I’ve wanted to write about this topic for a long time. I’ve needed to write about it. I’ve long been encouraged by a multitude of colleagues to broach the topic. After all, we want pet parents to know about it. We need them to know about it. So, what is “it?” Well, “it” is the scarily high rate of suicide among veterinarians. A 2014 survey of 10,000 veterinarians conducted by the Centers for Disease Control (CDC) found one in six American veterinarians has considered suicide! In the United Kingdom, veterinarian suicide rates are four-to-six times higher than those for the general population (and at least double the rates of dentists and human medical doctors).

I don’t know why it’s taken me so long to sit down and write this post. I’ve lost too many colleagues who have died by suicide. Maybe I was trying to purposefully avoid the topic because some of the truths may be hard for many to hear. After all, potentially upsetting pet owners isn’t exactly the smartest move for a pet-owner education blog. But, I’ve come to realize the main goal of CriticalCareDVM.com is to educate pet parents even when the topics could make one uncomfortable. So, I hope you’ll read this week’s post with open minds and hearts to learn about this exceedingly critical topic. Happy reading!

Veterinarian Suicide – Why is the rate so high?

There is no single root cause of veterinarian suicide. The problem is truly a multi-factorial one. These factors can cause intense psychological and even physical pain. I’m reminded of a statement made by Dr. Carlin Jones, a Maine Veterinarian who once contemplated suicide:

“As veterinarians, we do view death as the end of pain. That’s what we’re taught – when the pain is too bad, euthanasia is the one thing left we can do. So, when we’re in that much psychological pain, we’re going to look at it that way.”

What causes veterinarians such psychological pain? Some factors that degrade a veterinarian’s spirit are:

Perfectionistic Personalities:

Veterinarians are highly intelligent individuals. Some of my colleagues are truly geniuses, and I’m jealous of their immense intellects. Most of us have been called “the cream of the crop” our entire lives. We got As, not Bs, in school. We tend to be leaders, not followers. We’re passionate. We don’t leave our job at the hospital; the job comes home with us. Importantly, we’re not used to failing. So, when we feel like we’ve done just that – for example, when a disease wins – we’re crushed. We’re truly devastated, and are left quite emotionally vulnerable.

What you may not appreciate is this defeated feeling can easily be compounded by pet parents. A colleague recently shared with me a story of a client who chose to say to goodbye to her fur baby due to its terminal illness. The pet parent, herself, was living with end-stage cancer. After the humane euthanasia, she told my colleague she was going to go home to die since she no longer had anything or anyone for which to live. Can you imagine the concern this created for my colleague? For veterinarians, such emotional statements from animal owners are not uncommon. We understand the intense feelings experienced by families. We feel them too. But, as most veterinarians are introverts, we internalize these feelings, a practice that can become toxic to our souls.

Mental Health

In the United States, one in five adults has a mental health condition – that’s about 40 million people, more folks than in the states of Florida and New York combined. Unquestionably, veterinarians are not excluded from these astonishing statistics. Sadly, most American adults with mental illness don’t receive treatment for a variety of reasons, including self-denial due to societal negative stigmas and lack of access to care.

Compassion Fatigue

Veterinarians, just like other healthcare professionals, experience compassion fatigue. This condition is defined as “the emotional burden that health care providers may experience because of overexposure to traumatic events that patients are experiencing.” We have a keen awareness of our tremendous responsibility for the life and death of our patients. Indeed, I teach my students to never forget “there is a life at the end of every decision” they make. In many parts of the world – especially here in the United States – pets are increasingly thought of as members of the family. This growing belief adds a unique facet to the relationship between pet parents and veterinarians. For some veterinarians, such parental attachment creates emotionally draining relationships because they simply aren’t adept at managing people. Some don’t and can’t sleep properly. Some withdraw from work and life. Others self-medicate to cope. Combine this with the fact most veterinarians have trouble saying no to clients. We overcommit. We work late hours. We spend hours on the phone with pet parents without expectation of compensation for our time (do you expect this of your personal doctor or lawyer?). We only see family and friends on weekends. To top it all off, when we try to set reasonable limits with clients, we’re berated and branded as “uncaring”, “inaccessible”, and “only in it for the money.”

Financial Debt

Veterinarians – in general – have very little business acumen. We don’t effectively convey the value of our services to pet parents, and thus we have (too) many grumbling about costs. Frustratingly, there’s a prevailing belief veterinary fees are expensive and veterinarians must be very well-paid. So, let me take a minute to address these “alternative facts.” In 2016, according to data from the American Veterinary Medical Association, the average debt for veterinary school graduates was $167,534.89, and more than 20% had debt of more than $200,000. Contrast these numbers to the 2015 mean starting salary of $67,000 for graduating students accepted to a full-time position in private animal hospitals. Financial experts recommend a ratio of student loan debt to earning salary of 1 to 1.5. Currently, this ratio in veterinary medicine is at least 2.5 (and often higher for veterinarians). With such a bleak financial outlook, why do so many people still seek to enter the profession? Yup, you got it! They love animals, and simply want to help families care for them. For this reason, impugning our integrity about our intentions is deeply insulting and infuriating, and only serves to drive cynicism and create barriers to collaborative partnerships.

Bullying

Veterinary medicine was once a revered profession. Yet, as society has become increasingly cynical and its members have grown exceedingly entitled, there has been a concurrent and marked dropped in the respectability of my chosen career. A colleague recently commented, “Animal owners like us, but they don’t respect us.” Statements like, “You’re not a real doctor”, “I read on the internet that…”, and “My breeder said…” are quite disrespectful of a veterinarian’s education, training, and experience. As I mentioned earlier, veterinarians are incessantly accused of only being in it for the money. Being blamed by owners for forcing them to kill their pet because they can’t afford veterinary care is perhaps one of the meanest and harshest things I’ve ever heard. This is a wicked form of emotional bribery, and is entirely unacceptable. In the age of social media where pet parents can post anything they want if they don’t get their way, veterinarians are emotionally exhausted because we can’t reasonably fight back. Just know one’s 1-star review on Google or Yelp chastising a veterinarian for not providing free care because you couldn’t afford it bruises our soul and contributes to psychological pain.

Veterinarian Suicide – Why did I write this blog post?

Writing this piece was – in a way – therapeutic for me. Sharing this information helped me get thoughts out of my head and onto proverbial paper. Most importantly, I was able to share with pet parents information on a topic about which they likely knew very little. Knowledge is power, and I’m hopeful highlighting the topic of veterinarian suicide will ultimately help to strengthen the partnership between pet owners and veterinarians.

To close this post, I’ll leave you with words written by Dr. Tamara Vetro Widenhouse, a veterinarian who recently posted a powerful piece of prose on social media about legitimate bullying veterinarians experience daily. I was deeply moved by her candor and wanted to share it with you.

“Every Time” Every time you say vets are money grubbing or ‘too expensive’ or just in it for the money, Every time you decline all diagnostics, yet demand to know “what’s wrong with my pet”, Every time at a social function or other completely inappropriate place you find out that someone is a vet you ask them for free advice about your animal, Every time you feel justified posting a s&^**y practice or vet review when everything was done according to the standard of care but your pet died anyway, Every time YOUR lack of preventative care resulted in your pet’s early death, yet you blame the veterinarian, Every time she gets in early and stays late and works an 80-hour week because your pet that had been ill for days suddenly becomes an emergency at 5pm on a Friday, and you demand to be seen, claiming these heartless vets won’t treat your baby, Every time someone says, “Why didn’t you become a real doctor?”, Every time someone complains about the cost of veterinary care, comparing human medicine and insurance subsidies to pet ownership, Every time someone doesn’t pay their bill and thinks they are entitled not to because pet ownership is their “right”, Every time someone walks in to a clinic and threatens to “sue your ass if you make one mistake with my baby”, Every time a graduate vet looks at the hundreds of thousands of dollars in crippling debt and listens to clients driving Mercedes and BMWs complain about the cost of a spay using good anesthetic care and adequate pain management, Every time – You are part of the problem. The problem is suicide in veterinarians. Most of us went to veterinary school because we care. We have a calling to care, but there is a dark and expensive cost to compassion. Think before you act or speak.

All who read this blog consistently know I’m a staunch proponent of abiding by Dr. Widenhouse’s final imperative – THINK before you act or speak! Are your words and actions Thoughtful? Helpful? Inspiring? Necessary? Kind?

If your answer is no, then I respectfully say, “Be aware. Be compassionate. And shhhh!”

Wishing you wet-nosed kisses,

cgb