It’s that time of the year when dreams start coming true for more than 3,000 new veterinary school graduates. If you’re one of them, you’ll remember the day well. All the hard work you put in, the all-nighters you weathered, the tests you barely passed, the clinical rotations, the grueling professors, the patients that someone volunteered to be your “first.” Suddenly, you have the initials DVM or VMD after your name, and you wear a stethoscope regardless of whether you feel ready. You pack up your apartment, leave your safety bubble and start a job perhaps hundreds or thousands of miles away.
It’s showtime, kids! Do you feel qualified? Absolutely not. Are you scared to death of killing something? Absolutely. Things are going to start happening now.
As I think about where my journey took me, I wish I could have given myself some advice 28 years ago. I’ll share it with you here.
1. Keep close tabs on your patients and clients.
When you start as a veterinarian, clients aren’t excited to see “the new grad.” Most of them want the old guard, the seasoned doctor. They will say things like, “Are you old enough to be a doctor?” (Insert eye roll.)
You have to build a following. The best way is to call (or text) your clients the day after an appointment. It will blow the socks off pet owners who generally aren’t used to their veterinarian being so involved.
For example, if you have the bandwidth, do callbacks:
- After wellness exams to see if the client has additional questions.
- After administering vaccines to confirm no side effects.
- After a sick appointment or surgery. (Prioritize this one.)
My first job was at a high-volume emergency hospital in Portland, Oregon. My second was at a posh, client-centric, two-veterinarian practice whose owner,
Dr. Parkinson, had been there since the ’80s and was dearly loved by every client. They all wanted to see Dr. Dan. The situation was unlike my ER days, when I was constantly booked solid and nobody cared about which of the 13 doctors they got.
During those early days, my schedule consisted of either new local clients, tourists or pet owners who couldn’t get in to see Dr. Dan. Many established clients opened the exam by proclaiming their love for him and how they were bummed not to get in with him.
Dr. Dan and I had a three-part strategy for those unenthusiastic clients:
- I made sure to say I would run everything by Dr. Dan at the end of the day and give them a call.
- Dan would pop his head in the exam room and say how lucky they were to get me, “the fancy ER doctor from the big city.” (His words, not mine.)
- I called every client the next day to answer additional questions, make sure they gave the medication OK, or report that Dr. Dan agreed with me that a three-year rabies shot was a perfect choice. They were shocked that someone would take a personal interest in them.
I had a fully booked schedule within a few months. I continued callbacks as long as I could before turning them over to the staff, who always phrased the introduction like this: “Dr. Stacee asked me to call you personally to check on ….”
2. You can’t care more than the pet owner.
Sometimes, your heart takes over and you think the client isn’t doing enough. Be aware that those moments tend not to work out well. The truth is you can’t adopt every animal in the county. Instead, do your best to work inside the veterinarian-client boundaries, and don’t let your heart get too far over your skis.
For example, my heart sank when a new client walked in the door one day. I thought, “How could it have gotten this bad?” The owner said the skin disease emerged a few weeks earlier and that he believed it was allergy-related. “It’s happened before and went away on its own,” he said. However, I knew that wasn’t true. I locked eyes with the dog and saw how much discomfort he was in due to his half-eroded nose and the scabs all over his body. I recommended a biopsy and aggressive therapy. The owner declined and felt I was overrecommending. My heart wanted to take the dog and fix his problem. I just needed the money to pay for the procedures and drugs. The client couldn’t afford those things.
I prescribed prednisone instead, said a prayer and let them walk out the door.
Those cases will hurt your heart badly, my friends. Move to the next exam room. Try again.
3. You will get good at death.
You will stop feeling all the feelings at some point in your career. That’s normal and doesn’t mean you’re broken or dead inside. After you euthanize about 1,000 animals, you will start to become less emotional about death and view it as part of the cycle of life. It happens to all of us.
After about 10 years in practice, I worked with a newer veterinarian who cried at every euthanasia. I mean, she really cried. The staff commented on her big heart and how much she cared for each animal. I thought about how I used to be like her but wasn’t shedding tears now. When did it stop? At some point, it did. Dr. Dan didn’t cry, either. Did I not care anymore? I started to worry that my heart was hardening. However, I then realized I had stared death in the face so many times that I understood its purpose.
Clients who thought they couldn’t live without their beloved, now-deceased dog showed up with a puppy a few months later. Hearts healed, and life went on.
Instead of crying, which I couldn’t do anymore, I began saying a prayer of thankfulness to each dying patient. I asked the owners if they wanted to hear my prayer. Most did, but some declined. That was fine because the prayer was for me and my patient.
It went like this: “Thank you, dear one, for all the things you did during your life. For the love you gave and the comfort you brought to your family. The world is a better place because you were here. I want you to know you mattered and will always be loved.”
4. Stay curious.
Ask your clients lots of questions. The more bizarre the medical problem, the more questions you should ask. If you can’t diagnose something, go back to the patient history. Sometimes, you must get creative in your interrogation. Remember that the closer you get to the first symptoms, the closer you are to finding the root of the problem.
One case stands out in particular. A frantic client rushed in one morning, worried that her 1-year-old dog had suffered a stroke. The patient was fine the night before but was now stumbling and barely walking. I knew the lady, a widow whose husband had died from a brain tumor a few months before. I thought the dog looked stoned. I asked about marijuana. It was a ridiculous question when you think about a grandma getting high, but I had to ask. Her answer was a hard “no.” The conversation then went like this:
Me: Anything in the yard that seems weird?
Her: Oh, I found an apple in the yard.
Me: Do you have an apple tree?
Her: No.
Me: It’s winter. That’s odd to have an apple in your yard, don’t you think?
Her: Yes.
Me: Can you bring the apple to me?
Her: Yes.
I later saw that someone had cored the apple at a 90-degree angle. I was perplexed. Then, my kennel attendant said, “It’s a bong!” I later discovered that the kid in the house next door used the apple as a bong and tossed it over the fence so he wouldn’t get caught. The apple skin contained enough THC residue to impair a 5-pound dog.
Mystery solved!
5. It’s OK not to know the answers instantly.
After graduation, I was under the impression that I should know about every disease (and the corresponding treatment recommendations) for any dog or cat that crossed my path. If I could talk to my younger self, I would say that is a ridiculous expectation of anyone. As I gained experience in the trenches, I realized that clients desire honesty and effort more than quick answers. Clients appreciate things more when you say, “Would it be OK if I spent some time over the next few days researching this?” Who wouldn’t love that? People want to know you care about them and their pets.
One of my most memorable cases involved a young border collie that presented with vomiting, diarrhea and weakness. We ran the lab work while the client waited. It showed off-the-charts calcium. I checked the lymph nodes. They were fine. Kidneys? Fine.
New vet Stacee would have felt the need to magically and immediately conjure all the rule-outs for hypercalcemia. Seasoned vet Stacee said: “Things aren’t adding up. We usually see this in older dogs. I need time to research this and consult with my colleagues. In the meantime, let’s start fluids and supportive care. I will call you in a little while with my findings. Your dog is my top priority today.”
The owners were appreciative and left him with me. I pulled out my book and reviewed all the rule-outs. “Wait, what about vitamin D! It has to be!” I called to ask, and yes, the dog had recently eaten psoriasis cream.
My point is this: You don’t have to know all the rule-outs on the spot. It’s hard to remember everything when people are staring at you, crying and freaking out.
Here’s a trick: Listen to the patient’s heart last during a physical exam. Listen a little longer than you need to, and use the time to think about your recommendation. I’d ask myself, “What would I do if it was my dog?” Then, I would put down my stethoscope and say, “The heart sounds great, but let’s talk about what we need to do now.”
6. Always do what the technicians say.
My teacher, technician Than Tran, taught me to spay and neuter animals in real life. He knew before me when I dropped the pedicle.
I have worked with amazing technicians. For example, Bridget Wehmeyer and Rita Lopez saved my bacon more times than I can count. Stop, stop, stop and reassess if your technician ever says, “Hmmm, are you sure, doc?” Respect the fact that many techs have seen and done way more than you will ever do.
Here’s another story:
Shortly after I took a course on local anesthetics, a blocked cat came in one Saturday morning. The owner couldn’t afford hospitalization, so we sedated the cat, unblocked him, and gave him pain meds and a big bolus of subcutaneous fluids. Before we pulled the catheter, I spoke with Bridget.
Me: “You know, let’s put some lidocaine in there. That would be so nice for him. Poor guy. I can’t imagine how much it hurts.”
Super smart technician: “Sure thing. How much?”
Me: “3 cc’s.”
Super smart technician: “Hmmm, are you sure?”
Me: “Oh, yeah!” (I congratulated myself on the inside for being so thoughtful with my pain management.)
Super smart technician: “OK. Seems like a lot.”
Me: “Oh, I think it needs to swish around the bladder. Let’s do it!”
Fast-forward several hours. I discharged the cat, I’m finishing my charts, and I think: “Wait, that does seem like a lot of lidocaine. Is that over the lethal dose? Could it get absorbed into the bloodstream if he reblocked? Could he die?”
The answers were yes, yes and yes.
I won’t go into all the details of what ensued, but they involved about 10 phone calls and a drive to the house as I tried to reach the owner. No one was home, so I peeked in the windows, hoping to see Tiger alive and healthy. I thought briefly about breaking and entering but instead resorted to Plan B: prayer.
Finally, the owner called me back. “I saw you called a few times.”
I said, “Oh, how is Tiger? Has he urinated yet?
“Doing great. He peed in the parking lot before we left.”
Thank God.
Always listen to your techs. They will save your bacon.
7. Build a network of mentors.
Practice life is going to suck occasionally. Keep open your lines of access to veterinarians who have been around the block a few times. No one besides a colleague will understand the pressures of your job, so build bridges early. When the rainy day shows up, you will have someone to sit you down and help you process what just happened.
As I said, my first job was at a 13-doctor ER practice, which meant I had a fantastic network of colleagues.
When clients kept asking whether I was old enough to be a veterinarian, Dr. Suzy Hartmann taught me to smile, nod and charge them for everything I did.
After I made a surgical error and struggled to handle it, Dr. Ben Edwards guided me to “Always tell the truth,” even when it hurts.
After my use of a gastric lavage gave a dog aspiration pneumonia, Dr. Jerry Brown reminded me that those things will happen when you practice long enough.
Get to know all the veterinarians in your area, not just at your practice. When they hear your case went south, they will support you (and vice versa). Stop in, bring cookies and introduce yourself.
Finally, never — I repeat, never — belittle another veterinarian in front of a client. If you have something to say, say it to the veterinarian. Remember that the way you treat others matters.
8. You will recover after killing your first patient.
I was determined to never cause a patient’s unnecessary death. Then it happened. I forgot to slow the IV fluids on a cat during a C-section. She got the entire liter in 30 minutes and died about 24 hours later from pulmonary edema. It was awful. Kittens were without a momma. I nearly quit the veterinary profession that day.
When you have your first experience with this, remember that you are only human and people make mistakes. And do not forget that you are not alone. Pull yourself together kid, and get back on the horse. We have more lives to save.
9. Keep a journal.
Record your favorite case of the workweek. When you get old, you will enjoy reading those stories. For instance, when:
- Leo got his head caught in a mayonnaise jar.
- Kennedy walked home on two broken legs.
- Boomer was run over by a truck, and you stayed up with him all night.
- Jersey spent a week in the forest, his leg caught in an animal trap.
Take time to document the good stuff. Life goes by fast. You never want to forget those times.
10. Sometimes, you draw the joker.
I had just done a splenectomy on an old shepherd. Twenty-four hours later, it was dead. I did the postmortem and was sure a ligation had come loose. I saw blood in the abdomen, but not enough to kill the dog. I had monitored the PCVs and EKG. I was devastated.
I never learned if it was me or a sequence of unfortunate events. There wasn’t enough evidence. Either way, I was crushed and felt responsible.
Then, Dr. Dan Parkinson, my mentor, explained it to me like this: Each case you get is a playing card. Sometimes, you do everything right, everything in your power, and you win. Sometimes, you draw the joker, and the patient dies despite all your efforts. You don’t and can’t control all the outcomes. When you draw the joker, it’s over. Let the guilt go, pull yourself together, and get back on the horse. More patients are waiting for you.
I can’t think of any job better than being a veterinarian. Helping little creatures on the planet is one of the most noble and rewarding jobs a person could have.
Stay strong, my new veterinarian friends. We’ve been waiting for you, and we’re glad you’re here. We have your back.
WHERE THEY ENDED UP
According to the American Veterinary Medical Association’s Senior Survey, “Nearly half of all 2022 graduates — 47.6% — planned to enter companion animal exclusive or companion animal predominant practice.”
DON’T FORGET ABOUT THEM
New veterinarians should mark this on their calendar: National Veterinary Technician Week is the third week of October each year.
MENTORSHIP MATTERS
Studies show that a lack of mentorship can drive newly graduated veterinarians out of their first practice. Here are a few resources to support a good start for young doctors.
- “Real-Life Mentoring,” Today’s Veterinary Business, bit.ly/mentorship-TVB
- “The Evolution of Mentorship for Veterinary Professionals,” Today’s Veterinary Practice, bit.ly/mentorship-TVP
- “Guidelines for a Successful Veterinary Mentorship Program,” Zoetis, bit.ly/4bKOZM3
- MentorVet, mentorvet.net
- Ready, Vet, Go, bit.ly/49ZzChl