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Ernest Hemingway in “For Whom the Bell Tolls”

It is early May, after a spring snow storm, Roberto and Maria are together in Roberto’s sleeping bag, outside, in the mountains of Spain.

“Then they were together so that the hand on the watch moved, unseen now, they knew that nothing could ever happen to the one that did not happen to the other, that no other thing could happen more than this; this this was all and always; this was what had been and now and whatever was to come. This, that they were not to have, they were having. They were having now and before and always and now and now and now. Oh, now, now, now, the only now, and above all now, and there is no other now but thou now and now is the prophet. Now and forever now. Come now, now, for there is no now but now. Yes, now. Now, please now, only now, not anything else only this now, and where are you and where am I and where is the other one, and not why, not ever why, only this now; and on and always please then always now, always now, for now always one now; one only one, there is no other one but one now, one, going now, rising now, sailing now, leaving now, wheeling now, soaring now, away now, all the way now, all of all the way now; one and one is one softly, is one longingly, is one kindly, is one happily, is one in goodness, is one to cherish, is one now on earth with elbows against the cut and slept on branches of the pine tree with the smell of the pine boughs and the night; to earth conclusively now, and with the morning of the day to come. Then he said, for the other was only in his head and he had said nothing, ‘Oh, Maria, I love thee and I thank thee for this.’”

At three-thirty in the afternoon we started looking for an RV park. We passed several that were not worth turning around to go back to before stopping at a grocery store in Gualala, CA. I purchased some fresh vegetables for dinner and the checkout lady told me how to find the California State Salt Point campground. At the gate was a friendly park ranger who was talking to a young couple. I stopped and he told me to just pick a spot and then return and fill out an envelope from one of those in a box at the gate. Put five bucks in the envelope and I would be registered. I drove through the entire campground where all the spaces were empty. Too many choices.

I returned to the gate and stopped without getting out of Old Blue. The ranger turned from the young couple he was still talking to.

“You decided not to stay?”

“Nope,” I answered “couldn’t find an empty spot.”

He looked at me incredulously until I smiled, and then he laughed politely at my lame joke. I climbed out of Old Blue, retrieved an envelope and made the loop again. I consulted with Charlize and we picked a spot, filled out the envelope, put my five bucks in and walked back to the gate to deposit the envelope. The ranger and the young couple were gone.

Charlize found something to interest her.

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Wilma the Cat

Sidney, Montana, the summer of 1960. Ike Williams and Jon Wilkins were partners, the owners of Williams & Wilkins Blacksmiths and Mechanics. Their shop was large, chaotic and dirty. It occupied the entire frontage of their property hiding their small, immaculate, frame house. The shop and their considerable skills shielded them from the necessity of acknowledging their relationship, something the community had no real need or desire to hear or talk about. The partners were able to repair and, if necessary, fabricate parts for any type of motorized or pulled agricultural implement. That was what the community considered important. They had lived and worked together in Sidney for twenty-five years before my new bride and I arrived. I was a recent graduate and new associate veterinarian in the only veterinary practice within a fifty-mile radius.

Like an old married couple Ike and Jon finished each other’s thoughts, knew how to avoid conflict, were comfortable in their own skins, and with each other. All necessary accommodations had been made.

They both loved cats. I was never able to determine exactly, or even approximately, how many cats they had. There were shop cats, outside cats and house cats, all well cared for.

From time to time one or both of them would bring in a house or shop male for castration or a female to be spayed. All received annual vaccinations. I guess they had a method for deciding which cats would occupy which spaces. The outside cats were free to reproduce but each new litter of kittens was brought in for vaccinations and caring homes were found for them.

They were both sitting in the waiting room when I returned from doing rectal exams on twenty-five head of half-wild range cattle to check for pregnancy. I rubbed my sore left arm as I greeted them.

“Mr. Williams, Mr. Wilkins, what have you got for me today?”

They stood up as if joined at the hip. Wilkins held a huge tabby in his arms. The cat was whimpering obviously hurting.

“This is Wilma, she’s a house cat. Old Doc spayed her for us several years ago and she’s had all her shots every year. Today when we came in for lunch we found her, crying in pain. She’s paralyzed.”

As he talked tears welled up in Wilkins’ eyes. Ike put his arm over his partner’s shoulders.

“It will be OK Jon. Young Doc is good everyone says so. He’ll take care of Wilma for us, won’t you Doc?”

I held out my hands.

“Here, let me take her. Let’s go into the exam room and see what we can figure out.”

Wilma was too soft, too fat, and too lazy. Both hind limbs were flaccid. She meowed louder with Jon no longer holding her. She was also hyperventilating. I examined her carefully, noting that the white nails on her hind paws were tinged blue and the paws were cold to the touch. I was unable to palpate a pulse in either femoral artery.

“This is not good,” I told them. “I’m pretty certain she has what we call a saddle thrombus. It’s a blood clot blocking the two main arteries to her legs. I’ve never seen a case but I remember the description from vet school. All the signs are there. She is paralyzed in the hind legs, in obvious pain and there is no blood circulating to her hind legs.”

“Is there something you can do to fix her?” asked Ike.

“Well, theoretically I could operate and remove the clot. However, I’ve never done anything even remotely like that before, never actually opened an artery on purpose then tried to suture it closed afterwards. I don’t think we even have any suture material small enough to do that kind of thing. Also we have no idea what causes this and it could come right back. I’m sorry. I hate to say this. My job is to help animals not kill them. In this case I think the best thing I can do to help Wilma is to put her out of her misery.”

They were devastated.

“Are you sure you don’t want to even try?” pleaded Jon. “Cost is not a problem you know. We’ll pay whatever it costs,” he looked to his partner for confirmation. Ike nodded his agreement.

“OK, I’m willing to try anything, but I have to make certain you know this could be a disaster. I’ve never even seen anything like this done. First let me look to see if we have any suture material small enough to close an artery.”

I was apprehensive as I searched through the cabinet of surgical supplies. I found one packet of 4-0 silk, with needle attached. It looked to be several years old. I had no idea where it came from or for what my boss intended for it when he bought it. I came back into the exam room and held up the packet.

“This might work, but it’s old and I’ll need to sterilize it again, I have no idea how long it’s been around, the package says it expired two years ago. You guys are certain you want me to try this? I don’t really know what I’m doing. I’ll have to dissect down to the end of the aorta, that’s the main artery coming from the heart, where it branches to supply blood to both hind legs and the tail. Then I have to find the blockage, try to put a tourniquet around the artery above the obstruction, open the artery, remove the clot and suture the artery closed. Chances are very good Wilma will bleed to death while I’m fumbling around.”

“But she’ll be anesthetized, right Doc? She won’t feel anything? Ike asked.

“That’s correct,” I said. “As soon as I anesthetize her she’ll feel no more pain, until and unless we remove the clot and get everything repaired and let her wake up again. She could still be in a lot of pain after I’m done with the surgery, I don’t know.”

“But you can give her something for post-operative pain, right?” Jon pleaded.

“Sure, sure, we can treat post-op pain.”

“OK Doc. Go for it. Is it OK if we wait here? We already put a sign on the shop door saying we wouldn’t be back until tomorrow.”

“Sure, you’re welcome to wait here. It will take me some time to put a surgical pack together to sterilize with the suture material. I have to think about what I might need by way of instruments. I know we don’t have any specialized vascular surgical instruments or suction so I’ll have to improvise. I’ll let you know before I get started. Let me give her just a touch of tranquilizer to see if we can make her more comfortable. I’m afraid to give her anything like a full dose because her heart rate is so fast. The tranquilizer will slow her heart rate and the high heart rate may be the only thing keeping her alive.”

I got Wilma anesthetized, hooked up an intravenous drip, opened up her abdomen, packed off her abdominal organs and found the distal aorta. When I tried to dissect around the aorta I managed to break off some small branches and the abdomen quickly filled with arterial blood. The turkey baster I added to the pack was not an adequate suction device and Wilma bled out in short order. It was the unmitigated disaster I had feared.

Today we know that saddle thrombus is almost always associated with a disease called dilated cardiomyopathy. This is a condition, probably with genetic predisposition, that is uncommon but not rare in cats. The heart is enlarged and dilated and it doesn’t function properly. Normally blood is always moving inside the heart. This constant motion of the blood, even when the heart is resting between beats, helps prevent clots from forming. Because the heart is dilated and unable to beat strong enough areas of flow stasis develop within the heart chambers. Areas of flow stasis allow clots to develop. When the clot becomes large enough it is eventually washed out of the heart. It flows downstream until it lodges at a location too small for the size of the clot, usually at the terminal trifurcation of the aorta. Modern veterinary surgeons can deal with this, providing the underlying heart disease is treatable. Today, if diagnosed early enough and if the underlying heart disease is controlled, many of these animals can be saved and will go on to live a reasonably normal life. In 1960 my saving Wilma would have been a miracle.

Ike and Jon understood and were even appreciative that I tried.

I felt guilty and depressed, never acclimated to losing an animal, especially through my own clumsiness.

Excerpt from “Animals Don’t Blush”

5star-shiny-web-review sticker

 

 

 

 

 

 

“The purpose of this road trip was to try to figure out what I should do with my remaining years and how to do it. I’m seventy-six years old, and for more than fifty-two of those years, I was married to the only girl I ever truly loved. I’m not accustomed to making decisions on my own. Charlize is a good listener but doesn’t contribute much, except enthusiasm, to the decision-making process.” Travels with Charlize: In Search of Living Alone by David R. Gross is an open story of recovery.

 

Gross is on a mission to discover how to live without Rosalie, his late wife. Three-year-old Charlize is his third German shepherd, adopted less than two weeks after Rosalie’s passing. Charlize came with a different name, but, according to Gross who decided to mimic John Steinbeck’s Travels with Charley, he renamed her. Gross describes their bond as “two injured beings who need to support each other.” His travels with Charlize started with Old Blue, his 2012 Dodge Ram 1500 and The Frog, his camping trailer. Gross was pleased – “Frog pulled like a dream, sticking close to Old Blue’s tail.”

 

Travels with Charlize is truly engaging. Gross’s skill as a writer is evident. His narrative and thoughts not only focus on Rosalie and the travels, but also include his fond memories from his younger days, his sons, grandchildren and even his previous German shepherds. The pictures included in the book make the reading more appealing. The writing style is straightforward; I love the casual tone of the prose. Readers, whether or not travelling is their forte, should give this book a go and get to know Gross, and especially Charlize.

 

This is a photo of one of many small restaurants inside the Mercado del Puerto. All of the separated restaurants have an open, wood fueled, grill like this one where most of the cooking takes place.

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This is the chunk of loin I was served. Alexis had a rack of lamb with at least ten chops. The meat portions were gigantic, but tender and tasty, a carnivore’s kind of place.

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We saw several of these horse-drawn carts while out and about in the city. Although there is full employment in Uruguay, jobs for anyone who wants to work, one sees people going through dumpsters to salvage paper, cardboard, plastic bottles, and other recyclables. The horses are very calm amidst the heavy, fast moving, car, bus and truck traffic. Lane markers seem to be just a suggestion with two lanes accommodating at least three vehicles, more lanes more vehicles. Horns are used to let other drivers know where you are.

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Out in the countryside horse-drawn carts are even more common and are used to transport goods short distances. It is obviously much less expensive than gasoline that sells for about $8.00 a gallon. The high price of gasoline also accounts for the small size of the automobiles, although we did see plenty of Mercedes and other luxury vehicles. Protected parking space is also a premium and we saw many houses with just enough room to squeeze the car inside the security gate.

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Most but not all houses in the city were guarded by high security, walls topped with wire or broken glass, or tall spiked bars topped with electric fences, windows covered with bars and/or heavy shutters.

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The yellow sign warns of the charged wires above the ten-foot tall spiked fence.

We asked about all the security and received a variety of answers. It appears that violent crime, including home invasions, is rare. There is some breaking and entering and stealing from vacation homes when it is clear the owners are away. Mostly, we were told, the crime rates are quite low but when there is a crime the news media tend to sensationalize it and thus there is a high level of paranoia. This paranoia is fed and encouraged by a home security industry that seems quite robust. We talked to some home and business owners with lower levels of security and they seemed to be unafraid and unconcerned. Certain areas are considered to have higher crime rates than others, so that’s not unlike our own neighborhoods, but we did see a lot of security.

Click on this link to read the review:

<a href=”http://www.prlog.org/12440447-travels-with-charlize-in-search-of-living-alone.pdf”>Travels With Charlize; in search of living alone</a>

We discovered veterinary medicine in Uruguay is alive and well. Their College of Veterinary Medicine was started in the second decade of the 20th Century, and is part of the Universidad de la Republica, the National University. It is the only veterinary school in the country. We discovered it while on one of our extended neighborhood walks, an easy twenty-minute amble from our hotel

Here is a photo of my bearded self with the sign for the veterinary school.

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After meeting and talking to both students and faculty I discovered all education in Uruguay is free. Primary school for six years, secondary school for another six then a choice between a variety of trade schools or university. I neglected to find out if that choice is determined by an examination, as it is in Europe, or is just a choice by the student. Entrance to veterinary school is directly from secondary school and it is open enrollment. Anyone who graduates from secondary school, on the academic track, is admitted if they apply. Currently anywhere from three to six hundred students enter the program each year. The two faculty members I talked to both said they never know until the first day of school how many students will be present. The second year they lose quite a few students by failing exams or giving up but still have a heavy load for faculty. Each year the number of students who manage to stay in the program decreases and after five years plus one more year of “thesis” work they usually graduate about a hundred students with a dual degree in veterinary medicine and animal husbandry. The “thesis” work involves doing a project, sometimes what we would call research, and writing a paper about what they accomplished.

The good news is there is full employment for the graduate veterinarians. During our extended walking tours in Montevideo, usually four or more hours each day, we seldom go more than eight to ten blocks without encountering a veterinary clinic, almost always associated with a pet store and boarding facility. We have not seen a pet dog here that was not well cared for. Even the street dogs and cats appear to be in reasonably good shape. Many of the veterinary students find work in the agricultural industry, family farms and ranches that they go home to manage, large agribusiness companies that employ them as managers, plenty of small and large dairy farms both cattle and goats, that provide employment in addition to the pet practices, “mascots” they call them.

Dr. Rodolfo Ungerfeld is the Head of the Department of Physiology. A very kind and friendly Reproductive Physiologist who does some interesting work

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Here I am with Professor Ungerfeld on my right and one of his graduate students on my left.

One of his many project involves reproduction problems in Pampas Deer, a species that used to number in the hundreds of thousands in Uruguay and is now down to only a few thousand. A herd of several hundred are kept in La Reserva de Flora y Fauna del Cerro Pan de Azucar, a zoo/reserve near Sugarloaf Mountain. Pan de Azucar is the third tallest mountain in Uruguay, about 500 or 600 feet above sea level). The place is only a couple of hours from Montevideo by car so we rented one and took a road trip.

Here is one of the tiny but magnificent Pampas Deer.

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We also walked part way up the mountain and got an overview of the reserve.

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The other faculty member I had a productive afternoon with is Professor Alejandro Benech. He is in charge of the small animal clinic but taught cardiovascular and respiratory physiology for many years and does some interesting research on ischemia/reperfusion injury of the heart using a sheep model. From the data he showed me he could be looking at some very important results.

We only have three more days to enjoy Montevideo and we plan to make the most of them. My new friends have graciously invited me to return and give some lectures to their graduate students. We couldn’t do it this trip because next week the whole country shuts down for “Easter Week”. They call it “Tourist Week” because of the serious legal separation between church and state. I hope I will be able to return and give those lectures.

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