The Blue Vet Diary

The taxi journey that should have taken ten minutes lasted already over half an hour and I was seriously wondering if the price quoted : “Diecisiete!” – seventeen – referred indeed to Soles (= circa 4$) or in fact to US Dollars.

The taxi from Jorge Chavez International Airport in Lima had been paid in Dollars and also my hotel bill was settled that way. If Peru’s capital operated somewhere in a grey sone between the two currencies it could in the end be a costly surprise (for Peruvian standards)….

Finally we arrived in front of the Canis Minor Veterinary Clinic and my driver happily accepted my 20 Soles note as payment in full including a tip…..

Gilberto Bendezu Armas was already waiting for me in front of his clinic and was genuinely upset when he realised that I had already settled the fare.

“Gibi “ is running an orthopaedic referral practice in this part of Lima and somewhat similar to Peace Street in Hongkong, veterinary practices are located here virtually next door to another in one street – that makes at least the referral process very straight forward.

With not much ado I am taken straight away on a tour of the premises which feature just a small reception area

and a couple of minimalistic cubicles, plus an inpatient area and – of course – the operating theatre.

This is a very functional set up but it is meeting all the needs for Gibi’s patients.

The first one we meet a couple of doors down the road after he has just been admitted: a medium sized mixed breed dog that has been run over by a car and that has sustained a complex frontlimb fracture involving the right elbow joint. Thankfully it is not an open fracture, so that external stabilisation and adaquate pain relief will be sufficient and the procedure can be scheduled for the next day.

While a young Weimeraner wearing a body suit following her neutering procedure is been seen out with her owner,

we are called into the operating theatre. Here we are presented with an all too common surgical emergency:

a 3 year old cat has first played with and then eaten a piece of string and this is now strangulating the whole of the small intestine starting at the pylorus (the opening of the stomach that leads into the intestine).

The tissue is so far not too compromised, but following a diagnostic radiograph, the team (in this case all men – something we rarely see in a Northern European clinic these days) took the only right decision to perform an operation without delay.

Within a very short period of time these foreign bodies cause severe damage to the gut and not too seldom the tissue tears and digested food is leaking into the abdomen or the intestine is so damaged that a part has to be removed. And it is needless to say that this is an extremely painful condition.

This time the offending piece of string is very fast localised and with the help of two small incisions (one in the stomach and one in the end of the small intestine) cut and removed. A remaining piece that has already reached the large intestine is left where it was as it will exit the body without further help….

Providing the cat will not develop any postoperative infections, the prognosis is extremely good and there is a good chance for a full recovery.

Although the surgical case load appears to be very similar in Lima compared to us in Europe, the cost for these procedures (somewhat in line with the general cost of living) are considerably lower. A normal consultation is costing circa 15 $/12£ and operations are usually priced in the lower hundreds rather than in thousands of dollars. For orthopaedic procedures cheaper Chinese implants are used rather than European or North American hardware.

There is no pet insurance in Peru and only very limited options exist for the treatment of the large number of homeless pets.

So – is it such a bad life to be a pet in Lima ?……

Turning off to the right at El Alto, which is not more than a re-fueling stop along the Panamericana, the road starts to descend in narrow serpentines towards the ocean….

Apart from rocks, sand and a few oil wells, there is nothing here and it is hard to believe that the rich and famous had once driven through this utterly baren land to an exclusive address right by the sea.

In the years following the second world war the Cabo Blanco Fishing Club was the place on the globe to go, if you wanted to catch insanely large fish or if you wanted to be seen alongside them or alongside the selected group of people that were able to do so.

Considering how famous the address was, the building itself was in fact very small, with just 10 rooms (all with a fabulous sea view), a dinning room with a bar and a large terrace with an oval swimming pool. Driving up to the building one was passing through its very own “Marlin Boulevard” , lined with the tail fins of some of the largest fish that were ever caught with just a rod and a fishing line.

Arriving in Cabo Blanco one can’t miss the huge mural painting re-calling the probably greatest event in the history of the village

with the only other noteworthy features being the pristine white beach, a pier and a small flottila of fishing vessels. But there is no sign of the famous club.

Turning around and driving back the way we came, it turns out that the club is off limits in a restricted area belonging to the local oil extraction company. A gravel road, leading up a hill to get you to the site is blocked by a boom and a security guard.

Following some prompting it becomes apparent that Benjamin is far from being a man of a few words…. metamorphosing suddenly into a skilfull negotiator. A few minutes later the boom is lifted and we are allowed to follow the track to the famous dwelling.

We find the building in a truly spectacular spot, but equally in a truly run down condition. What is left of this once glamourous place is now seamingly used as storage facility and the only permanent residents appear to be a few emaciated dogs.

Standing by the banister next to the dry pool on the terrace with most of the concrete paving having disappeared, one can still imagine Humphrey Bogart having a cigarette here while enjoying the sun setting on the horizon or Marilyn Monroe sipping a Pisco Sour at a cocktail party.

The impressive line of marlin tail fins has disappeared and also the copy of the giant marlin from the wall in the dinning room has been moved to a museum in the capital.

A discarded scapula in the middle of the drive is the only trophy that remains as an indication of a sucessful recent hunt here and while we are returning back to Punta Sal, I think that everything has its time and once it has passed – like the giant marlins – it will never be the same….

Benjamin, my driver, was not a man of many words….. That was fine by me, as my Spanish didn’t stretch to any meaningful conversations anyway. In addition to this is was 5 o’clock in the morning and still dark when we set off along the Panamericana in a Southerly direction.

The reason why we had to make such an early start was that at this time of the day there is rarely any wind and only very few waves on the Pacific Coast. The place we were heading for was Los Organos – another unassuming and dusty fishing village

with a picturesque graveyard for wooden fishing vessels and a very welcome seasonal visitor : the humpback whale.

Although featuring not very high on the typical patient list of veterinary surgeons, aquatic mammals always hold a special attraction for the members of my profession. This might be because their way of life is so contradictory – why stay in or go back to the sea if your are breathing with lungs and not with gills ? Another reason is that all of these species – seals, dolphins, whales – are generally considered to be friendly (not always true) or even cute (also only true within limits).

The fact is though that during decades of organising evening and weekend courses for veterinarians in the South of England, the best attended event I witnessed was a presentation on “Veterinary care for aquatic mammals” . The room was so full that a lot of delegates had to sit on the floor or lean against the wall throughout the presentation.

I wonder if any of these colleagues then ever treated a harbour seal or a porpoise……..

Back in Los Organos a group of dedicated young marine biologists are giving visitors the opportunity to see humpback whales close up, providing you manage to turn up for an early start and …..you get not too affected by seasickness.

Following a brief introduction (when unbeknown to me my life west changed its owner …….)

the team split and while we were making our way across the pier to the boat, the other guides were climbing the hills behind the village.

It was adviseable to enter the boat quickly as the roof of the pier was doubling up as an over-night resting place for a whole colony of pelicans and quite a few of them had their rear ends strategically well placed over the edge of the roof…..

Armed with binoculars and their smart phones, the land party were our eyes and they guided the skipper to the places where they had seen signs of whales.

This could be spouting of sea water through the whales’ paired blowholes, it could be their dorsal fins while swimming or their tail fins when diving or – most impressively – a jump.

Not much of the latter for us today, but following the use of an under water microphone and listening in on the sounds of both whales and nearby sea lions, it took the team not very long until we spotted some dorsal fins breaking through the surface and we managed to drive the boat alongside some of these huge animals.

Over the following two hours we were lucky to spot and to identify quite a few of these gentle giants, but compared to September their numbers were much reduced as some females and their calves had already made their way South for the feeding grounds in Antarctica.

Back at the pier, the pelicans had woken up and had lowered themselves (not an easy maneuver for a pelican) to the pier itself where they were now patiently waiting for their share of this morning’s catch.

Benjamin must have managed to get some breakfast as well and with if not a lively but then at least a rudimentary conversation we set off to our second destination today – the legendary Cabo Blanco Fishing Club.

Ernest Hemingway was sitting on the terrace of the Cabo Blanco Fishing Club enjoying his Martini and he was looking over the endless Pacific Ocean in front of him.

It had been a good day – a rare occasion for an author who was struggling to constantly having to prove himself against an army of literature critics and fellow authors, who envid his success and probably even more so his colourful life …..

It had not only been a good, it had in fact been an excellent day…Cabo Blanco and the Peruvian coast had finally lived up to their reputation :

Following an early start from the fishing pier just down the road, when the water was still very calm and when there was hardly any wind, the skipper had found the right spot above an underwater canyon called the “Marlin Boulevard” and Hemingway had managed to hook a black marlin, that once landed weight in at 910 lbs (>400 kg) . Just short of a “grander” (a marlin >1000 lbs). It was probably smaller than the one he had caught a few years earlier, but that had been half eaten by sharks before the big fish could be hauled in. This was not an unusual occurence and he had tried everything including machine gunning the sharks, but with much more blood in the water that had made matters just worse and on one occasion he had even shot himself into the leg while trying to land a catch.

This one however was in one piece and unbeknown to him at the time, it would be the largest fish he ever caught…..

Yet it was still a far cry from the 1560 lbs monster that was hanging just behind Hemingway on the wall in the club house. A world record for a fish caught just with a line and a rod that remains unbroken.

It not only made it this rocky outcrop to a world famous location for sport fishers with deep pockets, it – for a couple of decades – became also an exclusive meeting place for Hollywood A-listers like John Wayne, Marilyn Monroe and Humphrey Bogart.

Hemingway had travelled here not only to pursue his passion for deep sea fishing, but also to observe some of the film work for the Hollywood adaption of “The Old Man and the Sea”, the novella that had finally earned him the Nobel Price for Literature and that had made him not only rich, but also somewhat immortal.

If it was good enough for Hemingway, than it will be good enough for me I thought and following a 36 hour journey with having to change planes three times, my feet were finally touching the warm waters of the Pacific ocean in Northern Peru.

The place I had chosen was a small sleepy seaside village not far from the border to Equador and the simple cabin I was staying at was build on the slope of a hill, allowing me a perfect view over the deserted beach and the ocean infront of me.

The land behind me was as desolate as it could get, featuring only rocks and sand where a few shrubbs were eking out a meager existance. The lack of rain was making any form of farming a hopeless undertaking and the very common sight of water trucks on the road was an indication how precious this commodity was in this part of the world.

All life, all activities here came from the Sea. During the day I could see pelicans flying in formation,caressing the crest of the waves, vultures and frigatebirds circling in the sky, cormoranes drying their feathers while sitting on the rocks and further out at sea the occasional humpback whale was passing by on its journey to Antarctica as it was the end of the breeding season.

There was the continuous sound of the breaking of the waves and at night there was the occasional roaring of a sea lion.

Not the worst place I would say to start another veterinary adventure ?!…..

One of the great advantages of being a veterinary surgeon is that compared with many other forms of employment, people usually have an idea of what our job might be and in most cultures the work we are doing is looked upon favourably, especially when it turns out that we are treating companion animals and possibly the odd exotic patient as well….

This is useful when travelling, because dogs and cats have – with the help of their human companions – now conquered every corner of the globe. As dogs and cats are getting ill as well, having a vet in the house is never a bad idea.

Moreover – that our line of work continues to enjoy a lot of public interest remains undisputed – one only needs to look at the multitude of veterinary television programs and their viewing figures regardless of the country you are in.

A lesser known advantage of this job is, that because there are just a few of us (in the US – as a typical example – vets are outnumbered by human doctors by 8:1) we are a much closer knit community, very much like members of a large family, especially if we are working in a more defined field like companion animal or zoo medicine.

Although we might not know each other personally, we might have heard from one another through colleagues, might have enjoyed the same lectures at conferences or might have worked online together on similar projects. We often face the same daily challenges and share the same moments of happiness and dispair. If all humans are not more than six handshakes away from one another, then with companion animal vets this figure can be safely reduced to two (ok – possibly to three if you include North Korea….).

Unlike our “human” colleagues I found that vets more readily like to communicate when meeting another member of the profession and we certainly like to “talk shop”, not seldom to the annoyance of our “no-vet” partners.

This unique feeling of community has been one of the most enjoyable aspect of my journey through Northern Europe this summer.

On a road trip covering over 11 000 km that took me through 13 different countries I met, shared breakfast, coffee or dinner and sometimes even the same roof with not less than twenty of these wonderful colleagues and often their whole families.

I was treated to excellent hand crafted cappuccinos in Lübeck in the North of Germany and enjoyed personally hunted wild boar in the South of Sweden. I finally managed to catch up with one of Poland’s best veterinary cardiologists West of Stockholm, got attacked by a lawnmower in the garden of an Austrian colleague at the Gulf of Bothnia, got invited to a Italian restaurant by a Croatian colleague in Sundsvall and had coffee following a couple of consults in a large kitchen near the border between Sweden and Norway being surrounded by a dozen very chilled huskies.

I was invited to their log cabins and went hiking with my Norwegian colleagues not far from the Northkapp, ate Mexican food in Finnish Lapland and was introduced over a Pizza to Finland’s National drink in Helsinki.

In Estonia I endured the wiping with birch branches in a sauna near Tartu, was invited to a family weekend on a knightly estate near Tallinn and challenged my vertigo on the top of a lighthouse on the Baltic coast.

I received a warm welcome and enjoyed the kind hospitality of colleagues on the tip of the Curonian Spit in Lithuania and even more so in the heart of Warsaw before being finally reunited with a whole group of colleagues on the German Baltic coast.

As this unforgetable journey drew to a close, I once more was grateful to be a member of this unique profession and part of this large family.

However, just before driving out of Kautokeino in the North of Norway, I had a premonition that a further part of this story – in a very different setting – will follow soon……

(At this point a HUGE thank you to Hartmut Wagner-Rietschel, Karin Frisk, Dorota Morawska, Gunnar Schöbel, Jurana Jelacic Vitaljic, Frauke Sappert, Maria Karlsson, Björn Sturnegk, Annette Kriller, Vigdis Børset Raedergård and the whole team at Tromsø Dyresykehuset, Kjell and Vigdis Korbi, Markus Killi, Sanna Hellström, Ingrid Hang (and Eva and Säde of course), Tiina Toomet (and the whole large Toomet family), Julija Abram, Linas Varanauskas, Magdalena Krainska (and the prefect host Robert), Sandra Lekschas and Luz (and of course Nanny) Burdinski for feeding and watering me, for giving me a roof over my head (or a space under an apple tree in their garden) or just for their company and for welcoming me. I hope that I haven’t been too much of a nuisance……)

1960 John Steinbeck took his standard poodle Charley on a road trip through America to learn more about the land and about the people he was writing about. His “Travels with Charley in Search of America”turned out to be not only one of the greatest travel narratives ever written, but it is also one of the greatest examples of literature depicting the relationsship between a man and his canine companion.

Traveling together with a dog makes a considerable difference to the dynamics of your journey, to the places where you might stay, to the activities you can and you can’t do and to the people you are going to meet.

On my own round trip through Northern Europe I took with me Mia, my 7 year old Hungarian Vizsla and probably the best travel companion you can ask for: very quiet but extremely social and reliably friendly, sizeable and fit enough to be able to joining me on my runs and when hiking, with no real health issues and without any dietary limitations.

In a nut shell – the dog a lot of people would love to have and I am lucky enough to call my own.

While stating this I should probably add that I am in fact not a real dog, but actually more a cat person (among other things I love and appreciate their independence). However – dogs like Mia are making it difficult to be too certain on this point.

As much as this journey included long hikes through the mountains in Norway, runs through forests and along deserted beaches and meeting many dog lovers who at times were more interested in the dog than in her owner, it also meant very long car journeys, days spend in a dog kennel at the clinic while I was working and it meant having to interact and to arrange herself virtually every day with other dogs and at times having to share a house or even a sofa with them.

This point can not be underestimated – although I knew most of the people I was visiting, that didn’t apply to Mia and the dogs of my hosts (mostly veterinarians themselves) and that their idea of hospitality might have differed considerably from that of their owners…..

But as different as these dogs were in size or in personality, my travel companion got on with all of them, which was to no small degree helped by the fact that she is a physically fit, but in no way dominant or threatening female with a fair amount of life experience, clever and fast enough to assess an encounter with another dog in time to pre-empt and if necessary to avoid any confrontations already before they are happening. Very much in line with Steinbeck’s description of his dog Charley, I would say that Mia is as well a born diplomat.

Having grown up in the UK with a lot of opportunities to socialise with other dogs (and humans) both on, but – more importantly – off the lead was vital for this.

It is something where I often felt things were going wrong with dogs in the German speaking countries: too rigidly applied rules to keep dogs on the lead are making it impossible for dogs to interact normally with each other and this in many cases is adding to behavioural problems.

A pre-condition to ease these rules is – of course – good training and an excellent re-call (which Mia has), but when this is in place and dogs are allowed the freedom they need, it will result in more relaxed individuals, in better behaved patients during veterinary consultations and it will also increase the enjoyment one will get from keeping a dog.

Another interesting difference in national attitudes towards dogs I observed, was when it came to visiting restaurants and hotels.

Whereas dogs are usually allowed in most restraurants and cafes in Germany, this is usually only the case in pubs in the UK and in Scandinavia it is absolutely out of the question (unless you are sitting outside).

A lot of hotels and also a fair number of mountain huts in the Nordic countries were not an option for me to stay at, as my dog wouldn’t have been allowed in. This problem was mitigated by me spending a few nights in my tent, which in turn extended my options of potential places to sleep. This was possible because of the public right of everyone being allowed to pitch a tent pretty much anywhere in these countries (something I can not do in Germany though….). Waking up in some of the most spectacular mountain settings was a result of this.

Being accompanied by a dog – especially one with a friendly face – will make you as a male stranger less threatening and it often gets you into friendly converations with both the locals and with other travellers regardless where you are. This effect is probably only surpassed by travelling with small children.

Thankfully neither Mia nor I experienced any health issue during our travels, but considering the very high fees for veterinary care in the Nordic countries – despite me being a veterinary surgeon myself – I would not have dared to take Mia along without comprehensive health insurance cover.

Crossing borders with my canine friend was never an issue, with her pet passport only been checked when leaving and when returning to the UK and with otherwise only Norway insisting on tapeworm prophylaxis (which was never policed).

Looking back at my travels with Mia, I think that she – being more a creature of habits like most dogs are – would probably have preferred to stay at home, but I can now understand better why Steinbeck chosed to take along Charley.

And one thing it certainly did – it helped me in my search of Northern Europe…..

“Yes, you will be fine – just leave it here !….”

 

I just couldn’t believe it – having driven over 400 miles from the Baltic Sea around the Russian exclave of Kaliningrad and through the rolling countryside in the East of Poland , I had found a free parking space right in the centre of Warsaw.

Robert, my host for tonight couldn’t have been more accommodating – I nearly had to fight him to be allowed to carry my own luggage upstairs to his beautiful flat in one of the city’s historical buildings, which featured high ceilings, no lift but a spacious staircase with wrought iron banisters and a great view directly on to the famous Swietokrzyski Bridge.

 

Magdalena Krainska – Robert’s partner – is one of Europe’s finest veterinary nephrologists and I had only met her a couple of times – for all together not more than 15 minutes – at the annual Polish Veterinary Congress in Lodz.

However, it turned out that both Magdalena and I are enjoying to work from time to time in Sweden and a regular dialogue ensued, which also included the occasional emergency call from me whenever one of my kidney failure patients required some external specialist input.

Despite the paucity of a long mutual history, Magdalena had invited me and both she and Robert looked after me as you would after an old friend.

Within minutes – while Magdalena was still working – I was installed in my own bedroom, Mia had made her acquaintance with Ella, the equally hospitable residential English Bulldog, my dirty clothes enjoyed the undeniable advantages of a well functioning washing machine and tumble dryer (something that is highly appreciated by all long distance travellers….) and Robert and I were sitting in the kitchen while a warm pasta dish was already on the oven.

After a short while Magdalena arrived and the evening was spend with stories about working in the North, about traveling in Central America and about our life as vets in the 21^st century.

With other words – there was a lot to talk about and while Mia had agreed with Ella that her longer legs made it much easier for her to get on to (and to stay on) the canine sofa,

we enjoyed an unforgettable evening with good food and a few bottles of wine……

When I woke the next morning, my head was still spinning and I realised that for the first time on this trip I had a hangover !…..

With a bit of an effort I remembered a bottle of Tequila Robert had produced while we were getting lost in our memories of beautiful sites in Mexico and Guatemala.

The rather large shot mugs they had brought home from their travels hadn’t helped either…….

 

The best way to wear it off was a long walk through the vibrant and beautifully restored city center of Warsaw where the eye catching architecture of the city’s central library is competing with the traditional buildings of the Old Town Market Place

and where famous church leaders are remembered just a stone throw away from one of history’s most famous scientists.

 

It was not easy to say goodbye to my friends and to this city, but the time had arrived to finally close the circle and to return home from another great veterinary adventure…..