Tell Me Where It Hurts: A Day of Humor, Healing and Hope in My Life as an Animal Surgeon

If the gold standard for writing by a veterinarian is James Herriot’s All Things Bright and Beautiful and All Creatures Great and Small, then Dr. Nick Trout’s Tell Me Where It Hurts generally achieves the pewter standard, with some sterling-silver highlights. Herriot, whose real name was Alfred Wight, evidently fictionalized some of his narratives, though their grounding in true-life experiences is indubitable. (And, anyway, Oprah can’t have Rex or Tabby on her show to, er, rat out a fabricator in this line of work.) Trout, an Englishman who is a staff surgeon at Boston’s Angell Animal Medical Center, does the same — as he acknowledges in his Author’s Note at the beginning of the text. He has compressed stories from many different days into one day, altered the names of pets and their owners, and traded “characteristic idiosyncras…among pets and owners to maintain anonymity.”

Still, despite these liberties and despite some chronic shortcomings, Tell Me Where It Hurts manages to convey, often with drama and humor, what a modern vet’s professional life is like. Running through the “day” here is the story of Sage, a German shepherd suffering from gastric dilation and vovulus (in which the stomach of a dog sort of flips over) and her owner, Mr. Hartmann, for whom Sage has been a lifeline since the death of his wife. Dr. Trout — summoned to the medical center early in the morning — and a young resident discuss the surgery needed to correct this problem and the procedure’s possible complications:

Mortality rates for GDV can be as high as 60 per cent, and factors associated with a higher chance of death include abnormal heart rhythms, extremely high pulse rates, the need to cut out part of the stomach….Sage had checked off nearly every negative prognostic factor for survival.

Trout uses Sage’s story as a sort of clothesline from which to hang other stories and dilemmas and statistics and veterinary issues. In this book resembles any number of contemporary accounts of a professional life — such as Dr. Katrina Firlik’s recent book about being a brain surgeon, Another Day in the Frontal Lobe — in which anecdote mixes with background and commentary. Here we learn that some 69 million Americans own pets; that a vet specializing in “exotics” can cut off a turtle’s penis, after his (the turtle’s!) girlfriend has already bitten half of it off, with no adverse functional effect, as the organ plays no role in micturition; that the toughest decision a vet has to make is, as you might guess, whether to advocate putting a pet to sleep; that, perhaps consequently, veterinarians’ suicide rates are very high; that American pets mirror their owners’ obesity problems; that cosmetic surgery for animals is against the law in England; that putting two ferrets in your pants, making sure they can’t escape, and attempting to endure the consequent fighting and biting within is an old sport in England, called by the uninspired and very Monty Pythonesque name “ferret-legging.” The record is held by Reg Mellor, of Yorkshire: 5 hours and 26 minutes.

Some of the more entertaining and powerful moments here include a spirited defense of animal euthanasia when it is clearly called for. In response to those who advocate letting nature take its slow and painful course, Trout exclaims, “Sometimes nature can take its course and shove it!” Another strong passage describes Trout’s own introduction to veterinary medicine, at his father urging, while he was in high school in England. He accompanied a Welsh vet named Ryan James on his rounds. James was a charismatic, no-nonsense practitioner who in one day showed young Nick Trout what vets did, including injecting a bull’s eyeball to cure pink eye (James made Trout do one of the injections), pulling the teeth of a Pekingese, and earning a patient’s owner’s trust by letting him or her see how conscientious you are at the very beginning of a consultation: “Make a show of cleaning your table in front of the client,” James says.

Tell Me Where It Hurts hurts a little when Trout tries too hard — or, maybe, not hard enough — to be funny. In discussing the famous rash of cat self-defenestration in high-rise New York apartment buildings in 1987 –132 in five months — and their surprising survival rates, Trout says, “I don’t know about dogs but it must have been raining cats in Manhattan that year.” Please! And he gives us his efforts at witty ripostes that often turn out not to have been actually riposted. “You really think he’s fat?” a pet owner might say to Trout. “Well… certainly would benefit from a little dietary discretion. But then again, so could you.” Trout then tells us that this last sentence in truth remained “unsaid.” And the book’s structure, which involves many chronological shifts and subject jumps, presents its own challenges.

The best aspect of this book is its obvious understanding of and sympathy with pet owners’ love for their animals. The origin of this recognition is easily found in Trout’s own childhood connection with his family’s German shepherd, Patch, who suffered a painful and saddening deterioration before he died. The second best is the polar opposite: the clinical explanations of pets’ afflictions and the surgical steps required to treat them — notably resetting a goose’s wing bones and removing a nerve-sheath tumor from a canine’s armpit. Since there are 69 million American pet owners, and many of them are pushovers when it comes to animal stories, as we can see from the enormous success of some recent books about dogs, the prognosis for Tell Me Where It Hurts may be quite positive.

I will not tell you what happens to Sage and her widowed owner, Mr. Hartmann. Take a guess.