There Will Be More

I’d like to paint a picture for you.

A Veterinarian enters room one. They had just walked into the clinic and read lab results of one of their long time patients. The dog is in kidney failure, and they are heartbroken. Yet, they shake it off and proceed to their first exam. Upon arrival into the room the owner is immediately irate with them at the wait time “just to get puppy vaccines”. The Vet smiles, nods, and apologizes. The exam concludes, and the owner says a goodbye followed by a, “your staff should really be more proficient next time”. After room one they proceed to room two. It is their kidney failure patient and it’s owner awaiting results. They sit with the owner, and hold their hand while they cry. After they leave, the Vet takes a deep inhale to hold back their own tears to move on with their day. Room by room they ride the roller coaster between good outcomes, happy patients, euthanasia’s, and verbally abusive clients. They end their 14 hour shift with losing their parvo patient that they thought was on the up. They make the call to the owners and answer all of their questions through their broken sobs. After they hang up the phone they spend thirty minutes reading the puppy’s treatment chart and medical notes seeing when the decline happened and if it was something they could have done differently. After finding nothing, they take a quick scroll through their email before leaving for the day. In their inbox they find a forwarded review. It is a review from their first client that morning. The review goes on to say that the Vet was “incompetent and late” and could not be trusted if they couldn’t even be on time. Any other moment the Vet might blow this off without a second look. But they had just lost a patient they had spent days treating, euthanized three of their other favorite patients, and were on hour 15 of their 12 hour shift after missing yet another family event. They drive home feeling defeated. Imposture syndrome kicks in and they question everything they have done. Maybe they were incompetent. Maybe they should give up. A glass of wine helps them forget for a brief moment, until they do it all again the next day.

Let me paint you another picture.

A Vet Tech just had to euthanize six infant puppies who were dying of distemper at their shelter. They sat with each one and sedated them to ease their pain, and helped them pass peacefully. Tears streamed down their face, but had to quickly wipe them to not upset the staff. They make their way to the front where a client is waiting on the phone. The client is irate by the time they answer. The client tells them that if they can’t get him on the schedule for a spay, he will just have to shoot his dog because he doesn’t want any more puppies. The client proceeds to say, “And you will have to live with that”. Wanting to not give into the ultimatum but also not wanting to possibly risk a dogs life, the Tech squeezes him in knowing that the surgery list is already full. The Tech proceeds to the Parvo Ward to find that one of the seven puppies being treated was failing fast. They consult a Vet and the Tech humanely euthanized the dying puppy. They spend the rest of the day wondering that maybe if they didn’t euthanize it could have been saved. That same day before leaving, another puppy starts to fail and they decide to give one last shot of a different antibiotic and fluid increase. They dance with the decision to euthanize or give it one more night and decide to give it a chance despite their gut telling them otherwise. The next morning they find the same puppy deceased in its kennel, the fluid pump beeping from an occlusion. They grind their teeth and hate themselves for knowing the puppy died alone when they could have helped it peacefully. It’s a constant game of “what if” that will happen again the next day.

There has been an influx of awareness towards the incredibly high suicide rate of Veterinarians and Vet Professionals. Between debilitating student loans, making close to nothing, and the harsh internal and external abuse; it is no wonder that your local Vet may choose to end their life.

I can’t tell you the amount of times I have laid in bed thinking of what I could have done differently; the amount of times I have drove 45 minutes home from work in silence replaying every treatment given to see what I did wrong to not save a dog’s life.

On top of it all, I can ramble off the top of my head things people have said to me in the midst of horrible days at work…

“I’m going to drown the puppies if my dog has another litter because you couldn’t get her on the schedule”

“Maybe if you were more competent at your job this wouldn’t have happened”

“You should be ashamed of yourself”

“If I have to shoot my cat because you couldn’t get him in that will be on you”

The worst part of it all is that more often than not, people’s words don’t hold a candle to the words we speak to ourselves as we lay in bed at night.

The perception from the public that we spend our days swimming in piles of puppies and kissing cute kittens is so grossly distorted it’s insane. For every fluffy new born posted on social media, there was a litter mate that didn’t make it. For every success story noted, there are five patients that took their last breath in our arms. For every 100 positive reviews, there is 1 that keeps us up at night.

The difference between human medicine and animal medicine is that animals do not have the choice to advocate for themselves. They are the voiceless that rely on their owners/us to speak for them. So, instead of a patient being able to communicate what is wrong, you either have the owners story or physical symptoms to go off of. You sit and listen to one side of the story and try and gauge what is really happening through a detective like exam that brings out all sensory methods. Just like when a human suffers from blindness, their hearing is significantly increased. As Veterinary professionals we take the lack of verbal communication from a patient and hone in on every other detail. This also allows for a different bond that is formed like no other. On the reverse, it also allows for incredible self loathing when you are wrong.

I decided to reach out to a few of my Veterinarian friends that work in different fields of medicine. I asked if any particular instant came to mind of being attacked my a client or brought down by someone. Almost immediately, each of them replied something along the lines of, “There are too many to type”. While this doesn’t surprise me, as I too have suffered the same attacks, it instantly made my stomach churn knowing that these brilliant humans who I know spend every waking hour trying to save lives have been brought down for doing their job. It wrecks me to my core, and it only fueled my fire to spread awareness of what is happening.

“As so many veterinary professionals do- I have a mental reserve of animals. There are so so many that stick with you because you were able to help them, save them, because their guardians were so grateful, because the outcome was so amazing, and on and on. These are incredible and will lift you and remind you why you chose this profession. But we all know there is the other side to that. A mental reserve of animals that we could not save, that died in our care, that we watched fade away due to disease or injury, we had to agonize with guardians that are in despair to lose their beloved pet, and on and on. Unfortunately, this reserve often takes over and the despair, doubt and extreme disappointment in ourselves outweighs the happy and positive ones. And on the daily sets doubt if we are enough, if we are in the right profession, and if we as individuals can handle this. We try to learn from each pet, each case, and each encounter. We try to make ourselves and our teams better in order to save the next one, or make the next surgery smoother or fight the next disease case.”-Dr. Hays

“I pride myself on spay/neuter and being able to do good for the community. I was working on a low cost spay/neuter mobile unit and this family came in with their two dogs. One was a senior GSD. During surgery, as soon as I made my first cut I noted she was incredibly vascular. I proceeded with the surgery. She was friable and so I went slow. She was oozy because of how delicate her tissue was. Everything went well, though and she woke up from surgery without any complications. At 4 pm, her owner showed up to pick up the two dogs. The GSD couldn’t stand up. This is unusual. I asked the technician to check her gum color. She said it was fine and that the dog probably just needed some time to recover from the anesthesia. I did not check the dog myself. I trusted the technician and did not question her confidence or her capability. The dog was carried to the car and the family went home. I received a phone call about 1.5 hours later. The dog died on the way home. She was taken to an ER where they found on postmortem exam that she had a hemoabdomen, which is a complication from surgery. I did not catch it before the dog left the truck, and I sent her home to die. Had she not received surgery that morning, she would still be alive with her family. I killed her. Nobody but me killed her. I took a family member away prematurely. I went into a very dark place after that. After the incident, I was fired from the job for being incompetent. I’ve done thousands of surgeries and this is the first time this has happened. I tried talking to friends about what happened. They stared at me when I said I killed a dog. There was never understanding. There was never empathy. How can you empathize with a dog murderer? I went into a darker place.”-Dr. Stocks

This “reserve” often has a tipping point- a bubbling over the pot when you least expect it. A reserve can only hold so much until it overflows onto the already hot surface. That reserve can be the tiniest comment from a patron, or jab from a fellow professional. We do our best with the self talk, but often times it just isn’t enough. Sometimes, that bubbling over comes in the form of self harm when you just can’t handle it anymore. This is the reality we live in. The reality where no one understands and dark places become a common occurrence.

I wouldn’t be lying if I said that there were times that compassion fatigue got the best of me. Many times I felt numb to the world. Any problems my friends or family had seemed worthless compared to what I had seen. I felt nothing and was going through the motions.

I feel that many of us dance the dance between putting up boundaries of emotion to keep our hearts safe, and feeling nothing at all because we are just “done”.

The Not One More Vet movement is incredibly important. We can do our best to help each other, and reach out when we need help. But until the public can see the world through our eyes, and not view us as anything but human beings doing our best…there will be more. There will be more vets that take their life because their reserve has bubbled over. There will be more vets that want it all to end because they have reached their limit. There will be more, until everyone else does better.

We need to do better to remember the human behind the white coat. We need to do better to remember the weight carried by the person delivering your bill. We need to do better to show compassion.

The next time you are upset about a long wait in your car to be seen at the Vet, be better. The next time you are overwhelmed at the bill from the hospital, be better. The next time you want to blame anyone else for the condition of your animal, be better. You are allowed to feel frustration and sorrow and terror, but the next time you want to aim those emotions at the only people there to help you- be better.

To the doctor who lost their patient under anesthesia, and has to face grieving owners-I see you

To the shelter technician that has to euthanize one of their favorite dogs due to kidney failure- I see you.

To the general practice vet that has to watch a sick animal walk away because the owners couldn’t pay the bill- I see you.

To the Vet Tech that couldn’t get the catheter in the dying 2lb kitten- I see you.

To the Veterinarian that barely makes enough to cover their student loans, yet is called money hungry for not treating ones animal for free-I see you.

To anyone in Veterinary medicine that is broken and burnt out- I see you. I hear you. I am here.

Until we do better, there will be more.

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