In the olden days, people used to turn to carnival medicine men or the back pages of Look Magazine for the latest way to solve all of their problems. People don’t change, just the technology. Now we have the internet to turn to. If the web is to be believed, and it always is for some reason, there is a new cure for all the world’s ills. That cure is coconut oil.
It’s good for your hair, your skin, your GI tract, your dog, your mental health, and your aura. It’s anti-inflammation and pro-synergy. You can rub it on your scalp, then scrape it off and use it to cook, or sit on the leather couch and make it more supple. I don’t think there is a single malady out there that someone has not suggested coconut oil can fix:
Dry skin? Coconut oil.
Dry face? Coconut oil.
Yeast infection? You guessed it.
Alzheimer’s? Eat up.
Athlete’s foot, acne, depression, hemorrhoids, anxiety, UTI, weight loss, heartburn, autism. I guess what I’m saying is you could nuke your local CVS and be just fine as long as there was a Whole Foods next door, because coconut oil’s got you covered.
I’ve done a Whole 30 challenge, which is a no-processed food crossed with a tinge of Paleo, so I’m no stranger to coconut oil. I’ve cooked brussels sprouts in it, stirred it in my coffee, used it to make paleo pancakes. They were good.
Sadly, at the end of a jar I have to say my life has not substantially changed. Everything broken in me before is still broken. Coconut oil, while delicious and no doubt healthier than, say, margarine, has not eliminated my need for my allergy inhaler. I asked my doctor if I could try shoving coconut oil up my nose instead, just for a little while. It’s way cheaper than Dymista. She didn’t think much of the idea. When I told her I was just joking, then she sighed and said, “I get that question a lot.”
While coconut oil is unsurprisingly gaining steam in veterinary medicine, we have an equivalent that already enjoys legendary status in the home remedy category: pumpkin.
Long treated as the pet pepto-bismol, pumpkin is the go-to far various GI maladies spanning the range from constipation to diarrhea. It’s a great thing for the colon. It’s a great source of fiber and most pets will eat it. Pumpkin is Metamucil in a more holistic package.
What pumpkin is not is everything else, like an anti-emetic or anti-inflammatory or something that will teach your dog to talk. Like, it’s no coconut oil or anything.
On a friend’s Facebook page, she recently asked if it was possible for a pet to develop an allergic reaction to a food they’ve been eating for years.
10 people chimed in (correctly) that yes, this happens. Then someone said, “Why do you ask?”
“Because my dog’s been throwing up every time he eats all of a sudden.”
As a veterinarian, my mind immediately collates a list of the differentials when I hear something like this. 3 year old pit bull, history of being a destructive chewer, clearly the problem is “pumpkin deficiency.”
Which is exactly where the comment thread went.
“OMG! You need to give your dog some pumpkin.”
“Seriously! My dog loves it.”
“Pumpkin cured my dog’s farts.”
“Pumpkin is a great source of electrolytes.” And so on and so forth.
Don’t get me wrong, I like pumpkin. As far as advice on the internet goes, it’s one of the more benign things I’ve read and unlikely to cause harm. My only concern is that people recommend this in lieu of something that might actually work, such as starting with a correct diagnosis. Fortunately this person has multiple veterinary professionals on the thread, and somewhere in between pumpkin recommendations she got some solid advice.
A couple of weeks ago, my neighbor came over with her adorable 6 month old Golden Retriever. She hopped back and forth on her toes before asking me if I had any thoughts about her dog’s diarrhea.
“How long has it been going on?” I asked.
“Go to the vet.”
“We’re going tomorrow,” she said, “but in the meantime……do you have any pumpkin I can borrow?”
I did. It’s on the shelf next to the coconut oil. Hope springs eternal.
PS The dog improved dramatically … once the vet diagnosed Giardia and started Flagyl.
I am training for a half marathon.
I thought about training for a full marathon, but then the reality what that was like the last time I attempted it kicked in and I remembered that oh yeah, I don’t like to run. I think you can do a full marathon once when you don’t like to run, just to say you did (Rock n Roll 2001 for me), but after than there’s really nothing to prove other than, “oh yeah, this hurts.”
A half marathon though, is doable. Still not fun, but manageable. I have decided, along with my friend from the gym who I kind of hate because she keeps inviting me to things such as “Summer Boot Camp!” and “Half marathon! It’ll be fun!” and I keep saying yes, that should we complete this without killing ourselves, maybe, just maybe, we will try and tackle a triathlon before our 40th birthdays.
Do they let people leisurely triathlon these days? All my competitiveness gets used up in my professional life so I have none left over for this.
Anyway, the point is I am doing this and it’s a grind, but I keep remembering that health is a gift and blah blah blah; I’m training with a group because it’s the only way I will drag myself out of bed at 6 am for the long Saturday runs.
Brody doesn’t come with me on those. He can manage shorter distances, but he’s made it clear he’s not yet ready for anything over 3 miles, tops, despite his summer cut. I appreciate that.
This Saturday I ran (‘ran’?) 9 miles, which sounds alternatively fantastic and psssshaw depending on where on the running spectrum you fall. To me, this is the longest distance I’ve done in a single day since I staggered off Mt Meru a few years ago, and that was because I had to since there was no oxygen up at the top.
I’m hunched over because I couldn’t straighten up, not because I voluntarily felt like standing that way. Teri is hanging on for dear life.
So after 9 miles, at the end of which I realized my entire body was numb from the waist down, I came home and sat on the floor to stretch. Soon enough I was laying on the floor, like one of those crime scene outlines.
020 0120 7141 023 0123 7173 Small is Beautiful Floor Black Still Life, by Steve James on Flicker
I began to appreciate why dogs do this, this splat sort of positioning. The wood was cool. Soon I melted and became one with the floor. Why don’t I do this more often? I wondered, and when my daughter asked me why I was doing that I realized it was not really possible for me to make it onto the couch at that particular moment.
Brody was excited I was in his domain, plopping down nose to nose and looking at me like, “Hey! What are you doing here?” He stared at me for a while, and then I decided I needed to stretch if I ever was to have hope of standing up again.
It went about as well as you’d expect.
Dogs don’t understand why we would come into their territory for any purposes other than play, and Brody was having none of it. He laid on my foot, licked me in downward dog, and dumped a soggy tennis ball on my stomach when I tried to stretch out my hip. It’s clear I’m not alone in this.
Dogs are awesome at many things, but sitting quietly by while you sit on the floor and bend into weird shapes is not one of them. If you’re going to goof off, they figure, might as well let me in on the fun.
Anyone else have a dog who simply won’t let you on the floor by yourself?
When I took my son in for his first routine eye exam, I had no idea he needed glasses. Neither did he. He seemed fine, wasn’t running into things, was reading fine in school, but nonetheless the optometrist suggested glasses. OK, I said, let’s give it a shot.
One week later, his glasses arrived and we went into the office to pick them up. He picked them up dubiously, slid them over the bridge of his nose, and stood there for a moment, blinking as the refracted light hit his retina in new and improved ways.
He spun, slowly, taking it all in. His lips twitched, burbling with something important. When he could no longer hold it in, he opened his mouth and shouted, “I CAN SEEEEEE!!!!”
Boy did I feel like a horrible mom as the assorted clients turned to see this blind boy get his sight back.
Later that week I was sharing this story with a friend. As we were talking, her daughter picked up my kid’s glasses and put them on just for fun to see how weird things looked.
She came over and tugged on her mom’s sleeves. “Hey mom. Things look pretty good with these things on. I think I can’t see too well.” Then I felt less bad. It happens to us all.
We thought things were fine, my kid thought things were fine, and then someone with tools I didn’t have access to and the ability to evaluate things said, “Actually, life can be even better.” And it was.
I think of this all the time when people say, “Oh, Buster’s doing fine, he doesn’t need an exam or meds or anything.” To a client’s eye, he is fine. His gait is the same it’s always been. But I can pick up things they don’t, that slight crunchy feeling in the knee, a stiffness when I extend the leg. It took some doing, but we convinced that lab’s owner to try some Rimadyl.
Or the dachshund who came in for a routine dental. “He’s fine,” the owner reported. “He eats kind of slow but he’s been that way since we adopted him two years ago.” When we opened his mouth, the fetid odor of eight rotting teeth hit my nostrils, teeth held in by tartar more than by tissue at that point. It took some doing, but we convinced the owner to let us remove them.
In both cases, we got a call about a week later to marvel about this new dog in the house. “He’s like a puppy again! I can’t believe his energy! Who IS this dog?” Like my son spinning around in the optometrist office, they had a problem they didn’t even realize existed lifted from their shoulders, and got to experience something better for the first time.
In the year since their last eye exam, both kids seem to be perfectly fine, but I took them in dutifully anyway. Both of them need new prescriptions. This time, I don’t feel so bad. Big things we notice- small ones? Not always.
It isn’t my job to evaluate such things in my kids, or to be able to recognize the more subtle signs of something needing help. All I need to do is get them to someone who can, on a regular basis. Next stop: orthodontist. Lord help us all.
Just a little reminder to everyone that there is a reason we recommend yearly (twice yearly, for older pets) checkups at the vet. We’ll probably find things you weren’t aware of, and that’s OK. That’s what we’re here for! Every pet deserves the revelation of improved health.
In the depth of my despair when Apollo was dying, the medical resident at the specialty hospital made a comment I will never forget.
He was dying of a blood clot, a sequelae of hyperthyroidism and heart disease. I was in shambles, having come home from the gym to find him immobile on the couch, and rushed in straightaway, sweaty and spandex-y. I scribbled his medical history as quickly as I could, which the resident pored over with her intern as I sat in the room planning to say goodbye. I knew at that point it was coming, I was just waiting for confirmation of the diagnosis.
I had checked ‘yes’ to allergies, in the interest of being thorough.
“What allergies?” the resident asked.
“Food allergies,” I said. “Chicken.”
She paused, and shared a knowing glance with the intern. “And how do you know this?”
I blinked. “I’m sorry?”
“How do you know he has food allergies? Did you just assume, or did you actually test him?”
“I….I did an elimination diet, 10 weeks…not the full 12…. but it was obvious by that point,” I stammered, though what I really wanted to say is “WHAT THE HECK (ok maybe another word) DOES THAT HAVE TO DO WITH THE PROBLEM AT HAND?? WHO CARES HOW HE WAS DIAGNOSED WITH AN UNRELATED MANAGED CHRONIC CONDITION A DECADE AGO??”
But you know, I just sat there because what are you going to do.
OK sure, let’s talk more about Hills z/d and then can you please get this cat some morphine?
Now, I understand that a teaching hospital is going to teach, but from the patient perspective I suppose I would appreciate the teaching being limited to the issue at hand instead of using an emergency cardiac event to make a point on dermatology. I don’t know if it was that, or the way she asked the question as if she were sure I was going to give the wrong answer, that rubbed me the wrong way. I also had to tell her not once but twice that I didn’t want to hospitalize him on the off chance his clot might dissolve enough to give us another month at home. We didn’t hit it off.
Fortunately I didn’t see her after that and was turned over to the lovely cardiologist who looked and talked like Oberyn Martell and understood when I said, “Please confirm my suspicion so I can give him a peaceful goodbye at home”, but it really reminded me, from the other side of the table, how hard it is to be a patient advocate for our pets. I knew what I was doing and I still had to push a little. It was a lonely experience.
It’s even worse in human medicine, as this ER physician who was hit by a car will attest to. Without someone who knows what’s going on to oversee the process and keep the focus on the overall wellbeing of the patient, things fall through the cracks. Flustered and underinformed family members get confused. Specialists focus on this problem or that problem and not the patient. How can we do better?
Um, no, actually.
In human medicine, many hospitals now have designated patient advocates who serve as an invaluable liaison between a family and a healthcare provider. In veterinary medicine, it’s not something I’ve ever heard of, so we’re stuck with ourselves, the vet clinic, or the internet to help us make sense of complicated issues, to understand why the vet wants to do this or that and to empower clients to make informed decisions, including “No.” It’s not the ideal system, clearly.
I wonder if people would benefit from a neutral third party patient advocate group in veterinary medicine. I think things are only going to get more complicated from here on out, and as both a patient and a vet I think that sort of thing could only help. Food for thought.
Have you ever felt confused and not sure how to proceed with your pet? Would it have been helpful to have a pet care advocate to serve as a liaison?
The look on the doctor’s face was more bemused than annoyed as he tried to explain what happened to the centrifuge we were supposed to be bringing to Nicaragua for the clinic. The valuable piece of medical equipment had been confiscated by a leery customs official the day before, and the shifty eyed official wouldn’t release it to us without running it by his boss. Who would be in tomorrow.
Mañana, the official said. Come back mañana.
So a local veterinarian, who understands the language and the local culture, was dispatched the following day to the airport to convince the customs officials that there was nothing untoward about a centrifuge and to please give it back to us. He met with a different and no more accommodating Nicaraguan official, who thought about it for a while before saying, No, you can’t have it.
Well, the vet asked, when can I have it?
Mañana, he said, come back mañana. I never really got how this worked until this experience. The days stretching into the infinite, equipment locked up in an office to lord knows what end, mañana becoming less of a day and more of a concept.Sometime, just not now, and maybe not ever. It’s not so much tomorrow, it’s the idea of tomorrow perhaps being more conducive to our goals.
Frustrating as the experience was for all involved, it’s not a foreign concept to any human. We are experts at procrastination, at remembering things a day after the deadline, of holding onto that bottle of champagne for a *really* special occasion that never materializes, of planning that special trip in our heads if not on our calendars and only committing to it after the chance has gone by.
Anyone who has lived with animals, seen a life arc before you in all too short a time, knows how this works. It doesn’t matter. We still continue to do this to ourselves:
We spend our childhood dreaming of things we can’t do, because we’re too young.
Then we spend our adult lives dreaming of things we won’t do, because of work and kids and life. Mañana, we’ll do these grand things mañana.
And at some point, they again become things we can’t do, because now we’re too old.
(I know I wasn’t the only one cursing out Pixar through my ugly cry when Paradise Falls never materialized for Ellie.)
Somewhere in the middle, if we’re lucky, we can shake ourselves out of our certainty of tomorrow long enough to make mañana today. I’ve been doing this a lot more in the last few years, which I suppose is the natural progression of someone beyond the reckless optimism of youth and not quite ready to acknowledge that old is lurking right there in the wings.
It started with travel. It’s why I signed up for two weeks in Peru one year and another two weeks in Africa the next over the befuddled protests of my husband who wanted to know where I was going (somewhere interesting), with who (strangers that are now friends), and why (Why not?) Because at some point, I’ll know that I can’t.
It’s never the wrong time to go somewhere new and make a new friend.
And while I can’t commit to globetrotting nearly as often as I’d like to, on a smaller scale I’ve decided to take on one mañana a year. Back in 2008, I attempted to train for a marathon and dutifully attended every group run, but my knees gave out at the 18 mile training run and I had to drop out. I can still do a half marathon, I told myself. Later this year, I said.
That was six years ago. A friend from the gym who is at the same point in her life asked me last week if I wanted to join a running club with her to train for a half marathon in August, which seemed like a good goal but maybe for later this year. I’ll think about it, I said, and later that afternoon read this story. If ever there is a sign from the universe to get off your butt and go do something, it’s a 91 year old cancer survivor running a marathon in your backyard while you lament feeling old at a little more than half a century younger.
So I signed up.
We never did get that centrifuge. I learned this in a dusty Central American airport back room: mañana never comes. Today’s it, so do that 5K or learn to make real macarons or take opera lessons or whatever it is you’re sitting on for later. What’s your mañana?
It is one of the sad ironies of being a veterinarian in clinical practice that most of your clients are majorly unhappy to see you. (Retrievers don’t count, they’re always happy to see you.)
The reasons are obvious: vet clinics mean temperature taking, and shots, and cold tables. Trust me, I don’t much enjoy heading off to my doctor’s office either, nice as the staff is. Those awful half length hospital gowns they give you (ladies, you know the ones I’m referring to)- cold and humiliating. I’m here for something I’m not going to like.
While we vets are working on it through incorporating Fear Free Practice ideas into practice- thanks Dr. Becker!- we still have a long ways to go. Which brings me to today.
One of the most common things I hear from clients at a home euthanasia appointment is, “I just couldn’t bear to do this at the clinic. My last dog was shaking like a leaf when we went in for the appointment and I felt so terribly guilty afterwards.” And who can blame them for feeling guilty? Who wants their last memory of their dog or cat to be them cowering in a corner? How awful.
Not all pets feel this way about the vet, of course, but for those that do, it just adds another layer of emotional trauma to an already challenging time. Is this the pet signaling they don’t want to die? No. As pain management expert Dr. Robin Downing says, “Pets don’t fear death. They fear pain.” They are telling us they don’t like the vet, but of course we are only human and it’s hard not to extrapolate that to a bigger message that isn’t there.
So what happens in the absence of the clinic and the coat, when a pet meets me outside the office? A pleasant hello, usually. Even when I am there to help them transition. Especially when I am there to help them transition. I will be honest, I wasn’t expecting that.
I was reminded today of a lovely Golden I met last year, who was winding down a battle with cancer. When I came to the family home, their sweet girl was almost nonresponsive. As I knelt down by her side, she opened her beautiful brown eyes and gave me a huge, enthusiastic wag. We all stood there in shock, as she had not been able to do much of anything in the hours leading up to that moment. She did not fear death, or me.
In the absence of a preconceived assumption of vaccines and thermometers, pets are free to judge me based on whatever it is they perceive I am there to do. I cannot tell you the number of kisses, licks, wags, head bumps I get from pets who by all rights should be past caring who is sitting next to them. It means something.
It’s not, “Oh boy! THE DOCTOR IS HERE!”
It’s not, “That blond lady sure does smell good, like bacon.”
It’s simply this: I see you.
I know what a birdsong is.
And I am ready to hear it.
A few years ago I ran away from my job.
At least, that’s what I called it at the time, that is how I framed it in my head. I couldn’t hack it, I was a failure as a vet. My mind was wrecked, my physical health was wrecked, and my stomach curled up into knots every time I pulled into the parking lot. It wasn’t only me who suffered; I knew my heart was not where it needed to be for my patients. They deserved for me to want to be there. It was a bad place to be in.
With the gift of perspective, I know now I was dealing with some pretty significant burnout. I didn’t know that was what it was at the time; after all, don’t you have to be in it at least a couple of decades for that to kick in? Or be a practice owner? This is how it works, I was told. No one really talked about it, or it was code for ‘bad vet’, not for a defined type of stress reaction. Old Doc Johnson who treats everything with pen G and steroids needs to get put out to pasture, he’s old and burned out.
No matter the reason, I knew I needed to leave and take a breather. I am very fortunate that my husband was supportive of the decision, even without knowing how it would play out, or when I would be back. Although I saw it as a failure on my part at the time it was the best thing that could have happened to me.
I have learned to let go of a lot of destructive ideas in the past few years:
- that taking care of yourself is an indulgence;
- that saying ‘no, I can’t’ means you are a slacker;
- that being a veterinarian means you put your work above all other things.
I had to practice those sentences a couple years before I really truly believed them, but I do now. I listened to a wonderful VetGirl webinar today on the topic of veterinarians, depression and suicide and was kind of taken by surprise when our wonderful presenter said, “self care is an ethical obligation- to yourself and to your clients.” She’s right.
If you recall, one week ago today this happened in my neck of the woods:
A few days after the smoke had cleared, I had a girls’ weekend getaway that we had been planning for almost half a year. Girls weekends aren’t really something I’ve done much of- too busy, other priorities- but we randomly decided at a Christmas party that we should plan one. I didn’t know how much I would be needing it at the time, but man, I’m so glad it happened the way it did.
I flew far, far away from my blackened streets and up to the land of one of the world’s finest philosophers: Santa Rosa, home of Charles Schulz.
We ate, all weekend. Really, really good food.
We tasted some wine. Really, really good wine. Our personal favorite was a wine by Ehlers Estate, which was founded by a man with a deep philanthropic interest and is now owned by a trust that funnels all its profits into cardiovascular research. (I tell you this not to try and sell their wine, though if you ever get a chance you should absolutely try it, but because it ties into the rest of this story.)
The wine we sampled is called “One Twenty Over Eighty,” in honor of an ideal blood pressure. We liked it, so we bought a bottle to share that evening.
We all came on this journey with our own piles of stresses and stuff going on, and one of those things involved a friend taking a spot check blood pressure monitor, just to kind of keep an eye on things.
“I feel really relaxed,” she said later in the afternoon. “I’m going to check my blood pressure, just to see how it went today.”
She took it, looked at the numbers, shook her arm a little, and held up the monitor.
“One Twenty…Over Eighty.” OK, maybe closer to 125/82, but nonetheless, it was pretty darn good. Magic, almost.
On the last morning before we left, we bumped into Kenny G in a bistro. All I have for proof is a surreptitiously snapped picture of the back of his gloriously curled head, but it was confirmed that yes, we lunched with the G himself. Seriously, if ever you were waiting for a sign from the universe that you needed to kind of chill out for a few, there are few signs more blatant than running into the king of smooth jazz. This may top the time I ran into Weird Al at Disneyland (story for another time).
Good friends, laughter that makes you snort in the most unfeminine of ways, and maybe a sip of an exceptional wine if that’s your thing. It may not replace all the medicines in life you might need, but a little self care now and then does wonders, it really does.
Here’s to your One Twenty Over Eighty, whatever that might be. Cheers.
There are many things I could be upset about today. The fact that authorities suspect arson in the vast majority of wildfires that devastated San Diego this week, for example. That’s a good place to start.
Or the trolls whose only response to the news was, “That’s what you get for living in a dry place, morons, burn” as though there were a place on Earth immune to Mother Nature in some form or another.
But I’m too grateful to worry myself with fools and psychotics at the moment. There is too much gratitude to the many to allow myself to be angry with the few right now.
I am grateful to my friend K, who texted me to see if I was OK when she saw on the news that my neighborhood was being evacuated. This was at the start of this whole mess, and when I got her text I had no idea it was even happening. Her warning came ahead of the official notification, and gave me lead time to get back to the house to evacuate Brody and Penelope before the roads were barricaded.
I am grateful I heeded my own warning and had all the pet supplies quickly accessible so I could get in and out in 5 minutes. It is an eerie feeling to be alone in an empty neighborhood with a wall of smoke bearing down. Corollary: also grateful to the cat for not hiding under the bed.
I am grateful to my childrens’ teachers and the district who evacuated them from their school before it became an emergency. When you turn on the news and see your little ones’ faces disappearing into the smoke, your heart skips a few beats for them, even when they are already out and safe by your side. They had no idea why I was crying when I found them at the 2 separate sites they were evacuated to, though they will some day. I credit the teachers with keeping them all calm in a stressful situation.
I am grateful to the first responders from Cal Fire, the police, and sheriffs who were on the scene quickly and efficiently. 1500 acres and not one home lost in the Bernardo Fire, despite a full head-on assault towards hundreds of home.
These crews left their families behind, from different counties and even different states, to fight for our neighborhoods as if they were their own. That’s a debt one can’t repay.
I am grateful to the many who heeded the evacuation warnings and let these men and women do their jobs, and to those who assisted with animal evacuations- especially with donating their trailers for the large animals who are disproportionately affected in these circumstances.
I am grateful to this community, who I know will help those who lost their homes. I have family here to take us in, but even had I not, so many friends offered their hospitality to us. Today, I turned on the TV and saw my friend’s dad on the news helping a member of his church hose down his property. We will pitch in, because that is what we do here in San Diego.
We’re about one month away from colleges and universities turning new grads loose on the world, a day of joy and, if I recall correctly, complete, abject fear. 2014 is a rough year to graduate vet school. In my day (cue Dana Carvey Grumpy old man voice), back in the middle of the dotcom boom and a perceived ‘veterinary shortage’, the world was at our fingertips, a lush green forest ripe for the plucking.
Now new grads are being forced upon a Dune-like landscape filled with such ominous portents as 3x higher suicide rate than the general population, decreased consumer trust, massive student debt, not enough jobs, colleagues who look suspiciously at your abdomen for signs of possible uterine occupation before deciding whether or not to hire you. Here you are, fresh faced grads. Can we get a sad trombone?
image by photoeverywhere – stockarch.com
Well that’s kind of bleak, isn’t it. Kind of like the veterinary profession itself, these are two snapshots of the same place- in this case, Hawaii- presenting two extremes of what is possible. Most of your time is spent existing somewhere in between. The key to success here is to remember that neither is the land in which you will likely live; do not fear that barren and bleak is forever, and accept those moments of plenty as a gift rather than a life expectation.
You are Bilbo Baggins. You are about to go on an amazing adventure, like it or not, and there will be trolls and spiders as well as angry humans and lots of long recitations of poetry. You will also find good things and good people along the way, and treasure at the end which will probably look nothing like what you envisioned it to be. I asked myself what 5 things I wish someone had said to me when I was spit out of Davis with a new labcoat and no clue, and this is what I came up with:
1. Don’t stress too much about finding the perfect first job.
It’s a starter job, like a starter car and your first apartment. If you get lucky and it’s the job of your dreams and you can see yourself staying there forever, great. If it’s a horrible job with a screaming boss and techs who walk around looking like they could kill you with mind bullets, take heart in the fact that you are still learning: learning what not to do. And you’ll have better party stories (trust me).
2. Accept that you are going to make some mistakes.
One of the smartest people I know quit the profession one year in because she couldn’t handle not being perfect. I get it, we’re perfectionists who like to map out every destination on Google maps complete with images of every turn. However, we live and function in an imperfect world, where it often feels like you’re driving in heavy fog with a linen blindfold and two people who are supposed to be navigating arguing in the backseat. You may drive off the road here and there. That is what being a new grad is like. Hopefully you will have a decent team to help you navigate, but if not- see point 1.
3. Be OK with the fact that a few people are going to hate your guts.
James Herriot ruined us all for this line of work, didn’t he? He taught us that even the grumpiest clients will eventually come around, and he taught clients that the barter system is still alive and well in this field. Neither are true. Some people are going to be nasty and mean and do their best to try and make you cry, quit, or vomit. Stop wasting your energy on trying to make them happy and focus instead on the many wonderful people you are going to come across, who will outnumber the horrible ones.
4. The Golden Rules never, ever go out of style.
Say please and thank you more than you think you need to, even to the grumpy people. Especially to the grumpy people. Don’t complain about work or clients at work. One, walls are thin and clients are often sitting in there with nothing to do. Two, it encourages everyone to go down that toxic drain and eventually the topic is going to be YOU. Third, the person you’re complaining about will most likely have what you said in confidence repeated to them verbatim. Expect it. Awk-ward. Be kind, even when your mind is screaming like Animal. P.S. This goes double for the internet. Repeat after me: There Is No Internet Anonymity. Again, trust your old Auntie V on this one.
5. Be selfish.
You’ve worked a really long time to get where you are, and now the expectations are going to get even more intense. When I say, “make time for yourself,” it’s not a feel-good sort of Oprahish platitude, it’s me grabbing you by the shoulders and saying “I beg of you to find a hobby and insist on indulging in it because you will go insane if you don’t.”
Conquering a mountain doesn’t have to be quite this literal a metaphor, but seriously- sometimes you just need to leave your life, your job, your little kids, your diabetic poodle behind for a couple days and go above the clouds. It works and it’s OKAY.
Whatever it is you give, it will never be enough for some people. Draw your own lines, make your own limits, and do not let others do it for you. We are in a profession that takes a lot of emotional energy out of you, and this time is vital to recharge. Travel, if you can. Remove yourself from that place where you feel like the world can’t go on without you to put out every fire because, honestly, it totally can. Human first, vet second.
“I found it is the small everyday deeds of ordinary folk that keep the darkness at bay. Small acts of kindness and love.” -Gandalf
March is Women’s History Month, if you didn’t know. I work in a strange profession, one that has changed quite solidly in demographics from its original incarnation to its current status, graduating classes of row after row of- well, men, mostly- now replaced, to an 80% extent, by women. I spend a lot of time talking about veterinary medicine, and I would say about 80% of the time I am talking about it with women (who’d have guessed?)
Does the changing demographic matter? Yes and no. I may be a little prejudiced here myself, but I think women are pretty badass and are doing a bangup job in veterinary medicine. Like their male counterparts, they’re practice owners, associates, specialists, leaders, and, you know, individual people with their own strengths and weaknesses.
Whenever I mention the idea of exploring that concept and what it had meant for the field, editors all run screaming. You can’t, they say. It’s too controversial. There have been some attempts, like this one from Dr. Don Smith at Cornell, but the conversation is by and large stagnant. Fortunately for me, I have no major sponsors to frighten here in my own little corner of the net, so let’s just go ahead and go there, shall we? It’s not like no one is talking about it, just not out loud.
So we’ve all heard of Lean In, right? Sheryl Sandberg’s go get ‘em tome extolling women to jump on in and take the bull by the horns? Yes, that was very nice, and excellent advice for a particular target group who want to be Sheryl Sandbergs. All you gunners out there- you know who you are- read and take note. And for the rest of us, who maybe want a break from running at full throttle at career advancement for a little while in order to live life?
Who said I hated her? I just have a different definition of success. Stop making us snipe at each other for goodness’ sake.
I’m here to tell you that it’ll be OK. And guess what I’m going to do? I’m going to use math, because I’m a woman who loves math AS WELL AS SHOES, and I also think more women should be saying out loud that you can like both. I write my own rules. You, by the way, should as well.
1. Logistical Growth Curve: Up, Up and Away
Let’s start with the typical career trajectory, as defined by the Sandbergs of the world, like a logistical growth curve:
Except instead of population growth, imagine perhaps income, or accolades, or whatever you want. Point is, you start slow, gain some momentum, then go out on top- ever moving upwards.
And in all the talk about women in the workplace, the one elephant in the room is always this: women sometimes choose to have babies. As do men, albeit in a less direct manner. And women sometimes want to take some time to stay home with their children. (Men do too, yes, but when we’re looking at a general trend here, I’m stretching to think of a single male veterinarian who left the field to be a stay at home dad.)
And in honor of Women’s History month, I am going to commit to words the experience I had, that my friends and I have all spoken about in hushed tones and felt we couldn’t discuss out loud because controversy and all. This was my experience. YMMV.
From the moment I set foot on campus, motherhood was presented in a subtle but unmistakable light as an either/or phenomenon when it came to veterinary medicine. Either you went all in or you went home. Women who took a year off to have a baby got eyebrow raises and sighs of “too bad she took the spot from someone who really wanted it,” as if pregnancy opened up a small but permanent hole in one’s brain through which all your knowledge dripped out, bit by bit, until all you were capable of is popping pacifiers in mouths and talking about Robeez. If you really wanted to be a vet, you would have not chosen to have a kid- especially in school.
This doesn’t end outside of school. I’ve been asked in interviews if I was pregnant (thanks for that, carb bloat I guess?) or planning to become pregnant, which is as illegal as you are thinking it is. I’m glad the guy asked it though, so that I knew where he stood on the topic. I’ve sat in meetings, 7 months pregnant and bloated from 12 hour emergency shifts, while the medical director’s best piece of advice to the interns was, “motherhood and medicine don’t mix. Mothers are terrible vets.” I’ve heard of a person who fired their veterinarian for having two maternity leaves, because she is ‘clearly not committed,’ because she wouldn’t give him her cell phone number while she was out on leave. The nerve.
So what’s the message here to women who want to have a family? If you want to be a good vet, you come back to work two weeks later and find a good nanny. By the way, I completely support any woman who wants to do this. The key word here, though, is “want.” What about the women who don’t want to do that? Get out. You don’t deserve to be here.
2. Extinction Curve: Down and Out
I’ll ask for a raise of hands- and I’ll be the first to put mine up: who has been told in an interview “I don’t like hiring young women because they always have babies,” as if all women inevitably do this, and those that do should be ashamed of their lack of commitment. Slacker.
Cue the sad trombone. You, my female friends, are now an extinction curve. Even the possibility that you might one day want to do something so egregious as reproduce is enough to keep you from getting hired in some places. I can see how that might make the women who choose not to have kids potentially a little irritated with the women who do. This is really, really counterproductive. But it happens.
The weight of a family is going to drag you right on out of there.
Being the troopers that they are, I’ve seen some amazing women fight tooth and nail to hold on to their professional commitments full bore despite the fact that it wasn’t exactly what they wanted to be doing at the moment, thinking that was their only option. Then they quit, never to be heard from again. They have been told that you are 100% in or you are a failure, and so they left.
And boy is that a shame. Wanting a personal life- whether that means kids, a hobby, a passion outside the field- is not only all right, it’s pretty darn important when it comes to retaining one’s sanity. I’m a big fan of that.
There is a reason we have one of the highest suicide and depression rates among professionals, and part of it is our own doing by having such distaste for those who strive to live a life outside the office. Martyr complexes only get you so far, and it’s become ingrained as part of the definition of what veterinarians do. I promise you this: I am so, so much better at what I do now than I was when I was stressed, overtaxed, and resentful. I am grateful once again to be a veterinarian.
3. Steady State: Fluctuating around a stable baseline
Now: let’s review what really happens out there in the world (no one will tell me my population biology course was a waste of time! Viva la diff eq!) Real life, messy, biological populations that are stable (though not necessarily stationary) enter what’s known as steady state, sometimes up, sometimes down, but maintaining height:
Who doesn’t want stability? Life- and the average vet- is tougher than we give it/her credit for. If populations can bounce back from plagues and droughts surely we can manage to have a kid, or vacation, or a marriage or divorce or whatever distraction that comes with being human without having to panic and toss away an entire career.
When I went back into general practice after two years of emergency medicine punctuated by two pregnancies, I hadn’t done a routine spay in a year and a half. I was freaking out. I was convinced it was as if I possessed virgin hands and somehow I would mess the entire thing up. I stood over the patient, my boss in the next room in case of mass emergency, and guess what? I did it as if I had been doing it just the day before. Muscle memory is an amazing thing, don’t let anyone tell you otherwise.
You tune out to take care of things and come back better than ever. This is how leaders are born. By cutting out a huge percentage of our field from believing they have what it takes to succeed long term because they want a breather, we’re killing off our future leadership.
When the increasing numbers of women in the human medical field pushed this same sort of reckoning, asking for flexibility and balance, the end result was happier doctors and both women and men who benefitted from it. Maybe you don’t want kids, maybe you want time to pursue hiking the Appalachian trail or to take care of an aging parent or further dominate your field. You deserve that too. The old timers tut-tutting the up and comers when I was in school a decade ago may still be hand wringing and bemoaning the fact that the new generation doesn’t want to work 80 hours with one day of vacation a year, and guess what? They’re right. Nothing wrong with that. Not everyone can or needs to be a Sandberg.
What made sense back then may no longer hold true.
When I was in school, one of my best friends was a woman named Carrie. She is awesome. Like me, we both decided halfway through that we weren’t all that interested in being small animal veterinary practice owners, and by junior year our colleagues were taking bets on who was going to leave the profession first.
We both did, in our own way. But we did it on our own terms, and we both came back, which is more than I can say for some of my really amazing classmates who opted out under the weight of unrealistic expectations. I am a writer, and now, in a strange twist I never anticipated, I’m exploring a new subcategory of medicine in hospice care. Dr. Carrie is- get this- travelling to the world’s hotspots as a public health consultant. She just got back from Peru, Indonesia and Thailand. THAT IS SO COOL.
Obviously trying to cover gender issues in one post is like trying to sum up War and Peace in a paragraph, but someone needs to start the conversation. Success in the veterinary profession the way we define it now stacks the deck against a whole lot of people. So let’s redefine what it means to be a successful veterinarian. Find a steady state. Your steady state.
To all you new grads and my old friends who are all emailing me saying they think they are ready to leave the field, I have this to say: leave if you need to. It’s OK. You can come back, you can. And if you don’t want to that’s ok too. If you want to single mindedly pursue dermatologic domination at an academic institution, you can do that too. This is a really, really cool field, and you are allowed to make your own path through it. You will always be a veterinarian no matter how you occupy your day, and don’t let anyone who chose a different path tell you otherwise.
14K feet up in Africa. Wouldn’t have happened without my DVM.
Stay. We need guides on all the paths up the hill.
There’s nothing worse than sticking your foot in your mouth. I hate that feeling when the words escape your mouth and hang there, floating in the air, as it slowly dawns on you what horrible thing you’ve just said.
I try to be cognizant of these things in my work as a vet. I’m pretty sure I’ve said some awful things unintentionally, and the most I can do is hope the person didn’t actually really register it. Like when I’m coughing in the middle of a euthanasia, and I apologize by saying, “My allergies are killing me today.” AW DANGIT I DIDN’T…UGH…. that sort of thing.
Unintentional gaffes, awkward as they are, are still better than remarks that are just plain oblivious. People who have adopted children can usually rattle off at least 20 awful things people have said. The always uncomfortable “When are you due?” question to a woman who is not actually pregnant. “Well, you can always get another one” to someone who has just lost a beloved pet. Or, “Who died?” to someone who has just actually lost someone.
I went to Disneyland this week, my first trip since the time they lost my wheelchair bound aunt on the Haunted Mansion. As fate would have it, she was with me again this time. There are few places better for people watching than Disneyland, a location of highly concentrated humanity teeming with all its best and worst attributes desperately, painfully intent on having a VERY MAGICAL DAY.
As we were waiting in line for our magical $15 burgers, I watched a member of the self-appointed mood police harass the cashier in front of me. She was very neutrally taking orders, neither kind nor unkind, simply doing her job. This man was having none of it. “Where’s that SMILE?” he asked, loudly.
She looked up, confused.
“Where’s your SMILE?” he asked again, a bit aggressively, forced cheer pulling his mouth into a rictus. SEE? LIKE THIS?
She gave him a wan smile. She looked tired. She was a captive audience, though, so she tried her best.
“I knew you had it in you!” he boomed in response to her most unenthusiastic ‘smile’, before engaging her in a totally unnecessary discussion of drink preferences. (The line is piling up behind him by this point.)
“I usually drink regular soda,” she said in response to his inquiry. “I like things sweet.”
“Yes,” he said, smirking. “You look like you like things sweet.” It was clearly a comment on her size. He looked up and around, proud of himself and his wittiness, and I slowly shook my head at him. His wife stared at her feet. I doubt this was the first time he’s said things like that.
I bumped into the same guy not 10 minutes later, as I was heading back out to the patio area with a tray of food. My aunt was waiting with the kids, sitting in her motorized wheelchair we had rented from Disneyland. Keep in mind, this is the standard grey wheelchair anyone can rent. It was not special in any way, an unwieldy, functional looking thing with a metal bumper on the front and a small metal basket.
Our friend paused, and pointed to it with a big grin on his face.
“How’s that working for you?” he asked. “You liking that thing?” He asked this the way one might admire a new Porsche 911, or a Harley, instead of an industrial grade medical device.
“Oh yes,” my aunt said without missing a beat. He nodded in admiration. “Yes, I love being in a wheelchair.” Then she turned her back to him while his wife stared on in embarrassment.
“How are you liking walking?” I started to say, but my mother saw the look on my face and kicked me before I could get past opening my mouth. She knows me well.
This is precisely why I prefer working with dogs.
“I’m never going back,” I have heard more than one pet owner say. They are talking about the office of their veterinarian, a person with whom they have built a relationship for years, someone they like and trust. But their pet died there, and the painful memories are too strong. So strong for some people that they go and find a new vet, even if they liked their old one just fine.
It’s one of the reasons I like having the option that I offer, of performing in-home euthanasia and pet hospice with Paws into Grace. Because I know more than anyone that as much as the client hated the office that one time, many pets hated it every time. That can be pretty upsetting for some families.
Which leads to the next concern, one I hadn’t thought of until a client voiced it to me. “I don’t want to go to the vet office, but I can’t euthanize my pet at home,” she said. “I can’t have that memory associated with my house.” So sometimes those clients end up decamping to a third party location, a park or a beach. And I respect that decision, though I would encourage those who feel that way to think on it a little while before making up their minds. Here’s why:
1. The precedent has been set in human hospice for staying at home.
The gold standard in human hospice, for those who have adequate support systems in place, is for people to pass at home whenever possible. That is by far the most comfortable place for a patient, in familiar surroundings. I was with my grandfather when he quietly died on a rented hospital bed in the living room he called his own for 40 years. He hated hospitals and I’m pretty sure had we put him in one, he would have haunted us all.
2. Moving an ill pet can be a challenge.
Pets who are very ill can be nauseated, painful, disoriented, and uncomfortable. This goes for people, too. How many times have we been down with the flu and known that we should probably go to the doctor but we feel too rotten to move? Same goes for pets. Add in mobility issues and it is just one more stress for owners, especially with very large pets or very upset cats- no matter the destination.
3. Your home is deafeningly, loudly, overwhelmingly a place of comfort.
This is the place Kekoa died:
But unlike a vet office where I might only have a handful of memories, I see this place every day and I don’t look at it as the place my dog died. I look at it as my living room, the place we opened Christmas presents, the place Brody plops down while I’m writing. It also happens to be the place Kekoa chose to settle down and leave this earth, because she knew as well that this is a happy place.
And you know what? It still is. I am glad she chose our sun dappled living room. At home, when I administer a pet’s sedation, they choose where they want to be: outside, in the kitchen, in mom’s lap. People find comfort knowing their pet selected the place they are most at home.
I’ve only been in this house a year and it’s had more than its share of sadness. I am looking at the floor where Kekoa died while sitting on the couch where Apollo died. I actually drove him home from the specialty hospital as quickly as I could- after he got lots of pain meds, so he could curl up on my lap after everyone got a chance to say goodbye.
But right now, it’s the place my dog is chewing up a toy and my son is doing his homework. This is our home, where life happens. And I feel good about that.
Want more info or to know if anyone in your area provides this?
Not all veterinarians even know this service exists, and information can be hard to come by. Here are two national databases of veterinarians that offer this service:
The International Association of Animal Hospice and Palliative Care
Association for Pet Loss and Bereavement
Here in America’s Finest City of San Diego, you can of course reach me or my wonderful colleagues through Paws into Grace.
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