This question from a veterinarian gave me pause recently: “Is there more fear in veterinary medicine than in other industries, or is everyone as scared as we are?” For years, I’ve written that while veterinary medicine is challenging, I believe it can be a hugely rewarding and fulfilling career. I also question whether the online doom and gloom around our industry’s future and the mental health challenges facing people in our profession are proportional to what is actually happening in practices.
I’m not saying individuals don’t struggle with burnout or mental illness. (Of course, they do.) Nor am I saying everything will be rosy in our profession as we wade deeper into the age of artificial intelligence, corporatization and private equity. Overall, however, my position on veterinary medicine has been (and remains) optimistic. Our profession is in a period of rapid, irreversible change, and while that experience can feel like a catastrophic breakdown, the uncertainty and upheaval are not necessarily bad. They are simply the uncomfortable path we must walk as the earth transforms around us.
That philosophy on the state of our profession pushed me to initially dismiss the idea that veterinary medicine fosters a more fearful culture than other professions. My knee-jerk reaction was: “No, we aren’t any more afraid in our daily lives than any other professionals out there. It’s just that every profession shares their struggles and fears internally while putting on a brave face for those outside their industry. We are no different.”
But then I stopped and thought about it.
The Sword of Damocles
I recently heard the story of the Sword of Damocles, and it spoke to me. In short, Damocles is a courtier in the court of King Dionysius I of Syracuse. Damocles flatters the king, telling him how fortunate he is to be in such a magnificent position. The king offers to switch places with Damocles for a day. Damocles eagerly accepts.
The next day, Damocles is placed on the throne to feel what it’s like to be the king. He’s given all the respect and power of the king. However, there’s a catch.
During the night, Dionysius had a sword hung over the throne, pointed down. A single hair from a horse’s tail supported the sword. This was done so Damocles would feel the great fortune of rulership and the fear and anxiety of constant danger.
Damocles was miserable. He couldn’t bear knowing the sword dangled over his head. He begged to get off the throne.
The story spoke to me because so many of us in veterinary practice have felt like Damocles: proud to be in a position of power and responsibility yet filled with a sense of fear that catastrophe might fall upon us at any moment.
The Culture of Getting it Right
During most of my career, I believed perfectionism was a trait I should aspire to. I looked to the veterinary school specialists, who seemed to do everything just right. I watched classmates pore over textbooks late into the night and heard them lament missing a single test question the next day — “I got a 98, but I should have gotten a 100,” they complained.
Perfection seemed to be the goal in practice. Heated battles took place over how best to tape a catheter, which antibiotic we should use and why, and exactly how much medical information could be given over the phone to a client who last saw a doctor who’s now on vacation. I remember fluid-pump wars when factions couldn’t agree on what “maintenance rate” meant and a particularly nasty “wizards’ duel” in which two veterinarians championed the published opinions of different world-renowned specialists to decide which flea medicine our practice would recommend.
In all those cases, what existed was a clear sense that getting the “right” answer was imperative and that being “wrong” meant a feeling of shame or existential danger. “Good enough” was for slackers and people who didn’t care quite as much, and not caring quite as much was viewed as a moral failure.
Maybe others didn’t perceive this battle for correctness the way I did. Maybe the stakes didn’t seem so high for them. For me, however, the lesson was clear:
- Medicine is complex and constantly changing.
- Failing to keep up with medicine’s bleeding edge is unacceptable and has vague but serious consequences.
That was the culture I believed defined veterinary practice.
Fear as a Superpower
When I was a teenager applying for college, I remember drilling the interview questions I thought would be asked. They were questions like, “What are you most proud of?” and “What book has most affected you?” and “What’s your greatest weakness?” I was ready for all of them.
My answer to the greatest weakness question was, “I’m a perfectionist.” I thought it was a superb answer because I got to act like an intense focus on getting things just right was a huge burden. It was the perfect backhanded weakness — or so I thought. I believed everyone knew that being a perfectionist meant working hard and continually striving for improvement. Telling an interviewer it was a weakness of mine was a way to share how great of a student I would be and portray myself as humble and vulnerable. Check and mate!
Looking back on my teenage years, I see my lack of insight. I didn’t comprehend a downside to perfectionism. (It looked like the road to success from where I stood.) The people who couldn’t bear to be wrong did quite well in academics, as far as I could tell, and doing group projects with those folks always meant I’d get a better grade than if I worked with a more laid-back crowd.
While my views on perfectionism have changed significantly since entering practice, I don’t think I was off base in terms of how perfectionism interfaces with academia. The drive to “get it just right” is hugely beneficial when you get the same reasonably manageable workload as everyone else, are scored on accuracy and are celebrated for individual achievement. Perfectionism is an excellent strategy for advancement through advanced education, and it’s, therefore, a compulsion many of us acquired on our path to becoming veterinarians.
But here’s the rub: Perfectionism, as I’ve encountered it over the years, is limiting and largely fear-based. I see doctors, technicians and practice managers who are genuinely afraid to delegate to others, accept pet owners’ decisions and make recommendations that other doctors might disagree with. Perfectionists seem to be:
- At a higher risk of burnout.
- More likely to internalize and ruminate on negative online reviews.
- Less willing to forgive themselves for human error.
I don’t want this to sound like I’m saying accuracy doesn’t matter. However, I believe we can be attentive, compassionate and highly competent without being afraid to fall short of perfection. I also think this sort of motivational fear is positively reinforced in our training, and it masquerades in practice as a superpower while taking a persistent toll on the perfectionist.
#MooseTruth
Last summer, I went on vacation with my family to Nova Scotia to go hiking and camping. A week before we left, my wife informed me that her greatest desire on the trip was to see a moose. I felt it a worthy goal and made it my mission to deliver the “moose experience” to my beloved.
When we picked up the rental minivan, I gathered the family and told them our objective: We would find a moose. From that moment forward, the hunt was on.
We got up a little earlier than normal every morning in Nova Scotia because that’s when moose were supposed to be out and about. We went on an extra walk each evening because the time just before sundown was supposed to be “moose o’clock.” We took turns watching the sides of the highway as we drove in case a moose might be lurking along the treeline, and we asked every other hiker we saw, “Hey, you haven’t seen any moose (Meese? Mooses?) have you?”
We remained on high alert for 10 days. Do you know how many moose we saw? Zero. Zip. Not one.
At the end of the trip, I had come to two conclusions:
- Moose are not real. They are a conspiracy created by Canadians and the U.S. parks department to sell merchandise and attract tourists to remote areas. Moose are a more successful version of Bigfoot, and while I still believe the Apollo moon landing happened, I can empathize with people who buy into that level of conspiracy. I am what I call a #MooseTruther.
- Moose are great motivators. We got up and going every morning because we wanted to
see a moose. We stayed out later than we would have, paid closer attention to our surroundings, approached our hikes with greater enthusiasm, laughed about our efforts and found a reason to talk with people we would otherwise have walked past. We found motivation in our search that made our experiences richer than they would have been otherwise.
The fact that we never saw a moose didn’t ruin our vacation. In fact, the search made the trip one of the best of my life. It turns out the act of searching can be far more meaningful than finding what we seek.
#MooseTruth Versus Fear-Based Practice
Veterinarians tend to live under a cloud of fear that’s probably unnecessary. We have learned to fear imperfection and use the fear as motivation to strive for self-improvement. Unfortunately, given that we live in an imperfect world, that fear never ends, and it hangs over many of us like the sword of Damocles.
We don’t have to live that way. We can be motivated by a desire to search. We can decide what “moose” we want to find in our careers or practices and derive great pleasure from seeking it.
We don’t need fear to drive us to be good at our jobs or to take care of our patients. We can instead throw ourselves into a quest to learn, heal, help, support or mentor. It doesn’t matter that quests like these don’t tend to end because ending the quest isn’t the point. The point is to choose the motivation to search for what we care about rather than to flee from the fear of imperfection.
That is how we step out from under the sword of Damocles and begin to practice in a mindset without fear.
GOOD LUCK FINDING ONE
As many as 1 million moose live in Canada. Mainland Nova Scotia has an estimated 700.