Vet Medicine and Suicide Prevention

An op-ed piece submitted to TVG Volume 51, Issue 1 by John Francis

                  One topic that doesn’t get discussed enough: suicide and veterinary medicine. It has come a long way. We still don’t talk about this issue enough publicly; hopefully you will take the time to read this article. Compare notes with your colleagues about my opinions and start more discussions. You can never really know who among us is struggling with depression (1 in 6 vets have contemplated suicide) and sometimes just starting a conversation with someone can help. It has been well published that talking about suicide does not increase the risk of someone attempting suicide. Most of that research is from the military; I have a lot of experience with military suicide. Throughout this article I will draw comparisons, but I am not an expert, I have no formal training, these are solely the opinions in my head. I would love someone to respond with theirs or in corroboration of mine. This is an attempt to get the ball rolling. 

                  My own personal experience with suicide came in 2005 when my uncle, a Marine, struggling with PTS died by suicide before his second tour to Iraq. Re-read that sentence. There are a few key points that I bet you missed. I used the term “PTS” to mean Post Traumatic Stress, I left out “disorder” intentionally. It has negative connotations and is being phased out. The next aspect of that sentence is “died by suicide.” I could have just as easily typed “committed suicide,” but that would be wrong. There is too much deliberation in the word committed when we know suicide is often not a conscious act. Again, I am not an expert, but my family members are and even run some of the largest non-profit organizations to help veterans and their families affected by PTS and suicide.

                  So now what about Veterinary Medicine and suicide. What about our profession has led to our current state of affairs. Money is an obvious starting point, but maybe not completely the way a lay person would think. I don’t mean entirely the debt side or the running a successful business part. Both can cause extreme stress situations and lead to depression. But that’s not exclusive to vet medicine, it shouldn’t be ignored, but I don’t know enough about those yet to say any more. I would love a reader with more experience to elaborate those two points and their own stress relieving techniques. I want to touch upon a different monetary concern among vets. Client satisfaction.

                  I have worked as a small and large animal technician at hospitals and for doctors that have served the poorest pets in trailer parks to the most expensive sport horse ever purchased (I kid you not, but don’t ask for names). What is one thing all people will complain about equally? Their vet bills. I have been yelled at, cried to, and shamed. They all say the same things, “Why are you so expensive?” “It’s a dog, I’m not going to spend the money” “I want to do what’s best for Fluffy, but not today.” Or equally disrespectful, “Do whatever you want, get it over with, it’s ridiculous.” So what is my point: This rhetoric from clients serves to devalue our self-worth because we too often contribute our success to our clients’ satisfaction.

                  We are taught many ways to cope with disgruntled clients: educate them so they know the value of the services, lay out the long term plan so they can properly save/are not surprised by the bills, and let your technician go over estimates so money and the vet care are separate (that last one was corporate protocol from my last job I often disagreed with). I would vote for another technique. Focus on the individual you are truly serving: the patient. This means you have to politely tolerate the rude clients, but then reassess how valuable your services truly are. Not just anyone can be a veterinarian. And very few vets are alike. We are all special in our own right and all bring our own blend of medicine to our patients. They are what matter.

                   The tough part about my suggestion is often the patient doesn’t like our services either. It may be hard at times to find goodness in the fractious patient that wants to (or is so fearful they try to) eat your hand or in the case of a mean cat, your soul. But this is all about understanding your environment which should only add to your self-worth. How many people would be able to help that animal? Very few. You are the unique individual, if not the unlucky person, who gets to try. And that leads to my final point, you will not be able to save them all. Sometimes it may even be our fault they pass away, intentionally or not. This is a responsibility we must bear. Allow that to sink in and once you’ve committed yourself to this field, add it to the self-worth column as a positive. You have decided to bear a cross few have the intelligence and, even fewer, the gumption to carry.

                  Before I finish this last section, let me say I have more respect for our armed services than any other group of people in the world. I hold them above all else. That being said I see comparisons to be drawn. Not directly, however much that dog wants to kill you, they do not create the hostile environment our Marines and Soldiers endure every day. However, in small animal medicine especially, both professions see death on a daily basis. It is something you sign up for when you take the job. The public does not understand this. I have never been in the military, so this is coming from talking to service members, but if you haven’t been in the shit, you’ll never understand what it does to people. On very different levels, the mental toll of the client not valuing what you have done for them hurts the psyche dearly. Before this happens, while it is happening, or after it has occurred remember who you truly serve. The patients. Deep down we all have a connection unlike any other group to the animals we practice amongst and I know if they could speak to us (and some of them do of course) we would know how truly valuable we all are.

Much Love,

John Francis

Comments

[Janelle]

John,
I think this is a very thoughtful article. It certainly makes the reader stop and think about how Vet Med can have a negative toll on one's self. I personally have lost a few close friends to suicide and now matter how much time passes I always find myself wishing I could talk to them one more time, comfort them and change their mind, and especially ask why.
I like that you elaborated on the monetary side of client satisfaction. I think this is the root of much of our disappointment with our jobs. Yes the days that we save a HBC or emergency colic are the days we remind ourselves of why we joined this amazing profession, but too many days end with clients upset about the bill or having to euthanize a pet because the owners couldn't afford any other treatments. In the end I think we need to remember that no amount of frustrated clients is worth ending the life of an intelligent, successful, and accomplished veterinarian. If anyone reading this is struggling with ways to cope with the stresses of vet school/the profession I encourage you to reach out and talk to someone you trust, I can assure you they are willing to listen!