. You would think Callie would love it here now,” Rebecca said.
“Our patients seldom give us any credit,” I said.
***
Nearly five years later, Rebecca and her daughter dropped by the clinic.
“We just want to let you know that Callie died at home last night,” Rebecca said. “We are so happy to have had her for all these years. They were really good years for her. And most of all, Brigit got to grow up with Callie sitting on her lap every morning.”
“Thanks for letting us know,” Sandy said. “Pets give us so much of themselves. It is just sad that their lives are so short.”
“You guys and Dr. Larsen gave her almost five extra years,” Rebecca said. “And we can’t thank you enough.”
Memoirs of a Country Vet 