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The Highland Hillbillies

Somehow it would have been easier if Matt was at least hooked on "All in the Family", M*A*S*H and "The Jeffersons".

As a young service professional, I was slower than I should have been to embrace the idea a dairyman can milk cows whenever he darn well pleases. With the late afternoons near his native Jackson Mississippi being famously “hotter than a pepper sprout”; from roughly 3:00 to 5:00pm was best spent napping.

A two-hour siesta will be followed by an epic case of inertia. A body at rest stays that way. It would take an hour of "Welcome Back Kotter" and "Taxi" reruns to get him back in motion. As a result, Matt and Barb didn’t get to the barn until most folks were reading bedtime stories to the kids.

When the pager went off about the time you got the dishes put away and your couch was calling, 9 times out of 10 you knew who it would be.

“Gooood eavnin’, this here is Matt Clampett and ahhv gots an old kayow that ain’t havin’ her keff, I don’t reckon y’all might be in the area and could take a quick look at her…” he would drawl.

One run-on sentence took him longer to speak than to drive to his farm, which is not to say it was close. (Yes, I am fully aware of the hypocrisy.) Instead, I’d use the time to look for something to throw, that I didn’t need or wouldn’t break. All of this was a futile attempt to vent the flash frustration that would quickly degenerate into a diatribe that inevitably earned me a head-shake and a half-dozen Hail Marys from Father Bob. To a former Navy Chaplain, I was a rank amateur.

Realizing that his supposition that we might be in the area, and that his problem might only require a quick look was an attempt to sugar-coat only fanned the flame. It also suggested the calf could have been pulled in the middle of the day, were it not for his ethnic insomnia and addiction to late 70’s situation comedy.

Not to mention, nothing on that farm had ever taken place quickly, and "lookin'" was not gonna git 'er done.

I recently wrote about coming to grips with frustration. I should make a footnote and give credit to Matt Clampett. By the time I’d pull on coveralls and boots and listen to the first half of Fred Eaglesmith’s Paradise Motel en route, my blood pressure would drop and benevolence would return. Thankfully, Matt’s ambition was pervasive, and his medical emergencies standardly had a degree of difficulty akin to Greg Louganis doing a cannonball.

Not this time.

He met me at the tailgate as I pulled my bucket, Nolvasan, lube and shoulder-length plastic OB sleeves. I knew to leave my calf jack for a second trip. In the clinic if you need to think or consult a colleague, you swab an orifice and excuse yourself to “look at it under the microscope”. In the country you “gotta get something from the truck”. Of note to all aspiring country vets, it looks more professional if you bring something back. Not to mention, there was barely room to shuffle sideways through the stacks of newspaper and empty feed bags in the milkhouse.

“Yup, I thawt she wus gonna kayv when ahh gawt to the barn this mornin’”, he’d say. Incidentally most of us here in Wisconsin are eating lunch around “first thing in the morning” on Mississippi Standard Time.

“When we went t’ the hows tu take us a rest, she’s jest standin’ there doin’ nuthin’”, like he was chewing on a bale of hay. If ever there were an authority on standing and doing nothing, Matt Clampett would make a county worker look like the Tasmanian Devil on Redbull.

The history that goes, “she started to calve and then stopped” is darn near pathognomonic for a uterine torsion.

(Incidentally, of all the words in my hybrid medical-construction vernacular that spell-check is mysteriously unaware of, it recognized pathognomonic on the first try. Translated, it means “dead lock cinch”.)

Eventually I would develop a bit of a swagger when it came to correcting uterine torsions and retrieving a live calf. That confidence did not commence until after Francine, the Clampett’s Jersey cross.

Good for more than just reaching the last jar of pickled beets, my arms are long enough to engage a calf’s head or hock and my wrists are thin enough to snake through a partially twisted cervix to heave the uterus into more natural anatomy.

On this particular occasion these long arms were as useful as a trailer hitch on a Toyota Prius. When I pulled on the sleeve and reached through her vulva, I made it to my wrist. My diagnosis was correct: her cervix was twisted tighter than a loaf of Wonder Bread.

Correcting the torsion vaginally requires being able to get through the cervix, and that was not to happen. On other occasions we will lay the cow down and roll her over, hoping the cow rotates around the twisted calf. That requires an area clear and free of debris at least three times the dimension of the cow. The Clampett’s door-yard looked like the set of Green Acres meets Sanford and Son. The nearest piece of naked ground was at the neighbor's farm.

The calf would have to come out the side door.

I was right to have not brought the calf jack. I’d need the surgery kit instead.

I’ve always wondered what a surgeon from the human side would think of barn surgery. We emptied the two stanchions to the right of our patient and shooed a half-dozen barn cats away. Our scalpels and hemostats are surgically sterile. Two square bales of straw are our standard instrument trays (I once used hay). There was a long-necked Holstein who thought my surgery table was more appetizing than the silage in the manger in front of her.

LED head lamps were years in the future. Mark’s middle son Bobby fetched us an orange trouble light with a cage protecting the bulb from under the hood of an Ford LTD in the driveway. On blocks, of course. Edison likely invented the light bulb in half the time it took Bobby to return. By that time, I had managed to clip and scrub the cow’s right flank in the shadows. We found a nail in the rafters to hang our 60-watt incandescent surgical light.

A seasoned midwife will famously direct a doting father to go “boil some water and collect as many clean towels as you can find”. The farm equivalent is to “hold the tail”. Just as hot water and towels, it is not a superfluous activity. We try and maintain surgical sterility to every extent possible, in a dairy barn. The sensation of a fly on her flank and a switch dangling in the gutter is by definition a violation of sterile prep. Not to mention, swatted across the face of a veterinary surgeon, it tastes… exactly like you would imagine.

If Mark had strength, it was not his stomach. The notion of impending blood and guts ignited an urgency to get started milking. He delegated Barb to be my surgical assistant. Often it takes some gumba to haul a Holstein calf lubed with fetal fluid through a surgery incision. I calculated that Francine’s calf would be about the size of a Cocker Spaniel.

A friend once argued that women can multi-task much better than men. Barb was about to demonstrate in living color.

Barb’s secondhand sweat pants were just snug enough to insure the pack of Camel cigarettes she tucked under the elastic waist band was secure, and just short enough they didn’t drag on the barn floor. Her once white V-neck “diego T” provided adequate ventilation on this warm summer evening that surely would have been hindered by any sort of “support”. Dr. Stork focused on his surgery.

On the rare chance that she would not be talking, the scuff of her barn slippers dragging in the barn lime and cow dung would mark her location in the barn.

As you may imagine, there are considerations to a bovine Cesarean section, beginning with the position of the incision. Too dorsal and you pull the calf straight up, making it challenging to close the shrinking uterus. Too ventral, and you risk miles of intestines pouring onto the floor.

As Barb arrived, she paused behind the patient. The motion didn’t stop as soon as she stopped walking; in order to focus, I looked high past her left shoulder and emphasized how crucial it would be for her to keep the tail out of my face and Francine’s incision. She pulled hard on the Camel cigarette wedged between the index and middle finger of her left hand. Gathering gumption for impending battle, she turned and exhaled the spent smoke into the air stream of the barn fan and gulped a dent in the two liter Mountain Dew bottle in her right. I fully expected her to find a spot to set down either the cig or the soda. I'd clearly underestimated the old gal.

Like Dean Martin with a microphone, she freed her left hand for the cow’s tail by transferring the Camel to the same position in her right hand, and hooked the quart of caffeine and sugar with her pinky and ring finger.

I prepared to incise. With the transverse process of Francine’s back striking me rib high, I positioned my left boot in the gutter and right foot on her platform. A calculated risk to save my lower back; yet all the while endangering my own ability to procreate in the event the 35cc lidocaine block I used for local anesthesia was not complete.

I pressed the scalpel against the little cow's flank. Like hitting the “Play” button on a cassette player, Barb dumped into a 20-minute dissertation.

“Hell, I’s already 18 when I went in to have Billy, I didn’t figure I’d have no trouble,” she paused only to service the cigarette and the Mountain Dew in her left hand.

“I’d already been pushin’ for half a day when that doctor walked in an asked me if I wonted a shot.”

You could feel her pain.

“'Well, Doc,' I said. 'Mark’s already been home, milked cows and cum back, good of ya ta take tom out-a-yer gofin’ to give me a hand'”.

I would not have wanted to be that poor obstetrician.

“You can either give me a shot or come close ‘nuff so’s when I’m feelin’ a sharp one comin’ on I kin squeeze yer balls. Thata way we’s all in this tu-gether,” she bargained.

As fascinating as the intricate details on Billy’s birth were, I fought to focus. I had exhausted every option to one-arm roll the calf. I had to calculate the best place to make the incision in Francine’s uterus.

I may have missed the old joke about 1 stitch or 2. By the time I was back with Barb, she was breastfeeding Billy.

“That same dern doctor told me that I hadn’t ought to be breastfeeding ma own kid,” she creased and cursed. In my peripheral vision she cupped her right hand in the direction of her chest and remembered she hadn’t had a drag and gulp for minutes.

“What the heeaal, Doc, whot ‘m ahh s’possed ta do with all THIS?”, as she outlined the evidence of her own lactation. "It takes weeks to dry up an old cow."

The one thing that went according to plan was the calf was no bigger than expected, and was alone. Anticipating the need, as I fended off the images Barb had made available, she beckoned Bobby. “Hey punkin’ head, git yer butt over here and take this calf from Doc, soon ‘s he gits it out,” she ordered.

The less-than-flattering moniker she routinely hung on her middle son was regrettably accurate. Continuing the comparisons to large fruit, she continued, “Ya’ shoulda trod to get that thing out. That boy had a heeaad lok a Georgia watermelon the day he was born.”

I began to anticipate and focused hard on the incision in the cow. Still holding the tail and her refreshments, she pointed the toes of her slippers wide, bent her knees, and slightly tapped the ashes. She used the glowing tip of the cigarette to trace what I can only hope was a gross exaggeration of the episiotomy incision. “That doc had to cut me from ma crotch to ma armpit,” she said, half proud.

Out of concern for our patients, we are always grateful when we are able to close the uterus securely and without incident. I had never been so grateful. A three layer closure of the body wall would take mere minutes, but it wasn’t fast enough. The Clampetts had one more.

“When I went to have Beau, I wus runnin’ the combine,” as if that’s what everybody does when their third child is about to be born. “I only had 10 acres of corn to pick, and it was s’possed ta rain, so’s I jest kept goin’”, she said flippantly. “Ah reckon we’d a made it ta the hospital on tom, but we had to stop at Farstone and get a tar for the grain wagon,” she shrugged.

“She just fell out on truck seat, I didn’t figure I’d have no truble ‘tal,” her accent was as thick as the day she left Mississippi. “Neow the same doctor that told me I shouldn’t, told me I had to breast feed Beau”, she said.

Barb’s calving interval was pretty tight. There’s no doubt in my mind his memory was fresh… like he would recommend otherwise.

Among agriculture-oriented folks, reproduction farm metaphors are free game, as long as everything is going well: “So Pat, heard you got Carrie settled, when is she do to calve?” Everyone laughs.

Mark learned a tough lesson about farm metaphors. “That baby wudn’t but two weeks old when I got a hot case of mastitis,” Barb winced. She gripped the never-ending cigarette in the corner of her lips, squinted, and shifted the tail to her right hand so she could properly demonstrate the exact sidedness of the infection.

“Mark popped off ‘bout rubbin’ some linament on it and givin’ me a shot of penicillin in the butt,” she said with disgust. “He spent the next three weeks sleepin’ on straw bales in the stock trailer.” She could not have been more serious.

As I pulled the scalpel blade from the handle and collected my instruments, Francine vigorously licked her new calf. By now I felt I had done my penance. As Barb started the loop again, “Hell, I’s already 18…”, I felt no obligation to pretend polite.

Francine and her calf went on to do well.

Dr. Stork is to this day saddled with images I’d pay a mental health professional, priest or exorcist a week’s pay to scrub from my memory.

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