Monday, March 11, 2013

Someone Else's Eyes

As with most veterinarians, I was away this past week on "vacation", which really means I went to a continuing education class and took a few days off before it so I could have some down time.   Vets don't take real vacations - you know, the two weeks off where you get to really decompress and start to realize maybe you have a good life, the ones where you actually are excited to return home?

Yeah.  It wasn't one of those. 

Now, granted, I will admit that the location of the CE class was pretty stellar.  It was held in Yosemite National Park, which, in my opinion, is one of the most beautiful places on earth.  Still, there's something wrong about sitting in a classroom, staring out the window at the granite mountains, wishing you weren't having to learn anything.  In fact, cashiering at the gift shop or working the flat top grill seemed more appealing to me than returning to my life as a vet.  At least, for a few minutes, that is....

But...

I did squeeze in two days of super duper fun in the....  snow.  Downhill skiing.  A good friend of mine told me that the only way she was ever really able to decompress was to do something that completely took her mind off of her practice and of being a veterinarian.  For her it was extreme sports.

It's kinda like that for me, too, in that I have to do things that completely exhaust me, that have nothing to do with veterinary medicine.  Thus, downhill skiing and scuba diving are my two favorite pasttimes.

So I downhill skied for two days and forgot all about being a veterinarian.

That is, after the first two hours of Day One.

See, I took some refresher lessons, and while riding the lift up to the sissy little bunny slope, the cute, nice ski instructor (are they defined any other way?) said to me:

"Your husband told me that you have my Dream Job.  You're a veterinarian!"

To which I replied,

"Yeah."

That was it.  That was about all that I said.  I did manage to mutter out a few words that said something along the lines of, "it's a really difficult job to be a vet" while the instructor was talking to me about various things related to animals.  I barely heard anything he said because - to be honest - I hadn't skied in a while and I was trying not to piss my pants before getting off the lift!

So the scary part did distract me.

Later on though, I realized how rude I must have sounded.  It may have been partially because I was trying to focus on not dying while downhill skiing, but...  the hard truth was that I had no positivity to offer about my profession, I didn't say much about my practice and I never once said, "Oh yeah, it's a GREAT JOB!"  I didn't even THINK that.

To him, I hold a high position, a dream position, and he was excited about it and envious.

But what I thought was, "wow, I have his dream job, and he has mine...  a ski instructor in Yosemite."

Could we switch places please?

I guess what has lingered in my mind about this interaction is my question to myself of when did I lose that feeling of ambassadorship for my profession?  When did I start rolling my eyes to myself when someone mentions that it's their dream job?  When did I start screaming in my head to people (that they never hear) that it's NOT a dream, but rather a NIGHTMARE job on some days?

There are theories that those of us who are the kindest, the most sensitive, most emotional types of people suffer the most of PTSD (post traumatic stress disorder).  I just never, ever, in my entire life, thought that my choice of career would worsen that for me.  But it does.

I have no idea how to break that cycle other than to continue to find and develop my life outside of vet med.  If anybody has any other advice, not just for me, but for our readers who might be experiencing the same thing...  please chime in.

Till then, I'll keep pursuing the things that make me happy that have absolutely nothing to do with being a veterinarian, and I'll keep going on vacation, pretending I'm living a different life, if only for a few weeks a year.

22 comments:

  1. When we started on this path in life most of us didn't realize the toll that financial based vet care and euthanasia in all it's various forms would take on us. As I terminated a sick, angry FeLv trap cat for the local authorities a week ago I tried to ponder how many such unwanted animals I had killed in 13 years. A scary number was what I decided, composed of similar cats, mangled HBCs from animal control, more fighting pit bulls than I want to think of ( most of whom were sickeningly friendly to people but ferocious towards other dogs). Then there is the other side of the equation, animals who I have cared for for years with wonderful loving owners where I am in tears by the time the deed is done. Would people want this job if they knew that it involved playing government assassin and grief counselor to people you've known for years on a regular basis? And then in the latter instance well meaning owners send cards THANKING me for euthanizing their dogs. That sounds nice but it really creeps me out.

    ReplyDelete
  2. I'm young enough and new enough to where I avoided emergency medicine. We here in a larger area have the capability to refer our emergencies to an overnight emergency clinic. Yes you lose some of that relationship you build over a late night helping someone's pet, but you get to have a real life when you go home at night. Now any veterinarian will tell you that you "never leave your work" and yes many nights I've laid in bed not sleeping wondering if what I did in that situation was right, should I have tried harder to push an owner into a specific test, should I have discouraged euthanasia more forcefully, I know that treatment is likely to be right, but what if it's a weird fungal infection and I'm wrong. However, I mostly go home and night and settle into my "regular" life. I do things and try not to worry about what might be going on with my patients. There is no correct answer, but I think especially with the abundant number of veterinarians coming into the field, we have got to do a better job separating work and life, and removing emergency work from our jobs needs to be priority number one. Yes, I know in some areas it's not realistic, especially those very rural areas, but emergency work takes the toll on us after hours beyond reasonable means. I didn't really experience outside of veterinary school, but I can remember the brain dead nights just drudging through, and with the quantity of quality veterinarians being produced should we ever settle for "drudging through"? Yes most of us can do adequate to above average jobs even while working on minimal sleep, but surely we realize that we'll be even better at our jobs if we don't push ourselves to those ends. I have no clue what you do, I just know as a profession we need a better job of making those situations occur. PS: I really enjoy reading your blog, even as it may be anonymous.

    ReplyDelete
    Replies
    1. >>I think especially with the abundant number of veterinarians coming into the field, we have got to do a better job separating work and life, and removing emergency work from our jobs needs to be priority number one.>>

      The OP didn't mention emergencies at all and as Lance clarified, he prefers emergency work. Do you not see any emergencies at all, even during the day? If you do very few, you probably shouldn't do any. The fact is, however, someone has to cover the emergencies.

      I am a large animal veterinarian. Part of the reason I was attracted to the field was that, like Lance, I prefer critical care to routine practice. It's more challenging.

      When I finally decided to leave practice altogether, I had to identify something else to do that would hold my interest without making me crazy. In my new job I won't be working with clients at all, and that is by far the new job's most exciting feature.

      Delete
    2. I'm using the term emergency very generically here. What I mean is after hours work. I think most veterinarians prefer emergency work, as it's where we absolutely make a difference. What I'm talking about is the after hours work in which we need to separate ourselves from working 24 hours a day, 7 days a week. Sorry for the confusion, as I'm not bringing down emergency work, as I think most veterinarians enjoy it over others. I just don't think veterinarians should be making their lives available to all 24/7/365.

      Delete
    3. I can't agree. I think veterinarians are a lot like physicians, but the options to specialize aren't available to the same extent because not enough of those jobs exist.

      As for after hours work, unfortunately, some veterinarians have no choice but to provide emergency services, either because haul-in hospitals aren't practical (large animal), the region won't support an emergency hospital, or the practice wouldn't survive without income derived from treating emergencies. I agree that it's probably better to limit any individual veterinarian's hours on call, though.

      Delete
    4. I agree with David. I am a large animal vet available 24/7/365, and I don't know how much longer I can go on this way. It is like this because that is what the client expects. They want to have "their" veterinarian at all times, and we allow this to happen by continuing to provide them that service.

      My feeling is that most regions would, in fact, have a sufficient caseload to be able to support an emergency service, if all the local veterinarians agreed to use it. The problem we have in this area is that each vet is afraid they will lose clients if they do not do out of hours work, because every other vet is doing it. This means that we have referral clinics doing routine ambulatory work in order to survive, and ambulatory vets on call at all times lest they lose a client to the referral clinics.

      If you agree that it is better to limit any individual veterinarian's on call hours, the best way to do this by setting up and utilizing a referral emergency clinic. Unfortunately if a practice decides to offer out of hour emergency work, then *all* the out of hours times have to be covered. So unless you work in a large practice with a lot of doctors, you will be doing a lot of on call. If you do work in a large practice with a lot of doctors, then your clients won't be seeing you for emergencies very often anyway, and then they might as well be using an emergency clinic staffed with people who are very good at treating emergencies.

      A note also on haul-in hospitals not being practical - that is again because we allow it to be this way. It is actually a lot more practical for people to bring their animal to a fully staffed, fully equipped hospital to treat an emergency than it is for one veterinarian to go out with whatever things they can fit in their truck to treat an animal under who-knows-what kind of conditions (dark, cold, wet, dirty, people who are physically unable to restrain their animal, etc). Requiring that the animal be brought to the hospital except under special circumstances would allow us to provide better care (and lead better lives, too). People would find a way to get their animals there, just as they do now when we require them to (eg colic surgery).

      Delete
    5. I am a large animal veterinarian in solo ambulatory practice, and I have been on call more or less continuously for almost 10 years.

      If you read what I wrote again, you'll note that what I disagree with is David's point re: all veterinarians enjoy emergencies and are talented in that area. Not true. We're not all the same. Some of us are actually drawn to emergency work, and I include myself in that group.

      Sure, it would be great if everyone would agree to send all their emergencies to the referral hospital (local veterinary school, in our case). Unfortunately, that's not going to happen in my area, even though when I leave town, that's what I do with my clients, who mostly don't complain. Then there are the times the large animal can't be loaded onto the trailer without considerable difficulty. The season before all the horses were finally vaccinated for West Nile wasn't a lot of fun here.

      Delete
    6. I never said all nor did I say all veterinarians are talented in that area. I said most veterinarians probably prefer emergency work over mundane vaccinations and treating ear infections.

      So you are disagreeing with a point I did not make. I went back and read again, because I would never insinuate all veterinarians are equally adept at what they do, I know for a fact that isn't close to true.

      Delete
    7. It's doubtful that most veterinarians prefer true emergency work. Most veterinarians probably do prefer interesting cases, but not all interesting cases are emergencies.

      If you yourself prefer emergency work, why aren't you working at an emergency clinic? Most offer shift work.

      Delete
    8. Being on call 24/7/365 is insane and a sure path to burn out. I was on every other week call at my first job and even that was a strain. I think on the small animal side referring emergencies to e-clinics and/or 24 hour refferal centers is getting pretty standard. I do cringe at the distances from which we receive emergencies some night but I understand RDVM s wanting to sleep at night. On the LA side I think getting dedicated emergency going has always been tougher. I think I came in at the very end of the collegial days of vet med, where we had lunch with the other DVMs in town monthly and could occasionally take call for each other without fear of client poaching. I think shared call was more common in the past but competition being what it is now I doubt much of that occurs between practices any more. Jeez not even 40 and I feel like a grumpy old man sometimes.

      Delete
  3. I got a college degree and certification in a profession that requires it. I worked in it for a few years and realized it stressed me out way too much.
    Well, I'm quitting. I submitted my resignation. I'm now enrolled in a class to become a CNA (certified nursing assistant- which in my state requires a five week course, an exam, and not even a high school diploma) and I already have a job lined up for when I get certified. It pays way less, but I like the place where I'm going to work, I feel certain that I can do well at it, and I'll never ever have to deal with my old job again. Yay! The nursing director who will be hiring me loaned me a textbook for nursing assistants. There's a line in it I love, where it's outlining who is responsible for what. CNAs are not legally responsible for anything (that is, no judgment calls- we're still responsible if we commit assault or battery or if we commit fraud by pretending to be nurses). Sounds like my dream job.

    It's a social and economic step down, but I expect to be happier. And if not, I can pick something else.

    If you want to become a ski instructor... become a ski instructor.

    I will admit here that I am not married or divorced and I have no debts. I am taking care my two disabled brothers, but that requires just a lot of my time- it's not a monetary commitment.

    ReplyDelete
    Replies
    1. Jonah, I'm glad you found the courage to leave your profession for something you really want to do, but unfortunately it's not that easy for everyone. If you have been following this blog at all you would know that the large debt incurred while becoming a veterinarian is not likely to be paid off easily doing something else. Most vets cannot justify changing careers to a lower paying job while balancing family obligations and loan payments. It would be nice if switching to a higher paying job was easier, but most require more education.

      Delete
  4. Didn't mean to sound so glum, just momentarily commiserating with the OP. I work ER at a refferal hospital by choice. I like to treat really ill patients. I also enjoy working a lower number of longer shifts. A side effect of choosing to do this is I see lots of death at work. That aspect is a lot more challenging than I thought it would be before I was a vet. On the other hand I get to do something different every shift and new situations still occur to challenge me after more than a decade of practice. I spoke with my wife about this the other day and the reality is despite the frustration I am happy with my career. But as I stated recently I was likely among the last classes where the bulk of the class finished on a reasonable financial footing. As for stress relief I spend time in the outdoors, cook, spend time with my family and friends I've had since before my DVM. And I get to do some mentoring of younger vets at my job which is really enjoyable and good for perspective. Too I try to keep work about the case in front of me. If the owner has financial issues I treat that as just another part of the diagnostic challenge and try to find a way to help that patient within the parameters given.

    ReplyDelete
  5. I think something that can help most of us is to realize that being a vet IS JUST A JOB. The asshole clients who disparage you, call you names, threaten to sue you even when you did your best... they are "part of doing business" as a doctor and the reason we all carry insurance. In my 10 years of doing this, I know people have always sucked (knew that long before becoming a vet) but the recession and our societal ways of life have worsened it and I think, even encouraged it. ANY job that deals with the public will get this wrath, but those of us in medicine get it the worst. So the only way around it, truly, is to see it as JUST A JOB with inherent pitfalls. I would encourage anyone considering this career NOT to see it as a career but rather a JOB. Because if you don't, the bloodsucking, emotionally damaged, time sucking public will suck the life right out of you! My post sounds so negative and when I wrote it that definitely was my state of mind, but the way to get around it is to continue to look forward to the ways you can live your life that have nothing to do with working.

    ReplyDelete
  6. Posts like this sadden me immensely. I'm a "client" and follow this blog because of my interest in animals and my work with dachshund rescue and I just want to say that for me and my wife our vets are heroes. We have never once questioned fees, in fact we are sometimes surprised by how much service we receive for our dollars. We give our hearts to our dogs and we will give them nothing less than our utmost to keep them healthy and comfortable. The compassion our vets show, their willingness to educate us, the time they take with us when things go badly, and the depth of their knowledge and dedication fill us with gratitude. And when the time comes that we need to help our pets with the final gift of an easy death the thought that they face this time and again day after day and always with compassion leaves us humbled. Maybe we don't express out appreciation enough, but the thank you card after euthanasia shouldn't creep you out - it is a way to say something that our hearts are too full to say any other way.

    ReplyDelete
  7. Rantmaster Rich, thank you very much for your kind words. Clients like you are much appreciated and you are why many of us do what we do.

    ReplyDelete
  8. Rantmaster, it's a personal hang up on my part. The reality is I love cards for dogs who were really sick and then we cured them or extended their lives ect. But for some reason getting a card after a euthanasia is difficult for me. That probably isn't this case for most vets, and I do appreciate the sentiment but for me, thank you cards after euthanasias a unsettling. It's hard to explain why that is and I would never tell a client that but there it is. So I do love my job and I do take my work home with me, check on my patients on my days off and dream about challenging diagnoses ( occasionally productively). But while I can deal with aggressive animals, and onery owners, the emptiness I feel when euthanizing injured strays and the failure and sadness I feel when I euthanize patients I've known for a while I just can't shake. It's a part of my job and I accept it but in some way that is hard to explain I think it diminishes me as a person in ways being an active and aware carnivore all my life doesn't. So that was the raw spot the OP hit for me and that's why my original post was so intense. This isn't to make anyone feel bad about euthanizing there animal when that critter QOL is not acceptable any more, I fully support this. It just means there are aspects of this that are very difficult for vets even when we know intellectualy we are doing the right thing.

    ReplyDelete
    Replies
    1. I can only dimly imagine the toll that the daily encounter with euthanasia must have on a vet. I get what you are saying. Having said that - we have sent cards after euthanasia because at that time some kindness and empathy are the only dim lights in a dark dark day and we so greatly appreciate it.

      Delete
    2. Lance, I have a whole box full of these cards. I keep them all, but I can only look at them once. They're beautiful, and much appreciated, but it also really hurts to receive them.

      Delete
  9. Sorry if I made you self conscious about a thoughtful act. On a lighter note what really makes my day is cookies or brownies, and always please address things to the vet and the staff, I like to see my techs get appreciation they make modern vet med possible. Cheers.

    ReplyDelete
    Replies
    1. Not at all. Got a little dog in early kidney failure right now so we'll be seeing a lot of our clinic. The suggestion of baked goods is a great one. My wife loves to bake.

      We always include the staff.

      Delete
  10. What about that one client who looks up to you, with tears in her eyes and says "Thank you for saving my beloved
    dog"

    ReplyDelete