Induction and recovery, simply put, are the acts of knocking a horse down and then getting it back up again. It sounds simple, but it is actually quite dangerous, both to the patient and to the team of people assisting the patient. To go smoothly, induction and recovery require choreography and communication. A little muscle does not hurt, either.
The day's first surgery was a large black gelding who was on the nervous side. After being premedicated and sedated he was led into a room with padded mats on walls and floor. I climbed thorough a trap door in the ceiling of the hallway next door to take my place in the loft overlooking the induction room.
Four people stand at the side of the horse. One, who is the vet acting as anesthetist, administers the injectable anesthetic. Nothing happens for a while, and people above and below chat.Without warning, the horse pitches to the side. All four people in the padded room brace backwards with their right leg and push with both hands on the horse. The absolute synchrony with which this occurred floors me. I see four sets of forearm muscles form cords.
The horse is lowered onto its side, and its legs are hobbled. Large hooks attach the hobbles to a track in the ceiling. The door into the surgery room is opened, and the horse is guided, feet up, onto the table where it remains in dorsal recumbency. Pads are placed to mitigate the crushing of its own body weight on the horse's nerves. Finally, the horse hooked up to the ventilator and the anesthetic gas begins to flow.
Recovery is no less dramatic. The scene in the surgery room occurs in reverse; the anesthesia machine is disconnected, the pads are removed, the door to the padded room is opened, and the horse is guided back inside, where it lies in lateral recumbency. The anesthetist stays by the head, monitoring the anesthetic depth by looking for nystagmus, the strength of the palpebral reflex, and other signs. The horse has standing wraps placed on all of its legs to prevent it from injuring itself as it gets up. From my vantage point up top, I admire that two legs are red, one green, and one blue.
This time I am not alone up in my crow's nest. Someone climbs up and grabs hold of a rope attached to a pulley. Another person down below attaches this rope into the horse's halter. This person ties a second rope around the horse's tail; this rope attaches to a pulley in the opposite corner of the room from the head rope. Yet another person climbs a ladder and takes hold of that rope.
Recovery is relatively long. This is preferable; a horse that pops up from general anesthesia is disoriented and dysphoric and poses a threat to itself and the people helping recover it. Two techs and the anesthetist remain in the padded room. They kneel with their hands on the horse to discourage the horse from getting up immediately upon awakening. This is when the atmosphere becomes festive. Dr. C up holding the tail rope chats with Dr. I, the anesthetist, and L the tech, who is basically running the show. The conversation meanders, and we laugh freely.
As quickly as it went down in induction, the large black beast on the floor gasps. Two gasps, later, the horse is extubated, and the three individuals in the padded room hold him onto the floor. The anesthetist, her job done, makes a hasty exit. The horse is disoriented, a dark shape on the floor and gasps and snorts, resembling nothing so much as a waking dragon. I am reminded forcibly of the sheer animal-ness of this beast. He is frightened and confused with every pound of his considerable body weight, and we have no way to reassure him that our restraint is only to help him.
When he brings his head up, it is the job of the head rope person in the loft to heave upward. The trick to holding the head rope, however, is the rope must follow the head. The horse uses its head for balance, so when the head goes up, the rope must go up, and vice versa. The tail rope, on the other hand, is more of a brute strength operation. As soon as the hindquarters come off the ground the tail rope person must pull and tighten and pull some more. This is because the horse is unsteady on his hindlimbs, and the rope acts as support.
This horse's first few attempts at recovery are abortive. He ends up in a corner, gasping, back on his side. After much encouragement by the people on the ground, he stands shakily. I almost can't help looking away, because this 16 hand animal is teetering like a poplar in a windstorm. Added to his general unsteadiness is the fact that, on account of his surgery, one of his forefeet is completely numb to him. I hope the adage about the three-legged stool being stable is true in the case of horses. He does not fall, and he calms as a regular lead rope is snapped back onto his halter.
This was the first equine induction and recovery I have every witnessed, and I was amazed, not by the process itself, but by how magical it seemed to me. Both the human and the animal were displayed at their most archetypal: the human planning, choreographing and executing; the animal displaying 1500+ pounds of flight mechanism. I am certain this is a dance I will witness several more times. I am sure that at times I will witness it when I would rather be somewhere else, like in the middle of the night, perhaps. But today it was magical.
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