Two-year-old dachshund Ruby is rushed to Fitzpatricks by a distraught friend of her family after being run over by a car and sustaining life-threatening injuries.

Mum Maria is on holiday so Noel has to break the news to her on the phone that her beloved dog has multiple fractures of her pelvis, sacrum and femur bone, which have damaged her nerves and rendered her back legs paralysed: in fact, Noel counts thirty-four separate fractures. “I’m going to do my best to fix this, but I don’t know if we’re going to be able to get all the fragments back into alignment again,” says Noel, “and we don’t know how the biology’s going to respond. We’ll do our best.”

He then begins an intensive six hours’ surgery, one of the most complex he has ever attempted, to repair Ruby’s pelvis and sacrum and save her life. He fixes her fractured hip sockets using small plates and screws, brings the front part of the broken pelvis and the larger fragments of the smashed sacrum back into position using a series of pins and medical cement; and finally he builds an external frame with more pins, to support all of the fragments of the pelvis for healing. Then he also repairs a fracture in Ruby’s femur.

Maria can be momentarily reunited with her beloved dog, but Noel warns that there’s still a long road ahead before she will find out whether Ruby can ever walk again.