Once more unto the breach, dear friends, once more.

imageAs a veterinarian I have seen death aplenty. I have been responsible for the ending of thousands of little lives, inflicted the pain of loss on thousands of people in my own “professional” way, and experienced loss of my own – family, friends, pets, patients. There are times that I feel as though I specialize in death and dying.

This isn’t unusual for veterinarians, of course. Our dog and cat patients have short lives compared to ours. Many of my clients, like myself, feel empty without the love that a pet can provide and will have the opportunity to live with many animals over the course of a lifetime. They will also have the opportunity to say goodbye to those pets one by one, experiencing the pain of loss and the psychic and emotional toll that takes over and over again.

As their veterinarian I will hopefully ease some of their pain by providing a peaceful ending for their pet. This doesn’t, however, entirely negate the effect that each euthanasia has on the person performing the procedure. (See that? I can distance myself from the reality of death a bit by becoming clinical and calling it a “procedure”. But it’s still killing.) After every euthanasia I feel a little heavier, like I’ve got lead in my pockets. Over the years the amount of lead grows from ounces to pounds, and it really starts to weigh you down.

In addition to death, we get to deal with being business owners, human resource managers, therapists, mediators, negotiators, fathers and mothers, sons and daughters, imperfect human beings existing on planet earth and interacting with all the other imperfect beings around us.

For some reason people in this country are becoming more and more edgy and intolerant of actual signs of humanity. Veterinarians (and human doctors) now simply can’t make mistakes. Most of us are intrinsically perfectionistic anyway (and self-critical) but we’re not perfect, and for me this sets up a big internal conflict. I have made mistakes, some serious and some minor, and each mistake I make adds to the lead in my pockets. The joyous dance of early practice inexorably becomes a funeral march.

Thankfully, I haven’t made a fatal mistake yet. My clients know about the mistakes that impacted their pets; I am very up front about things like that, and I tell my clients when I screw up. Lately, though, I’ve considered rethinking this.

The down side to telling clients about minor screw-ups has suddenly grown, with the advent of Yelp and cyber-bullying hate sites directed at veterinarians. When one mistake, something as small as trimming a dog’s toenails too short, can result in a complaint to the veterinary board, vile postings to your clinic Facebook page, calls to burn down your hospital, and picketing on the street, I really have to think twice before admitting to any imperfections. And the supply of lead in my pockets grows and I battle with the moral issues this raises.

As a veterinarian, doing the moral thing can get you killed. Dr Shirley Koshi, a veterinarian in New York city, was presented with an abandoned cat. The people who brought him in had found him living in a city park and had tried supplying him with food, but he wasn’t doing well. Dr Koshi treated him at her own expense (because that’s what vets often do with the abused innocents that grab at their hearts), got him well, and adopted him.

A couple of months later a woman of dubious mental health claimed that this cat belonged to her, because she “owned” a “colony” of cats in a public park in the city, and this cat was one of them. What followed was an all-out hate-a-thon, as the woman demanded the cat back to release into the park again and Dr Koshi declined to subject him to a short life of starvation and cold. After enduring months of abuse and bullying online and in person, picketing in front of her clinic, the consequent loss of most of her clientele, and looming bankruptcy, Dr Koshi committed suicide. All because she took a stand and wanted to give a poor little cat a better life. I read about her, and the lead accumulates.

Last week we lost Dr Sophia Yin. I don’t know how it’s possible to be so affected by the death of someone I’ve never met. Maybe it’s just that the lead is becoming really heavy, and I’m feeling the little additions. Maybe it’s just that she seemed so… normal. So just like all of us who put on our brave faces and every day go once more unto the breach. I have no idea what was going on in her personal life, what the factors were that went into this decision. But I can start to understand, late in my career as I am, how very tired one can get from all the weight in one’s pockets.

Every month there is another veterinarian who can’t take the pressures of personal and professional life and decides to end it all. Veterinarians lead all professions now in rates of suicide. Sadness.

I don’t know what we can do about this as a community. Maybe just reach out a little, check on each other, make a phone call, pay attention, listen. Behave more like a family. Give each other the benefit of the doubt. Doing the right thing is easy when it doesn’t cost us anything, and benefits we can gain from the suffering of others is tainted, so go out and support your colleagues who are being bullied online, and do it publicly, especially if they are your “competitors”. Become vets united in adversity.

If you are reading this and are not a vet, consider reaching out to your own veterinarian. Just say thanks, if you mean it. Or tell him how much your dog loves him (or his treats). Or bring her cookies just because. Lead is a soft metal and easily scraped away by kindness. You have no idea how a little thing like this can remove some of the weight your vet is carrying around.

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121 thoughts on “Once more unto the breach, dear friends, once more.

  1. Very nicely put. The problem is death is final , hence the mistake is final. Its the age old story mistakes in others are unacceptable but mine must be overlooked.
    As we approach the place of no return life grows heavy and our helplessness stares us in the face.
    Have no fear we must all make way for the new jostling crowd who are filled with the optimism of youth.

    Liked by 1 person

  2. Hi, I am a human doctor ( 🙂 working with humans), so very passionate in the elderly and terminal ill, and I am pondering upon the euthanasia-debate on humans, and while reading your post, I could almost feel the lead accumulating in your pockets. I appreciate your sensitive confession and sharing. And since I am not living on the other side of the ocean, :), I don’t have the same problems as you all have with all the hatred and aggressiveness that give some people’s real heart away. Some of us call ourselves Christians, and have a real hard time loving those around them, and forgiving, as they themselves received love and forgiveness. I bless you in Christ’s Name, and call His Face and Love upon you! He may lift up your burden and empty your lead-full pockets! Blessings.

    Liked by 1 person

  3. I really liked your post. I’m not a vet, or a doctor, and think those professions are delicate and hard, specially when there’s people that think animals are “not as important”. Sometime ago my dog’s vet and I were speaking about that. Jundging people is so easy… and also pain of loosing someone you love (2 legged por 4 legged) it’s so hard and even blinding. And now with social media bulling can spread so fast. I admire vets and docs. What you do is important and to your patients you are hope.

    Liked by 1 person

  4. Could you please submit this to The New York Times – or at least USA Today. (Try the Times first). More people need a better understanding of the veterinary profession and this is excellent. Share it more broadly.

    Liked by 1 person

  5. Thank you for writing this. I think vets have the most wonderful job and fulfilling job in helping and saving so many of our fellow creatures. I also feel some of the weight you must experience when your job requires you to make unhappy decisions because someone, somewhere has inflicted pain and suffering deliberately or through neglect on helpless animals. Vets need our support, and they need a legal system that is sensitive and sensible with regard to both human and animal welfare. Cyber bullying of any kind is deplorable, but bullying people in professions whose primary purpose is to make life, or death better or more bearable is something we should not tolerate. We have several rescued cats and dogs. Our vets are wonderful. We love them and so do our pets past and present.

    Liked by 1 person

  6. I regularly see my vet as one of my cats is diabetic, and six months ago my oldest cat was put to sleep (she was 19 and had cancer). My vet is caring, always honest with me and after my cat passed away she took the time to send me a card. You guys do an absolutely wonderful job in very difficult circumstances and I’m sorry you’ve had such bad experiences… While they may not always say it, I’m sure that there are many pet owners who are very grateful for what you do. I will take your advice on board and take a thank you present next time I go…

    Liked by 1 person

  7. Dr. Koshi had her own mental health issues, and that situation is not exactly as you have presented it. I nearly stopped reading this piece when I reached that point, which would have been too bad. I think the best advice for all of you comes from Luke– “Physician, heal thyself.” And not to put too fine a point on it, but regardless of what USA Today, Veterinarians are not the most likely to kill themselves— here’s the actuarial table. http://www.newhealthguide.org/Highest-Suicide-Rate-By-Profession.html

    Liked by 1 person

    • That link actually supports the concept of high rates of suicide among veterinarians:

      “Research and clinical data suggested that certain occupations especially in healthcare sector (like doctors and nurses) along with veterinarians are among the most common professionals who commit suicide…”

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    • Unfortunately the quote from Luke is a bad one as even then the context was spiteful. This is written by a human being who has feeling as we all do no matter what job we do or what beliefs we have we all have feelings

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    • The situation with Dr Koshi is exactly as it is presented here. Watch Gwen Jurmark videos on YT. Since when cats dumped in a public park are anybody’s pets? Jurmark had no claim to the cat, I have more claim on the squirrels in front of my windows than she had on this cat. Dr Koshi was willing to get it a home, and the internet bullies with a vendetta against all web made her life hell for that. You claim that Dr Koshi had mental issues of her own – do you care to provide a proof? There is plenty of proof that she was driven to suicide – all those posts on VAN website and facebook, fake negative reviews; interview with her lawyer on YT; Gwen Jurmark’s conflicting statements on her own video and the video of her little cat colony.

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    • What a dumb comment: Luke– “Physician, heal thyself.” If the person posting this had half a brain they would realize veterinarians cannot practice human medicine without a license, so it’s not even legally or medically possible. Sounds like Larkin is the one with mental health issues. What a Lark.

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  8. Actually I followed this link from my own vets face book page.
    Even though I blog her eon WP I was not aware f your blog.
    My vet is the best and I show her often with hugs, thank yous and flowers.
    With out here working with me financially and emotionally, my sweet kitty would not be alive as she lives with feline auto immune disease.
    God bless you.

    Liked by 1 person

  9. You have done an incredible job shedding light on a difficult topic. The anonymity of the internet has turned people into heartless bullies. Thank you for talking about the taboo, and admitting your humanness. I think people need these reminders- that they are dealing with real people, with real feelings- before they go blasting people on the web. I hope you find some relief, or at least some way to ignore the idiot bullies.

    Liked by 1 person

  10. I was once just a vet tech in the process of studying to become an animal law enforcement agent. I ended up dropping out due to the horrible scenes I witnessed. I totally appreciate everything you vets do for my great many animals, you guys are a blessing I could never offer. So from the bottom of my failed heart I thank all the vets of the world for being stronger than I could ever be.

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  11. Firstly I would like to thank the author of this piece for having the courage to express things that weigh all of us in the profession down on a daily basis but aren’t often discussed. It’s comforting to be reminded that we are not alone in feeling unbearably heavy some days.

    Secondly as a scientist by training & natural inclination, insensitive people who shoot off their mouths without checking their facts is a major pet-peeve of mine. So to the person that fits that description who commented a few days ago (Oct 10), and anyone else that may be interested let’s delve a little deeper then just the first site that came up when you googled ‘veterinarian suicide rate’.
    The site referenced by the above person to say that veterinarians do not the highest rate of suicide (http://www.newhealthguide.org/Highest-Suicide-Rate-By-Profession.html) only compares the suicide statistics of white males – for a female dominated field considering this chart to be representative is laughable. Furthermore when you access the NOMS database (the source that the above article was supposed to be based off) & change the parameters to include both genders the PMR (Proportionate Mortality Ratio) of veterinarians actually becomes greater than that of physicians.

    The most famous of the studies that made this an international topic of discussion is a 2008 study by Bartram et al. (Veterinary surgeons and suicide: influences, opportunities and research directions) showing that veterinarians in the UK are four times more likely than the general population & greater than that of other professions (including but not limited to pharmacists, dentists, farmers and physicians)

    This inspired studies in other nations & Australia didn’t fare much better. A study in the Australian Veterinary Journal (Suicide in Australian Veterinarians) by Dr. Helen Jones-Fairnie found that the suicide rates among Australian Vets is similar to that of the UK – about four times the rate of the public.

    So do US vets hold it together any better. Probably not – In a recent review Belinda Platt et al (Centre for Suicide Research at Oxford University) found research pointing to significantly elevated rates of suicide among veterinarians in Australia, Belgium, Norway and the United States.

    After the initial studies showing the high suicide rates in veterinarians most then research shifted focus to find the contributing factors (this is too long a discussion to get into in this forum)

    So for those who think we veterinarians should just ‘heal thyself’ – it’s not happening world wide, wouldn’t expect it to in the immediate future. How about having some compassion

    Liked by 1 person

  12. I think that expectations of immediacy and perfection can largely be attributed to the rise in use of internet and technology. Being able to have questions answered within moments by Google, having a vast pool of information right at our fingertips and being able to cipher through unwanted material to reach the exact thing we are searching for has trained us to approach real life situations with similar expectations – which is unrealistic.

    Liked by 1 person

    • The internet is a double-edged sword, and I say that as a recently retired university professor. Information is readily available, yes, but so many students lacked the ability to distinguish between the solid information provided by reputable sources, and the junk given by those without any authority to speak on the subject, that I wouldn’t allow students to use a web source without running it by me first.

      Reputable books and journal articles provide readers with the bibliography, endnotes, and other information that the author used to build and support his or her theory, thesis, or whatever (never trust one that doesn’t), but you so seldom find that on the web.

      Please keep in mind that I’m only referring to people who don’t know that you can’t believe everything you read, or even worse, subscribe to the “I believe it, so it must be true” school of thought. The web has made some people anonymous “experts” who find it perfectly acceptable to verbally attack the people who actually are. It’s getting a little scarey!

      Thanks for enduring my diatribe!

      Liked by 1 person

  13. Pingback: Something Good | A Thousand Shades of Gray

  14. Please consider posting this to major news outlets. It is impressive and has the potential to open up a national debate and further appreciation of vets. A very heart felt and impressive article. I applaud you!

    Liked by 1 person

  15. I just recently got a dog, and am reading some wonderful things about dog training. From those pages, I found this blog, and since I have only begun to have a relationship with a vet, I will certainly make a point of being sensitive to him as a someone who is doing his best. Thank you for raising my awareness about the issue of veterinary suicide.

    And thank you for being open about the heavy weight you carry around.

    Liked by 1 person

  16. This reminds me some of our vet whose dog was sick – here is this skilled veterinarian with everything at his fingertips but he could not save that dog and had to put him down. He was devastated, of course. Many of us who work with animals have to make really difficult decisions and the unselfish one often involve euthanasia. I have nothing but admiration for you and what you do – thank you.
    As for the mean and cruel people – is it simple ignorance or just no heart? Either way, I feel sorry for them. There are people who walk softly upon the earth and make life better – and there are those who bulldoze their way and make life harder.
    By sharing your story, I hope some of that lead is removed – there are many who admire you and what you do, who respect you for caring, who understand the pain and the toll on your life. But what you do is important and necessary. Thank you for being one of the good guys.

    Liked by 1 person

  17. Thank you for this much-needed post that could not have been easy to write. I too am a Canadian veterinarian, and often wonder if we spend too much effort sheathing our claws – as Canadians, and as veterinarians.

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  18. Thank you for sharing this story, and I hope you know that there are lots and lots of owners who cannot thank their vets enough for caring for and saving the life of their fur child.

    Regarding what you said about mistakes’ being magnified, I think it is actually becoming a trend in a lot of other professions also, even in the office setting. Definitely, metrics are necessary to measure efficiency and raise accountability. But when an overly dense measurement is implemented, it becomes an ineffective micromanager.

    For companies, they seem to focus so closely on the efficiency pinhole and often leave out the human factor, driving their staff away. And as customers, while some are better than others, we have become so entitled, altering the anticipated job satisfaction of our service providers. Police, doctors, teachers, vets, etc. are not as highly respected as they were and as they should be. We need to stop and think for a second that these guys are here to help us; it’s more than a mere business transaction. (Granted, there are always black sheep here and there.)

    Liked by 1 person

  19. I have been fortunate to have some wonderful human beings as veterinarians to my companion animals, and I know it’s a job I could not do – though as the person who makes the decision to let my loved one go when there is nothing more I *can* do — the vet never takes all that responsibility. People make mistakes; if my vet makes a mistake, it’s no more than I’ve done myself. (I remember the panicky call I made one morning after realizing I put the antibiotic into my cat’s ear and the ear medicine into the cat; I had a cold and boy, was my brain fried. Luckily it was a tiny dose and no harm done!)

    I’ve been to lousy vets and I don’t stay with them. It’s a pity that vet didn’t file stalking and harassment charges against her persecutor; I’m sure her clients would have backed her up. The Internet needs laws against cyber-harassment.

    Thank you for the good you do. Don’t let the bastards grind you down.

    Liked by 1 person

  20. I like your story, and I agree. Being human means making mistakes occasionally. However, my experience was with a very timid rescued feral cat who turned out to be cryptorchid when I took him to be sterilised. I was told the procedure would cost more, which was fine. Well. First, the vet had difficulty locating the internal teste. Then she said she couldn’t remove it so she just cut the blood vessels leading to it and then stitched him up. She did not give me a collar to prevent him licking the stitches, and she used stitches that dissolve, with the result that his stomach fell open the following morning. I live on an island where there are no other vets and this one had already returned to the mainland. When I rang her, she suggested bandaging the wound and keeping the cat confined in a cage until her return in 3 days time. So I flew him out, took him to another vet who recoiled in horror when he saw the wound. He said he could staple him up temporarily but that I would have to go to a specialist. The total cost of this mistake was enormous pain, worry and about $1300.00 to repair the damage. But what really makes me angry is that this is not the first time this exact mistake has been made by this vet. When there are repeated mistakes I believe that is a sign of “I can’t be bothered” and not the sign of a genuine animal lover. The suffering caused by this attitude was huge. Let’s learn from our mistakes remembering that the animal has no voice and no choice.

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    • Sometimes repeated mistakes are lack of training or competence. Sometimes an apparent lack of caring is depression,or compassion fatigue. But sometimes it’s ego, and once in a very long while it really is a lack of caring. If it really is a case of “I can’t be bothered” it should be reported to your local veterinary regulatory body.

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  21. Thanks for sharing such great post about pets. The social adaptations of pets and humans are similar enough that pets can live perfectly happy lives surrounded by humans and vice versa. Dogs are pampered with the best of food and medical care, frequently have a rest in their owners’ comfortable sofa.

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