Article Text


Working on the Mona Lisa smile

Statistics from

SHORTLY after graduating, I was doing evening surgery at a small branch practice a few miles from our main hospital. The last appointment of the day was a double-slot first vaccination consultation for a 10-week-old spaniel puppy.

‘Rory’ was enthusiastic and wriggly and was accompanied by his owner and her three well-behaved, interested children. We discussed diet, training, discouraging play biting and preventive care. The children watched avidly while I examined the puppy and involved them in the consultation, just as I'd learned at vet school.

Embedded Image

I could feel an expression of benevolent responsibility settle on my face as things went exactly according to plan: happy family, healthy dog, simple consultation. Even the sun was shining! I chatted merrily as I drew up the vaccine and changed the needle.

The puppy had been happily sitting for ‘treats’ of puppy kibble and so I put a small handful on the table, while grasping his scruff between my fingers and injecting the vaccine.

No whimpers – he didn't even look up. I was congratulating myself on a job well done when I noticed him start to sway. Time slowed down. He staggered. His head went down. He collapsed onto his side.

The situation did not look promising. Status of mucous membranes: white. Pulse: strong but low. Mental inventory of emergency drugs or equipment at the branch practice: none. Status of lady owner: pale, silent. Status of children: pale, tearful.

My hasty reassurances were belied by my speed. I grabbed the floppy puppy, zoomed into reception, gabbled at the receptionist, galloped to my car, dumped the barely responsive puppy in the footwell and shot off down the hill to the main hospital.

I hadn't even made it halfway when I heard a bark from the passenger side. Rory had recovered, defecated prodigiously and was now in an excited and exploratory mood. My speed only increased as he had a smelly squabble with the mat, gnawed on the gearstick and awkwardly attempted to ascend onto my lap. The nurses were waiting with the crash kit as I pulled up, but the wriggling puppy that tried to precede me out of the car couldn't have looked healthier.

Later on, the owner, having dropped her children at home, was delighted to find a very lively and freshly washed puppy awaiting on her return.

‘What a relief!’ she grinned. ‘My son said to me in the car, “Mummy, I've never seen anyone look so scared!”’

My Mona Lisa smile obviously needed some work!

Never had vaccination consults been loaded with so many misgivings. Never had I given such all-encompassing prevaccination warnings. Never had my face appeared more enigmatic.

I adjusted my expression of inscrutability as I surveyed the large, bouncing American bull terrier puppy in front of me a few days later. ‘Just be aware, some puppies become very sleepy after this injection – nothing to worry about,’ I explained to the owners.

With an inexorable feeling of déjà vu, I watched the puppy keel over. The owners were really tickled. While they laughed and stroked the puppy, I kept my face blank, surreptitiously checked for a pulse and made light conversation.

Fortunately, this puppy recovered much more quickly than the first. The owners left in high spirits and I had the feeling that this little interlude had made their day.

Da Vinci would have been proud.

If you would like to contribute to ‘A practitioner ponders’, please e-mail inpractice{at} for further information. We pay a small honorarium for contributions that are published.

View Abstract

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.