What Being a Veterinarian Really Takes | Melanie Bowden, DVM | TEDxCoeurdalene

Transcriber: Eunice Tan Reviewer: Tanya Cushman As I mentioned before, I am a

veterinarian

. And in my experience, most people don't personally know a

veterinarian

in their own life. They may have one that they turn to for services, but they don't have one as a friend or family member or something like that. And as such, I found that very few people can relate to

what

I do as a profession and truly understand me as a person. So, to get us all on the same page, I wanted to start by going over some facts about the veterinary profession.

It took me ten years to become a veterinarian. That includes four years of college work and two years of post-baccalaureate studies while working as a veterinary assistant to earn clinical hours. Then I enrolled at WSU's College of Veterinary Medicine, "Go Cougs," and there I did three years of lectures and lab work and then a rotating year in clinics, where you can practice on animals, under supervision. $286,000 is about the amount of student loan I took out just for WSU. I affectionately call this my “brain mortgage.” It's $1,100 a month for the next 30 years of my life, and I'll make my last payment when I'm 62. 60% of veterinarians are now women.

We broke the 50-50 mark when I was a sophomore, so I'm very excited to be able to be a female representative of veterinarians today. We have a problem within our industry where each year more veterinarians leave the field than enter. Currently the dropout rate is around 5%. Some of that has to do with the fact that baby boomers are leaving, but it also has to do with a lot of compassion fatigue and burnout that is happening among my colleagues and the fact that they are choosing to leave because they just can't. do it more. It's hard to transition to the next stat in any smooth way.

Of the veterinarians who have died since 2010, 10% have committed suicide. Of the veterinarians who commit suicide, 75% are small animal veterinarians who work with dogs and cats. Three is the number of my veterinarian friends who have taken their own lives since I graduated in 2016. All of them were in their first five years of practice. And then there is me. As a small animal veterinarian with a high debt load, I represent one of the groups with the highest suicide rate in our country. And my profession is second, right behind police officers, but I am three and a half times more likely to take my own life than anyone else in this auditorium today.

I'm sure for most of you it was

really

shocking to hear and not

what

you expect when you come to hear a veterinarian speak. (Laughs) The vast majority of people I introduce myself to imagine me doing something like this. And they are not wrong. There are definitely great moments in veterinary medicine and I love what I do. But I usually snuggle a dog like this because I just dealt with a case like this. So I would like to tell you about a day, a typical day, at my veterinary office, right now. It will get to you pretty quickly and that's okay, that's how I experience it myself.

This particular morning, about two or three weeks ago, I arrived at the office around 7:45. I like to arrive a little early so I have time to review my schedule and what's coming up that day. That particular day, my technician met me in the parking lot: "Dr. Bowden, you have to come right away. There's a pet here; the owner is crying. I don't know what to do, he's dying." I was like, "Okay, I'm coming." I ran back, assessed the pet, turned to the client, gave my bad prognosis that the pet

really

wasn't doing well. He turned to me and said, "But Dr.

Bowden, you have to save her." So I turned to my team: "Guys, we need to put in a catheter and start giving fluid boluses. I need to monitor this pet, blood work, x-rays, immediately. Let's get started." They're running around, trying to do these things. Everyone has stopped what they were doing to focus on this pet. And while we start the treatment, the pet's heart stops. So we start CPR, but she dies. And the client is crying in the back with us, so I turn to offer her a hug and I'm comforting her. But I'm distracted because over her shoulder is my other tech, Sarah, and she's poking her head around the corner, obviously trying to get my attention.

And so, to the extent possible, I transition my hug and hug to this client to find out what's going on with Sarah. So I walk over and Sarah says, "Oh, Dr. Bowden. I don't know if you know, but it's 8:20. Your first appointment is at 8:00. You're waiting, furious; you're late for work. You said If you disrespect her time, she'll walk away and post it on Facebook." I said, "Okay, don't worry. I'll come in right now. What is she here for?" She "she has a new puppy; they need shots." Excellent. So I walk to the door and take a deep breath to compose myself. (Breathes) I put on my best award-winning smile, open the door and say, "I'm so sorry, Mrs.

Smith, you have my full attention. Oh my God, who is this cute little puppy? Where?" Where does he come from? Congratulations on your new family member! And our day progresses from there. In the next room I had a dog that has chronic allergies. The client was upset because she spends so much at our practice, so I printed out all of her invoices to show her, for the fifth time, that if she paid for her allergy medications, it would be much less expensive than seeing me. all the time. In the next room we had a dog that had a broken leg.

He blew out his knee; he needed orthopedic surgery. Put that on the schedule for next week. Then I had a couple of wellness appointments, thank goodness. Those go faster: they only need vaccines. Then another technician took me aside and said, "Dr. Bowden, we have a couple of drops here." For those of you who don't know, when a vet's schedule is fully booked (no more availability, but your pet is sick), we offer a drop-off appointment, which basically means the little snippets of time I have between appointments. . , I will see your pet and make sure she gets the care she needs.

So I went in the back to evaluate these animals that weren't on the schedule. One had gone into the trash. There was vomiting and diarrhea all over the house: a big mess. We weren't sure if he had a foreign body or maybe it was just a dietary indiscretion. And we had a pet with diabetes who we were worried was very sick and might be in a life-threatening condition called diabetic ketoacidosis. And a cat had been attacked by a dog and had injuries that needed repair. I triage these pets, give my technician the treatment plans, and say, "Call the clients, get approval.

I'll talk to you later." So, head on over to my next appointment. One of my favorite clients, a little old lady who lives in a retirement center down the street, comes mainly because she wants someone to talk to. She has no family in the area; Her husband recently passed away. And her decrepit, old, elderly, cute cat is the last connection she has left with her husband. And that's why she really wants Fluffy to live forever. And so, after that appointment, I went into what we call "same day access," meaning an emergency appointment that had to be booked that morning.

And there is a pet that can't stand it. She went to the bathroom, she didn't come back in; The owners came out, the pet can't get up. So I talked to them about this and the client said, "Yes, Dr. Bowden. Whatever you say, we'll do it. We'll go to WCU, see the neurology specialist. Back surgery, whatever it costs, the money." It is not an option". And her husband says, "I don't know what he's smoking, but we're going to put the dog down." (Laughter) So I have to get them on the same page and advocate for what's best for that pet.

I leave this and enter a phone call slot. Phone call slots are for what they sound like: phone calls. I have lab tests to call people, medical records I need to do. I need to call those customers with those delivery pets and come up with a plan for them. I'm sitting down to do all this work, when my receptionist shows up. She says, "Oh, Dr. Bowden, I'm so glad I caught him; he's not doing anything. (Laughter) Mr. Johanson is in front. He came for that diet for his cat, about the crystals. He doesn't know how "It works.

I don't know if you know I'm really busy. I have a whole line of people I need to talk to, so I was really hoping you could come over and talk to him." And I said, "Of course, that's what I'm here for." So I walk up front and talk to Mr. Johanson, and as I do, I know I'm not going to have a lunch break now, because I was going to sedate that cat and do that. I'm going to have to stay late and make all these phone calls. And guess what time it is? It's only 11 a.m. m.

It's not even lunch yet. (Laughter) And that's a very typical day at a veterinary clinic. It's not bad; It's not stressful. That's just my day. The vast majority of veterinarians are scheduled to work 50 hours a week. They often end up working much more than that. They have to make phone calls; They need to connect with their customers. And many times they end up having to stay late to do this after hours. The vast majority of my friends and colleagues also end up needing a second job, which I never thought I would need. So I do extra relief shifts, and on the weeks I do, I end up working close to 80 hours.

Being a veterinarian requires a lot more than just my medical training, something no one told me in school. You are expected to be a counselor, educator, financial advisor and team leader. I am the face and reputation of our business. When we cannot meet this impossible standard, when we cannot accept one more pet without compromising the care of others or compromising the health and well-

being

of my team by forcing them to stay late, we are often attacked by our clients for

being

incompetent, for not caring and, in the worst case, they sue us. There is a particular case that I will always remember.

It was a cat named Ollie. And Ollie came because he had been struggling to urinate for two or three days and the owners thought he was very painful. We really hoped, he was around, we didn't have time, but we really hoped it would be something easy, right? Like maybe Ollie just had a urinary tract infection; We could give him some antibiotics and everyone could go home. But of course it wasn't easy. Ollie had a urinary tract obstruction, which is when they develop stones, they can't urinate because they get stuck when they try to pass them and they die.

And then I said this to the client. I explained what was happening and said, "You're going to have to go to the emergency clinic. This is beyond what we can treat today." And she turns to me and says, "But I can't afford it." I said, "Well, you know, this condition is life-threatening. You're obviously in pain and there's no guarantee you'll survive the treatment. There's no guarantee it won't happen again; in fact, in 50% of cases ". , she does it. You know, one of the options before us today is also euthanasia." And she turns to me and says, and I will always remember this in vivid detail: "Dr.

Bowden, you're going to make me kill my pet because I'm poor." And she goes on to say, "Why are you a vet? You clearly don't care about animals." And I should have said something rational, like, "No, I'm offering you euthanasia because your pet is suffering and suffering and will die." But instead, I fled the room because I had struck a chord. It was the end of a long day, I was going to cry, and I didn't want her to see the impact she had on me. I went to the back, turned to my team, and said, "Look, these people really don't deserve our compassion. , but Ollie needs our attention.

That's why I need two people to volunteer to stay late and help me treat this pet." There is nothing more heartbreaking in life than having the skills and ability to help something helpless, and you can't do it because someone can't afford the treatment. And in Ollie's case, we were able to save her life. But I didn't do it for them. I did it a little bit for Ollie, but mostly I did it for myself because at the end of that day, my mental health couldn't handle taking that guilt home with me. So I assumed the consequences.

The next day, my practice manager reprimanded me for adjusting the bill to what they could pay. They deducted my salary for the difference. But he had saved a life. And I understand and empathize with my colleagues how at the end of a really bad day, a bad shift, they come to a really dark place. And they sit at home and think about how, handcuffed by their student debt, there is no other way out than to repeat this pattern of burnout and compassion fatigue over and over and over again for 30 years. And in my profession, if a soul is suffering and there is no treatment option (there is no other way out), euthanasia is not only acceptable, but also compassionate.

And we end up with headlines like one I read a couple of years ago. I think veterinary medicine can be different. Our profession is working very hard to take our part in this problem. But the change in the entire professionIt's really difficult, time consuming and unlikely to help someone like me who is suffering today. And that's why I got on this stage. Because I think the people who have the most impact on my friends are all of you. There are two groups available to us: one is called Not One More Vet and the other one is called the Veterinary Confessional Project, where veterinarians can come in and vent or talk about their issues with compassion fatigue, burnout, and suicidal thoughts.

And the posts I read over and over again are the ones about how every perceived failure, every time we have to put down a pet because we can't help, every time we have a negative customer interaction or there's a bad review about us online , little by little it is undermining our humanity and our love for this profession. But the posts that really scare me are the ones where he alludes to the fact that a really negative customer interaction, maybe like the one I had with Ollie's parents, tipped the scales and made that day his last day.

You'll see hundreds of vets posting below: "Call me, here's my cell phone number." "Reach out, you are not alone." But they never respond and you just don't know. And I bet you that client has no idea the impact his words had that night. I think change will require open conversations like this, where we truly understand how we impact each other. I think it's going to take being more compassionate and empathetic as humans, in general, and really listening to each other and meeting each other where we are. But it will also be necessary for the general public to understand what it means to be a responsible pet owner.

Because I guarantee you: no vet wants to be in the situation I was in with Ollie. And if we could prevent that from happening, I would be ecstatic. So for every client I see who comes in with a new puppy or kitten, I recommend that they get pet insurance or open a savings account for their animal. Because that puppy or kitten... the only thing I can guarantee is that it will grow, get old, get sick and die. And there will be difficult decisions and discussions to be made not only about what is medically possible for that animal, but also about what you can afford financially and what your lifestyle really allows you to do in terms of managing chronic diseases in your pet. .

I also believe that people should not give pets, not even to their own children, because pets are not only a financial commitment but also a time commitment. Pets need love, they need socialization, they need training, they need exercise and mental stimulation on a daily basis. And I see too many people who come in and ask for sedatives, tranquilizers, or anti-anxiety medications because their young lab is bouncing off the walls and they just can't handle it at home, when in reality he needs a training class and needs more exercise. But the most important thing you can do, and I can't emphasize this enough, is to partner with your veterinarian to be a proactive member of your pet's health.

Whether or not your pet is healthy or sick, needs vaccinations or not, you should visit your veterinarian every year for an exam. By detecting diseases early, I can be more effective for you. The disease is not only much more treatable but sometimes even reversible, it is less expensive and there are many more options available to us. By partnering with your veterinarian, we can get what we are both looking for. You are in my office because you love that creature. It means a lot to you. In many cases, it is your child. I'm there because I love that animal equally.

And we both want Fluffy to live the longest, happiest, healthiest life possible. And that's why I became a veterinarian in the first place. Thank you. (Applause)