Tuesday, August 24, 2021

Veterinary bibliotherapy: All My Patients Are Under the Bed


"All My Patients Are Under the Bed" by Dr Louis J. Camuti, Marilyn Frankel and Haskel Frankel.

I’ve been delving into veterinary history for a couple of projects, and stumbled upon the veterinary biography of one Dr Louis J Camuti, written with support from his clients and friends Marilyn and Haskel Frankel. The book, AllMy Patients Are Under the Bed: Memoirs of a Cat Doctor provides a fascinating insight into veterinary practice in the 20th century.

Dr Camuti was born in 1893, and worked until his death – likely due to a fatal arrythmia when driving – in 1981. He was aged 87 and had been in practice for over 60 years.

The book is intended for a non-veterinary audience, focused mostly on anecdotes about quirky cat owners and their cats. But it contains some fascinating insights into veterinary practice in a different era.

Dr Camuti graduated from New York University in 1920. He lived through the great influenza pandemic in 1918, contracting the virus in 1919 when he was a second lieutenant in the New York Cavalry. When the flu struck his camp, over 100 men died. He made it home – with a fever – and married, but as a precaution didn’t kiss his new wife.

When the horses were struck by shipping fever, Dr Camuti was given the job of destroying all of the sick horses - one that caused significant distress.

"I told myself over and over again that the animal was sick and could not be saved. Wasn't I really sparing it pain? yes, but it was something I had to remind myself of everyday. I knew that bringing the peace of death to an animal was as much a part of being a veterinarian as helping a dog to give birth to its puppies, but still I suffered. I guess I was still a kid, and like all kids who think of becoming
doctors, the first thought is of life. It is only later on that you have to face death as part of the job" (p51).

We now know that killing animals can be a source of moral stress for veterinarians. And moral stress can indicate there are systemic animal welfare issues that need to be addressed. In Carmuti's case there was no alternative to killing the horses, he was a subordinate given the order. But he did endeavour to change the method of killing to ensure it was as humane as possible in the circumstances. Perhaps these traumatic early experiences drove him to focus on companion animals.

He later discussed a request for euthanasia of a seemingly healthy St Bernard. This didn't occur because Dr Camuti, who purchased a bottle of chloroform from the pharmacy on the way to the housecall, accidentally anaesthetised himself when he opened it in a poorly ventilated bathroom. Both the vet and the dog survived.

Early in his career, Dr Camuti established a few practices, but his penchant for feline patients became known and he performed house calls in New York City. In the latter two decades of his life he set up an exclusively house call practice. He would begin his evening rounds from about 4pm, sometimes until well after midnight, often getting to bed at 4am. His wife Alex would book appointments – before people had mobile phones or email. She also rode alongside him and waited in the car, ready to move it if the parking inspectors or police turnedup. He would attend up to 30 housecalls a week.

Many of Dr Camuti’s clients did not have cars or cat carriers. Getting to the vet was impossible. And Dr Camuti felt that his patients were more relaxed in their homes – though he did spend a lot of time trying to find his patients in their homes (that aspect of house calls remains unchanged).

He would ask clients to have his favourite hand-soap ready (Cashmere Bouquet), and boil syringes (they were glass then) on the stove tops of his clients. He practiced when there were no analgesics registered for use in companion animals, when Nembutal (pentobarbital) was used as a sedative, and when blood tests weren’t routinely performed. If a patient needed surgery, a spey for example, he would often perform this in the owner’s home, on the kitchen table or similar. Veterinary practice is very different now.

After he survived a cardiac arrest, Dr Camuti couldn’t climb the stairs to reach patients in apartments above the first floor. So he took to examining many cats in the hallways of huge apartment buildings in which they lived (I would have been terrified of a patient escaping). On the day he died, he was still seeing patients.

The book makes much of the “quirky” relationships people had with pets. It was written before anthrozoology was established as a field of scholarship, well before James Serpell’s book In the Company of Animals put the human-animal bond on the academic map.

When I read about practice, at a time when there was no pain relief for veterinary patients, when there was little awareness about animal welfare, when humane euthanasia could not be guaranteed, it reminds me how far our profession has come.

That is not a criticism of Dr Camuti. He was the first feline-only veterinarian in the USA. Despite limitations in practice, Dr Camuti was deeply concerned about animal welfare, expressing his views about declawing: 

"People who have cats declawed usually do so for one of two reasons: to prevent being scratched by an aggressive cat or to preserve their furniture. Such people are obviously thinking only of themselves, not of the pets they are supposed to love. For their own selfish reasons they put their cats through a surgical procedure which is severe, both physically and emotionally. Very often a cat is declawed without any attempt on the part of the owner to train the animal first to use a scratching post. The cat never had a chance. In fact, I've known of cases where a prospective owner demands a cat to be declawed before he'll adopt it. I certainly would never give a cat to such a person because the request itself is an indication that the household is not suitable to a cat". p91. 

And he goes on. This passage reminds me of important positionstatements on declawing in cats, published more recently by the American Association of Feline Practitioners and the International Society for Feline Medicine.

He was also against ear cropping and tail docking in dogs, and raised concerns about the neglect of long-haired cats, the impact of inbreeding, failure of many people to recognise (and control) their cat's reproductive potential, and the hoarding of animals. He treated a range of exotic pets, back at a time when people could acquire a primate on a whim without any sort of license, permit or clue as to how to meet the animal's welfare needs.

Veterinary biographies like these are such important historic records, often for the minor, seemingly routine details they capture about past veterinarian’s daily routines and habits. This biography is worth a read. Especially if you do appreciate cats. 

On another note, if you are tempted to write your own veterinary (or non-veterinary) biography, the Vet Cookbook is hosting a writing workshop on narrative non-fiction with award winning author Brendan James Murray. Check it out here