Mystery

God, I hate a mystery.

I had two of them this week, which made the week both diagnostically interesting and somewhat frustrating. Today is Friday and one of the mysteries was solved (post-mortem, unfortunately) but I’m left with a lingering sense of having not done a good job.

It’s interesting that despite the “wins” this week (patients with complex issues that I was able to sort out, the rare disease I recognized at a glance, curative surgeries that went off without a hitch), I’m dwelling on the “losses”. I know I’m not alone in this habit. Most of my vet friends express the same pattern, where the great good they do and the many lives they save are relegated to the attic of the mind like the crazy old auntie, while the mysteries and failures occupy the main floors, making our heads into haunted houses.

I’m not sure why we do this. I suspect it’s because most of us are perfectionists at heart. Like any challenging profession that requires a lot of smarts, we attract the intellectually gifted and those with a high drive to succeed. Our definitions of success change as we go through school and then start working, but “succeeding” is tied to our happiness. If one factor in “success” is to accurately and quickly recognize, diagnose, and treat disease, then the mystery cases make us feel unhappy.

There may also be an unhealthy amount of reticence going on, and a lack of a sense of self worth. Most of the vets I know don’t really know how to acknowledge how wonderful they are.

One of the most talented diagnosticians I know, someone who can think circles around me and whose patients and clients love her, honestly thinks she’s just average. She’s worked very hard to perfect her craft, and it shows in what she does, but she’s unable to really enjoy the fruits of her labors by recognizing that she’s arrived somewhere and accomplished a great thing. That’s a shame.

This is not to say that vets should all grow gigantic egos and think they’re all that, all day. Far from it. It’s good to examine our actions when we haven’t done out best, and to recognize why we’ve made a mistake so we don’t do it again. What factors came into play on this one case that made the outcome less than desirable? What can we do in future to realize when a case is going down the wrong path and bring it back on course?

But when we dwell on the failures for much longer than we need to in order to learn from them, that’s very harmful to ourselves and our patients. We are no good if we are crippled by self-doubt and second-guessing. Sometimes you really do need to be the bold surgeon who is invested in this case, not the one who’s preoccupied with the last case like it that didn’t go well. We need to learn to let these millstones go or we’ll just drown.

And sometimes, frankly, we just need to celebrate the wins, no matter how small. Life’s too short. So you spotted the Addisonian dog? Win! Have a glass of wine. Managed to regulate that fragile diabetic? Win! Have a nice dinner out. Got through that fat 5 year old Rottie spay without saying the F word more than three times? Win! Definitely have a stiff drink after that one, and some pasta or your comfort food of choice. You may eventually turn into a fat alcoholic, but at least you’ll be happy.