Thursday, May 10, 2012

PTSD and the vet- true, but not funny

This past month has been a trial of various medications in order to allow me to overcome being anxious about dealing with clients.  I have a therapist, a couples counselor (because this kind of thing makes your spouse crazy), a primary care internist, and the psychiatrist.  The actual diagnosis is being worked out, but this is a marathon and not a sprint.  So, cost THIS week of therapy: $205 for the combined therapists and @$290 for the psychiatrist.  I get a small break next week: one therapist is out of town.  Oh, insurance covers NONE of this so it is out of pocket.

My PCP, therapist, and psychiatrist all agreed that I have PTSD.  The psychiatrist mentioned that there are two main types: several small instances (non-combative) vs single/multiple combative PTSD.  She thinks I have both.  I had a boyfriend in junior high that abused and threatened to kill me and my whole family.  He held me hostage with threats against his own life, attempting suicide when I broke up with him.  Less than a year later, my father died when I was 16 and in a new school.  Two big traumas.  Then all of the little money grubbing digs, all of the rich doctor heartless jokes, all of the animal abuse, euthanizing 10-30 patients a weekend on emergency.  The fear of never knowing if when I told an owner "I have a 90% chance of saving your dog, but it will cost at last $2000 and might go up from there," what they were going to say.  Some would hug me and tell me to go ahead, then send thank you cupcakes. Some could not afford it and I euthanized their dog, but still got a nice card and sometimes bakes recriminations.  And some called me a thief.  And some just yelled at me.  And when you have PTSD, all your limbic system processes is that all of things that stand out are the traumas.  And you have constant cortisol release.  And then your hippocampus shrinks.  And you become angry and at its most base form, anger is fear.  I was paralyzed when picking up the phone.  I was paralyzed going into exam rooms.

Given my previous history, I would have been better off going into pathology or anatomy or research.  But I am an adrenaline junky...jumping horses goes along with that, diving competitively goes along with that.  I despite what my doctors think, I believe that I am high functioning ADD.  My psychiatrist says that my brain just works differently and that I have a busy brain.  It makes me good at solving problems, but does not help with the mundane things.  I can diagnose and manage several severe medical cases, remove a spleen in 10 minutes, and start treatment on an animal my techs show me through the surgery window and I am closing the splenectomy.  However, I cannot clean the house.  I can cook a fabulous meal without a recipe but I cannot repeat it.  I can create pictures that make people cry.  I can give lectures and create inventions, but I cannot work through the mundane task of patenting them.  Talking to a single client picking up the phone is trauma inducing.  Giving a grand rounds lecture to an entire human hospital staff makes me high for at least a day.  Instead of a wall that only lets a few things in, my mind is a colander, letting all sorts of things in and out.  The box that all the exec want people to think outside of does not exist in my world.  And even though my doctors all agree that this a 4 D way of thinking makes me a wonderful doctor, it makes me a shitty wife, and a less than mundane mother.  At this point, I am agreeing that polygamy is a good choice...if I could have a wife that did all of that day to day perfect would that be?

I am finding my way in this new world of purely capitalistic veterinary hospitals, where so many hospitals are competitors and not colleagues.   And so many hospitals are being bought by corporations.  I am navigating the land mines of the big box companies forcing pharmacist, with no veterinary training, to sell veterinary drugs that they *MIGHT* learn about through the hazy filter than is their rep (and do they know what they can trust, do they know about the interaction of Comfortis and Ivermectin products??.)  I am trying for education rather than anger.  I have already given one pharmacology CME, might as well charge Wally World for more.

And I am fighting this battle with suicide.  Veterinarians have one of the highest suicide rates in the to dentists.  Money problems, easy access to drugs that kill, a feeling of helplessness, of being devalued....those all come into play.  PTSD and the unending anxiety also

So you vets and human health care might have some PTSD too.  ED medics, nurses, and doctors are at risk.  Be safe.  Get your help.  I am mortgaging my future to do so, because without this help, my future will be in the state run loony bin or in the ground.

Yes, it is a downer post.  But it is true to my life.  Off to watch more TED talks and work on my next lecture.  If I get my grant, it should gain some national attention.


  1. I'm sorry for your struggles but I thank you for the courage to go to work every day and (maybe) care for my beloved pets.

  2. I commend and sympathise with your daily struggles!
    I share the heart pounding stress when discussing quotes for treatment, or the fear to answer the phone at work. I hope my nurses don't think its because I'm the vet and I'm "too good" to answer the phone, but the thought of not knowing what to say or how to help scares the hell out of me! I have had my home phone disconnected and I communicate through texts and emails, so work is the only place that I have to deal with unknown people on a daily basis.

    I always knew it would be the hardest part of my job. But I continue to do it because I love the difference that I can make in each animal's life, and over time I have developed fantastic and lasting relationships with some of my clients. I am 10 years in and hope that I can continue for many more. I wish clients realised that everyone standing behind a counter, or on the other end of the phone or wherever they meet them, are just people too...trying to get by!

  3. I work with children and have an anxiety disorder; though clearly not as serious as your condition I do on some level feel your pain.

    Keep fighting it, keep focusing on the good, and eventually we'll both get to the point where we know that no matter what anyone else is saying we're doing the best job we can and nobody can say otherwise.

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  5. Wow. I couldn't sleep tonight because I keep thinking about those few cases that wreck my day (or week). So many good experiences, but only the bad ones linger and I can't stop thinking about it until the next bad experience comes along for me to obsess over. I keep going over and over in my head if there was something else I could have said or done that would have made client relations go over smoother or helped the animal any more than I already did. It's the struggle with hindsight. It's that paranoia that a case where you've done everything right will still go wrong. It's that feeling that things have been going too well for too long - something must go wrong soon - maybe as you're laying in your bed thinking about it! It's that worry that one of your cases that you sent home because they couldn't afford to keep the dog in the hospital is getting sicker and there's nothing you can do about it because the owners haven't come in for a checkup and you can't seem to reach them on any of their numbers. And somehow they're going to blame you when their pet gets worse.
    I was just wondering if I should talk to someone about this. Somehow I thought that checking in with VBB would make me feel a little better. I'm not happy to see that other vets are also suffering - and more severely than me. But it helps to know I'm not the only one (well, duh, but you know what I mean). Thank you for making this post. It couldn't have come at a better time for me.

    1. Get help now. I was almost paralyzed before I could get up the energy to do it. It took a kick in the pants by some other VBB authors. We are people that are taught not to ask for help...but we need someone and something outside of ourselves in order to get better. I see a light at the end of the tunnel....and I am hoping that it is not the train.

  6. I'm a veterinarian with PTSD. I experience flashbacks. I am hypervigilant and startle very easily. I also have compassion fatigue. This is not a nice combination.

    For a while I was paying a therapist cash, so my insurance company wouldn't discover I was in therapy and either raise my rates or drop me entirely. It helped somewhat, but what has helped most is leaving full-time veterinary practice. Now, I practice part-time in addition to another part-time, non-practice job. I can't wait to leave practice entirely, which I no doubt would have done long ago if the recession hadn't happened. Clients and their needs bleed me dry, and even on the best days, it's an ordeal to go to my practice job (in contrast, I love my other job). I try for my patients but this job will kill me if I continue for the 25-30 years I have ahead of me before retirement age.

  7. Take care of yourself and your family.

  8. I wish you the best. This post made me want to give you internet hugs. *hug*

  9. How horrible! I wish you all the best. Just know that not all veterinarians mesa az are like that./