Shared with permission from Uncharted Veterinary Conference
Presentation by Dr. Carrie Jurney
By now you all know I love veterinary medicine…I love the science, the clients, the pets, the agriculture…I love it all. Those who really know me understand that, while I adore helping animals, my real joy is in helping people with their animal’s problems. After all, isn’t that what most of private practice is? If we look at the number of veterinarians in the US, a big majority of us are in clinical practice, so why have so many of us fallen victim to the “us versus them” mentality? That in some way we are opposing forces fighting each other?
Every day I hear concerns from frustrated vets, - complaints and judgments from exhausted veterinary staff and doctors about clients. And, sure all people in service industries are naturally going to gripe about certain client interactions, its human nature…but have we taken it too far? Do we actually see them, the clients, as our enemy?
These frustrations and concerns are understandable. Veterinary medicine is a challenging profession. It requires knowledge, empathy, emotional intelligence, and physical stamina. Practice can drain you of each of those things; sometimes simultaneously. But I still have to ask: Aren’t we – veterinarians, staff, and clients – all in this together? I know my paycheck is signed by the practice owner every month, but I earn it from the clients I serve. Relationships I build provide better care for pets, celebration of the human animal bond, and builds the practice. So, in truth, how can they, with whom I must partner for the care of their pet, be my enemy?
Anyone with access to the news knows the United States and the world more generally are divided and, at least so it seems, increasingly so. Could it be that this trend toward tribalism in the culture at large is causing our cultural divide in veterinary medicine to grow deeper? Are we influenced towards judgment, blame, and disdain to those who are “not like us”? Does the current lack of civility and increasing cultural anger encourage us towards professional anger and resentment? I would submit, it’s an idea at least worth consideration.
As a community we need to support each other and further encourage each one of us to build our own emotional intelligence. We need to step back and realize our clients are often hurting people who are not rational, fair, or kind…and that is rarely a reflection on us as people or professionals.
It can be exceedingly difficult to not respond in kind when we are mistreated. When I have a particularly challenging or negative experience with a client, I try very hard to stop myself and ask where I could have gone differently. Could I have explained something in a different way? Was my tone appropriate, was I wearing my resting bitch face? Did I close them off? Should I have stepped out and brought someone else in? It was so easy for a while to just join in the bandwagon, grab a pitch fork and declare they make my life hell. But…that made me burnt out, angry, sad, and lost. Yes, I still get mad,. Yes, I still complain, and yes I’m rude sometimes. But centering myself back to a place of empathy helps. I am learning to understand that the folks who attack me in person or on social media likely come from a place of true pain all of their own, separate from me. I have given myself permission to have my own self value, self-worth, and esteem regardless of the judgment of others. This has made practice more enjoyable, and while still just as demanding as before, it is sustainable. So long as I remember to practice self-care, I can have a long career. But the most important self-care begins inside my own head as I learn to respond positively and view my clients not as opponents, but as members of the team.
Dr. Lauren B. Smith DVM
Original Content from Uncharted Veterinary Conference 2018
We’ve all heard about the death of expertise. And if we haven’t heard about it, we’ve witnessed it with our own two eyes. Clients come in with a diagnosis from Dr. Google long before they even step into the hospital. They bring paper work from their breeders telling them under no circumstances to let their vet “sell” them on lepto vaccination because it will kill their pet. They tell us what medications they want before their animal has even been examined.
This isn’t just a veterinary problem, it’s happening everywhere.
Big Pharma is poisoning us to make a buck
Climate scientists are in it for the money
Lawyers are crooks (okay so that one’s not really new)
People today don’t trust “experts.” They don’t trust us. There are a lot of reasons for this, most of which I’ll leave to the sociologists. But there is one reason in particular that I think resonates in veterinary medicine.
We’ve always been relatively powerless to the whims of biology. People and animals get sick. No matter how many advances there have been in modern medicine, we still keep getting sick. But add in all the new ways we feel powerless in our lives—powerless to the politicians who govern our society, powerless to the big corporations that rule our economy, powerless to Mother Nature and the ever-worsening natural disasters that cripple our cities; and people are grasping for any little bit of control they can get.
Sickness is scary. And when the health of you or someone you love is at the whim of someone else, it’s even scarier. I experienced this first hand last fall when I got sick. I had stomach pain and nausea. I could barely eat. I lived off matzo ball soup and sherbet for two months. I had ultrasounds, CTs, MRIs, and endoscopies. I got no answers. And it took an awfully long time to get those non-answers. I had to wait for insurance clearance. The first available endoscopy appointment wasn’t for over a month. Eventually I just got better, but for those two months I was miserable, not just physically but emotionally too.
I thought of all the ways veterinary medicine was superior to the care I’d received. I thought of all the things I did for my patients that were better then what I was getting, but also the things that I didn’t do but wished were done. How could my doctors have helped to empower me and make me feel less out of control.
This video is a collage of thank you's collected during a Dr. Ron Shaw's first year in practice! What an awesome gift his practice gave to him for the anniversary. We all should sit for a minute a let our hearts and minds really bask in the joy of gratitude and a job well done. As driven, Type A , perfectionists we are skilled at self judgement and criticism... let's work on being gifted at truly hearing gratitude and praise.
A huge NOMV thank you to Dr. Shaw for sharing this piece of awesomeness!
by David Bledsoe DVM
Dear NOMV Nation,
By now most of us are aware of two recent celebrity suicides. These events have a tendency to focus attention to mental wellness and the additional dialog can be healthy and helpful. But it’s also a fact that such events can act as a contagion of sorts and may perversely increase acceptance of suicide as an option.
NOMV exists to provide a safe space for veterinarians to discuss and seek support for these issues. Our goal - as our name says - is that not one more vet will feel the need to take their life as a “solution” to their problems and pain.
PLEASE reach out to NOMV if you need to talk, vent, cry, or shout. Go to the NOMV anonymous post page if you want us to post anonymously for you. We are here for you.
Together we are stronger. We are not alone. We are ALLONE.
On behalf of the admins and moderators, thank you for making NOMV what it is.
If you are struggling, please do not hesitate to reach out to a NOMV moderator, or contact these numbers. Additional resources are also listed on this page: Support Resources
Bosnia & Herzegovina: 080 05 03 05
Bulgaria: 0035 9249 17 223
Canada: 5147234000 (Montreal); 18662773553 (outside Montreal)
Finland: 010 195 202
Hong Kong: +852 2382 0000
Ireland: 116123 or 1800 247 247
The Netherlands: 09000113
New Zealand: 0800 543 354 or 0508 828 865
Russia: 8 (800) 100-49-94
South Africa: 0514445691
Sweden: 0771-22 00 60
United Kingdom: 116 123
USA: 18002738255 or TEXT 741741
Dr. Monique Koll
A few months ago I had made a commitment of 1hr/week of writing to NOMV. I managed that okay at first, and then, I was hit by Hurricane Harvey. I live just north of Houston and am a single mom living alone with my kid and pets, and to further complicate matters our 15yo Spanish exchange student had just arrived two weeks prior. But no biggie! I really wasn’t concerned. I had a quite serious boyfriend, but I was just fine on my own the way things were. I was renting my house, and besides I *really* didn’t think I was going to flood. I grew up in New Orleans so I’m an old hand to this flooding business, and it’s just stuff, anyway.
My son turned 11 on August 26, about a day before Harvey was scheduled to affect us, and the city was eerily quiet as we went out to celebrate. In the wee hours of the next morning, my boyfriend and I made the decision to pack the kids and pets up and leave. It would be no fun being stuck in my neighborhood, so we made a vacation out of it and went to Dallas for the weekend. We had so much fun!
I came back to find 8” of water had gotten in my house. It had mostly drained, and I had picked a lot of my stuff up, but the carpets were ruined, the insulation inside the walls were ruined, it was too early to tell about my piano yet and we couldn’t stay there, at least right then. I did the best thing for the house; we stripped out the carpets right away, started cleaning up. The landlord didn’t want me to do the sheetrock at first but I convinced her. My kids pets and I could stay with my boyfriend so no big deal, but he lived 30 minutes away, and they still had to go to same school and I still had to work, so I was super determined to get back in my house asap.
It didn’t work out that way. Under Texas law, I had the right to abandon that rental and get my deposit back, but it’s not what I wanted. I wanted to move back in asap. My friends and I worked really hard on the house, but the landlord still did not want to give me enough of a break on the rent to make it worth it. We did thousands of dollars worth of work, but the landlord did a shoddy job to get it together as cheap and as quick as possible. They did not remove the cabinets to remove the wet insulation behind them. They replaced the floors with cheap tile.
So then,, I’m waking my kids up at 5a, driving them to the bus stop 30m away, driving to work also 30m away for my 12 hours shift, repeating in the evenings. I work as an emergency veterinarian and we were busy, no rest for the weary! I was not happy anymore about moving back into that house, and life as it was was not sustainable. My exchange student was contemplating living with someone else. My son couldn’t attend Cub Scouts or anything after school. Sure, it is “just stuff” that I lost, but now what? It was easy to sink into depression for sure.
It was time to make some big decisions that I wasn’t ready to make. Fighting depression, for me anyway, means changing my circumstances. This is not always feasible, I know! In this case though, I made the huge financial leap and decided to buy a house! With the recent flood I was scared the market was going to skyrocket, and I wouldn’t be able to afford rent anyway. At that point, my boyfriend and I discussed our future. Buying a house now meant either buying one again in a couple of years if we were really going to move in together, or him and his kids moving in on my turf which would be less than ideal. In what was not the least stressful decision but maybe the one that made most sense in the long run, we decided to get engaged and buy the house together. Living with someone all of a sudden isn’t easy, especially since we were both just fine by ourselves, never mind four kids under one roof. The house-buying process was a whole other headache that I don’t want to relive enough to type. BUT, it worked! We are now in a house we love, in a neighborhood we love, where my kids can get to their school easily and attend all activities they like. I am engaged to the man that I love and we get to start our lives together earlier than we ever expected. I am not one to think things happen for a reason, but good can come from bad, and I am so thankful and fortunate that it did for us. We are not unscathed, financially or emotionally or otherwise, but I still have my job and my family and now a beautiful home that I own.
I know a lot of veterinarians in my city that did not make out nearly as well as I did. There is so much chaos and pain in our area still. It was wonderful seeing the community come together to help people and their pets. My son and exchange student grew so much out of it, and gained a sense of societal responsibility that they may never have had before. I’m still thinking of all of you that are still struggling with this disaster. Please let me know if there is any way that I can help you.
Monique Koll, DVM
Dr. Melanie Goble
Have you ever had those days when life just seems to be overwhelming you and you feel like you are going to drown in the chaos of life? Yeah, me neither…
Alright, yes, I have felt that way.
I struggle to remember that when life appears to be taking over, I need to take time to breathe. To take that 10-30 seconds of deep breaths. To ground myself. I recently attended an active shooter response training and the officer leading the training spoke about “Combat Breathing.” When things start to go out of control, you get tunnel vision (and hearing). Taking the deep breaths allow your body to get the oxygen it needs to focus well, not on the “other thing” that does not actually need your focus.
When the clinic gets crazy, especially during an emergency, I find myself obsessing over the wrong things. Things like:
How many clients are waiting? How long have they been waiting?
Is the next client going to be mad at me for being late?
Seriously, what did I drop on my shirt? I haven’t had time to eat anything!
I need to be focusing on the case at hand, but my mind seems to scatter and then focus on that stupid stain on my shirt.
How do I get myself to focus? I am still working on that. Asking those that I am working with to remind me to breath helps a lot. We can all take those deep, calming breaths, focus ourselves, and then kick butt like the amazing heroes that we are!
Abby Whiting, DVM
It's no surprise to those who know me, that I love veterinary medicine. It is, in part, a piece of me. It's a piece of how I define myself, what some of my purpose here is. But I am also a terrible hypocrite.
I am an incurable introvert….while I play an extrovert in my daily professional life...in truth I am an ISTP with heavy emphasis on the I. So I rarely talk about my profession or my life in public...it's not because I am ashamed, its because telling someone you are a veterinarian starts a lengthy conversation filled with endless photos of their kitten, questions for free medical advice without an exam, tales of how they always wanted to be a vet...and on and on. When I fly I cherish my travel time, its the time I meditate the best...so no I really can’t bear the thought of flying to Anchorage with 6 hours of tales of your cat’s health concerns and how expensive your vet is. I’ve been known to tell a white lie or two: some days I sell insurance, once I told a very talkative lady I was a mortician (insert guilty smile)..it worked it was the quietest flight of my life. I also don’t really appreciate it when a friend or family member calls me out in public…”Oh my sister is a vet, she's right here let’s ask her!”...sigh…
Many people think I feel like this because in some way I am ashamed of my profession: on the contrary...I am well aware that vets are superheroes in disguise and I am honored to be among them! I have been an active member in organized veterinary medicine and as such I have gotten to travel and interact with many of the “top brass” in vet med. As an emerging leader I have attended conferences throughout the midwest and I have met and learned from so many people...and one question I still have... are we ashamed of who we are?
A little while ago, in a galaxy very near to us, I attended a conference with the top thinkers and leaders in vet med who, for the purposes of this post, will remain anonymous. As part of our entertainment we were taken to a state fair to visit the agriculture and veterinary medicine exhibit (as well as to eat funnel cakes and cream puffs! ). What fun! I was excited! As the bus pulled up to gates and the ferris wheel came into view, a top leader stood up on the bus and addressed us all. The leader said that this was a public fair, one of the largest in the nation, and that we would have no way of knowing if animal rights folks would be there too. The leader then removed the Aesculapius pin from their shirt and asked us to remove all outward signs that we were veterinarians. All in unyson everyone removed their ID badges and lapel pins etc. I stood frozen on the bus, clearly wearing a light jacket with my alma mater's vet school logo and script on it, pondering why. Why would we hide? Why do we hide? If the only voice in the crowd is the misguided one; its no wonder we have trouble in the realm of public perception.
It was then that my mother may have rolled over in her grave...you see I am a gen X er and an emerging leader...I tend to speak my mind. My mother came from a generation where young women were seen and not heard..and certainly would not contradict the “leader”. As politely as I could muster I simply said, “I am not ashamed of my profession. It is a badge of honor”. The leader smiled at me, asked if I was sure and let me climb off the bus into the crowd. I was happy no one tried to stop me...but sad no one else took my lead.
I wandered around the crowded fair that night consumed by questions of why we don't try to re educate people. Whether it be the anti vaxer crowd, the my groomer told me crowd, the animal rights crowd. Is it because we are ashamed? Or is it because we are tired? Or are so many of us introverts; that the very thought of this level of interaction gives us hives? I visited the agriculture barn where farrowing crates were explained and demonstrated. I visited the vet barn where dairy cattle where delivering their calves in front of the onlooking crowd. I watched ag students answering questions and redirecting misinformation. I watched everyday people learning and understanding.
While I understand the "don't engage" policy when it comes to subjects like animal rights, anti vaccines, etc...I wonder if we are not doing more harm by not trying?
At the end of the day I am proud to wear my Aesculapius. I am proud of who I am and of my profession. My challenge to all of you: Be proud. We are true superheros. We are one of the most respected professions in the world...We should all embrace our profession. But feel free to tell your in flight neighbor you sell insurance!
Melanie Goble. DVM
The Answer is “No”, but…
A clinic that I was recently providing relief services at had a client come in and an opioid was prescribed for the patient. Later, the client asked if they could just return here if they needed another prescription.
The other doctor and I discussed this. The answer was, “No.” but we then had to deal with the concerns of is the patient actually getting the pain control that it needs? How do we balance the needs of the patient and the risks for the client, and society? We all get know the obvious answer of no when we know the patient is not ever going to get those medications, but when there is doubt? What about when the client shares that they are on the same medications? What about when there is high suspicion, for whatever reason, of non-prescription drug use by the owner or someone in the household?
Yes, there are other medications that we could use, but what happens when those medications are not an option? When those medications don’t actually touch the pain? When costs are a major issue? When neither surgery or euthanasia is something the client is willing to consider?
How do we maintain our oath? How do we relief animal suffering and promotion of public health? This same client said, “The opioid epidemic doesn’t exist.” We know that it does.
Being admitted to the profession of veterinary medicine, I solemnly swear to use my scientific knowledge and skills for the benefit of society through the protection of animal health and welfare, the prevention and relief of animal suffering, the conservation of animal resources, the promotion of public health, and the advancement of medical knowledge.
I will practice my profession conscientiously, with dignity, and in keeping with the principles of veterinary medical ethics.
I accept as a lifelong obligation the continual improvement of my professional knowledge and competence.
Let’s really talk about this. What do you say?
The Admin Team of NOMV is a group of veterinarians dedicated to improving veterinary mental health.