Vet (just) off Cowley Road

Having returned from Italy, I came across an advert with a job offer that was just too good to miss: in the heart of Oxford and only a couple of hundred meters away from patient 58 (see last summer’s blog….), a veterinary clinic was looking for a vet to help out for three weeks.

I had known for a while that there was a veterinary practice in this area, but I had always failed to spot a sign (this was due to local building restrictions as I found out later). Working there for a little while would give me the opportunity of finally finding the time to explore Oxford a bit more, to improve at the same time the family finances and possibly even having the chance to go out for dinner with Fred, our older son.

I duly applied and within a few days Katharine and Cameron – the partners at the clinic – agreed to let me join their team.

The interesting point with the location of the clinic is, that it is just off Cowley Road, which is probably the heart of “The Alternative Oxford”……..

Just on the other side of picture – postcard Magdalen Bridge and of a whole line of historic buildings and the famous colleges, Cowley Road is chaotic, ramshackle, colorful and certainly not glamorous – a melting pot of less well of students, immigrants (and their businesses) from all over the world and some left overs of the Hippie generation. But because of this, it has its own charm and personality, a kind of unexpected beauty with its cosmopolitan food, music, shops and lifestyles which might not always agree with the expectations of the council or even the police.

This is were college students would not necessarily take their parents, but where they will unavoidably have ended up after an alcohol fueled outing at some point.

Just next to this is a veterinary clinic, providing care for the pets of both communities in Oxford, including a dedicated specialist service for exotic species.

Once again I was surprised how easy it was to adapt to the routine of the friendly team and after lending a hand to restrain a sizably, but unruly Argentinian Tegu (without getting bitten…..), I was back in the consulting room and in the operating theatre, vaccinating and neutering the local dogs, cats and rabbits, very much in the same way as in Virginia Water.

My Swedish adventure had – if anything – broadened my knowledge and I have to admit that having to read clinical notes just in English made life much easier…..

Insisting on a decent lunch break I ventured every day to the local coffeeshops

and to the very international and reasonably priced food outlets and enjoyed the colorful street life, which was such a contrast to rural Bavaria, especially at this time of the year.

Once again though I was caught out by another lock down and although it curtailed somewhat the dinner plans, it didn’t affect the culinary delights I was enjoying, as most businesses on Cowley Road had already adopted to take away services.

May be this is a new way of traveling – rather than visiting only for a few days, stay for a few weeks and if possible work and immerse yourself into the local community?

Italy

It is the middle of September (yes, I know….I am a bit behind with my blog….) and finally, after a pretty crazy and unpredictable year, where working appeared to be the best option to spend your time, there was something appearing on the horizon that roughly resembled the idea of “holidays”….

Before COVID 19 was tightening its grip once again around the countries of the Northern hemisphere, there were a few places in Europe you could go to without running the risk of having to subject yourself to a two week quarantine.

Italy was one of these places. Everyone who knows me (or if not, then you know it now…..) will be aware that in my mind – as a holiday destination – Italy is the “Gold standard” !

With this opinion I find myself in great company with the famous German thinker Johan Wolfgang von Goethe, who visited the country from 1786 – 1788 and who’s later work was considerably influenced by his experiences as a central European writer by the Mediterranean climate and the way of life and by the constant reminders of a civilization that had laid the cultural foundations (together with Greece) of our continent a couple of millennia ago.

After being reunited with Silke, we started our road trip due South allowing Mia finally an ample amount of space in the rear of the car (I had left my mountain bike and the skis behind) and we had this time only with us a couple of bags and our credit cards. Nothing had been booked and the only plan was to go there where it was still warm, where the wine and the food was good and where the sun was shining….

For this we had to cross through Austria, stopped for a brief visit at Monte Grappa near Venice (excellent hill running !)

and arrived finally in a medieval castle near Monteriggioni, right on the Via Francigena. Walking through vineyards, having cappuccinos on a Piazza or just enjoying Italian ice cream without having to worry about the time or without any commitments for the rest of the day is the ideal recipe to recharge the batteries.

In addition to this, stopping for a while being a veterinary surgeon (as far as that is possible….) and to be just a traveler, concerning yourself only about the next meal and where to go in the next hour, is a well worth exercise. Jo Nesbø’s new Harry Hole outing “Knife” and Raynor Winn’s unusual novel “The Salt Path” were great companions for this.

Unfortunately the nice weather in Tuscany lasted only for a couple of days and as the Met Office’s App forecasted a low pressure front for the next day, we decided to follow the sun further South to Northern Apulia, right to the “stop pad” of the Italian boot, where we were guaranteed constant sunshine and no rain……

Just after sunset, with the heavens opening in biblical proportions and with the night sky being illuminated by lightning worthy to feature in a Frankenstein movie, we arrived at another 15th century fortified dwelling in the middle a plantation of dark olive trees and without a soul in sight – Masseria Barone Gambadoro.

After struggling to find an entrance without having to scale the walls and preparing ourselves for the worst (or a night in the car….) – the contrast of the interior to the outside couldn’t have been greater:

brightly lid rooms with white walls decorated with books, mirrors and a few paintings. Each room – including the bathrooms – an interior design statement, making good use of the curved ceilings and the uneven texture of the walls. A tasteful blending of modern furniture and a few antiques gave everything a warm and inviting atmosphere and we knew : we had arrived!……

This little gem of a B&B with only five guest rooms (of which never more than two or three appeared occupied….) at less than half the price of a sad double room at a conference hotel in Birmingham ticked for us all the boxes. The next day – when thankfully the sun had returned – we enjoyed breakfast under olive trees in the garden, had the pool to ourself and enjoyed the local wine and the regional food at the restaurants in the nearby towns. There was absolutely no point to travel further and while writing this (during the second lock down…..) I am realizing again how lucky we were for having had the opportunity to travel to a place like this in the middle of this strange year……

I am not sure though, if the same can be said for Mia…..

Thankfully she is an extremely good traveler and she doesn’t seem to mind long car journeys.

She also approved of the Italian cuisine

but after a few close shaves and a number of frightening encounters with the local canine community including

a few Maremma Sheepdogs – actually herding pigs – I got the impression that she would not have agreed with Goethe and that she was rather happy to eventually returning to the North again…..

Cultural afterthought

While now sitting nearly 3000 km away from Falun, in a medieval fortress (with a slightly more modern interior than 500 years ago….) in Apulia, on the East Coast of Italy, with Mia sleeping on the floor next to me, after a long hike through the countryside, my mind is traveling back to a memorable evening run we both had a month ago along the Dal River in Sweden.

While the sun was setting late at night over the water, I started to understand why artists like Carl Larson or Anders Zorn (eventually) decided to remain in Dalarna, rather than moving South to a much warmer climate and possibly to a more entertaining and probably more comfortable life like here in Italy or France…..

It all had to do with a single view that lasted not more than 15 minutes:

The beautiful spectrum of colour and light in this evening scene reminded me immediately of a couple of paintings of two other artists of two different periods, working with completely different styles.

The sun slowly setting behind the chimney of the local steel works, creating a rich palette of blue, red, grey and yellow tones, both on the sky as well as in the water of the river, was not dissimilar to the scene so famously captured by J.M.W. Turner in his great painting of “The Fighting Temeraire” nearly 200 years ago. Here too the water is virtually still, reflecting the warm light of the sky above in its entire glory, while this once great man-of-war was tugged to its final resting place.

The trees and the illuminated house on the other side of the river however, devoid of virtually all colour and appearing like completely black silhouettes, could also have been – just over a hundred years later – the setting for René Magritte’s surrealistic masterpiece “The Empire of Light”, just lacking the paradoxical clouds and the blue sky above the scene.

Neither Larson nor Zorn were great landscape painters, but undoubtedly the long evening light in the middle of the summer and the effect it had on the people in their paintings must have played a role why the summer and probably the life in the Northern hemisphere can be so irresistible.

The Swedish Case Files

Working in different countries or regions as a veterinary surgeon, I consider the exposure to conditions and treatment solutions I have not encountered before, both as a real challenge and as a great benefit. For many years my work for FECAVA, the Federation of European Companion Animal Veterinary Associations and the involvement with FVE, the Federation of Veterinarians in Europe, has been a constant inspiration for me and it had helped me and my patients in Virginia Water – especially the ones that had non – UK backgrounds – to consider unusual conditions in my list of differential diagnosis or to employ treatment protocols that were unheard of in the UK.

Although there are undoubtedly a lot of similarities between the usual case load in the UK and the patients I have been presented with in Sweden, there were also a few – for me new – conditions and I also noticed a much higher concentration of some very familiar presentations. These were often due to the different environmental circumstances in Sweden.

Similar to my patients in the UK , the size of my patients in Dalarna ranged from 48g (in the case of this Russian Hamster)

to nearly 100kg (which required a small army of technicians to move….).

Compared with the UK, “exotic species” like rabbits or small rodents were rare and I hardly saw any cage birds and absolutely no reptiles or fish (which in Virginia Water frequently included Koi Carps).

Due to far fewer dogs being neutered in Scandinavia, reproduction disorders are more common and I frequently had to operate on dogs with pyometras (severe womb infections) and with breast cancer.

There have been a range of studies highlighting health problems associated with early neutering, but comparing the health of my canine patients both in the UK, on the continent and in Scandinavia, I am remaining convinced that the early neutering – especially of female dogs – is the best solution and I am very content that I have performed this procedure on all of my own dogs before their first season.

With the neutering done so early, it is virtually impossible that a dog will ever develop breast cancer and if the spaying is done before the second season, the risk is still reduced by 90% compared with unneutered dogs.

Working at a large clinic also meant, that we were more frequently asked to help with delivery problems, which sometimes just required medical support, but it sometimes demanded surgical intervention.

The delivery of the eleven (!) puppies of this tough mum went through most of my whole shift one day, but in the end all puppies were delivered alive and without the need for surgery.

Although fleas are not as commonly encountered as in the UK, due to the colder climate and due to the different interior design of Swedish houses (more wooden floors and less carpets), the same can not be said for ticks. Quite often we admitted dogs and especially cats that were going outside, with twenty or more ticks. This was also the reason why I diagnosed here, after over thirty years in clinical practice, my first case of Canine Anaplasmosis, a tick borne bacterial disease, in a dog with a very high fever. Admittedly I would have struggled without the friendly pointer of Tilda, one of my very helpful Swedish colleagues, who was more familiar with this condition.

In a country like Sweden, where great outdoor life is always just around the corner, encounters with the local wild life can be a big issue for dogs and cats.

During the summer the biggest problem without doubt are certainly adder bites, which mainly affect curious or just unfortunate dogs and to a lesser degree cats.

The most common presentation are dogs with a – at times grotesque – swelling of their face

or with a severe swelling of a limb.

Very rarely did we use antivenom in these cases. The standard treatment was fluid support and regular pain relief with Methadon. Only if patients developed cardiac arrhythmias or deteriorated after admission in any other way, was the – fairly expensive – antivenom considered necessary.

Dogs getting into fights with wolves, with bears, with wolverines or with wild boars are not uncommon, but this canine patient was extremely unlucky by being bitten into his hind limb by an angry beaver while trying to run away…..

Cases of Salmonella infections are seen frequently in Sweden. This form of enteritis I diagnosed only occasionally in Surrey, although I checked faecal samples on a regular basis for this serious zoonotic condition. Speaking to my Swedish colleagues about this, we came to the conclusion that the possibly more common hunting and the ingestion of droppings of wild bird must probably play an important role in this.

Beside of this, Swedish cats seem to fight as frequently as their British counterparts, they appear to have the same problems with bladder stones and obesity and Swedish dogs in the same way break their nails and get infected ears, but as in UK, Swedish kittens and puppies never fail to brighten up the beginning or the ends of busy days at the emergency clinic.

The Swedish Fjäll

Undoubtedly a great advantage of working so far North in Sweden, is the direct proximity to large areas of undisturbed countryside and forest and – a bit further North from Falun – to the Fjäll areas.

Not as steep as in neighboring Norway, these high alpine plateaus feature a tundra landscape which is otherwise only found North of the polar circle. Very forgiving for even inexperienced hikers – you can’t really fall down anywhere – these rolling hills were reminding me at times of the Brecon Beacons in Wales.

No wonder though that only a couple of hours driving away, you need to watch out for groups of reindeer occupying the roads….

Travelling to Fulufjället National Park and to Langfjället, both located near the Norwegian border, gave me once again the opportunity to spend a few nights in my tent or even in a mountain hut

– something I had not expected to be able to do for a long time earlier this year.

Even better having Mia with me, who thoroughly enjoyed the long hikes, but who was less impressed by the fast dropping temperatures at night, by the occasional rain and by the mosquitoes. I think that I have to face up to the fact that after all, she is not a husky …….

For the first time in my life I was also able to supplement the provisions in my back pack with fresh cloudberries, which this year can be found in abundance.

Highly priced, they can only be found in small quantities on the local markets or in form of exclusive jams. A large bowl was added to my breakfast cereal every morning…..

Another advantage of hiking in Scandinavia at this time of the year are the virtually never ending days. In June the sun is hardly dropping below the horizon at midnight and even at the beginning of August there is never complete darkness on the Northern horizon.

A long weekend in the Fjäll is the ideal way to recharge the batteries for more busy days at the clinic with my Nordic patients……

Watch out for…….

Working in a busy small animal clinic during the summer months, I noticed that in Sweden we are seeing – thankfully – only very few dogs and cats that had been hit by cars. To be honest, during the whole month of July, I can only recall seeing a single patient with a pelvic fracture and that unfortunate puppy had in fact been run over by his owner reversing out of the drive……

So, why is this ?…..

Well, to some degree it might have to do with the lower population density and probably also with the rigorously enforced speed limits on Swedish roads, but I would argue that in addition to this, the plethora of warning signs will play a not inconsiderable role here as well. Some of these are pretty unique to Sweden or to the Nordic countries.

Let’s start with a classic :

Yes, this one can be seen pretty much anywhere in Sweden and as I have shown in one of my previous blog posts, there is a good reason why these signs are out there : you definitely don’t want to hit an elk (or a moose for my American readers….) with your car. This sign has proven to be so popular, that it has turned out to be one of the most sold Swedish souvenirs (even if the tourists have not even seen a single elk during their travels….) and as the probably most frequently stolen road sign worldwide…..

Elks also have their smaller Arctic cousins – the reindeer – and sure enough, they too can’t do without their personal warning signs (this photo was admittedly not taken in Sweden, but 10m over the boarder in Norway – it was just too great an opportunity to miss…..)

It appears that these signs are working for Vizslas (without antlers !) as well!….

A completely different sort of animal appears to be in need for these signs:

I find that somewhat surprising, as I would have thought that both the petrol fumes and the noise would give them away already from a considerable distance…..

A kind hearted Swede near our clinic came up with this version, which couldn’t be more self explanatory …….

Finally, while cycling around Lake Ruun – at a pretty moderate speed anyway I like to add – I came across my personal favorite ……..

Not even a warning sign – please note here the zebra-crossing!……..

But then I think that we always knew that cats are special……

Man’s best friend

After savouring a few continental delights, I finally had to leave Silke and Bavaria behind to , once again, follow a call to the North.

Yes, it was time for a return to Sweden, but this time in the summer !

On this journey – for a change – I was not traveling alone, but I was taking along a trusted companion : our Hungarian Vizsla “Mia”.

Mia had – unplanned – weathered the COVID19 lock down in Stade, near Hamburg, in Germany and had been utterly spoiled with endless walks and fine food by my kind sister-in- law Ute. It was with a very heavy heart that she let the ginger canine go with me and admittedly I felt a bit guilty for taking her out of her comfortable existence.

Luckily it didn’t took much convincing to make her jump into my already pretty packed car (a fairly normal situation vets’ dogs find themselves in….) and Ute had to rush off, to spend the next 2 months on a sailing boat on the North Sea, which admittedly hadn’t been Mia’s thing….

Traveling with a dog is automatically changing the dynamic of a journey, as you are forced to make more stops and certain modes of travel – like motorbiking or flying – are no longer possible or at least not practical. This not only gives you more time to think and to reflect on the environment you are finding yourself in, it also helps with social interaction.

John Steinbeck described this half a century ago in his “Travels with Charley” – the standard poodle who joined him on his epic search for America. When Nansen made his historic winter crossing of the Hardanger Vidda, to attend a skiing competition in Oslo, he only took a dog with him – probably because he couldn’t encourage anyone else to join him….. So I was just following in very big footsteps…..

Mia’s excitement to go on a journey didn’t last very long though, because as soon as we boarded the ferry from Rostock to Trelleborg, I had to fit her – for the first time in her life – with a muzzle.

Thankfully the ferry was virtually empty (Sweden is at the moment not a very popular tourist location, unless you are Swedish….) and no-one cared very much for this canine dress code, so that for most of the crossing we could do without it.

Sweden is a bit of a dog’s paradise with the potential though to turn very quickly into hell…..

There are endless opportunities for outdoor life – you can go hiking, running, mountain biking or just walking and take your canine companion with you. Most dogs (including Mia) are health insured and at least in rural locations like Dalarna, people are in general very dog friendly and accommodating to the needs of dog owners.

Possible problems though – especially for sheltered canine souls from more Southern climates – can be the weather (with snowfall in the mountainous areas even in the summer), with possible encounters with the native wildlife which include wolfs, wild boars and snakes and – in Mia’s case – the exposure to swarms of mosquitos in July and August.

But all in all – especially since being the only dog and hence the permanent centre of attention in a house of traveling veterinarians missing their own dogs, I think Mia is not complaining about her little adventure.

She now comes to work with me every day, getting a few extra hours of sleep in one of the kennels at the clinic, before being “stolen” by one of my colleagues.

Well, Mia doesn’t mind as long as there is an extra walk in it for her or if someone is cooking and – very important – is accidentally dropping some food on the floor……

The little things in life…..

It is often the little things in life which we are taking for granted, that often make a huge difference.

Once exiting the Channel tunnel at the beginning of July, the road took me and my once again filled to the brim BMW (this time taking my mountain bike, rather than my skis with me….)

through the North of France and through Belgium to some good friends in Bonn, the former capital of West Germany. As I was a bit ahead of my agreed time of arrival (which is unusual….), I just couldn’t resist to stop at one of the many excellent Italian ice cream parlours, which are a stable in most city and town centers in Germany.

Oh,……. the delight of – once again – being served a good coffee, while being allowed to sit down and then the pleasure of a “to die for” cup of hand made ice-cream…….

It was then, when I started to fully understand the story my Estonian friend and colleague Tiina Toomet told me (while we had coffee and cakes) some years ago, while sitting in the sun in a cafe on the shores of Lake Geneva:

As a teenager, as a Soviet citizen at that time, Tiina enjoyed the rare privilege of a visit to West-Berlin and was walked in a tightly controlled group over the Kurfuerstendamm – during the time of the Cold War Berlin’s main shopping street – to observe the way of life of the “decadent” West. I am not sure what exactly the idea of this exercise was, but at least with Tiina it failed spectacularly…..

Seeing people with full shopping bags interacting in a relaxed and seemingly happy way with each other wasn’t that off putting at all. The pleasure she envied the most though, was to be able to sit in a cafe and to enjoy an ice-cream in the sun !….

Good for her that she could still recall this feeling after so many years, to enjoy a simple pleasure like this now even more.

I think that it was this, that went through my head in the not more than three minutes it took me to finish off my Cup Malaga.

The next “little thing” that made a considerable difference for me and my mental wellbeing, happened the following day in Neu-Oetting (another – younger – sister of Alt-Oetting) in Bavaria: after probably four months I was finally getting a haircut !

I will spare you the photos of the result, but thankfully the hairdresser had a solid broom and a large bin in her shop.

It was followed the next day by a visit to the dentist (no photos here as well….).

Although I am usually attending the definitely best dentist in the world in the UK, she was this time not able to help me with a lost filling, as all British dental surgeries had shut down completely since the middle of March. Making good (and possibly final) use of the UK issue of my European Health Card, I got my troubling molar rebuild and received at the same time a lot of useful tips on how to handle the Bavarians by the East German locum who saw me.

The final “little thing” I was now able to enjoy as well, was admittedly not quite so little – it was in fact nearly 2000 m high!

Driving just an hour South, Silke and I reached the foothills of the Alps and the tranquil and picturesque town of Bad Reichenhall.

After supplying ourselves (unnecessarily) with food and water, we finally went on our first hiking trips this year, visiting high alpine grazing sites and small mountain huts.

Once again we were able to walk for miles without hardly meeting anyone, enjoying the blue sky and the panorama of the Northern Alps around us. What a pleasure to be able just to travel and to walk where you want, without any restrictions.

And to make things even better – following the hiking, back in the valley, we could sit down again for a coffee and an ice-cream (or may be a piece of apple struddle ?!….)

Altötting and Burghausen

Ok,…..time to introduce you to two sisters….

One is hard working and virtues, she is neat and tidy, prays a lot and is a very regular church goer. The only man she ever loved went on to become the Pope.

The other one is naughty, she doesn’t know if it is better up on a hill or down on the river, she likes to joke and enjoys good music. An angel was so in love with her, that the rest of the world just saw his naked backside.

The sisters I am talking about are the Bavarian towns Altötting and Burghausen, situated in the fare Southeast of Germany, right at the border to Austria.

Just before the lock down I had an opportunity to visit these places and after three months of social distancing in the UK, I am enjoying here again some of my first restaurant meals and something that resembles what I would call “normal” life.

Altötting is probably the closest thing catholic Germany has to places like Lourdes or Krakow: a multitude of churches, cathedrals and chapels, of which one – right at the town square – is dedicated to a small statue of Maria, the Mother of Jesus. Not less than eight pilgrimage ways pass through the town center. They even appear to have one for me!…..

Tilly – General of the catholic forces during the Thirty Years – has his own crypt in the local cathedral and if you are exhausted from shopping for the right crucifix, candle or other devotional equipment

in the multitude of dedicated outlets, you can do so with a coffee and a few incense truffles…..

Monks, nuns and pilgrims, some of whom are carrying crosses of various sizes are frequently encountered on the streets and the regular ringing of church bells makes it unnecessary to wear a watch.

Joseph Ratzinger, better known as Pope Benedict XVI as born just around the corner in the small town of Marktl.

Just 10 miles away from Altötting, hugging the border to Austria, is Burghausen – divided into an old part in a gorge, next to the river Salzach and a new part on the hill above it. It not only features Europe’s longest castle, but also a renowned annual Jazz Festival, a selection of Tattoo parlors and a cabaret. When walking through its medieval streets, you come across a lot of small and often hidden features which tell a tale of mischief and of a great sense of humor….

Apparently the two sisters are planning to see more of me in the nearer future, but I am wondering how veterinary life is going to turn out in this part of the world……

Grounded…..(not much longer……)

COVID 19 and the associated restrictions including the social distancing rules have not been very helpful for the activities of the Blue Vet, at least when it comes to this diary. The last few weeks have shown how lucky we are to be able to travel and to socialize physically with other human beings and that this is one of the key pre-conditions for this account.

Unlike many of my fellow veterinary colleagues I had been lucky though and shortly after writing my last article, I had a call from the team in Abingdon, asking me to help out with their emergency work over the following few weeks. That meant that rather than spending long mornings in bed, I had – at times – to work much harder than in my own clinic in Virginia Water (or at least it felt like it….).

It also meant that I had many opportunities to explore the beautiful villages and the countryside of Wallingford and of the Thames near Abingdon on long evening runs, obviously helped by the absolutely outstanding weather in April and May.

It was also nice to see the account of our CPD expedition to Armenia covered in a well circulated veterinary newspaper – hard to believe that this was soon a year ago…..Looking at the images didn’t help to settle the travel bug though……

Making the most of the good weather, patient 58 in Oxford got a long overdue roof repair, which should finally make all rooms in the building fully habitable (without the occasional indoor use of an umbrella…).

Working once again with the great team of nurses and vets in Abingdon brought included a lot of memorable and satisfying cases. Practicing while socially distancing was at times a challenge, but it also had its comical moments……

The new safety screens are great – if they have the right size and if they are properly secured on the ceiling….

The long hours at work – not made easier with the additional provision of video consultations as a new service – were not only sweetened by the occasional lunch break in the sun, but also by some excellent chocolates, courtesy of some grateful owners.

All in all, the last two months didn’t turn out as inactive as I thought they would be.

However, with the days still getting longer and with life slowly normalizing again, it is also getting time for the Blue Vet to move on and to start travelling again……