As you probably know, I have a bit of a complicated relationship with the PTA moms. Not moms in general, mind you, just the small subset of Pinterest loving, glue-gun wielding domestic lifestyle experts whose expectations I can never, despite my best efforts, seem to live up to. It doesn’t matter what school we’re at, it happens every time. First it was the art project/pooper scooper incident in kindergarten. Then it was the Have a Very Agro Valentine’s Day episode. And now it’s crudite, crudite that torments the soul.
It started simply enough: an email asking for volunteers to bring in food items for the teachers this conference week. I looked on the sign up sheet and put my name next to crudite: veggies and dip. Easy, I thought, a quick run to the grocery store for some carrot sticks and dip and done.
I forgot where I was.
(Not two weeks ago, I found myself in the midst of a malestrom for the fifth grade Halloween party when all the room moms got together and asked the parents to bring in food. I asked my class parents to bring in pretzels and fruit. The other moms showed up with cookies shaped like rotting fingers with almond nails and jelly blood, and eyeball eggs with veins hand-painted on with food dye. My pretzels were shoved under the table.)
So now, a few minutes after signing up for the veggie tray, I received an email instructing me to be creative! which is always concerning. To illustrate her point, the organizer included this helpful photo:
As to what our vegetables should aspire to be.
Now at this point a normal person would laugh and say, “OK, lady,” and bring in a tray from Costco, but unfortunately I still have the sin of pride to contend with on a regular basis, so I instead spent the afternoon standing in line at the grocery store watching YouTube videos of Martha Stewart blanching asparagus. Three hours of cursing later, with piles of peeled burnt chestnuts and carrot shavings dripping out of my hair like Jackson Pollock on a bender, I came up with this:
This is the dogged tenacity that makes people like me get through vet school even when all indicators point to the “why?” factor. We can’t explain it. We just have to.
I shared this with my friends, and they all got a good laugh out of how silly it was, and then later in the day my friend in Ohio sent me a link and said, “See? You’re not alone.” It was a photo of some artfully arranged food items a group of mothers had arranged for their teachers.
It was, upon further inspection, a photo from my very school from earlier in the day. It had already made the Pinterest rounds and ended up in Ohio, where my friend saw it and sent it to me as an example of Moms Gone Styled. I scrolled through it, looking for my contribution.
Notably lacking? The crudite. They were apparently so lackluster as to have not even rated a Facebook photo, and when I returned to pick up the dish I found they had been shoved in the corner in order to make way for some gluten free turkey wraps with hand-whisked dressings in, of course, Mason jars.
At this point, even a not quite normal person would just give up, which is theoretically what I should do, but it’s become clear to me I live in a parallel universe where I am destined to almost-quite get it, over and over and over, but not get it entirely. This is why I am a veterinarian, the almost-quites of the medical field.
So you know what? I’m embracing it. This afternoon I decided to go on a Pinterest binge and make a little Pinterest and dog-friendly crudite platter my way. Hope you enjoy it.
A bright autumn day, full of promise and gently whispered secrets amongst best of friends, calls for sustenance.
Lovingly hand-extruded kibble, with ingredients sourced from local artisans in an organic human-grade facility in Portland by men with bushy beards. In a Mason jar.
We end our afternoon in the garden of delights (it’s water friendly succulents! We’re eco friendly here in drought-parched SoCal) with hand-cut carrot bones from the local CSA, mint from the garden, words of wisdom from the dog sketched in canine-friendly peanut butter hand ground at Whole Foods. And of course, no pet garden of delights would be complete without the coup de grace:
nitrate free ham roses.
You saw it first here, folks. I’m waiting on sponsors for a YouTube tutorial but I think a ham bouquet is a lovely thing.
There was a time, back in a pre-internet era known as the Good Old Days, when two people who had different opinions on a topic could talk about it and, even if they did not come to an understanding, could at least part ways with a better grasp of the other person’s point of view. People with different opinions were still, at the end of the day, people.
I’m not entirely sure that is the case anymore.
Lest anyone doubt me, proof enough should be the fact that we’ve just come off an election cycle. I live in an area with one of the most hotly contested Congressional races in the country, better known to us locals subjected to the campaign ads as “Mouthbreathing Carbuncle-Having Satan Worshipping Slimeball” versus “Luciferous Mucusbucket Festering Wound.” (Definitions supplied by opposing parties.)
It was a close race. I think most of us voted for one or the other not based on deep unabiding adoration so much as we held our noses and selected the one we found less odiferous. Nonetheless, after the Slimeball defeated the Festering Wound by the narrowest of margins, the loser went on the air and graciously wished his opponent “all the best”, which is a strange thing to wish someone you truly thought was the Antichrist. If you truly thought he was the path to death and destruction, you think one would continue to rage against the injustice of it all and exhort people to do something to undo this miscarriage of justice.
But politicians know the truth that a lot us seem to have forgotten. All that bluster is just that, bluster. And at the end of the day they actually have a lot more in common than not:
- both middle aged men of the same demographic savvy enough to be successful in local politics
- Neither advocates overthrowing Congress and disbanding the Constitution
- both against selling tanks to minors
- Both for free sunlight
- Both generally want to work for the constituents in order for people to live well in our beautiful city, though their ideas of how to get there might vary.
And now they will retreat to their corners to do whatever it is they do until they are again required by the tenor of American culture to again start yelling about how much the other person stinks.
Rumble In the Doghouse
We all know this about politics, we all roll our eyes with the silliness of it all, but don’t be mistaken- this “live and die by the sword”, “you’re with us or you’re worthy of a messy death” attitude has permeated many corners of our lives, and it’s not pretty.
The first time I met someone at a breeder’s event, I started talking to a person very involved with the dog fancy world. When she learned what I did, she looked at me a little sideways and said, “So you’re an animal rights person.”
PETA, protesting that abhorrent group of animal haters known as the American Veterinary Medical Association (true story).
“Not animal rights. Animal welfare,” I corrected her, as the person who introduced us (you know who you are, you rotten troublemaker) rubbed his palms together and waited in glee for us to start ripping each others’ hair out.
“What’s the difference?” she asked. So I called her a puppy mill, because all breeders are the same, right?
We looked at each other, hesitated a moment, then burst into laughter as she said, “Point taken.” We’ve been friends ever since.
I suppose in another world, maybe hidden behind an anonymous screen and keyboard, we could have become mortal enemies, but we’d spent too much time face to face to be able to call the other person demon spawn. We both knew we had too much in common, including:
- a love of good wine
- writing long and probably way too involved stories
- thinking dogs are the absolute bee’s knees. We both totally adore and spend most of our free time thinking about, canines.
This friend recently began a Kickstarter campaign to create a website commemorating National Purebred Dog Day. Now, I’m not trying to convince anyone to go and support the campaign if it’s not your thing, no more than I would try and convince someone to donate to a political candidate they did not agree with. But the simple fact that she waited a long time to even begin the campaign because she was nervous about people targeting her for being an Evil Dog Person is honestly, pretty sad. I feel the same way about that as I do people who target pittie advocates trying to end BSL: why would you do that? We are not each other’s enemies here.
A few weeks ago I wrote a piece for Vetstreet about purebreds versus mutts. I wonder if perhaps the editor was wanting me to go for the easy kill, the one that would bring 5000 shares and bloodshed in the comments section: quote people talking about how wrong the other side was, how misguided. But I didn’t want to do that.
Instead, I talked to someone from the American Kennel Club and the ASPCA, and guess what? They said the exact same thing:
We want people to find the right dog for their family so they keep them forever.
They had different ideas about the best way to do that, but they’re both perfectly valid approaches, really, and people have been using both successfully for some time. Let me repeat: at the end of the day we all want the same thing. The rest is just window dressing.
Can you tell which dog is more worthy, loved, or better for my family? I can’t.
Who’s the real enemy here? Apathy. Ignorance. Greed. Say what you want about either the dog fancy or the rescue community (and indeed, the large numbers who belong to both): they are not apathetic people. They care, and they want what’s best. Instead of shaking your fingers at the other side’s perceived shortcomings, listen. There is much to be learned, on both sides. I know this from experience.
It’s very easy to continue to point and shoot at the easy target. Keep on doing it if it makes you happy. It certainly makes life easier for the people at CheapPuppyMillDog.com; whenever someone gets turned off by the antics they encounter at either end of the spectrum, guess who’s waiting with open arms?
We are not each other’s enemy. If you want someone to hate on who really deserves it, I suggest these idiots. Seriously, no redeeming qualities whatsoever.
Things were simpler back in the 80s. We only has three things to do the week before Halloween:
1. Watch the Great Pumpkin.
2. Carve a pumpkin. No one helped. If you cut your finger off, oh well.
3. Run to Woolworth’s and pick out your plastic costume that tied in the back like a surgeon’s gown and suffocating mask you could only see out of one eyeball at a time. Trying not to kill yourself tripping over the pavement was half the fun.
And that was it. Our biggest worry at the time was the ever ubiquitous ‘old man hiding razor blades in apples’ trick, which we were all scared of but no one actually ever saw.
I long for those simpler times. My week has been, shall we say, a bit more complicated.
1. Who has time to watch the Great Pumpkin? I have a Halloween party to plan at school. Except we can’t call it Halloween, so it’s a “Harvest Party” (with costumes) in grade 3 and a “Mystical Science Party” (with costumes) in grade 5. Two weeks ago I was summoned to a summit of all the room moms so we could coordinate our party activities, which were delegated as follows:
- candy potions lab
- luminescent fingerprint experiment
- homemade spooky finger cookies
- dry ice punch
- Pretend blood coagulation experiment
I missed the meeting. When I was asked after the fact what I’d like to do I offered to contribute some sort of preserved creature in formaldehyde, which was the best I could do. I was assigned plates and cups.
2. Pumpkin carving has now become an Olympic sport.
My garage is filled with half-used Pumpkin Masters and the sad remnants of plans gone awry. This year, we’re painting them and calling it a day.
3. Costume shopping began two months ago when the Chasing Fireflies catalog arrived. They cost a small fortune, but they are the only catalog where ten year old girls are still allowed to be ten year old girls.
Over my dead body.
“Why aren’t you wearing a costume, Mommy?” asked my daughter.
“Because I can’t find anything I like, honey,” I responded.
“How about a dog?” she asked. “You like dogs.”
That was out.
“Maybe I’ll just be a veterinarian,” I said. “That’s hard to mess up.”
Desperate, I tried to think of the least sexy things on the planet. A lamp. A body bag. A hazmat suit.
We’re all doomed.
“I don’t think that’s going to happen,” I said to her. “Maybe we can just get Brody a costume instead.”
Or maybe not.
Go home, Halloween. You’re drunk.
Back when it was just a foreign concept whose name was limited to public health journals and the occasional horror movie, my sister and I used to joke about Ebola. Every time we got the flu and felt like garbage we would text each other “Ugh, I have Ebola.” It was shorthand for “I feel very under the weather at the moment.”
But now that it’s finally happened, this snaking into the global population that public health experts have warned of for many years, we stopped joking about having Ebola because now we might ACTUALLY HAVE EBOLA.
I know the risks are low. They are, for now, still very low, and I am grateful for that. But it’s hard not to panic unless you turn off the TV, because all we see are bridal shops being bleached and entire school districts shutting down because someone rode on a plane with someone who might have at one point been symptomatic. My own school district just sent out an email assuring us that they have an Ebola plan in place, and we’re in San Diego, with not an exposed person to be found. Preparation is key, though, so I’m glad they are thinking of it.
I was at the doctor yesterday, for a routine sort of thing, and when they took my temperature the doctor noted it was 99.5.
“Are you feeling sick?” she asked.
“Well, I do have the tiniest bit of a sore throat, now that you mention it,” I said. “I’ve been travelling all week, and you know how that goes. I mean, I lysol that plane seat down and…” My voice trailed off as I noticed her giving me the side eye.
“Not to Dallas,” I said. “New York. No one I met had Ebola.”
“Oh, thank goodness for that,” she said. “How about West Africa?”
“No,” I said. “Do you get that a lot?”
“No,” she said.
“So you don’t think I have Ebola?” I asked, being serious.
“No,” she said.
So she gave me a flu shot instead. I had totally forgotten about the flu in the midst of this Ebolademic, to be honest. Fortunately for me, she hadn’t.
As I stood in line at the pharmacy behind an elderly emphysematics on oxygen, a guy picking up Lipitor and a diabetic purchasing insulin, I looked down at her discharge notes: take Vitamin D. Wash your hands. Get some sleep. But just to be safe, and because I want to protect my spin buddies, I decided on a self-imposed quarantine from the gym for the next 24 hours. Can’t be too careful.
Like many of you, I’ve been mesmerized by the bravery of Brittany Maynard, a 29 year old woman who is dying of Stage IV brain cancer. After hearing the course of the disease progression from her doctors and considering what the end of her days were likely to be like, she made the incredibly difficult decision to move to Oregon, one of a handful of states in which assisted suicide is legal, and choose the day and manner in which she will die.
While her story is compelling and awful, it is not so surprising a concept. For veterinarians, taking part in these sorts of heavy decisions is an everyday occurrence, and to the Maynard family I say: I am so glad you have the ability to make that choice.
As I travel to Indianapolis for the annual meeting of the International Association of Animal Hospice and Palliative Care (the mouthful acronym of IAAHPC), I find myself struck by the two most common things clients say to me when I come to their home to euthanize a sick pet:
- This must be so hard.
- I wish we had this for people.
Though we all wish for ourselves, and our pets, to die peacefully and unaware in our sleep, the truth is, that doesn’t always happen. Sometimes death is peaceful, but sometimes it is horrible and painful and agonizing and drawn-out. To say that is a fate worse than death is not a metaphor in this case. Death can be a relief. We don’t always get to choose the way in which we die, but when we know it is coming and it is going to be unpleasant, I am very grateful this is an option we have for our pets, and for some people.
I suppose in many ways veterinarians are leading the charge in normalizing people’s attitudes about this possibility, right in there with hospice workers and other professionals who deal with these realities. None of us probably gave that much thought when we signed the dotted line on vet school admission forms, but it’s there nonetheless.
There is a small but important distinction I wish more people made when talking about Brittany’s situation: they say, “She is choosing to die.”
This is not true. She wants very much to live. She has no choice in the matter. She is dying.
The accurate statement is, “She is choosing how to die,” and that is a vital distinction. I’ve seen differing views on this, people who genuinely believe that there is beauty in every moment of life, even in suffering an agonizing death with a ravaged body, and to that I simply say: I respect your view on it and your right to choose that end. I also respect those who choose as Brittany is doing, and I find beauty in that as well.
There are limits, of course. I do not show up at people’s homes and simply provide euthanasia on demand for pets who do not have a terminal disease. For my own emotional well-being I have very specific requirements and lines I do not cross. There are situations (such as a dangerously aggressive pet) where the lines about what is ethically acceptable are fuzzy, but my personal limits are not. I feel very proud and honored to be able to do what I do.
This is how I continue to do this every day: by reminding myself and the grieving owners that we are not killing a pet; the disease is killing him or her. We are simply aiding the process and making it more comfortable. I wish for the Maynards the same I do for my patients: comfort, peace, as much as can be gathered in a stressful situation.
I am the midwife at the end of life.
And I am OK with that.
This is not about Sophia Yin.
I feel the need to say that before launching into a discussion about suicide and depression in the animal community, because the horrible news that she took her own life and the ripples it is causing in the veterinary world is the reason I’m talking about it today. But it’s not about her or her situation, which none of us will ever really know; Dr. Yin’s legacy is the work she did during her life, and it should remain that way. This is not about one person.
Whenever a tragedy like this happens, I see the same posts over and over: “Shocking. Tragic. Hold your loved ones close and tell them you love them. If someone seems to be suffering ask if they are OK.” And so it goes for a day or two, as we hug our kids and our spouse and our dog and then go back to work and assiduously ignore the suffering of those around us. Not that we recognize it most of the time anyway, but I’ll get to that in a moment.
One of the biggest misconceptions people seem to have about stress, burnout, and depression is that it is inevitably obvious to those around the person. I blame Zoloft ads for making us think all depressed people walk around weeping with little clouds hanging over them.
I think a lot of depressed people look like this:
Totally fine, I’m fine, I’m fine.
You know how we always say cats walk around looking like a million bucks with BUN levels through the roof until one day, way past the point it was an issue, it’s finally too much but you never had a clue? A lot of depressed people look like that. So maybe this is a little more accurate:
They do just fine at work, and out amongst friends, and then come home and realize man I am not fine. But we’ve normalized stress in our lives to the point many of us don’t even necessarily recognize the signs of depression in others, and even in ourselves. I sat on the floor of the bathroom for four hours straight one day, when I was suffering from postpartum depression, and still had no idea that sitting on the floor of the bathroom unable to muster the energy to move two feet might be a sign something was wrong (protip: it is).
I don’t like talking about that time in my life, but I will because every time we censor ourselves from discussing these things we perpetuate the stigma that drives people away from seeking treatment. We are more scared of the consequences of admitting depression than we are the consequences of not being treated, and oh my god, how awful is that? I’m pretty sure the mental health professional community has been watching us in horror for years, waiting for us as a profession to finally say yeah, we could probably use some assists here.
So while asking someone if they are ok and offering virtual hugs is lovely and kind, I really think the time has come to try and do something a little more impactful. Open dialogue is a good place to start. So let me share some things that I have discovered over time, watching us wring our hands in despair over and over while we wonder what we could have done differently:
1. You would not believe how many other people out there are going through the same thing.
People at the top of their field, with lovely families and good jobs and beautiful dogs. People who seem to have it all together. And maybe they do, if they have good treatment.
2. I wish someone had told me about these things in vet school.
I thought I was the only person plagued by worry and self-doubt in school. In retrospect, ha! That was really not the case. Nonetheless, a little peer-to-peer support or support from people already out there would have been very reassuring. I believe we need to start letting people know at the start of their career, not at the middle or end, that stress/anxiety/depression/burnout are common, but solvable problems.
3. There’s support, although it’s hard to find.
Do you know what the hardest part was for me about getting through my depression? Figuring out who to call. My OB didn’t help, the psychiatrists she gave me the numbers for didn’t take on new cases, I wasn’t actively suicidal, and by the fourth call I was too tired to deal with it any more. So I laid on the bathroom floor for a few more days until I had the lightbulb idea to call my primary care physician, who was horrified and got me in that afternoon and life got a lot better after that.
I feel like our profession is still in the same place. Help should be very visible and easy to access, a rope already floating in the water instead of a life preserver someone has to yell for when they are drowning. Want to really do something to make our profession better? Help me figure out how to make that happen.
So you think you’re depressed/ burned out/ feeling off? Take a deep breath, you are in good company. You do not stop being a successful professional and accomplished person. Life can be good and you can still rock out and kick ass and laugh till your cheeks hurt. Here’s some places to start:
1. There is active peer support, through VIN, and on Facebook. A closed group has been started on Facebook for people dealing with these issues as well as their family and friends- to request membership, click here. Peer support is fundamental, though of course it is not a substitute for-
2. Calling your primary care physician, who if they cannot handle it themselves can at least get you where you need to go. I guarantee you every mental health professional out there is going “uh, of course,” at every thing I have said because they are experienced in these things, while we are not.
3. Stop googling. Seriously, all you will do is come out blaming yourself for not juicing enough and while it is a lovely way to get vitamins, it’s probably not going to be enough. Talk to a pro, just like we tell people to stop treating their dog’s ear infections with diluted alcohol that they read about on a yahoo group and go to the vet. Right?
4. VetGirl has offered their excellent webinar about suicide awareness available for free, for everyone. It is well worth the watch not for anyone who works in the field to help increase your understanding of the issue. You can find it here.
5. VIN is offering a webinar this Sunday at 9 pm PST to honor Dr. Yin and discuss “Dealing With You and Your Colleagues’ Stress and Depression.” My understanding is that this webinar will be made available to non-VIN members as well, so stay tuned as I get more information. Both webinars, by the way, are taught by mental health professionals who know their stuff.
I will be honest and admit I hate overly sentimental statements accompanied by soft-focus ocean pictures like “fall into my arms and I will catch you” and “the world is full of hugs if you just ask for them” and all that other stuff, so I will offer you my own personal unfiltered thoughts on this:
Depression sucks, and it’s real, a physiological crap storm of neurotransmitters, and if you are reading this experiencing a dawning sense of dread with unasked-for tears rolling down your face as you desperately say nonononononono I’m fine, you might not be. So call someone who can help so you can stop feeling miserable, ok? Do it today.
OK maybe one overly sentimental picture. But just one, and only because kittens. And with that, I demand some good news so we can get back to our regularly scheduled program of fur removal device discussions and derpy dog pics.
This has been an almost unbearably terrible week for those in the veterinary profession, and those who love animals. First the awful news that Dr. Sophia Yin had passed away, and then not one day later, we learned of the passing of another tremendous voice and educator, Dr. Lorie Huston.
Like many of you I considered Dr. Huston a friend. She was extremely well regarded for her work online as the Voice of Pet Care with the Pet Healthcare Gazette, her many contributions to various publications, and most recently her position as president of the Cat Writer’s Association. But I think even more than her fantastic work, she was admired for her kindness.
Her gentle manner and empathy were unrivaled, and a shining example of the compassion that veterinarians so often extend to animals but sometimes struggle to extend to each other. She never had an unkind word for anyone. I don’t know how she did it. She made me want to be more like her.
As a denizen of the online community, I have nothing tangible to offer in condolences, no casseroles to deliver, no walls to place a white flower upon. All I have are words, those intangible, ethereal ideas that seem so unremarkable in the face of such sadness, and my attempt to express them in the hopes that in some small way they help someone else understand what Dr. Lorie was all about. And because I cannot bear to cry any more today, I want to instead share a story that will maybe make those of you who knew her smile a little through your tears.
The Marble Room Incident
A couple of years ago, the AVMA national convention was in San Diego. I touched base with Dr. Huston and learned she would be attending, and made plans to meet up with her at the Winn Feline Foundation booth, where Dr. Huston was sharing the work the foundation is doing to advance the health and well-being of cats. Dr. Huston had six cats, six well-loved, adored felines.
“Shall we go get dinner?” I asked, and she said she thought that would be a good idea. We walked a little bit through the Gaslamp district, and as I was starting to get tired I saw the name of a restaurant I had been to before and said, “How about the Marble Room? They’re great.” Lorie agreed.
I had been to the Marble Room with my husband shortly after it opened, a throwback steak house type place with amazing truffle fries. That was how I remembered it. No one told me they had changed ownership.
We sat outside since it was a pleasant evening, which in retrospect was an error since had I gone in I would have seen the new theme: old timey bordello masquerading as a saloon. Within a minute, what I thought was a streetwalker but was instead an embarrassed-looking server in a too-tight corset and can-can skirt asked us what we would like to drink.
“Iced tea,” Lorie said with a pleasant smile, as I sat horrified. “Me too,” I squeaked out. “Are these uniforms new?”
The server nodded with a frown, trying not to catch the edge of the menus on her fishnets.
A quick Google search would have helped immensely in this situation.
So Lorie and I shared a pleasant meal of not-quite-as good as I remember truffle fries while we talked about the role social media played in the evolution of veterinary medicine.
As always happened when we spoke, I was blown away by how sharp she was- never mind her calm and quiet demeanor, her brain was always churning away a million miles an hour about what the next big step was in improving the human-animal bond. Her greatest gift, as many of you know, was in explaining these complicated health concepts in concise and clear language. She made medicine accessible, and to those like me who knew medicine, she made social media accessible too.
Midway though dinner, she excused herself to find the ladies room. When she returned, she assured me that she located it just fine. When I followed suit a moment later, wedging between red leather banquettes towards the back, I saw that the hall leading to the ladies room was hard to miss as it was covered in, uh, tasteful I guess, nudes. I paused a moment to dab my forehead with cold water, mortified that I took poor, sweet Dr. Lorie to the world’s tackiest themed restaurant for subpar potatoes.
Seriously, naked people everywhere.
When I returned, Lorie was talking to the server and quite kindly ignoring her attempts to hold her top up as she cleared the plates. “I am so sorry,” I said. “This is not the place I remember.”
“Oh no, it was delicious,” she said kindly, ignoring the rest of the situation. “The truffle fries were excellent. Thank you.”
And that was Dr. Lorie, always. Gracious to a fault. She was generous with her friendship, advice, and compliments, even when they were not deserved, even when her friend subjected her to an awkward, PG-13 rated evening out after a long day at the conference booth.
She will be missed.
When I was in school, I accumulated a lot of textbooks. Books from the titans, the Nelsons and the Feldmans and the Fossums. I stood in line at the bookstore with these heavy tomes weighing me down, and noticed every other person in line with a tiny mahogany text balanced on top of their piles.
“What’s that?” I asked.
“The Nerdbook,” they said. “I heard you can’t make it through vet school without it.”
I had an earlier edition, because I’m old.
They were right. I spent many hours in rounds with my Nerdbook balanced on my lap, trying to look up answers to questions before the clinican called on me. It was unlike any other book I ever owned: concise, easy to navigate, organized by clinical signs to be completely usable. I heard it was written by a veterinary student, which made sense because it was so perfect for the way we used it, but also made no sense because who had time to write a book in vet school?
“Some gunner student a few years back,” I was told. “She was brilliant.” The author? Sophia Yin.
It was the only book I brought to the teaching hospital each and every day, taking it with me the following year into clinical practice: highlighted, scribbed on, well-loved. One time, I made a diagnosis that my clinician, a man who had been in practice for 167 years, said was impossible. “How did you know to put that on your differential diagnosis list?” he asked, before telling me I would be an amazing internal medicine resident. “Oh you know,” I said, but the answer was it was in the Nerdbook. Dr. Yin told me. The Nerdbook was everything. My techs used to hide it from me sometimes just to watch me panic for a few minutes.
Dr. Yin’s name popped up again soon after I began work, this time as a behavior expert. When she got into practice, she again sensed a void: a need for reasoned, science-based behavior approaches that would keep pets in homes and out of shelters. It’s hard to imagine now, but in the early 2000’s behavior was held in lower regard than specialties like neurology or internal medicine, a fluffball elective. “Nothing in life is free”, the foundation of positive reward based training, was in its infancy. Alpha rolling was still the norm in many circles, and training programs based on shock collars were being franchised left and right.
She helped lay the groundwork for what we now view as the best science-based approach to training, one of the most fundamental paradigm changes in our field in the last decade. Dr. Yin became a world-renowned behavior expert and fierce advocate for positive training, an amazing communicator whose lectures were always overflowing into the halls by an audience who finally recognized that her advice, when passed onto clients, was saving lives.
Though she was often known as a dog behaviorist, I remember her most for a series of cat lectures I attended at Western around the time Apollo was marking in the house. My husband was about to lock him permanently in the garage. In one hour, she gave me enough actionable tips to fix the problem, for me, and later on for clients and blog readers. Those tips keep animals out of shelters and in homes.
Dr. Sophia Yin- you are missed.
Dr. Yin’s latest work is, again, revolutionary. As a board member for Dr. Marty Becker’s Fear Free Practice movement, she is one of the key figures teaching us low-stress restraint techniques that change the way we practice medicine. It makes sense, right? Why do we just accept the fact that pets hate the vet? Why do we not try to make it better? Just this week I used a technique of hers I watched on video to help bring a frightened cat out from under the bed; he was already ill and the last thing he needed was more terror. Dr. Yin’s reach and her influence is everywhere, her touch felt every day in the way we practice modern medicine with compassion.
Dr. Yin was the best of what veterinary medicine is all about, a passionate veterinarian, a dedicated revolutionary, a person whose accomplishments knew no bounds, an inspirer of colleagues. Her unexpected passing has left so many saddened; I hope her family and friends know just how much she was beloved by so many people. Thank you Dr. Yin for everything. You will be sorely missed.
If you were awake at 7:50 this morning and happen to have been watching San Diego 6, you’d have seen me trying with varied success to get a very sweet and nervous Saint Bernard to eat some treats. You know what they say about pets and kids. But that’s OK, because Gabana was still a precious prop to our perhaps less entertaining but still very important topic, saving money on pet care. Here’s the tips I shared:
1. Don’t skimp on preventive care.
Pop quiz: what is more expensive-
- Regular dental cleanings on healthy teeth once a year
- One set of extractions on a majorly diseased mouth, complete with antibiotics and an echo to check out that heart murmur the bacteremia ended up causing over time.
I brought in some Minties as an example of a home care item you can use in between cleanings. Love them within caloric reason, but again- cleanings at the vet are just an important as cleanings at your dentist.
Early detection of problems like diabetes, kidney failure, and cancer results in lower vet bills, and more importantly, a healthier pet.
2. Ask for a written prescription
Yes, veterinarians often charge more for some meds than what you can get it for at Target or Wal-Mart. They pay more for them in the first place than the big pharmacies. The tradeoff is convenience, which is fine when you are getting one prescription but can add up if your pet needs regular medication. We all get that.
Ask for a written prescription. The veterinarian should provide one on request. Sometimes they will price match, too. The primary concern of our office is to make sure your pet gets the care they need, and the price of meds is often the difference between getting treated and going without.
3. Make your own treats
I’ve covered this extensively, from cupcakes to donuts and jerky, but making your own treats can save money and be a ton of fun as well as give you lots of control over ingredients. Making dog treats is how I got my kids interested in cooking.
Words cannot express my deep love for Fido’s Frosting from K9 Cakery, which is how I made the donuts above. If you recall, Kekoa like to eat this straight from the bag.
There’s only so much you can fit in a quick segment so I didn’t get to cover other topics like pet insurance, but we just spoke about that here a couple of weeks ago anyway. If you have any other tips that’s helped you save without losing out on quality care for your pet, I’m always up for ideas!
Please share far and wide because we only have until Monday to get our voices heard.
I imagine you have noticed things have changed a bit for us in the last ten years or so. A decade ago, you could look in the “Help Wanted” section on VIN or AVMA classifieds and have your pick of positions. This is good, since most of us carried modest student debt we needed to pay off. Being a new grad was exhilarating, a little nerve-wracking, but thrilling. Now?
Vet school, you in danger, girl.
The Changing Landscape
Three things have happened that have dramatically changed the landscape for new grads, leaving them nervously optimistic at best and apprehensively regretful at worst:
1. The economy tanked.
Vet visits are down, and clinics are responding by tightening their belts. Job openings have dwindled.
2. Educational costs have skyrocketed.
I know we have all heard this, but have you really read the numbers? In-state tuition at my alma mater has doubled since I graduated. The average vet student now graduates about $150,000 in debt; some students are racking up debt as high as $500,000. To live comfortably- not extravagantly, I mean comfortably- your debt should not exceed an average starting year’s salary, which hovers around $64,000 in our field. We’re off by over double, and in many cases far more.
This is compounded by the fact that a change in student loan policies in 2007 allowed students in professional schools to borrow whatever amount they needed, no cap, assuming doctors and lawyers and dentists would earn enough in the future to make short work of the added debt. But in our field, the numbers just don’t add up.
3. Despite fewer jobs and higher debt, new veterinary schools continue to open.
Why? After a threatened lawsuit brought by Western University against the AVMA Council on Education in the early 2000s, the accreditation process was relaxed to allow new institutions to become accredited without the added expense of building a teaching hospital. Instead, schools could use local veterinarians to provide clinical experience, which made the cost of opening a new vet school suddenly doable. (Please note, I’m not presenting an opinion on whether or not the quality of education differs- the Western grads I know are fantastic- simply presenting the history.)
Given how much money prospective vet students are willing to pay, this is a very lucrative proposition for private institutions such as Lincoln Memorial, or Midwestern, two new schools opening this year. At some private institutions, expected costs of attendance are reaching over $300,000.
More grads, fewer job choices, more debt. Sounds great.
The New Law School
It is no secret to those paying attention that veterinary school is being viewed as the next law school, that horrible disaster we’ve all read about, except- ugh- worse. The market fixes itself, economists argue, when prospective students see new grads flail and sink and stop applying, like that happened with dental school. So, you know, sacrifice a generation or two and it’ll be ok.
Except vet students don’t do that, because there is an emotional pull to this field that dentistry and law simply don’t have. Knowing the debt, and knowing the fact that things will be hard, vet school applications are still up. Will they regret it ten years later when it’s too late to change their mind and they are still living in an apartment because they can only find a 30 hour a week job? I guess we’ll find out.
Can we do anything about it?
Other than the aforementioned ‘let a few drown’ approach, I mean. I have read many practitioners state, “Their fault, too bad, sucks to be them,” and I can’t tell you how sad that makes me. Don’t we want to do better by our future colleagues than shrugging?
VIN has tried, by attempting to educate prospective vet students on the costs of education. Life with that amount of debt is not sunshine and roses. There’s nothing wrong with telling someone the truth about what that can mean for your life; if they choose to take it on anyway, that’s fine, but at least we presented them with realistic scenarios.
And what about the American Veterinary Medical Association, the “collective voice for its membership and for the profession”? Would it be a good idea for this organization to take a good hard look at the impact of these changes and attempt some proactivity in speaking out about the impact of these new schools?
So far, the response has been, “not our job, not our job, not our job.” Then what is? (Aside from making movie theater trailers.)
Accreditation and the AVMA
The AVMA Council on Education is responsible for accrediting new schools. If you’ll remember our history lesson from Part 1, this whole debacle started when the Council hesitated to grant Western a reasonable letter of assurance for accreditation and they threatened to sue. The AVMA cannot act in a protectionist way because as an accrediting body, it’s a conflict of interest to their neutral evaluation of new schools.
But they should, dangit. They should protect this profession. Not from the influx of new grads. FOR the new grads.
And the only way to do that is to completely sever the tie between the COE and the AVMA so they can function independently.
Every five years, the US Department of Education reviews an accrediting program and decides whether or not to renew its status. If you are an AVMA member, you received an email this morning letting you know this is the year, and asking you to write a letter to the NACIQI stating your support for maintaining the status quo. But I have a different letter to present to you:
We know where we are headed in terms of the status quo. The scattered corpses of lawyers and dentists line the way. We can do better.
You can submit a different letter, one asking the NACIQI to seriously consider the relationship between the AVMA and the COE, here. For more information about what I’ve written, check out the Resources page.
Just another non-high-level-leadership peon who loves this field and wants the future to love it too
My first year of practice, I was talking to an owner in an exam room when I saw her eyes go wide and she yelled, “SPIDER!”
I looked down and saw a large arachnid crawling across the table towards her poodle. Without missing a beat, I grabbed a large drug compendium and put an end to the assault. The lady looked up, cocked her head, and said, “I guess you don’t love all the animals, then.”
I felt terrible, actually. My grandmother would not have approved. She would capture daddy longlegs in little glasses and transport them outside, or just as frequently, leave them alone. “They eat bugs,” she said. “It’s bad luck to kill them,” she said.
But I didn’t live with my grandmother, my dad’s mother. I lived with my mom, who learned from her mom that the best way to deal with a spider was a Dr. Scholl’s sandal, the one with the big wooden sole.
I think about that day, and how I would have to make up for it lest I be followed through my life by angry hordes of spiders. As you are about to see, I think I’m still paying.
Yesterday, the kids called me in to assess a spider situation in the guest bedroom. It was, they claimed, a huge spider, which could mean anything from “dime sized” on up. I went in, and yes, it was actually a huge spider. Probably an inch or two across, I didn’t get too close.
The good news was, it wasn’t a black widow or a recluse, and in the interest of being good to my grandmother’s memory I told the kids, “let’s just shoo it under the armoire. See? It’s as scared of you as you are of it.” I did not notice the tiny peals of laughter from the spider as it ran away. I did not realize she was simply approaching us with a familial sense of pride to show off her brood.
A couple of minutes later, my son came out again. “There’s a bunch more,” he said.
“What?” I asked. “Spiders?”
“Yes,” he said. “Like, 8.”
I went back into the office, a sense of disquiet taking over me. “Where?”
“On the bed,” he said.
And there, crawling all over the guest bed, was an army of teensy tiny baby spiders, which had apparently just hatched from whatever hellspawn was hiding under my armoire.
No. I do not love all the animals. This I can say now with great certainty.
Since I can’t find my flamethrower, I was stuck with simply tossing the entire set of bedding out into the courtyard with a scream and spending the next two hours vacuuming every nook and cranny in the room, stopping only long enough to call my husband on his work trip and freak out into the receiver. The mother spider, of course, was now nowhere to be found. Her work was done. For now, at least.
I was up until three in the morning startling at every shift of the bedsheet. If anyone can recommend a good pest control service in San Diego, I need one out stat. *shudder*
I remember this about September 11, 2001: I felt very lonely.
It was my senior year of veterinary school. My husband, who had only been my husband for about 2 months, was far away in San Diego. My mother was the one who called me, waking me up to tell me to turn on the news. She was alone too, as my father was on a rare business trip in Texas, one he ended up having to drive home from. We held the phones to our ears together until there was nothing more to do, so I said, well, I guess I ought to go to school.
I was doing a rotation in a lab that week, spending my day alone in a dark basement underneath the medical school looking at slides. Every few minutes I’d wander upstairs where I could get radio reception, and the other lab denizens would join me for a few minutes before we retreated back down to our holes.
Later that afternoon, after I returned home, there was a knock on the door. It was two nicely dressed missionaries. “How are you?” they asked.
“Not so great,” I said.
“Why?” they asked, genuinely concerned. “Do you want to talk about it?”
“Do you have any idea what’s going on?” I asked. They shook their heads in confusion. I shut the door.
Behind me, Nuke gently pressed his head into my hip. I had adopted him the year before, thanks to my friend Dan. “I want a dog,” I had said. “A Golden, maybe, or a pug.”
“I have just the dog!” he said, before referring me to the radiology department and the 10 year old coonhound who had been getting irradiated on a weekly basis as the vet students learned how to take films.
“He’s not housebroken and doesn’t know what outside is, so he’s a little addled. If it doesn’t work out, it’s ok,” said the tech. “They were going to euthanize him so I figured, I’d give it a shot.” No pressure.
He was a little addled. He was the dumbest dog I’ve ever had. He was neurotic and howled if he was outside for more than 2 minutes because he was scared of open spaces. He refused to learn ‘sit’. I loved him.
In those long and sad days after September 11, he was my greatest comfort. He died of cancer shortly after I graduated the following year. I miss him.
This Sunday marks National Pet Memorial Day. I hope you’ll join me in thinking of those we lost, or sharing a memory below. They leave this earth but they never leave our hearts.
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