Dr. Andy Roark Community

I’ve diagnosed and treated a lot of conjunctivitis in my career as a veterinarian. But, I’ve never had to treat myself for conjunctivitis until this year. What misery! I had no idea inflamed conjunctiva (the pink tissue that lines your inner eyelids) feels like burning sandpaper contacts in your eyes. I never knew that the erythromycin ointment I prescribe commonly to cats feels like Vaseline on your eyeballs and obscures your vision like a greasy oil slick.

After a few days of strange discharge and redness in my eyes, I made a hurried appointment with the first ophthalmologist I could find, who saw me in her plush office in Chevy Chase. I explained to her that I has been suffering from the flu when days later my eyes developed symptoms of excessive tearing that progressed to sticky discharge, ocular redness, and burning. The doctor perfunctorily diagnosed me with “pink eye” and informed me that my eyes looked pretty average in regards to pink eye cases she’s diagnosed.

Her manner was not very empathetic, but I took some comfort knowing my condition appeared average. The doctor explained that she would prescribe antibiotic eye drops that “probably wouldn’t do anything for me” because I likely had viral conjunctivitis.

She hurriedly explained all of this while backing slowly out of the room with her manicured gloved hands up in the air. I had to delay her exit with my questions. Will there be a steroid in the drop? (My inflamed eyes were begging for something to soothe the inflammation). And, how many times a day do I have to instill the drop?

Her answers:

“No steroid in the drop; steroids can delay healing.”

And then, “Four times a day.”

(For a drop that probably won’t work and also won’t relieve my discomfort…. Great. Eerily this sounded like stuff I’ve said and done in the past. Can’t give you the relief you need because there’s a tiny chance it could make you worse. So, I’d rather practice doing no harm.)

As I left, she weakly offered, “if you start to have trouble seeing, do schedule a recheck exam”.

It was interesting to be on the receiving end of this bout of conjunctivitis and trip(s) to the doctor. Not only did I earn a new level of understanding and empathy for my patients with conjunctivitis but it really highlighted to me what’s important during a visit to your doctor.

Yes, I got my diagnosis and I got treatment. But, I didn’t really receive care.

I ended up making a recheck appointment a week later with a different ophthalmologist because once again I felt I needed to be seen quickly. The redness and discharge in my eyes had improved a lot, but suddenly I couldn’t sleep because my eyes seared in pain when I closed them.

This second ophthalmologist was outstanding. She greeted me with a warm smile and immediately gave some needed empathy: “Wow, I can hear how congested you are!” And then, “Oh, your poor eyes—they are soo inflamed! “ After her exam, she told me that she was going to remove some membranes lining my conjunctiva. I was nervous, but when the procedure was over I was thankful for the intervention.

Finally, she prescribed me another antibiotic eye drop. However, this drop contained a steroid! She also prescribed me an antibiotic ointment to instill at bedtime and re-wetting drops to use during the day. The coup d’etat was when I asked her how long I should use the drops. She informed me I was coming back for a recheck exam in 3 days at which time she may tell me.

It seems ridiculous that I was grateful that she wanted to follow my treatment. I’ve since been back to her two more times and finally my eyes have healed. Looking back on this experience I know both ophthalmologists were equally well trained and knowledgeable. However, there was a real chasm between what they provided. Diagnosis and treatment are important. But so is listening to your patient and being interested in their results and recovery.

That’s the difference between medical treatment and medical care.

Nicole Cohen DVM graduated from UC Davis School of Veterinary Medicine and completed a 1 year rotating internship in small animal medicine and surgery in northern California before moving to Washington DC. She has worked at Friendship Hospital for Animals as a primary care and emergency veterinarian for the past 10 years.

Through social media we’re faced with an onslaught of information. While some may call it a blessing to have access to so many knowledgeable individuals, we as veterinary professionals know that this is most often not the case.

Everyday, I see people spreading false messages and it really grinds my gears. I feel compelled to speak up whenever I see someone giving treatment suggestions, breeding advice, nutritional recommendations, etc. My intentions are always good but in the heat of the moment I become a Facebook warrior.

I’m loud, opinionated, and passionate. At times I can be rather blunt and abrasive. While I don’t mind these character traits, they used to get me into trouble. Sometimes my heart spoke without censorship. This resulted in social media arguments about topics that are important to me: animal rescue, population control, research, welfare, livestock, etc. I felt as though it was my responsibility, as an educated individual (in these matters at least) to correct people when they were wrong.

You may think that I am righteous in my stances, or that I’m just downright obnoxious. Things used to be very black and white with me. I didn’t look too kindly on backyard breeders or animal rights activists. I took every opportunity to let these people know how I felt about them. It was easy to start an argument when I always felt as though I was right. I felt entitled to my opinion and that it was my way or the highway. It’s unfortunate to say that it took me a while to realize the fault in my actions.

[tweetthis]Everyday, I see people spreading false messages and it really grinds my gears.[/tweetthis]

One day I became very aware of the consequences. I had been arguing with someone about animal welfare and why it was wrong to sell unvaccinated puppies at five weeks of age. Things got a little heated and they decided to investigate my background. “I see you work at a veterinary hospital. You’re harassing me. I should contact your employer.”

Upon reading this I panicked! As quickly as I could I deleted my posts and blocked the user. Who would’ve thought a harmless Facebook spat could result in me being reprimanded by my boss?! Luckily, nothing came of it, but it was a rude awakening.

Life changes when you join the professional community, especially in veterinary medicine. You are now seen as a role model. Your point of view is valued and you are expected to represent the field. This is a heavy burden to bear especially when you are still maturing, like myself.

Now I’m not saying that we should be any less passionate or change our opinions. Instead, we should simply be aware of the way we conduct ourselves, especially over social media. This might sound like common sense to some, but it is not unusual to see veterinary professionals hashing it out with the public.

It is difficult to hold back, especially when we love animals so much. We are emotionally tied into our work and it is easy to speak before we think of the possible implications of our actions.

In the future I hope we can continue to uphold our professional beliefs and communicate with the public. Information should be shared in a well-versed and conducive way. Instead of attacking and arguing, we can work together to educate. We do not need to agree all the time, but spreading awareness in a positive light is the key to success.

[tweetthis]Instead of attacking and arguing, we can work together to educate.[/tweetthis]

Paula Simons is a first year veterinary student and creator of the blog Beyond the Blue Coat. Before her time at Ontario Veterinary College she worked as a veterinary technician in small animal practice. She currently lives in Guelph, Ontario but is originally from Philadelphia, PA. In her free time, Paula enjoys photography and hiking with her dogs Liberty and Bristol.

One of my favorite songs is “I Lived” by One Republic. The lyrics include:

I owned every second that this world could give

I saw so many places, the things that I did

With every broken bone, I swear I lived.

Isn’t that what we all want to do? If I could give a new graduate one piece of advice, it would be, “Don’t limit yourself.” The veterinary degree that you sweated bullets to earn can open up a multitude of possibilities.

[tweetthis]If I could give a new graduate one piece of advice, it would be, “Don’t limit yourself.”[/tweetthis]

Like most of you, I knew I wanted to become a veterinarian about as soon as I could form coherent thoughts. And like you, I adopted a wide variety of critters when I was a child: snakes, gerbils, fish, dogs, cats, turtles, and even a Madagascar hissing cockroach. Growing up, I worked hard, got good grades, and spent a lot of time with a variety of veterinary mentors to figure out my focus. When I was accepted into veterinary school at Michigan State, I knew that I wanted to practice small animal medicine, so I built my electives around that choice. I couldn’t envision doing anything else with my life.

When I graduated, I found a job with a progressive small animal practice in Midland, Michigan. My bosses were excellent mentors, both clinically and in terms of client service. But I had married a classmate and he wasn’t faring so well, so I followed him to Minneapolis, where he found a job in industry, and I took the only job available in a not-so-progressive small animal practice.

In that era, industry jobs were viewed as the “dark side.” (How could you leave practice?) But far from being dark, I saw my husband thrive. He was partnering with colleagues in practice; helping train them to provide the best care possible for their patients. And for the first time in our professional lives, we not only had time for a personal life, but could actually pay our bills.

Our next move was to Kansas City; again, we moved because of my husband (this time, he got a promotion). There weren’t many practice jobs available and I couldn’t find one that matched my practice philosophy. I saw how happy my husband was professionally, so I thought, why shouldn’t I investigate an industry job?

A veterinary journal was looking for an editor at the time. I had always loved English in high school and college, and the position was a great fit. I collaborated with specialists and honed my editing skills. I eventually grew into a position where I oversaw all things clinical, including the journal, website, and CE conferences.

It was professionally fulfilling and I stayed for quite a while. But eventually, I felt stale. About this time, I had a conversation with a friend who told me that he likes to reinvent himself every seven years to grow and feel challenged. I got it. So I looked at my options and moved on again.

I’m now with Putney, a veterinary generic pharmaceutical company. It’s an amazing small company with a very entrepreneurial feel. More importantly, what we do is vital to veterinary medicine. Our mission is to make pet healthcare more affordable by providing veterinary approved generic drugs so that clients can make decisions based on their pet’s medical needs vs. their paycheck. I feel proud to be a part of that mission.

The position involved a move from Kansas City to Portland, Maine, which wasn’t easy for my husband (but it was my turn for a move). The change in scenery has been fantastic – the ocean, mountains, lakes, lobsters. We love it.

I don’t know where you are on your own professional journey, but I want you to know that there are a lot of options out there and many ways to fulfill your passion for veterinary medicine, even if you’re sure you know exactly what you want to do right now. I recommend that you own every second of your experience. See places, do things and take the risk of trying something new. For me, that has been the key to no regrets.

[tweetthis]Own every second of your experience. See places, do things and take the risk of trying something new[/tweetthis]

Dr. Tracy Revoir graduated from Michigan State University (Go Green!) and practiced in Michigan, Minnesota, and Kansas. She is currently Manager of Veterinary Support for Putney, located in beautiful Portland, Maine.

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I spent most of my adult life preparing for veterinary school without admitting it, because I figured I would never make it there.

Every financial and academic decision I made, I made with this goal in mind, even though I never discussed it. I went to community college on a scholarship for free tuition, worked multiple jobs, budgeted and built up my credit, did my damnedest in school, got a cheap apartment, and when I transferred to my in-state university, enrolled in the Animal Science program. I always put in my best effort, but I truly believed that, at some point along the road, I would have to give up.

Going Forth With Optimism

I almost didn’t even apply to vet school. I’m not a book-smart person and I don’t master things by reading and writing them. I never thought my place was as a doctor, but I have an almost rebellious urge to push myself.

Toward the end of my degree at Rutgers, I met my friend Kevin. When I told him that I was going to apply to veterinary school but I might not get in, he was encouraging – he made it seem so attainable. Soon, I began telling my friends that I would apply, and then my family. Before I knew it, I was applying and asking freely for help. So, I told myself I would apply to vet school just once. If I got in, it was a sign that I should go. I applied, got into one school, and off I went to Ross.

When I began my first semester at RUSVM, I was extremely hopeful for my academic success. I had done well in undergraduate years, but not as well as I’d always wanted. Many of the veterinarians I knew said that vet school was much easier for them than undergrad – not because the information was easier, but because it’s more “in their wheelhouse,” so they felt more compelled to study and thus understand the material. Many of them said that their GPAs in veterinary school were much higher than their undergraduate GPAs. I hoped I’d follow suit.

Setting the Wrong Standard

That first September, my personal goal was pretty simple. At the end of my last semester, I just wanted to see more As on my transcript than I’d gotten in undergrad. Even just one more. Always the practical and realistic type, I didn’t put too much pressure on the first semester since I’d just moved to a foreign country and faced lots of new obstacles on a daily basis. When I got a neat row of Bs for final grades, I felt very neutral about it. I told myself that I could only go up from here, and promised myself As and Bs next time.

What seemed like optimism actually turned into the most painful, unachievable standard I have ever set for myself.

[tweetthis]What seemed like optimism turned into the most painful standard I have ever set for myself[/tweetthis]

Second semester, I did nothing but fail or barely pass exams, despite spending all my time studying or in-office hours. The fact that I was working so hard and barely squeaking by made me hate myself; but a challenge is a challenge. In the end I scraped by with mostly Cs and one lonely B. At first I was relieved, but then, in crept the thought that I had fallen short yet again: “My goal was for As and Bs, and I only got Cs and a B. How low do I have to make my standards?”

It began to take me down. Struggles surfaced that I hadn’t faced since I was a teenager. When you set a goal for yourself that you can’t achieve, and then you have to start lowering it, lowering it, and lowering it — in the face of all these people who are achieving it — you begin to hate yourself.

Because I will always push for progress, I came out fighting in third semester. The material was less abstract and more palatable – I was learning about bacteria (one of my favorite things) and viruses (for which I developed a passion). For the first time, including undergrad, I felt what it was like to master material, and it was awesome.

When we got our final grades, I found that all of my As had slipped down to Bs. Still, I was ready to accept that as progress, until I began to listen to my classmates. They’d hated the semester. They’d felt like it was useless information, stupid and purely memorization, but they’d still done better.

There it was: a year of personal progress, diminished in an off-hand way by people who I hold in such high regard. My best work easily and dispassionately outstripped. Maybe my improvement didn’t actually mean I was any good since it was “just stupid memorization.”

Halfway through vet school, I threw out my original goal, and instead pushed for just one A per semester. Fourth semester started, and in a massive effort to prove myself, I excelled. It was another great semester full of tangible, useful, inspiring material. I enjoyed it from beginning to end, but in the end my grades were the same as my third-semester grades – the ones that I had devalued to worthlessness. With all the right ingredients working for me, I still couldn’t make progress, and I still couldn’t perform above our class averages.

Defining Failure – and Success

Now, at this point, the only reason I was “failing” was because I was telling myself that I was. But, that is when I truly began to fail. I lost my spirit and slipped into a fierce, soul-sucking depression. These comparisons against my own previous performances and against my classmates’ performances undid me.

In fifth semester, I returned to therapy for the first time in a long, long time. Every day was a fog and I couldn’t recognize my own thoughts or words. I had so much love and support all around me, but it just hurt that my loved ones wanted to support me when I was so disgusted with myself. Class was a living nightmare. I felt that I was sitting in a room, being presented with my own ruin, being lectured by my own failures, being taught that my very best was the rest of the world’s mediocre.

I tried for a long time to heed the advice I give friends on a daily basis: “Bs are exceptional grades; you should be proud! Don’t beat yourself up too much — you had a lot going on that week! Stop being so hard on yourself or the stress alone will stop you from getting questions right! You’re in vet school and you’re passing. Isn’t that enough?” But when you’re stubborn and you aim to always improve, you can’t take your own advice. I would tell my friends these things knowing how hypocritical it was. But I needed to prove to myself that I could get an A, and I once again lowered my goal — if I got one A in all seven semesters, I would feel valuable.

In the end, I passed fifth. It was due to the help of my friends, who tutored me, and my boyfriend, whose voice drove me when I couldn’t empower myself. It was thanks to professors who gave me all of their time and became my personal coaches. I found a love for the material that had been taught all semester, despite my absence.

I began to fix the problems in my personal life, and I made a pact with myself. As long as I was happy with my own mastery of the material, I could dismiss grading and class statistics.

Setting Myself Up to Win

Since then, I have regained my old day-by-day happiness. Not because I’m doing an amazing job academically, and not because I’m “beating personal bests” or “always making progress.” It’s because I am happiest when I work hard on material that I love to learn, and to the simplest degree, that’s all I need to be successful. I check my gradebook to make sure I passed, then ignore it. I allow myself to have downtime without feeling wracked with guilt, and I no longer hide it when I watch TV or spend extra time Skyping with my family. I let myself watch a movie or take a drive without being defensive.

[tweetthis]I am happiest when I work hard on material that I love to learn.[/tweetthis]

Sixth semester yielded me the best grades yet. They happened to fall 0.01 GPA point short of the overarching goal I had set for my seven semesters – something that would have destroyed me a year ago. I still don’t have one single A on my transcript from my entire time here at Ross (oh, let me count the B+s!), but that’s okay. I was never cut out for academia. I hate studying, and I hate getting lectured to for six plus hours a day.

What I have learned is that I was cut out to be a veterinarian. I love learning, and I love being on my feet twelve-plus hours a day just to solve a few problems. From now on, I will utilize the strength I had from the start: being a happy worker. This is what has made my final semester so rewarding and empowering.

With my final months of vet school coming to a close, I am looking back on what I put myself through for 2.5 years. To be honest, I don’t remember the hard times and the pain as much as I remember all the shiny moments that made my heart happy, the small triumphs I prided myself in that others would have dismissed. Like when after months of repetition I finally recalled anatomical details of the horse leg that everyone already knew, when I pulled my Reich average up from a 60 to a 70 with one great exam, or the appreciation I developed for clinical pathology puzzles.

I remember the conversations I had with professors who rooted for me, and all the times I took a drive to chase down a moment of pure peace in a beautiful corner of the island. The time I passed my aseptic exam, the time I changed our donkey’s bandage in record speed, or the time the surgeon hated on me through a whole procedure and at the end admitted that I suture beautifully. These are the moments I’m basing my success on.

My advice for anyone on a tough path, veterinary student or not, is that when you start to struggle, look to yourself first. Maybe it’s you who is standing in your way. You will be your biggest antagonist unless you can learn to work with your strengths and forgive yourself the weaknesses. My drive is what earned me a seat at this school, but it also almost caused me to withdraw. Build the relationships that will love you at the bottom and celebrate you at the top. Create those tiny moments to live for. One tiny shiny moment after the next, you will have a grand accomplishment. Nobody blossoms without a little appreciation – that goes for yourself and the people around you.

Erin Gruber is a third-year veterinary medicine student at Ross University in St. Kitts, and will be attending her clinical year at Purdue University. Her career interests include large animal medicine, public health, and bison. She is from Beachwood, New Jersey and has two dogs, Abbey and Rascal.