Dr. Dr. Abby Whiting
So a few months ago I got my very first death threat from a client. I have been practicing for nearly a decade and I have had my share of upset families. I am blessed to have a great mentor who jokingly reminded me, “If this is your first threat in 9 years of practice, its not cuz you’re good, its just cuz you’re lucky.” While I found this piece of advice helpful, it also made me mad. We as a profession have come to expect this level of emotional abuse from our clients; from those folks we are partnering with to ease the pain and suffering of animals…and maybe it’s partially our fault?
I’ll say that in this particular case myself and the hospital staff actually did everything right. As a matter of absolute fact: we got the diagnosis spot on without any diagnostics beyond a good history and physical exam. When the client finally consented to the confirmatory tests we discovered in fact we were correct: this pet had cancer and it was serious. The discovery that a beloved pet has a serious and terminal illness is hard on anyone, and for some of us the perfect excuse to inflict emotional harm on others. Now, I didn’t give this pet cancer…the diagnosis was present long before I met the pet. Whether we had done these tests immediately stat at the moment, or scheduled with proper protocols, safety measures, staff etc. like we did…at the end of the day nothing would have changed. But you know what has changed? Me…I’ve changed.
It was a busy day in the clinic, lots to do. I was finishing up about 4 hours after my “scheduled off time”. (I am type A over achiever; work a holic, overly dedicated practitioner). I went to check my mailbox before leaving and discovered a card. It was a lovely envelope with flowers drawn on the outside. I was hoping it was a thank you card…it was not. I don’t possess the language to describe the wave of emotion that washed over me. It seemed like the world stopped spinning. I probably read it 47 times, partially in disbelief. Not only was this a threat of violence against me, and a list of why I deserved it…the author even stated how they realized Vets are at a higher risk of suicide and that they hoped I would “make the right decision and do it myself”. They had done some research: they knew me…too well. They knew what municipality I lived in, what type of pet I owned, that I was a board member on Not One More Vet, etc.
Well, I had recently helped a clinic through a similar situation and I knew what to do…sort of. I called the authorities. I’ve had great relationship with the local first responders: we care for many of their personal family pets and the working dogs, so they are super familiar with our hospital and me. Here’s where I went wrong. I should have scheduled a time for me to bring the note to the station and be interviewed in private…but not thinking it through, I said thanks when the dispatcher told me they would send someone to get my statement and make the report.
Because most officers have been to the facility with their own pets, and because I rarely separate first responders from their working dogs: The officer walked right on back to the treatment area to locate me. This would have been fine: except there was a brand new grad on duty with me that night and I hadn’t told her about the threat and wasn’t planning on it. Needless to say it caused her concern and emotional terror. She is altered from this experience too: less trusting, less enthusiastic, prone to burn out and harsh self judgement. I should have known better. I love vet med and I am eager to help new vets find their love and passion for it, not destroy it.
The report was made, the paperwork filed. I was given instructions on how to proceed. I changed my car’s plate number, I changed my daily routines, I stopped leaving work alone, and I started being afraid. Not afraid of this client, or this threat, but afraid of every future client. I became afraid to open an exam room door, to offer care at all. I saw the new grad afraid too. We are different because of client experiences like this. I am more reserved, I am not loving my job as much. I live fearful of the next threat against me, my mental well being, my ability to make a living; I am tired more than I should be. My spouse was stunned and utterly shocked. He never dreamed in a million years a vet would have this happen, and he is harboring disdain in his heart for my profession.
I started to get angry. I was (or am?) suddenly angry about: my educational loans, my long work hours, my inability to provide for my family, my acceptance that I am a vet and a part time untrained human behavior counselor, my hyper commitment to my patients to the detriment of my family.
I went into veterinary medicine to help animals, that’s true: but more than that I wanted to help people. I am blessed to have a fantastic support system and a unicorn of a clinic to work for. I’ll be ok. But I feel an obligation to start this conversation and to share some of what I have learned.
What I’ve learned about myself:
1). Being an incurable stage 5 people pleaser is not a compliment. Boundaries are critical to success and wellbeing: they are not a negative or a sign of failure.
2). Someone’s failure to manage their own emotions in a challenging situation in no way reflects failure on my part, unless I jump in the mud too.
3). Do not accept critique from someone you wouldn’t ask advice from. People like this should get to occupy 0.00% of your thoughts. Don’t give them the power to make your inner thoughts a dangerous neighborhood to walk in alone.
4). Every time I close an exam room door I need to ask myself “Did I do the best job I could, given the situation (this includes the financial constraints, the available options, the client’s willingness to trust the process of medical diagnosis and treatment)…and if the answer is yes, then I must be proud of myself.
5). It is ok to tailor my scope of practice. I can choose to focus on clients able to trust the process of medical diagnostics and treatments, or I can choose to offer the best I can given the restrictions the client chooses. But if I am going to expect the same quality of diagnosis from myself in both situations I am insane.
6). 97% of my clients are grateful and truly appreciative. I get verbal thank you’s and thank you letters and reviews all the time…and I just let those wash over me…choosing to focus all my thoughts on the 3% of disgruntled people. I am reversing this. Instead I will pause at each thank you and try to really be present in the moment. I will let the folks like the client who threatened me go. They are not worth the space in my head.
What I’ve learned about humans:
1). We are complicated creatures. Being upset gives you no right to lash out at those trying to help you.
2). Guilt, shame, and regret can cause serious irrational behavior in a stressed human.
3). Grief takes many forms, and always calls for compassion.
4). Veterinary healthcare costs money. Holding your vet accountable for the outcome or diagnosis without granting them access to the tools to make a proper diagnosis is like asking to the plumber to fix a leaky pipe from the phone. It is totally ok to decline diagnostics: but know and be able to own: that this puts the vet at a disadvantage in guiding treatment for your pet. We will do whatever we can to help your pet: but we are a team, and each of us holds responsibility in the outcome.
Some of this is my fault. This client’s intent was to frighten and terrorize me. They needed to feel like I was undergoing as much pain as they are. We are, after all, addicted to stories of the underdog being wronged by the system. And: I let them. While I have not been truly afraid I would be physically harmed: I am still afraid to do my job…and that is my fault. I have given this insignificant person the power to direct my self-talk, the way I interact with future clients, and my passion for the profession I love. I am a work in progress. Like I said, I am lucky and I’ll be ok. I fully intend on a 100% recovery for my emotional and intellectual self, and a return to the veterinarian I want to be.
The Admin Team of NOMV is a group of veterinarians dedicated to improving veterinary mental health.