6 Oct 2020
Anthony Andrews, BVetMed, PhD, DipECBHM, DipECSRHM, FBIAC, MRCVS, in the first of a two-part article, looks at the influence the world's greatest fictional vet has had on the profession.
Tony Andrews
Job Title
Characters from Channel 5’s All Creatures Great and Small (from left): Mrs Hall, Siegfried Farnon, James Herriot, Helen Alderson and Tristan Farnon. IMAGE: ViacomCBS / Photographer: Todd Antony
A recent Vet Times news item (2020) reported the outstanding success of Channel 5’s remake of All Creatures Great and Small. Doubtless it will spawn a new flock of aspiring fledgling vets eager to join the profession for pure and idealist reasons.
In the past couple of years some have been worried by the influence of these Herriot series. As a reactionary old fart and grumpy old git, I have become increasingly concerned, upset and agitated at the way in which the world’s greatest fictional veterinary surgeon has been having his name taken in vain, and perhaps abused.
Unfortunately, unlike the world’s greatest fictional private detective, he cannot be raised from the dead. While many more capable than I, including Alf Wight’s son (Aitken, 2019; Noakes, 2019; Tufnell, 2019; Wight, 2019), have defended Herriot, I thought I would like to add my own tuppence-worth as an appreciation for the many hours of enjoyment he has given me.
He has described many of the appropriate characteristics, aspirations and qualities for me to aim at, and perhaps also the modern profession to achieve. I should perhaps point out that I qualified before Herriot’s first book, If Only They Could Talk, was published, so I can claim that my career choice was in no way influenced by him.
I understand that we are now considered a scientific profession. Science – particularly in the biological, medical and veterinary areas – has always been in a state of flux and is a constantly evolving subject. Good science always includes at least an element of argument. Therefore, today’s truths are tomorrow’s fallacies.
I have always found it very hard to believe politicians and others when they trot out the mantra that their arguments are “science-based”. It usually means that whatever scientific “facts” they are using agree with their own views that they wish to expound. Covid-19 is an example par excellence.
It may come as a surprise to many that many brilliant veterinary surgeons existed in the 19th century – that is, pre-Herriot – who, with limited instrumentation and using the knowledge available of that time, were able to determine the causes of many of the common animal diseases and how to prevent them.
In fact, they were even able – by astute observation and using common sense – to control and eradicate from Britain some major epidemic diseases, such as cattle plague (rinderpest) and contagious bovine pleuropneumonia, before the causes were known.
RCVS Knowledge (2019) and Jones (2019a) highlighted some pioneers who helped mould the profession. At that time, other vets were already undertaking major surgical operations in large and small animals.
Anyone studying a specific topic in science in a truly scientific way must always go back to the original authors and sources that have been written on the subject, and then progress their search and research from there.
In the case of some – or many – of the Herriot detractors, it is suspected their views were most probably formed on the basis of the various popular television series or possibly articles written on this fictitious Yorkshire vet, rather than going back to the original sources – that is, the books written by Alf Wight.
While they are very entertaining, under the surface they do include much more information of the real everyday country life in-between the two World Wars and then its evolution following the second one, certainly much more so than could be concluded from the television series.
Perhaps it is not generally known that recorded veterinary professional knowledge began in Egypt and Mesopotamia about 4,000 years ago (Jones, 2019b). These ancient writers identified individuals recognised as undertaking the art of veterinary medicine.
The science of veterinary medicine did not begin until much later with Hippocrates (around 460BCE to 370BCE) and Aristotle (384BCE to 322BCE). However, even by about 450CE (AD), the Romans knew much about hygiene and disease control (Jones, 2019c).
In more recent history – the 1500s – some veterinary information was developing from the early medical teachings. Sir Thomas Browne (1605-82) differentiated between “common farriers” and “good veterinarians” – the latter worked to heal animals (Jones 2019d).
The start of British veterinary education began following a meeting of the Odiham Agricultural Society of Hampshire in 1788 and the rest, as they say, is history.
However, it would be fair to say the art and science of the veterinary profession has progressed over the years in fits and starts, and has often been relied on for its progression on the industry and inventiveness of individuals.
Therefore, in Isaac Newton’s words in 1675, we can see further “by standing on the shoulders of giants”. It can be argued that Herriot, in his own way, was one of these giants (also, perhaps as a pub quiz fact, the above quotation appears on the edge of the current £2 coin).
The RCVS oath sworn by graduates before entering the profession is that their constant endeavour is to ensure the health and welfare of animals committed to their care. Even without the oath, surely this should have always been the aspiration for all those wishing to enter or entering the profession?
This is exemplified by the Herriot books, which, in their warmth to animals and their owners, ably demonstrate this most important characteristic of a veterinarian’s raison d’être.
Often with Herriot, it involved doing the best for his patients and having the worry of not knowing what was wrong with a case, such as initially being unable to diagnose copper deficiency in a herd of cattle. However, by constant perseverance the problem was solved, as also was the case of Alfred, Geoff Hatfield’s (the sweet shop owner’s) cat with furballs (Herriot, 1992), and so on.
Beynon and Ackerley (2019) described Herriot as possessing “important qualities, such as compassion, communication and empathy with the patient, customer and colleagues alike, [which] remain core to the profession”.
Although these are still the attributes of many vets, unfortunately some appear to be losing sight of these values, at least according to their clients. The need to act on our vocational training has also been made (Smith, 2019).
A thoughtful view expressed by Henry Lamb (2019) suggested that while moving away from the romanticised imagery of mixed practice, we should not lose all connection with Herriot’s world. It is not surprising many veterinary practice clients are finding differences that make them uneasy.
“Maintaining a personal level of service is important to us, and we wonder whether the continued expansion of practice removes the personal touch” (Steer, 2019).
In Herriot’s day, the absence of many diagnostic tests or equipment meant the clinical skills of veterinary practitioners were honed to become razor sharp. Lewis Grant (2019) commented that one thing he “…learned from these older practitioners was their admirable ability to diagnose conditions without resorting to, for example, blood tests and scans…”. Grant hoped some of this skill had rubbed off on himself.
I also saw these diagnostic wizards at work and, again, I hoped that I learned from them. I and my undergraduate contemporaries were taught that tests were to confirm a diagnosis, not to initiate one. Grant put it as: “Perhaps modern veterinarians would learn a lot if they could be transported back to those times for a week or so.”
Part of the reason Herriot’s books were so successful was due to his clinical ability to determine and minutely assess not only the animals, but also their owners, environments and the situations in which they found themselves. Wight himself appreciated veterinary clinicians, but was also proud of veterinary science’s progress (Taylor, 2019).
Perhaps the undergraduate today should be made to form a potential diagnosis of each sick animal before resorting to tests to confirm it. I suggest that such discipline would assist their clinical acumen and possibly increase their confidence once they are in practice.
I am advocating this pre-graduation as I am aware that in practice many clients will expect tests to be undertaken, regardless of whether they are necessary. However, I hope it could be explained to the client only certain tests would be required and not a machine gun scattering of them, just as I hope that all today are explaining that antimicrobials will only be prescribed for their animals when absolutely necessary and not as routine or on demand.
It has never been that easy to obtain fees or suitable payment for the veterinary work undertaken. In fact, just prior to the Herriot debate, an article was published warning of a difficult veterinary business future that would increase pressures on staff (Chanticleer, 2019).
Then a report suggested the then-new BSAVA president blamed Herriot’s books for people thinking they need not pay vets (Loeb, 2019a). This was also echoed by an eminent equine vet who suggested clients could exchange goods such as cake for professional services (Loeb, 2019b).
It might surprise these speakers that the points they make that vets should charge properly for veterinary services are nothing new. These speakers may not realise that all they are doing is echoing the arguments made nearly 60 years ago – that is, pre-Herriot books.
Alasdair Steele-Bodger, who at the time was SPVS honorary secretary, set up a survey on fees, which was published initially as the Economic Committee Report of 1960 (Jones, 2002). He stated on numerous occasions, as well as when he became BVA president, that the veterinary profession should be charging for its services realistically on a time basis, and not rely and subsidise them with drug sales or in other ways (for example, at that time local veterinary inspector duties).
Therefore, our current perceived monetary woes or demises are really nothing new and are our own fault. They cannot be blamed on others.
The accusations against Herriot about finance have already been ably refuted by Alf Wight’s son, Jim (2019) and, in reality, they were very far from the truth. If one wishes to know what human medicine practice was like prior to the NHS, one need look no further than the readable books of AJ Cronin.
Conditions were well described in The Citadel and Country Doctor; the latter became a successful television series at different times and was entitled Dr Finlay’s Casebook. Alf Wight qualified two years after The Citadel was published and describes looking for work in the depression. No gap years for these graduates except those enforced by failure to find employment.
Often work meant receiving bed and board, with no or minimal pay, and with no weekends off and no holidays. It was accepted by the new entrants as they were learning the art, science and clinical skills of being a veterinary surgeon. Today I think this would be defined as modern slavery.
Wight was “lucky” in that, besides accommodation and food, he was given a share of the money made from tuberculin testing, which often far exceeded the takings from all other work undertaken within the practice.
He also describes how on Mondays they would collect their fees after the farmer clients had sold their animals and produce. For small animal owners no insurance policies existed to fall back on.
The animal charities were fewer and less available in early Herriot days, so some genuine hardship cases were subsidised in various ways as they were in many other practices throughout the UK, thereby exhibiting their own caring professional credentials.
Even in 1966, 25 years after qualifying and marriage, Alf Wight had only £20 to his name (Routen, 2001). He was later described as “one with an expert knowledge of his subject, not a practice economics guru” (Jones 2019c).
Many clients and also financial groups have always had the impression that veterinary surgeons coin money and make fortunes. This has been nurtured by them not realising the fees charged not only include the costs of treatment, but also the costs of medicines used, overheads and so on.
A colleague of mine who graduated with me said that if you were entering the profession to make money then you should join another. Many of the public today would also have little sympathy for the low income of many veterinarians as we still earn more than the national average wage.
The situation has become worse after the creation and expansion of the NHS because patients usually have no concept of their treatment costs, surgery or maintenance of hospitals and GPs’ surgeries. It might also be the root of many of the woes of the NHS.
Lewis Grant admirably summed up veterinary finance by saying “although we did not make a fortune, we did earn a comfortable living”. While monetary values change as to what is important, in essence, this is still the case today.
