We do these jobs under a local anaesthetic nowadays, and in most cases the cow lies quietly on her side or even stands during the operation. The animal can’t feel anything, of course, but I have a few extra grey hairs round my ears which owe their presence to the occasional wild cow suddenly rearing up halfway through and taking off with me in desperate pursuit trying to keep her internal organs from flopping on the ground.

  But that was all in the future. On this first occasion I had no such fears. I cut through skin, muscle layers and peritoneum and was confronted by a protruding pink and white mass of tissue.

  I poked at it with my finger. There was something hard inside. Could it be the calf?

  ‘What’s that?’ I hissed.

  ‘Eh?’ Norman, kneeling by my side, jumped convulsively. ‘What do you mean?’

  ‘That thing. Is it the rumen or the uterus? It’s pretty low down, it could be the uterus.’

  The student swallowed a couple of times. ‘Yes . . . yes . . . that’s the uterus all right.’

  ‘Good.’ I smiled in relief and made a bold incision. A great gout of impacted grass welled out, followed by a burst of gas and an outflow of dirty brown fluid.

  ‘Oh Christ!’ I gasped. ‘It’s the rumen. Look at all that bloody mess!’ I groaned aloud as the filthy tide surged away down and out of sight into the abdominal cavity. ‘What the hell are you playing at, Norman?’

  I could feel the young man’s body trembling against mine.

  ‘Don’t just sit there!’ I shouted. ‘Thread me one of those needles. Quick! Quick!’

  Norman bounded to his feet, rushed over to the bale and returned with a trailing length of catgut extended in shaking fingers. Wordlessly, dry-mouthed, I stitched the gash I had made in the wrong organ. Then the two of us made frantic attempts to swab away the escaped rumenal contents with cotton wool and antiseptic but much of it had run away beyond our reach. The contamination must be massive.

  When we had done what we could, I sat back and looked at the student. My voice was a hoarse growl. ‘I thought you knew all about these operations.’

  He looked at me with frightened eyes. ‘They do quite a few of them at the clinic.’

  I glared back at him. ‘How many caesareans have you seen?’

  ‘Well . . . er . . . one, actually.’

  ‘One! To hear you speak I thought you were an expert! And anyway, even if you’d seen only one you should know a little bit about it.’

  ‘The thing is . . .’ Norman shuffled his knees around on the cobbles. ‘You see . . . I was right at the back of the class.’

  I worked up a sarcastic snarl. ‘Oh, I understand. So you couldn’t see very well?’

  ‘That’s about it.’ The young man hung his head.

  ‘Well, you’re a stupid young fool!’ I said in a vicious whisper. ‘Dishing out your confident instructions when you know damn-all. You realize you’ve killed this good cow? With all that contamination she’ll certainly develop peritonitis and die. All we can hope for now is to get the calf out alive.’ With an effort I turned my gaze from his stricken face. ‘Anyway, let’s get on with it.’

  Apart from my first shouts of panic the entire interchange had been carried out pianissimo and Mr Bushell kept shooting enquiring glances at us.

  I gave him what I hoped was a reassuring smile and returned to the attack. Getting the calf out alive was easy to say, but it soon dawned on me that getting the calf out in any way whatsoever was going to be a mammoth task. Plunging my arm deep below what I now knew was the rumen I encountered a smooth and mighty organ lying on the abdominal floor. It contained an enormous bulk with the hardness and immobility of a sack of coal.

  I felt my way along the surface and came upon the unmistakable contours of a hock pushing against the slippery wall. That was the calf all right, but it was far far away.

  I withdrew my arm and started on Norman again. ‘From your position at the back of the class,’ I enquired bitingly, ‘did you happen to notice what they did next?’

  ‘Next? Ah yes.’ He licked his lips and I could see beads of sweat on his brow. ‘You are supposed to exteriorize the uterus.’

  ‘Exteriorize it? Bring it up to the wound, you mean?’

  ‘That’s right.’

  ‘Good God!’ I said. ‘King Kong couldn’t lift up that bloody uterus. In fact I can’t move it an inch. Have a feel.’

  The student, who was stripped and soaped like myself, introduced his arm and for a few moments I watched his eyes pop and his face redden. Then he withdrew and nodded sheepishly. ‘You’re right. It won’t move.’

  ‘Only one thing to do.’ I picked up a scalpel. ‘I’ll have to cut into the uterus and grab that hock. There’s nothing else to get hold of.’

  It was very nasty fiddling about away out of sight down in the dark unknown, my arm buried to the shoulder in the cow, my tongue hanging out with anxiety. I was terrified I might slash into something vital but in fact it was my own fingers that I cut, several times, before I was able to draw the scalpel edge across the bulge made by the hock. A second later I had my hand round the hairy leg. Now I was getting somewhere.

  Gingerly I enlarged the incision, inch by inch. I hoped fervently I had made it big enough, but working blind is a terrible thing and it was difficult to be sure.

  At any rate I couldn’t wait to deliver that calf. I laid aside my knife, seized the leg and tried to lift it, and immediately I knew that another little nightmare lay ahead. The thing was a tremendous weight and it was going to take great strength to bring it up into the light of day. Nowadays when I do a caesar I take care to have a big strong farm lad stripped off ready to help me with this lifting job, but today I had only Norman.

  ‘Come on,’ I panted. ‘Give me a hand.’

  James manages to bring the foot of the calf round and grasp the other hind leg, and then, both men pulling with every vestige of their strength, the tail appears, then a huge ribcage and, finally, with a rush, the shoulders and head. As the calf snorts, the farmer exclaims, ‘By gaw, he’s a big ’un.’ It is indeed a massive bull who would have never come out the usual way.

  My attention was whisked back to the cow. Where was the uterus? It had vanished. Again I started my frantic groping inside. My hand became entangled with yards of placenta. Oh hell, that wouldn’t do any good floating around among the guts. I pulled it out and dropped it on the floor but I still couldn’t find the uterus. For a palpitating moment I wondered what would happen if I never did locate it, then my fingers came upon the ragged edge of my incision.

  I pulled as much as possible of the organ up to the light and I noticed with sinking disquiet that my original opening had been enlarged by the passage of that enormous calf and there was a long tear disappearing out of sight towards the cervix.

  ‘Sutures.’ I held my hand out and Norman gave me a fresh needle. ‘Hold the lips of the wound,’ I said and began to stitch.

  I worked as quickly as I could and was doing fine until the tear ran out of sight. The rest was a kind of martyrdom. Norman hung on grimly while I stabbed around at the invisible tissue far below. At times I pricked the young man’s fingers, at others my own. And to my dismay a further complication had arisen.

  The calf was now on his feet, blundering unsteadily around. The speed with which newly born animals get on to their legs has always fascinated me but at this moment it was an unmitigated nuisance.

  The calf, looking for the udder with that instinct which nobody can explain, kept pushing his nose at the cow’s flank and at times toppling head first into the gaping hole in her side.

  ‘Reckon ’e wants back in again,’ Mr Bushell said with a grin. ‘By ’eck, he is a wick ’un.’

  ‘Wick’ is Yorkshire for lively and the word was never more aptly applied. As I worked, eyes half closed, jaws rigid, I had to keep nudging the wet muzzle away with my elbow, but as fast as I pushed him back the calf charged in again and with sick resignation I saw that every time he nosed his way into the cavity he brought particles of straw and dirt from the floor and spread them over the abdominal contents.

  ‘Look at that,’ I moaned. ‘As if there wasn’t enough muck in there.’

  Norman didn’t reply. His mouth was hanging open and the sweat ran down his blood-streaked face as he grappled with that unseen wound. And in his fixed stare I seemed to read a growing doubt as to his wisdom in deciding to be a veterinary surgeon.

  I would rather not go into any more details. The memory is too painful. Sufficient to say that after an eternity I got as far down the uterine tear as I could, then we cleared away a lot of rubbish from the cow’s abdomen and covered everything with antiseptic dusting powder. I stitched up the muscle and skin layers with the calf trying all the time to get in on the act and at last the thing was finished.

  Norman and I got to our feet very slowly, like two old, old men. It took me a long time to straighten my back and I saw the young man rubbing tenderly at his lumbar region. Then, since we were both plastered with caked blood and filth, we began the slow process of scrubbing and scraping ourselves clean.

  Mr Bushell left his position by the head and looked at the row of skin stitches. ‘Nice neat job,’ he said. ‘And a grand calf, too.’

  Yes, that was something. The little creature had dried off now and he was a beauty, his body swaying on unsteady legs, his wideset eyes filled with gentle curiosity. But that ‘neat job’ hid things I didn’t dare think about.

  Antibiotics were still not in general use but in any case I knew there was no hope for the cow. More as a gesture than anything else I left the farmer some sulpha powders to give her three times a day. Then I got off the farm as quickly as I could.

  We drove away in silence. I rounded a couple of corners, then stopped the car under a tree and sank my head against the steering wheel.

  ‘Oh hell,’ I groaned. ‘What a bloody balls-up.’

  Norman replied only with a long sigh and I continued. ‘Did you ever see such a performance? All that straw and dirt and rumenal muck in among that poor cow’s bowels. Do you know what I was thinking about towards the end? I was remembering the story of that human surgeon of olden times who left his hat inside his patient. It was as bad as that.’

  They leave convinced that they will never see Bella alive again, that she probably has a good-sized hole in her uterus and peritonitis (caused by infection) is inevitable. The next morning, however, James phones Mr Bushell to see if Bella has survived the night, only to discover that she is up and eating and ‘bright as a cricket’. James is utterly astonished and Bella recovers fully without showing any symptoms from the ordeal.

  That was the way it was at my first caesarean. Over the years Bella went on to have eight more calves normally and unaided, a miracle which I can still hardly believe.

  But Norman and I were not to know that. All we felt then was an elation which was all the sweeter for being unexpected. As we drove away I looked at the young man’s smiling face.

  ‘Well, Norman,’ I said. ‘That’s veterinary practice for you. You get a lot of nasty shocks but some lovely surprises too. I’ve often heard of the wonderful resistance of the bovine peritoneum and thank heavens it’s true.’

  While cattle can be remarkably resistant to infection, as Bella the cow shows, there are a myriad of complications that can ensue after giving birth. Uterus inversion, when the cow continues to push out the entire uterus, presents veterinary surgeons with one of their most difficult and physically demanding challenges. Returning a uterus, an enormous pink mass, through the relatively small opening of the vagina is both awkward and exhausting work.

  It happens when the cow, after calving, continues to strain until it pushes the entire uterus out and it hangs down as far as the animal’s hocks. It is a vast organ and desperately difficult to replace, mainly because the cow, having once got rid of it, doesn’t want it back. And in a straightforward contest between man and beast the odds were very much on the cow.

  The old practitioners, in an effort to even things up a bit, used to sling the cow up by its hind limbs and the more inventive among them came up with all sorts of contraptions like the uterine valise which was supposed to squeeze the organ into a smaller bulk. But the result was usually the same – hours of back-breaking work.

  The introduction of the epidural anaesthetic made everything easier by removing sensation from the uterus and preventing the cow from straining but, for all that, the words ‘calf bed out’ coming over the line were guaranteed to wipe the smile off any vet’s face.

  I decided to take Tristan in case I needed a few pounds of extra push. He came along but showed little enthusiasm for the idea. He showed still less when he saw the patient, a very fat shorthorn lying, quite unconcerned, in her stall. Behind her, a bloody mass of uterus, afterbirth, muck and straw spilled over into the channel.

  She wasn’t at all keen to get up, but after we had done a bit of shouting and pushing at her shoulder she rose to her feet, looking bored.

  The epidural space was difficult to find among the rolls of fat and I wasn’t sure if I had injected all the anaesthetic into the right place. I removed the afterbirth, cleaned the uterus and placed it on a clean sheet held by the farmer and his brother. They were frail men and it was all they could do to keep the sheet level. I wouldn’t be able to count on them to help much.

  I nodded to Tristan; we stripped off our shirts, tied clean sacks round our waists and gathered the uterus in our arms.

  It was badly engorged and swollen and it took us just an hour to get it back. There was a long spell at the beginning when we made no progress at all and the whole idea of pushing the enormous organ through a small hole seemed ludicrous, like trying to thread a needle with a sausage. Then there were a few minutes when we thought we were doing famously only to find we were feeding the thing down through a tear in the sheet (Siegfried once told me he had spent half a morning trying to stuff a uterus up a cow’s rectum. What really worried him, he said, was that he nearly succeeded) and at the end, when hope was fading, there was the blissful moment when the whole thing began to slip inside and incredibly disappeared from sight.

  Somewhere halfway through we both took a breather at the same time and stood panting, our faces almost touching. Tristan’s cheeks were prettily patterned where a spouting artery had sprayed him; I was able to look deep into his eyes and I read there a deep distaste for the whole business.

  Lathering myself in the bucket and feeling the ache in my shoulders and back, I looked over at Tristan. He was pulling his shirt over his head as though it cost him the last of his strength. The cow, chewing contentedly at a mouthful of hay, had come best out of the affair.

  Out in the car, Tristan groaned. ‘I’m sure that sort of thing isn’t good for me. I feel as though I’ve been run over by a steamroller. Hell, what a life this is at times.’

  In It Shouldn’t Happen to a Vet James is called to Dick Rudd’s farm to take a look at his prized dairy shorthorn cow, Strawberry. Shorthorns, their red, white and dark roan colours once a common sight in Yorkshire, could be bred for milk or beef. At one point most of the Wensleydale cheese, originally made in the Yorkshire Dales, was made from the milk of shorthorns.

  Dick’s cows had been scratched together over the years and they were a motley lot. Many of them were old animals discarded by more prosperous farmers because of their pendulous udders or because they were ‘three titted ’uns’. Others had been reared by Dick from calves and tended to be rough haired and scruffy. But halfway down the byre, contrasting almost violently with her neighbours, was what seemed to me a perfect dairy shorthorn cow.

  In these days when the Friesian has surged over England in a black and white flood and inundated even the Dales which were the very home of the shorthorn, such cows as I looked at that day at Dick Rudd’s are no longer to be seen, but she represented all the glory and pride of her breed. The wide pelvis tapering to fine shoulders and a delicate head, the level udder thrusting back between the hind legs, and the glorious colour – dark roan. That was what they used to call a ‘good colour’ and whenever I delivered a dark roan calf the farmer would say ‘It’s a good-coloured ’un’, and it would be more valuable accordingly. The geneticists are perfectly right, of course: the dark roaned cows gave no more milk than the reds or the whites, but we loved them and they were beautiful.

  ‘Where did she come from, Dick?’ I said, still staring.

  Dick’s voice was elaborately casual. ‘Oh, ah went over to Weldon’s of Cranby and picked her out. D’you like her?’

  ‘She’s a picture – a show cow. I’ve never seen one better.’ Weldon’s were the biggest pedigree breeders in the northern Dales and I didn’t ask whether Dick had cajoled his bank manager or had been saving up for years just for this.

  ‘Aye, she’s a seven-galloner when she gets goin’ and top butter fat, too. Reckon she’ll be as good as two of my other cows and a calf out of her’ll be worth a bit.’ He stepped forward and ran his hand along the perfectly level, smoothly fleshed back. ‘She’s got a great fancy pedigree name but missus ’as called her Strawberry.’

  I knew as I stood there in the primitive, cobbled byre with its wooden partitions and rough stone walls that I was looking not just at a cow but at the foundation of the new herd, at Dick Rudd’s hopes for the future.

  It was about a month later that he phoned me. ‘I want you to come and look at Strawberry for me,’ he said. ‘She’s been doing grand, tipplin’ the milk out, but there’s summat amiss with her this morning.’

  The cow didn’t really look ill and, in fact, she was eating when I examined her; but I noticed that she gulped slightly when she swallowed. Her temperature was normal and her lungs clear but when I stood up by her head I could just hear a faint snorting sound.

  ‘It’s her throat, Dick,’ I said. ‘It may be just a bit of inflammation but there’s a chance that she’s starting a little abscess in there.’ I spoke lightly but I wasn’t happy. Postpharyngeal abscesses were, in my limited experience, nasty things. They were situated in an inaccessible place, right away behind the back of the throat and if they got very large could interfere seriously with the breathing. I had been lucky with the few I had seen; they had either been small and regressed or had ruptured spontaneously.