Day 4: Rolex and the Medina

Hello loyal blog followers! The last twenty-four hours have been one heck of a professional and emotional roller coaster. When I last signed off, I was headed out to dinner with Anna, Jeremy (one of two new directors), Mohammmed (the "foreman" of the Fondouk) and four European vet students who are here volunteering. We had a lively meal out and then continued our evening like any other local would do--by going out for the special Moroccan mint tea. Because this is a Muslim country, there is very little alcohol consumption. Drinking sickly sweet and piping hot tea with fresh mint leaves instead of beer and wine definitely limits the amount of trouble that one can get into.
We were all jazzed up from an evening out so when we returned to the Fondouk to find our previously-colicky gray mule down and rolling from abdominal pain, the mood instantly got more somber. We got him up, gave him some sedation and then I stuck an arm in him (yup, that's the most glamorous part of job). However, it was really only a hand that I could get into him because his intestines were so severely distended with gas. We passed a naso-gastric tube on him and, not surprisingly, got back a bucket of fairly fetid reflux. This told us that things were backing up in his GI track enough that his stomach was starting to become stretched out. Combined with everything else going on, this changed his prognosis from fair to grave. We discussed whether or not to pull the plug and euthanize him then and there whether to see if we could keep him comfortable enough to wait it out a little longer.
This mule was gas-distended to the naked eye. Although I had never done this or even seen this done before, I proposed trocarizing the mule in an effort to relieve the gas. This would involve placing a trocar (a large-bored catheter-like instrument) through the body wall and hoping it would pierce the colon and serve as an exit route for accumulated gas. The best outcome would be resolution of the colic if a sufficient amount of gas could exit the colon. The worst outcome would be necessary euthanasia if the trocarization seeded a septic peritonitis. After a brief pow-wow, Jeremy and I decided that we had nothing to lose. This mule was very close to death and if he did die, at least we'd know we had tried everything. With our entire dinner gang present, we clipped and prepped the site and then I stuck a  trocar into this mule's colon. The gas poured out. That puncture was so successful that I suggested we do it on the other side, too. Again the gas poured out as we all watched with amazement.
I re-rectaled the mule after the trocarization and I could now get my entire arm into him. Jeremy had been kind enough to buy the Moroccan tea for everyone that night. I announced that if this mule pulled through, the next round of tea was on me. We all went to bed shortly thereafter and, interestingly, not one of us was able to fall asleep last night. We individually tossed and turned and some of us rendezvoused in the kitchen at 3 AM for a snack. This mule's unknown fate was clearly wearing on all of us.
Well, I am pleased to report that our tough little gray mule was standing in his stall bright-eyed and bushy-tailed this morning. Our mule, whom Anna and I have named "Rolex," is going to make it. Some of you may think we named him "Rolex" after the famous 3-day event held in Lexington, KY every year. He was, after all, covered with a sheet overnight bearing the Rolex insignia. But no--we consider this mule to be the best of the best, the Rolex of mules. We took our Rolex out for grass this morning and he ate ravenously. He passed manure like a champ and even gave us a cliched little hee-haw when we approached his stall. When his owner came to check on him this morning I gave him the thumb's up. It turns out that that's a universal sign for "everything's going to be okay." If all continues to go well, he'll go home tomorrow. I've never been so excited by the prospect of buying a round of tea.
We saw a whole bunch of other colics today (weather change?), although none were as severe as Rolex's. They were all examined, medicated, rectaled, tubed, and sent on their way. We also saw a few small herds of emaciated sheep who came in mostly for "control," as Houssine puts it. A shot of vitamins and dewormer for all. I find this shot of "vitamins" sort of interesting. Even if there's no intramuscular injection indicated, the Moroccan people who bring us their animals want them to get a shot because a "shot" fixes everything. While it sounds ridiculous, I've had numerous clients back in the United States ask me "why can't [I] just give him a shot, Doc?"
Anna and I bowed out of our afternoon work a hair early in order to be given private tour of the Medina, the walled city-within-a-city that is home to 250,000 Moroccans. This is not a place you would ever want to explore without someone who definitely knew the way out. It's a claustrophobia-inducing maze of incredibly crowded cobblestone pathways and narrow alleyways. There are no street names, there is no order, and every ounce of our bodies was overstimulated. Between the hurried bustle of the foot traffic, the bright colors of the weavers' threads, and the remarkably pungent odor of the tanneries, we were thoroughly exhausted by the time our tour was over. Interestingly, our guide introduced us to everyone by our association to The American Fondouk. Even people who don't own animals know of the Fondouk and respect the work that goes on there. We were even treated to some special discounts--it's like being one of the "in crowd"--Moroccan style.
We are heading to Tangier tomorrow afternoon for a weekend of exploration since the Fondouk is closed on the weekend. We are being hosted by a man who was introduced to me by one of my MHVP clients. We will stay with him and his family on Saturday, stay at the hotel belonging to a Fondouk employee's friend on Friday, and dine at a supposedly excellent restaurant owned by one of Dr. Frappier's friends. We sure do know how to travel in style.
I don't expect an Internet connection this weekend so you, my faithful blog followers, may just have to wait until Monday for my next post.