“What do you mean we have to come back!?” The younger of the two senior citizens glowered at me over the top of her glasses. The daughter in this mother-daughter duo must have been in her 70s. She had apparently decided that her mother (who, I assume, was in her 90s) needed a kitten. She brought both mom and the kitten in for my patient’s first round of vaccines.
“Yes,” I told her. “I will need to see the kitten once more to administer a booster vaccine and give him his rabies vaccine.” The younger woman became irate. “We are on a fixed income, and we can’t keep paying for visits! So, what are you going to do about it?!”
As I looked from the angry daughter to the older woman holding a rowdy kitten, I asked myself the same question: “What am I going to do about it?”
Later, I would question my obligation in this circumstance. I take my role as a veterinarian seriously and feel a deep commitment to supporting the human-animal bond and the families seeking my help. Many of us think veterinary medicine is a calling, but sometimes I am unclear about the details of the call we answered. Did I fail to read the fine print?
I’m not convinced our duty is to unquestioningly support every person who decides they want a pet, regardless of their circumstances. I wondered about the responsibility of the women in the kitten exam room. Yes, I want people to have pets. At the same time, putting aside any concerns I might have about a cat in a retirement home, am I allowed to believe that having a pet might be a bad idea for these people? I mean, there was absolutely nothing wrong with this patient — no sneezing, no parasites, no diarrhea, no goopy eyes. And yet, his owners were already having financial hardship.
Does my calling as a veterinarian obligate me to support pet ownership in all circumstances? Am I a bad veterinarian for thinking that maybe a kitten was ill-advised in this case and for feeling a pang of resentment about the expectation that I should make this new pet relationship work?
Those thoughts would come later. In that moment, I felt a pang of dismay that I was about to let these women down. I worried about what would happen to the kitten if I didn’t make their financial problem go away. It felt like I had an obligation to lean in and make things go as smoothly as I could. I didn’t want to let this newly expanded family down. I also found myself thinking about how other veterinarians would find a way to support my clients.
At that moment, I felt immense pressure to make the right decision, fearing that any mistake would have lasting, negative consequences. Given that my patient was a kitten, I worried that my choice would set a precedent, implying that veterinary care could be more affordable for those on a fixed income, or that I, as a veterinarian, didn’t care about a pet’s well-being if the owner lacked adequate funds. My feelings about a decision having far-reaching effects reminded me of the stressful choices my wife and I faced when raising our children, where a wrong move felt like failing those we cared about most.
How I Ruined My Kids (Part 1 of Many)
When my children were starting elementary school, the county allowed parents to request transfers to schools different than the ones initially assigned. If your kids were zoned to a less desirable school, all you had to do was go to the county education office and ask for enrollment in a different school. Simple, right? Wrong.
Only a limited number of “swaps” were allowed. After the number was reached, all other requests were declined. Also, parents knew that magnet middle schools were much more accessible if their kids went to certain elementary schools. So, if you thought your daughter might like to go to the engineering magnet program when she turns 10, then you had better get her into the elementary school that naturally feeds into that program while she’s 6. Sure, your kid is into playing dress-up and catching frogs, but, in four years, she might desperately want a middle school engineering education. If you don’t make the right call today, she’s almost certainly going to end up with all the other kids who didn’t go to middle school magnet programs and had their lives ruined by parents who dropped the ball.
I know that line of thinking sounds bizarre, but parents have those kinds of thoughts. Some of them are willing to camp out for days at the county education office to ensure their children get into the ideal schools. I’m not exaggerating. I remember being at a child’s birthday party and hearing how parents planned to sleep in a parking lot for multiple nights to ensure their kids got to go to the “best” school. These parents were our co-workers and peers. I felt a certain kinship with them, as we were all raising children of around the same age.
After the party, I went home and asked my wife, “Do we need to sleep in the parking lot to make sure we give our kids the best shot possible at a good life?” In that moment, I was having the same emotional response I would have later in the kitten exam room.
Fortunately, my wife looked at me like I’d asked if we should hug a beehive. “No,” she replied.
I blurted, “But if we love our kids and we want them to be successful, don’t we need to do this for them? I mean, I don’t think we love our kids any less than those other parents love theirs. Shouldn’t we be making this commitment?”
My wife, who does not tend to get swept up in the expectations of others, simply looked at me. She blinked slowly and then said, “Andy, we love our kids, and we are not sleeping in the parking lot for three days. Both of those things are true.”
In that moment, I felt a great weight lifted off my shoulders. It was as if a pair of expectation handcuffs had been unlocked from my wrists. My desire to be a good parent was validated, but the idea that I needed to prove I cared by participating in a contest and suffering personally was simultaneously deflated.
In veterinary medicine, we take great pride in caring. I do not, however, abide by the idea that we need to prove we care by enduring hardship that others would not. The idea that compassion is measured by the willingness to sacrifice the needs of our team or to be personally miserable is unfortunately common in our profession. As we consider the nature of our calling, we must remember that suffering in the place of others is not a requirement to prove we care.
The Suffering Olympics
One of the most common questions people ask themselves is, “How am I doing?” We all want to believe that we are good people, that we are meeting the obligations and expectations set for us, and that we are “succeeding” in the life we have been given. The challenge for each of us is how to answer the question.
Some people try to gauge how they are doing based on their paycheck. Others look at the number of followers they have on social media, the size of their house, how many degrees or certifications they possess, or their job title. One very visible group in veterinary medicine is the people who seem to judge themselves on how much they sacrifice and how miserable they are. These people proudly let others know they haven’t taken a vacation in years. They never turn away a pet owner, regardless of the sacrifices required to help the client. In service of the community, they have missed every dance recital and sporting event their kids have ever had. They allow every pet owner to have 24/7 access to them. Et cetera. These people are participants in what I like to call the Suffering Olympics.
Do not get me wrong. I respect and celebrate the veterinary community’s commitment to supporting pets and people. The relationships we develop with our neighbors and community are essential to having a meaningful and rewarding life. Serving the weakest among us is a deeply noble undertaking. I also firmly believe that there is no inherent virtue in being miserable and that glorifying unhappiness and a lack of boundaries is a path to mental health ruin.
The Suffering Olympics, as broadcast across social media, pulls on veterinarians the same way parents talking about getting their kids into the “right” school pulled on me. In a world where we ask ourselves, “How am I doing?” the temptation to accept other people’s measurements of success is undeniable. Just as I never held a baby and thought, “One day, I will sleep in a parking lot to help you go to a middle school with a magnet program,” most veterinarians never walked across a veterinary school graduation stage and thought, “Now I can keep my team late after work, call clients on my day off, and discount my services so people will know that I’m trying hard to be a good doctor.” Yet, at some point, thoughts like these seem to take hold for many of us.
If We Are Not for Ourselves, Who Will Be?
I do not want to practice with a mentality that the medicine I deliver to patients is no different than the boxes the Amazon delivery driver drops off in my neighborhood. What we do is special, and I care deeply about the impact my actions have on the patients I see and the people around me. Every day, I ask myself if I am meeting the obligations I took on when I put a stethoscope around my neck.
I know I am not alone in this commitment. I would not write this article if I thought veterinarians had a greater tendency to look out for themselves than their patients. I am writing this because the burden hoisted onto me by the client asking, “What are you going to do about it?” is a weight so many of us feel, and we struggle to know how to respond verbally and emotionally.
In the first century B.C., the Jewish religious leader, sage and scholar Hillel the Elder said: “If I am not for myself, who will be for me? But if I am only for myself, who am I?” That sentiment is the key to understanding the calling we have answered. If we give ourselves to our clients, accept their burdens and wade into the Suffering Olympics in a quest to prove to others and ourselves that we are worthy to wear our white coats, then no one will come to save us.
Also, if we only look at what is beneficial for us and what is easy, convenient and profitable, then who have we become? What calling have we answered, and does it make us proud? I think not.
We Must Do Good Work
I now have an answer to the question “What are you going to do about it?” I am going to do good work. I am going to behave in a way that is not meant to maximize the pet owner’s pleasure or the clinic’s profitability. I’m not going to judge my success by how fast I can see cases, by how little I can make them cost, or by how many diagnostic tests and advanced therapies I can order up.
Yes, I understand that no one is going to be maximally thrilled with this approach. The people who will think I could do a better job will include people who want to have:
- Very long appointments with me
- Very short appointments with me
- The maximum amount of revenue possible being generated
- The cheapest services possible being delivered
- Complete and unlimited access to me
- Very easy days where those working with me don’t have to work hard
And the list goes on.
What I am going to do is make sure pet owners feel heard and respected, that I act with compassion and integrity, and that I advocate for those who do not have voices. I will do what I can to get the best outcomes possible with the resources available to me. I will also support the practice, my family and my team members (who need me to generate revenue to pay their salaries). To me, those are the components of “good work.” They may not be exactly how you define the term, but that’s OK.
If you believe we have been “called” in veterinary medicine, then I want you to think we have specifically been called to do good work. It is work that aligns with our values as caregivers, our mission as healers, our responsibility as animal welfare advocates, and our obligations to support our clinics, our teams and, ultimately, our families.
A big part of understanding the unique calling you answered is knowing what “doing good work” means to you. We each have the power to decide what our lives will be like and to answer the question “How am I doing?”
WISE WORDS
According to Chabad.org, Hillel the Elder is also credited with these sayings:
- “My feet take me to the place I love.”
- “Do not say something that should not be heard, because ultimately it will be heard.”
- “The soul is a guest in the body: here today, gone tomorrow.
SUFFERING FOR MEDALS
Six sports medicine professionals interviewed by Business Insider rated water polo, gymnastics and swimming as the hardest Summer Olympics sports. As for winter sports, Outside magazine selected biathlon, Nordic skiing and speed skating.
STORY ARCHIVE
Before he became the Discharge Notes columnist, Dr. Andy Roark wrote about how to handle misbehaving clients. Read “You’re Fired!” at go.navc.com/firing-clients-TVB.
BE A BETTER LEADER
Dr. Andy Roark has partnered with VetFolio to release the Uncharted Leadership Essentials Certificate. The program provides training appropriate for anyone who leads or manages others. The topics covered include setting a team’s vision and values, building trust, achieving team buy-in, delivering feedback, understanding communication styles, setting priorities, delegating effectively and managing time. Learn more at bit.ly/Uncharted-VetFolio.