Tuesday, 29 September 2015

The Conduit Sequence

Regular blog readers may be surprised to learn that I've also written some novels as well. I know I was. For the next few days, Soul Purpose, my first novel about a typical vet who has some extremely un-typical things happen to him, is on offer for 99p ($1.54) Come on! That's cheaper that a cup of coffee! Even a relatively rubbish cup of coffee from a less-well-known but taxpaying coffee shop!

Still not convinced you? Here's an extract to whet your appetite...



The barn was an old building, rickety and wind-blown and, at this time of year, ankle deep in cow shit. It had a thin scattering of straw on the ground as if in an attempt to disguise the dirt. It didn’t work. The beam from the nervous farmer’s torch bounced around the room as if it would rather be in a nightclub. The acrobatic lighting added to Alan’s feeling of discomfort and displacement. It should have been a relief to be out of the driving rain but at this moment Alan would have gladly stood out in it naked until sunrise if it meant he could avoid seeing what had turned Mike White, who had calmly held prolapsed uteruses up on his knees and sawn rotten heads off stinking lambs to get them out of the ewe, as pale as his cows’ milk. 

‘What… er… what have you got for me, Mr White?’ Alan asked nervously.

Mike turned to Alan, his weathered face deeply troubled. He had been a farmer all his life. He had seen just about everything nature could throw at a person, most of it before he was twelve. Alan wasn’t at all sure that he wanted to know what it was that had shaken him, but thought he should at least have some warning about what he was approaching.

‘It’s the damnedest thing, Alan. Never seen anything like it in all me born days.’

‘What is it, exactly?’

‘I was ’opin you could tell me. Maiden heifer, just calved. See for yerself.’

Mike turned back again, and trudged forwards, his torchlight illuminating a cow-shaped form in the corner of the barn. Alan followed, squinting, trying to make it out. It was a Friesian-Holstein heifer, slightly on the thin side, and as Mike had pointed out, obviously just calved. She was standing and licking forlornly at a small pale object lying in the straw. Alan’s mouth formed the ‘w—’ of ‘what’ but whatever else he was planning to say was lost to posterity because at that moment Mike shone his torch directly onto the object. The word retreated from Alan’s mouth and hid, quivering, down by his diaphragm.

The thing the cow was licking was a calf - of sorts. Alan had seen foetal monsters before, bizarre furry blobs of flesh with incongruous feet, tails or even heads protruding. Accidents of nature, never meant to live. This was different - it appeared normal. Four legs, head, tail, everything in place. At least, Alan thought so. It was hard to make out, because the torchlight shone right through the calf, illuminating the bloodstained straw beneath, which reflected the light right through the calf again as if it wasn’t there.

The calf was transparent.

Alan’s brain didn’t quite grasp the concept as it zapped through his neurones the first time, so he tried thinking it again, more clearly this time.

The calf was transparent. 

He could see its ribs, its beating heart, its lungs, which were twitching and contracting as the neonate fought for breath. Alan watched in astonishment as the calf gave a feeble cough and a blob of pleural fluid travelled out of the lungs, up the trachea, and into the mouth, where the calf swallowed it.
The mother briefly glanced at the two intruders and then turned back to licking her miraculous calf.


Alan’s heart skipped a beat. A moment later, it skipped another one. It was preparing to skip a third when it received an urgent communiqué from his brain, suggesting that if it did so, there would be trouble. Reluctantly, it started up again, and then made up for lost time by hammering away at double speed.
Alan took a cautious step towards the calf. Mike stayed where he was.
‘What d’you reckon, then?’ the farmer asked.

Alan couldn’t tear his eyes away from the creature in front of him. He wondered if he was still asleep. Half of his brain was gibbering with sheer incomprehension. The other half was running through his notes, searching for the section headed ‘photo-transparent idiopathies’. Either he had forgotten all about them, or no such section existed.

The heifer looked up at him again. Alan had never been very good at reading bovine expressions.

‘Did she calve all right?’ he asked automatically, buying time so that his brain could stop gibbering and start working.

‘Reckon so,’ said Mike. ‘We didn’t help her out or nothin’, anyway.’

Alan was at a loss for what to do. Surely he should be gathering evidence, taking photos, something. This was obviously a whole new disease. He switched himself onto autopilot, clinical exam mode while he wondered what the bloody hell he was going to do.

The heifer was fine; normal heart rate, normal temperature, mucous membranes salmon-pink. A little bruised, but nothing out of the ordinary. She had cleansed fine - the shrivelled mess of perfectly ordinary placenta lay on the floor next to the calf.

The transparent calf.

‘Er… aren’t you going to look at the...?’ Mike asked from his safe distance, his voice dying off as he indicated the newborn with his torch beam.

‘Oh… erm… sure,’ mumbled Alan. He moved back around to the front of the cow and looked down.

It didn’t make any sense. How could it be alive? Weren’t there… reactions and things that had to happen in the skin? Didn’t it need to absorb light or something? Alan wasn’t clear on the specifics. Biochemistry was not his favourite subject.

Slowly, he knelt down beside the creature. It turned its head to him, making a weak mewling sound. Alan could see its larynx vibrate as it did so. It was clearly dying. The calf’s heart had slowed its beat since he had first looked at it, and the wretched thing was almost too weak to hold its head up. 

Alan was strangely reluctant to touch it; a quiet but insistent voice in the heart of his being suggested that it would be a really bad idea. The cow nuzzled her calf again. Slowly, desperately trying to shake the feeling that this was all a dream, Alan reached his hand out to it...



Get the rest here: http://www.amazon.co.uk/Soul-Purpose-Nick-Marsh/dp/1904853315 (or here for you colonial types: http://www.amazon.com/Soul-Purpose-Conduit-Sequence-Book-ebook/dp/B00BVMGVA4/

Monday, 28 September 2015

Drugs of the Devil!

I have a new post about the perils of antibiotic use over at the Vet Times website - you can find it here. There's very little satanism in it, so this may please or disappoint you depending upon your interests and religious beliefs. Enjoy!

Monday, 7 September 2015

That is not dead which can eternal lie...

The blog is not dead, only sleeping! The reason for the quiet here is that I've been commissioned to write blogs twice monthly for the Vet Times, as and the subject matter is very similar to the sort of things I normally pop here, my usual posts have died down.

I am still posting, though - you can find all my Vet Times blogs here! They're still just as funny/annoying/tedious as before, only now I'm getting paid for them. I may see if I can sell them some of this old rope I have lying around too...

Thanks for visiting, though! There's still plenty to see here. How about taking a look at my books - my humorous (well, I thought so, anyway) veterinary/science fiction novels Soul Purpose and Past Tense, my epic fantasy novel The Ancients, or my thrilling Orient-Express-based horror novel, The Express Diaries. Mmm, 1920's terror! The best kind.

If you're still bored or still have more lunch to eat, here's a list of my personal favorite blog posts (your opinion may vary, of course - feel free to comment, I'm still here!).

Dog #86324 - not a cheery one, but the most honest writing I have done, about euthanasia
Lingua Medica - my favourite informative post, detangling medical terminology
The Mutt's Nuts - this consultation still makes me shudder
Geri - a lament for my beloved lurcher, Geri
Breeding Difficulties - home truths about what it means to breed pedigree animals
A Disease of Economic Importance - the foot and mouth disease crisis of 2001

There are plenty more, so feel free to explore - just please remember to wash your hands afterwards. See you in the Vet Times ;)

Thursday, 21 May 2015

Doctor of what?

Consulting is an art, not a science. No matter how well you know your medicine (and I am certainly not claiming any special expertise in that department), a consultation can often be spun in an unexpected direction by what we shall charitably call 'the human factor'.

Yesterday afternoon, I opened up the medical file of my next consultation - a booster vaccination for a cat. Something about the surname rang a bell, but I hadn't seen this cat before, and the client didn't seem to own any other animals. Something still nagged at me, however, so I clicked another button in the top right-hand corner of the screen. The button is marked 'Show deceased'.

Three more animals appeared under the clients name, all cats. The names all sounded familiar. Sure enough, I had seen all of them. Not only had I seen all of them, it was me that had been with them for their final consultation. I had put all of the owner's previous cats to sleep. The most recent had been several years ago, and try as I might I was saddened to find that I couldn't bring any of the cases to mind, or the client. Nevertheless, I was glad I had checked; I didn't remember the client, but it was a fair bet that they would remember me, having euthanised three of their previous pets. Now, at least, I could show a little tact, caring and diplomacy in the consulting room, even though I was just vaccinating their last remaining pet.

I stepped out into the waiting room, and quickly located a tall man sitting with his daughter, a cat box on his knee. I smiled at him, and with a quiet, respectful demeanor I called his cat's name.

The man looked up, smiled, and nudged his daughter in the ribs. 'Oh hello!' he called, cheerfully. 'It's Doctor Death!' He stood up and cheerfully walked towards me, while his daughter and I competed on which of us would rather a hole opened up in the ground and swallowed us up.

The man continued his own brand of peculiar gallows humour all the way through the consultation. 'Careful, Misty,' he said as I plucked the black and white cat from it's box. 'He should have a scythe, not a stethoscope!' I smiled politely while his daughter rolled her eyes and folded her arms, staring at the floor.

'Yes,' I said, trying to lighten the mood as I drew up my vaccination. 'It's a happier occasion, today, isn't it?'

'I'll say!' said the man. 'At least we won't need a coffin at the end of it!' I felt like saying that if he kept this up, then I couldn't promise anything, but I remained as ever, calm and professional. Still, it was a surprise that I had no memory of this man. If he was like this during a vaccination, God knew what he was like during an actual euthanasia.

'All done,' I said, putting his surviving cat back in it's box and closing the door behind it. 'There,' I said, smiling at the man, 'All of us made it through in one piece!' The man smiled and winked at me. His surprising attitude was growing on me. There was no malice at all in him. Why not be cheerful? The cats weren't suffering, and I had done a professional job. Doesn't joking about a dark subject make it something less to fear? Maybe we could all learn something from his attitude. I was starting to decide that perhaps I rather liked him.

I opened the door and let the man, his embarrassed daughter and his still-alive cat out to reception, where upon he announced loudly to the packed waiting room, 'This is the first time one of my pets has seen that vet and come out alive!'

I shut the door, and decided that maybe the best thing would be if a hole opened up in the ground and swallowed him instead.

Monday, 4 May 2015

Doctor, doctor, gimme the news...

Alright, I will. Because I am. A doctor, that is - as of last week.

You see, unlike many of our overseas colleagues, veterinary surgeons in the UK have long languished under tedious titles of Mrs, Miss or Mr. Not only do these titles call upon people to make a snap judgement on whether we're married or not, they simply don't sound quite as sexy as 'Doctor'. If anything, they make us sound more sinister - 'Mr Kildare' just sounds creepy, doesn't it?

There are those in my profession that will try to tell you that the vanilla title is right and proper. Human surgeons are known by them, after all - it's something of a badge of honour for them to go from Dr to Mr, in fact, and is a right granted them by the Royal College of Surgeons.

'Well,' say the misguided (and slightly less cool) vets of the UK, 'we're surgeons too, aren't we? So we should be Mr or Mrs too!'

Well, I disagree. For one thing, human surgeons undergo a metric craptonne more training than veterinary surgeons do - years and years more, in fact - so if they want to call themselves Mrs, I think they're quite entitled to. Secondly, as vets, we never got called 'Doctor' at any stage of our training, so it doesn't feel so much like a promotion as a, uh, nothing at all. Thirdly, I think I'd be more on board with it if surgeons had an entirely different title again, something like... I don't know. Powerman/woman? That would work. I could cope with being Powerman Marsh. (Pwn. Marsh - except if you're familiar with internet l33tspeak, that does sound a little like I just got my ass handed to me in an online game. I'll keep thinking).

Anyway, this particular powerman has strayed from the point a little. A couple of months ago, the RCVS - the august body that oversees veterinary surgeons in the UK - decided that vets are now entitled to use the title 'Doctor' - with a couple of caveats.

Firstly, when we use it in full we should add 'MRCVS' after our name, to signify that we are members of the Royal College, and not actually licensed to poke about inside another human being (well, not with surgical instruments, at least). Secondly, it is a courtesy title - it's up to us whether we use it or not.

When I heard about the news, this last point threw me into a dilemma. Was it really that important, I wondered, to be called a doctor? Is it something we deserve?

My point about training above wasn't just true of surgeons. It's a fallacy that it takes longer to train as a vet than as a doctor. The veterinary degree takes five years, just as the medical degree does, but then medical doctors have at least another two years of on-the-job training before they are fully qualified. Vets are just thrown in at the deep end, though the RCVS is considering changing this too.

In my career, occasionally a client would start a consultation with a 'Well, what it is, doc, is that...,'. Even on the rare occasions when I would point out that this title wasn't one that I had been granted, I would do it with a bashful grin (and possibly even come-to-bed eyes) that indicated I was not at all unhappy on being accidentally promoted, and it always gave me a little thrill.

But still. Doctor. I have been a veterinary surgeon for fifteen years, and a change in my title wouldn't change my experience, or my skills, or my simple honest-to-goodness dashing good looks. A courtesy title. If I actually changed it, would it just make me appear vain? Would my colleagues consider me so? Would there be two tiers of vets now? Ones that were secure in their own skills, and ones that needed something more? A veterinary surgeon, by any other name, would still smell of anal glands and hibiscrub, after all. This was a decision that required careful, considered thought.

Thirty microseconds later, I was logging in to the website of the RCVS, and ticking a box on my profile that indicated now, and forever more, I would be known as 'Doctor Nick Marsh MRCVS.'

Such decisions come at a cost. Households have been split on the issue. My wife, for instance, remains plain old Mrs Marsh - although this has less to do with any high-minded ethical stance, and more to do with the fact that she has forgotten her login details for the website.

As for myself, I find I am much the same person - with one added bonus. Thank you, The Simpsons. You have made me a very happy man.


Doctor Nick Marsh, MRCVS

Friday, 24 April 2015

For the blood is the life... Part one

Watch out, haemophobes! This one is about blood - specifically, blood transfusions in dogs and cats. For the first of this two-parter, we're going to have a look at how you might end up wanting to give a transfusion in the first place, before we get down to the meaty stuff in part two. Before we get too carried away learning about motion lotion, though, here's a quote from one of the true horror greats to get us in the mood:

'Something was pouring from his mouth. He examined his sleeve. Blood!? Blood. Crimson copper-smelling blood, his blood. Blood. Blood. Blood. And bits of sick.' 
Garth Marenghi, Slicer

Thank you, Garth. Blood. We all have it (unless you're a 13th generation cyber-mind reading this in the thirty-fifth century, but I can only cover so many angles with my writing) and we all have an idea of what it's for: to take oxygen out of your lungs and transport it to all your other bits to prevent them from being dead. It has other uses too, but this is the one you will be most concerned about if you start to run out.

Let's do a bit of jargon de-tangling here - us medical types love our jargon (see this post on the subject). The medical prefix for blood is 'haem' (or heme if you prefer; you know who you are. Go on then, just this once, I will do you a favor and leave the 'u' out of that favour. Happy now?). So: haemophobia - fear of blood; haemorrhage - blood loss; haematuria - bloody pee - and so on. Lack of blood - specially red blood cells, the Werther's original-shaped cells packed with the oxygen-loving haemoglobin that do the donkey work of moving oxygen around - is known as anaemia (presumably because anhaemia is awkward to say), and in its severe forms is what is going to make us reach for the blood bags.

Anaemia (and, so y'know, there's a lot more to know about anaemia, but let's keep it simple) is the most likely reason that you're going to find yourself at the business end of a blood giving set, and my extensive study of human literature has revealed that commonest form of human blood loss is, of course, vampiric attack. For dogs and cats it's a little different. We are not, at least in general practice, ER (my close resemblance to George Clooney to the contrary). If an animal has suffered such severe blood loss in an accident that it is in immediate need of a blood transfusion, then I'm afraid it is very unlikely to survive - principally because in general practice we are not allowed to store animal blood products, and so the dog or cat is going to have to wait for us to find a donor animal and drain it before it gets a snifter of the good red stuff, by which time it is highly likely to have given up waiting in a terminal fashion.

So, for vets in general practice at least, the most likely reason we are going to want to give a blood transfusion is either due to a slow semi-controlled bleed (like a ruptured splenic tumour) or expected blood loss (which reminds me of one of my lecturers telling us about attempted surgery to remove a tumour from a dog's aorta - the main artery from the left side of the heart; the vessel ruptured and our lecturer, a master of understatement, told us that the dog 'experienced brisk haemorrhage' which later had to be scrubbed off the ceiling of the op theatre), or because of IMHA.


IMHA stands for 'Immune-mediated haemolytic anaemia' - please don't switch off, we can get through this, don't worry. Haemolytic anaemia we can already work out - lysis is the medical term for cells breaking down, so 'haemolytic anaemia' just means 'red blood cells breaking down, leading to a lack of blood cells'. I think HA is punchier, though.

As for Immune-mediated - well, as it sounds, this just means the disease is mediated by (i.e. caused by) the immune system going a bit tits up. Lots and lots of diseases are immune-mediated - all allergies, for instance. Just like The Force, the immune system is a powerful tool, but it can be used for evil as well as good. In IMHA, the immune system has decided that red blood cells are invaders and must be destroyed without mercy. Anything that stimulates the immune system - infections, drugs, and yes, sadly even vaccinations can trigger the immune system off in the wrong direction. Regardless of the In a grim parody of the Russian Revolution, all throughout the blood vessels, red cells square off against white. And red always loses.

The treatment for IMHA, like many of the immune mediated diseases, will be familiar to IT professionals. Switch the immune system off as quickly as possible, then let it come back online slowly and hope it's calmed down a bit. Steroids are the cheapest and most-frequently used drugs to do this, though there are a number of others. The problem is, it takes time for the immune system to stop popping the red-blood cells like an overactive needle-armed toddler in a balloon shop, and during that time the anaemia can reach severely (and frequently fatally) low levels.


Another definition for you (sorry) -Anaemia is - or at least can be - measured by the Packed Cell Volume - or PCV. If you spin down blood in a centrifuge, all the red cells will squish up together at the bottom of the tube, and the PCV is just the percentage of tube that is filled by these red cells - the lower the PCV, the fewer red blood cells you have. Dogs and cats normally have a PCV in the 30-40% range. Unless they're planning to run a marathon any time soon, they're going to be fine until it drops below 20%, where they're going to start looking a little tired. By the time it drops below 12% they're heading into trouble and are probably going to need a transfusion very soon. For dogs, if it drops much below, say, seven or eight percent, they are in serious danger of death. Cats seem to tolerate very low PCVs a little better, and I've know a few survive even with PCVs of five or six - but it's still brown-trousers territory for the clinician involved.

So, for whatever reason, we have a dog or cat with a worryingly pale gum colour and a PCV that is making us sweat. What now?

Let's talk about that in part two (although - spoilers - it involves sticking more blood into the animal).

Wednesday, 1 January 2014

A Disease of Economic Importance - Reflections on the Foot and Mouth Crisis of 2001

One afternoon in early 2001, Kate and I were sitting watching a news report about a disease outbreak on a farm in Essex.

            'Foot and mouth disease,' Kate said. 'That rings a bell. Which one is that?'
            I shrugged. 'Um... is it... it's the one with... er. It's notifiable, isn't it?'
            Kate looked pointedly back at the telly. 'Obviously.'
            I shrugged again. 'Well, I'm sure it'll be okay.'

            Hitherto, my sole encounter with the disease that would cause such destruction in Devon was while I was failing my public health examination in the fourth year. On the next page from the fabled 'Write short notes on the process of cheese making,' there had been an essay question on foot and mouth disease. In the exam I had wracked my brain to try and remember my crib notes, and splurged it all out onto the blank sheet in front of me: A viral disease - a picornavirus, to be precise. Very stable in the environment and highly contagious - the virus can potentially travel miles as an airborne particle - possibly even across the English Channel[1]. Predominantly affects ungulates. Causes fever, followed by ulcers in the mouth and around the feet. Rarely fatal in adults, but can cause heart problems in neonates. Otherwise self-limiting[2] in a few weeks. Not present in the UK at this time.

            I surrounded these bare bones with a fair amount of waffle, but that covered most of the things I knew about the disease... which is another reason I failed the public health exam. I had written my notes as if I was looking at an individual animal. I wrote (and knew) almost nothing about the economic implications of the disease.

            That was going to change in the Spring of 2001.

            Events moved quickly from that first diagnosis. A few days after the disease was confirmed in Essex, movement restrictions were placed in a five-mile radius around the site - no one could move animals in or out of the zone. By then, of course, it was already too late. A few days after that, a case was confirmed in Northumberland. The EU imposed a ban on the UK exporting any meat or meat products, and shortly after that, foot and mouth arrived in Devon. Within a week, cases had been confirmed in Scotland, Cornwall and Cumbria. It was becoming clear that the country was in the grip of a full-blown epidemic.

            The Ministry of Agriculture, Food and Fisheries (MAFF) appeared to be moving swiftly to combat the disease. They quickly instigated movement restrictions all over the country - not just for cattle, sheep and pigs, but for horses and dogs and humans too. Very soon into the crisis, they adopted a policy known as the 'contiguous cull' - every time a new case of foot and mouth was discovered, every cow, pig and sheep within a three mile radius was to be slaughtered.

            Kate and I watched the news unravel with some confusion. Foot and Mouth (and, from here on I'm going to use the accepted abbreviation FMD) was, in my mind, stored in a category along with kennel cough - highly contagious, but low severity. FMD wasn't a zoonosis - humans can't catch it.[3] It wasn't a pleasant disease to suffer from - what disease is?  - but it certainly wasn't in the same league as the horrors of rabies, or anthrax, or any number of other diseases that I could think of without even reaching for my large animal medicine notes. It was incredibly contagious, of course - but there was a vaccine available, wasn't there? I was sure there was. Quite an effective one, as I remembered. Why was the government behaving as if the dead had risen from the earth to feast upon the living?

            Nevertheless, with outbreaks popping up all over the place, and with us being repeatedly told what a dreadful disease the government was dealing with, we assumed there were good reasons behind all the measures. I had failed that exam, after all - I was hardly an authority on the subject.

            Within weeks it became clear that two counties had been particularly badly hit by the disease - Cumbria, and Devon. MAFF was rapidly running out of staff to help with the crisis, and the call went out for veterinary surgeons to assist in combating the disease. Locuming at the time, there was no reason for me not to help out - no reason, except that I was not an experienced cattle vet, and I was concerned that I wasn't really the sort of person that the ministry was looking for. I really wasn't sure that I wanted to be involved in this 'contiguous cull', however necessary it was. I was, after all, a vegetarian[4], and so to some extent had opted out of the system already - although I still drunk milk, and ate cheese, and I knew I was fooling myself if I thought that didn't make me complicit in a lot of the problems of modern farming. Nevertheless, it didn't seem like something I could help with.

            A few weeks into March, I changed my mind. I would dearly love to recount here that it was out of a sense of patriotism, or 'Blitz spirit'- wanting to do my part for the country. I would, more dearly, like to announce that the reason I became a Temporary Veterinary Inspector (TVI) for the Ministry of Agriculture, Fisheries and Food was because, if more slaughter was necessary, then I would do what I could to ensure the welfare of those to be killed was as good as it could be. There's some truth to both of these, but here's the main, rather depressing one: MAFF were so desperate that they announced they were doubling the pay of TVIs from £125 per day to £250. A fortune for me - a week's pay for working a couple of days.

            I applied, was accepted, fast-tracked, and within a few days found myself standing outside the MAFF building near Exeter, hoping that someone in charge would explain to me, in very simple terms, exactly what the hell I was supposed to do.

            While I was sitting in a large conference room, amongst many other vets - some large animal veterans, some dyed-in the wool small animal-types, some new graduates, and many, many Spanish vets, taking advantage of the sudden opportunity for work and pay far better than anything they might find in their home country - experiencing a very short induction lecture, arguments were raging across the county and the political landscape. The countryside had been, by this point, effectively shut down. People weren't supposed to travel into it unless absolutely necessary. Tourists stopped coming to the UK. Opposition party leaders were asking why MAFF hadn't imposed restrictions as soon as they had confirmed the disease in the Essex abattoir - as reports on the 1967 Northumberland epidemic were very clear that speed was of the essence in controlling the disease. Many members of the general public started asking the same question that had crossed my mind - what was so terrible about this disease that demanded the extreme response of the contiguous cull?

            As I sat, flipping through my induction pack, listening to the explanation of the disease control policy, a line from one of my favourite childhood films ran through my mind. In Aliens, when Ellen Ripley discovers that the colony on LV421 has been overrun by the terrifying creatures that wiped out her entire crew in the first film, her solution is simple but effective.

            'I say we take off, and nuke the site from orbit. It's the only way to be sure.'

            It occurred to me that someone high up in the ministry was a fan of the film too.


Despite my worries, the job itself was simple - far simpler than my normal day job. Every day we (myself and a technician) would be assigned a number of farms to check in Devon. We would drive to the farm entrances in our MAFF-assigned vehicles, park outside, then don disposable boiler suits, hats and masks, dunk our white Government-issue wellies into virucidal solution, and inspect every single animal on the farm for symptoms of FMD. If all was well, we would move on to the next farm. If we found anything suspicious, however, we would call in the back-up, who would slaughter the suspected animals and test them for the disease. If it was confirmed, then the contiguous cull would come into force - every cow, sheep and pig in a three-mile radius would be culled, and their bodies burned to prevent spread of infection.

            By the time I started at MAFF, there were a lot of bodies burning in Devon.

            If we ever found FMD, then we would be, from that point on, classified as 'dirty', and my veterinary services would then be required to assist with the culling, and the clean-up afterwards. By this stage, with up to fifty new cases being found every day, there was a lot of culling that needed to be done. The military had been called in to help, and 'clean' vets were becoming harder to find; hence the pay increase to attract new TVIs. Within a few hours of my training video, I was inspecting sheep on a farm near Okehampton, worrying that the few slides I had seen wouldn't be enough preparation for me to tell the difference between FMD and footrot. By now, the epidemic was at its height, and MAFF had introduced a 'suspected slaughter policy' - no more waiting for confirmation of the disease. If I saw lameness, would I be confident enough to cry wolf - and thus potentially condemn every livestock animal within a three mile radius to death?

            I was in a better position than some, however. A lot of the Spanish vets had never seen a case of orf - a relatively common disease of sheep in Devon, that caused blistering lesions around the teats, mouth and feet. If they suspected FMD, it didn't matter how many times the farmer pointed out they were actually looking at orf. All the animals on the farm would then be slaughtered, and if the case was deemed suspect enough, everything within three kilometres.

            Visiting a farm as a MAFF vet was a very different experience from visiting one as a normal vet. Some farmers were friendly and welcoming, but these were the exceptions. The majority were scared that we would find something on their farm, or suspicious that despite our extravagant precautions at their gate, we would bring the disease to them. Who could blame them? Farmers were compensated for the loss of their animals, but money doesn't go very far in alleviating the distress caused by watching everything on your farm get slaughtered and burned. Those were uncomfortable visits, farmers nervously showing you their animals, silently praying that you didn't suddenly order them to stop, to take a closer look at something, and speak the words that would mean destruction of everything they had built up.

            A couple of weeks into my work as a TVI, the Ministry for Agriculture, Food and Fisheries transformed into the Department of Environment, Food and Rural Affairs, or DEFRA. It must have been in the pipeline before the outbreak started - the wheels of government turn slowly - but at the time it felt like a response to the perception of poor handling of the crisis in the media. Don't worry - MAFF are no longer in charge of fighting the disease! DEFRA is on the case now. What it meant, in practical terms, was that one day I went to work to discover that all the headed paper had been changed from one logo to another.

            I worked for about two months as a TVI during the crisis, travelling from farm to farm - usually three or four a day, but some of the big units, especially large sheep farms, took up a whole day or more. I was lucky. The farmers I visited were lucky. I saw plenty of lameness; I saw footrot, and I saw orf, but I never saw anything that resembled foot and mouth disease. I made it through clean.


The final case of the outbreak was reported on a Cumbrian farm at the end of September. Movement restrictions were finally lifted in 2002, a year after the first case. DEFRA's contiguous cull policy had worked. FMD was once again eradicated from the United Kingdom, after the slaughter of around ten million sheep, cattle and pigs.

            I kept turning it over in my mind. FMD was a relatively mild, self-limiting disease in adult cattle. That was a hard thing to reconcile with the huge pyres of blackened, burning bodies that I, thankfully, only ever encountered on the news. The contiguous cull policy had worked. So would have taking off, and nuking the site from orbit.

            Here's the reason that FMD was taken so seriously by the Government: the economy, stupid. Affected cows suffer 'milk drop' - a reduction in the milk that they produce. This milk drop is usually temporary, but it can be permanent.

            There is, as I had suspected, all those years ago, a vaccine available for FMD. It's very effective, and relatively cheap. However, once you've vaccinated an animal, it is then impossible to test for the disease itself - the animal will test positive if the vaccine was effective. For this reason, the World Health Organization classifies countries according to their FMD status thusly: 1 - FMD present; 2 - FMD-free with vaccination; 3 - FMD-free without vaccination. The third and last group gets better access to export markets, so countries in this group work hard to stay there; it's fair to say that, in 2001, the UK worked very, very hard to stay there.

            There have been a lot of studies on the economies of the 2001 FMD outbreak - some of which say it was worth it, in economic terms, some of which strongly argue that it wasn't. It seems to be a close-run thing.[5] DEFRA has, since the outbreak, acknowledged that vaccination might be a sensible policy move faced with such an outbreak next time - vaccinations are allowed in some circumstances by the WHO in order to bring an epidemic under control.

            In case you missed it, I'll say it again - ten million animals were slaughtered during the FMD crisis of 2001 - the vast majority of them being sheep. It's since been confirmed that roughly one in three of the 'suspect' diagnoses were correct. Thanks to the contiguous cull policy, with the three-mile 'protection' zone, this means that something like ninety percent of those slaughtered were uninfected.

            Now, there's an argument to be made that all these animals would have been slaughtered anyway - we eat them, after all. As a counterpoint to that argument, consider this: slaughter in an abattoir is tightly regulated and controlled in order to minimise distress and discomfort to the animals. I have visited a number of abattoirs in my time. When it goes smoothly, the killing is painless, and very quick. It doesn't always go smoothly.

            At the height of the disease in Devon, ninety thousand animals were being slaughtered a day. Ninety thousand. On farms. By vets, by technicians, and by the army. If you think that it went smoothly, then I would suggest you are a poor student of human nature. None of the abattoir regulations were in place. Animals were not stunned prior to slaughter. They were not insensible at the moment of death, nor were they ignorant of the deaths around them. They were distressed, they were terrified, and then they were killed. Vets did what they could. Farmers did what they could. But that stark number of ten million animals, I can assure you, blurs an immense amount of suffering, fear, pain, and death into an easy-to-swallow statistic.

            Foot and Mouth is a disease of economic importance. I stayed clean during the epidemic of 2001. Somehow, I still feel dirty.

[1] I was very proud of remembering this point - it must have appealed to the SF writer in me; also, I honestly did remember that it was a picornavirus.
[2] a medical term, meaning 'it goes away by itself'
[3] Not strictly true - there have been a few reports of direct transmission from animals to humans, but these cases are very rare, not confirmed, and (just like FMD itself), get better very quickly.
[4] I won't mention it again, I promise!
[5] Here's some figures for the interested: getting the outbreak under control cost £8-10 billion pounds. Lost revenue for allowing FMD unchecked across the UK (and so ending up in the 'FMD present' group) could be £1.2 billion/year. Vaccination of all herds in the country would probably cost about £150 million. I can't find any figures for what the UK being downgraded to Group 2 would be.