Jessica Vogelsang DVM

There is a hypothesis, made popular in the book “Born to Run,” that humans evolved to run long distances.  You see, around 2 million years ago our ancestors brains grew to unprecedented sizes.  Brains use a lot of energy—the kind of energy that comes from eating meat.  There is little evidence to support hominid’s ability to hunt at that point in history.  We had no claws, nor were we particularly powerful.  Sophisticated hunting tools have only been discovered as far back as a few hundred thousand years.  So where did we get all that brain growing meat from?

The answer, according to some, is persistence hunting.  Persistence hunting is the idea that early man hunted by chasing prey to the point of heat exhaustion.  We were slow and weak, but we had the stamina and fortitude to literally run an animal to death.  Endurance was our evolutionary superpower.

Burnout is a big problem in veterinary medicine but if early man’s endurance could help him not only survive, but thrive in the savannah, then we can surely survive and thrive in our modern day careers.  We were born to endure, all we need to do is take a little advice from our own bodies.

Slow Down

Speed and endurance are a trade-off.  You can only go full sprint ahead for so long before you collapse.  The persistence hunter’s prey will run off faster than they will, but as soon as they get ahead, they have to stop and rest, giving the hunter a chance to catch up again.  It’s the tortoise and the hare.  Slow and steady really does win.

At work it can feel like all that work is chasing you down like you’re the prey, but you’re not.  You’re the predator, taking tasks down one by one.  But to do that right, you need to take your time.  When you rush, you wind up feeling discombobulated, you miss things, you make mistakes and you get burned out.  Slow down.  You’ll get caught up eventually and you’ll feel better about the work that you did when you do.

Be Efficient

Efficiency is key.  Humans have evolved several adaptations that help us run more efficiently—ligaments that help stabilize our neck and shoulders, longer legs, shorter toes, rubbery tendons that store energy, and large adrenal and thyroid glands that help us metabolize and utilize energy stores better.

Efficiency at work is vital.  That means scheduling properly, having enough support staff, and also, not wasting time.  Write your medical records up for each patient before moving on to the next (guilty as charged here). If you have a spare minute, refill that script that’s been sitting in the pharmacy instead of waiting impatiently for the front desk to finish checking in the next client.  Delegate tasks to the right support staff instead of trying to do everything yourself, but offer help to each other when needed.

Stay Cool

One of the biggest advantages humans have to help us go the distance is our ability to cool off.  We’ve all probably had the misfortune of seeing what happens to an animal who over heats—pulmonary edema, seizures and DIC for starters.  Most mammals cool by panting, but it’s not very efficient, and you can’t pant and run at the same time.  But humans sweat!  This allows us to dissipate heat off of a much larger surface area and helps keep us cool.

We need to adapt and find ways to keep cool at work too.  Sometimes it’s just stepping away from a situation for a couple of minutes.  Sometimes it’s making sure you get a proper lunch break.  And sometimes it’s bigger.

In those circumstances when it seems like life and work is getting to hot too handle, it’s important to make sure you have people to confide in that can understand what you’re going through.  Having a good relationship with the people you work with so that you can celebrate wins and commiserate losses together is important.  If you work in a toxic environment where that’s not possible, it might be time to move on to a new practice.  In the meantime, look for other colleagues you can vent to.  Join your local VMA, or look online.  There are some great Facebook support groups like Not One More Vet or Veterinary Support Staff Unleashed.

Get Some Air

Anaerobic respiration will only take you so far.  We need to breathe in oxygen if we want to last and humans are excellent breathers.  As bipeds we are able to standup tall, puff out our chests and suck in large amounts of air.

We all need to take time to catch our breath if we want to keep moving forward.  Working all the time is a sure fire way to feel suffocated.  The oxygen that sustains us is our friends, family and hobbies. Just as it’s important to have colleagues who understand what you’re going through, it’s important to have a support system that’s unrelated to work.  Surround yourself with people who will take to you about sports, travel destinations, or politics (okay, maybe not politics). Go for a run, take up knitting, read a book (but not a medical one).  Just make sure you take a little time to get fresh air.

The truth is, we’re losing too many good veterinarians and technicians to burnout and compassion fatigue.  And many people in the field are only still here because they feel trapped by large student loans or other circumstances.  That is not okay. Veterinary medicine is a fulfilling and important vocation, not a prison sentence.  It’s not always going to be easy and sometimes we’re going to struggle, but we were built to endure.  So slow down, be efficient, stay cool, get some air, and enjoy the run.

The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.

 

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About the Author

Dr. Lauren Smith graduated in 2008 from Ross University School of Veterinary Medicine and completed her clinical year at Cornell University. Her professional interests include internal medicine, preventative medicine and client education. Dr. Smith lives and practices on Long Island with her cat, Charlie and dog, Frankie and loves to read write and run in her free time.  You can check out more of her writing at laurensmithdvm.com

In the midst of the emotional trials of the start of my small animal rotating internship, I needed a way to escape on my days off. The siren song of binge watching mindless television was inescapable, and I turned to that old standby Grey’s Anatomy.

During vet school, my friends and I watched Grey’s – for me, the second time through the seasons, but the uninitiated were among us as well. We made fun of bad medicine, cursed the show’s ability to draw us in, and quickly decided which characters we loved and which we hated.

This summer as I restarted season one in those first fragile months of my internship, Grey’s reached a level of, dare I say, poignancy. Meredith, Christina, Alex, Izzie, and George were interns. I was an intern. They worked long, stressful hours. I worked long, stressful hours. They hated their lives. I hated my life. Grey’s Anatomy spoke to me on a level that I had never appreciated before. (And then, of course, I stepped back and incredulously asked myself “Grey’s Anatomy? It speaks to you? Seriously? Seriously.”)

Let us for a moment set aside the ridiculousness of my finding relevancy in my life through the soap opera that is the lives of everyone at Seattle Grace. There are actual valuable things to be learned from that show.

1. One of the most indelible lessons for me: find your people.

I feel like this is an especially poignant reminder for me because I – like many in the sciences and medicine – find relationships with people to take special effort to form and maintain. And here was Grey’s telling me in no uncertain terms that relationships mean survival.

We all have people we’ve acquired throughout life, best friends we picked up along the way. But Grey’s reminded me that an internship comes with people built in and even though these people were selected for me by that mysterious veterinary-dating-game that is The Match, they are who I have for the next year. Now, I should take a moment here to say that my intern class is a bunch of awesome weirdos so we get along famously. But the point that Grey’s was so keen to teach me was that these awesome weirdos aren’t just part of my work life: these people are the reason that work-life balance exists.

2. The second most important thing I learned? Dance.

Crank up the music, forget that anyone is watching, and dance your heart out. Get your blood pumping and shake off all that stress that is dragging you down.

3. And finally, a reminder from a certain raven-haired neurosurgeon: “It’s a great day to save lives.”
Seriously.

The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.

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ABOUT THE AUTHOR

My name is Kendra Rushing, I am a recent graduate originally from the Pacific Northwest. I’m currently a small animal rotating intern.

“Are you sure?” I replied when I found out. Tears rolled down my face. This had never happened in my career. How could I tell Tanner’s family? I could not believe this was happening.

It’s one of the hardest parts of my jobs as a veterinary cancer specialist. Clients who want to treat their dog or cat but cannot afford it. Treating cancer in pets can be really expensive. I always try to present a range of treatment options at a variety of costs. I am used negotiating which diagnostics might not be needed before we start treatment. I am used to discussing plan B, plan C and sometimes plan D for treatment. And then sometimes the no treatment option is picked because everything else too expensive. And even though I am used to it, it can be heartwrenching.

Treating a pet for cancer is not the right choice for everyone.  Tanner was just diagnosed with lymphoma. He is an 11 year old gorgeous Golden Retriever with a distinguished white muzzle. For Tanner’s family, it wasn’t that they did not want to treat his lymphoma. It wasn’t the logistics or the almost 2 hour drive each way for treatment each week. It was the cost. I completely understood as I stood in the exam room. She was pregnant and she explained her husband was on strike. She was still working as a teacher but they also had another small child at home. Tears rolled down her face, and her mom’s. Tanner looked at his owner, concerned about her sadness. They so wanted to treat with chemotherapy but they could not make the numbers crunch. It was decided. They would take some steroids home for him and recheck locally with their primary care veterinarian when needed. I thought it would be the last time I would see Tanner.

Even though lymphoma is an aggressive cancer, it is very treatable in dogs, treatment is very well tolerated and treatment makes a huge impact on a dog’s survival time. Without treatment most dogs only live a month – it’s devastating to tell owners that. Especially since the majority of dogs are still feeling normal with no symptoms at the time of diagnosis. Besides the swollen and enlarged lymph nodes, Tanner was pretty good – just one recent episode of vomiting. He wagged his tail throughout the appointment.

I explained with a 5-month weekly CHOP chemotherapy protocol, there was reason to be hopeful. Response rates are very high (>90%). Treatment increases the median survival from 1 month to 13 to 14 months. Eighty percent of dogs have no side effects from chemo and if they get them, they are usually mild and self-limiting, lasting just a few days. Most owners are so satisfied with their dog’s quality of life on chemotherapy – and after. My motto is live longer, live well. And dogs treated with chemotherapy do both.

Tanner’s family elected prednisone, a steroid. He should live about 2 to 3 months, I told mom as she cried. I educate clients to hold on starting prednisone until the decision to give chemotherapy is 110% off the table. It has been shown to make the chemo less effective.   As he walked past the Christmas trees in the waiting room, I knew this was not going to be a merry Christmas for Tanner’s family.

Then late that night I was informed that an anonymous donor had decided to pay for his $9000 chemotherapy treatment. “Are you sure?” I replied when I found out. He had started prednisone this evening, and tomorrow was my last day in the clinic before the weekend. I called work at 11 pm and got mom’s email and told her the good news. Tanner had a guardian angel. I hoped she would get the email and could somehow get Tanner back in to start chemotherapy in the morning. I could barely sleep.

First thing I did when I woke up was check for a reply. None. Disappointed, I guessed my email was in her Junk mailbox. I texted my nurses before work and asked them to call 1^st thing when they got in. As I commuted into work, I anxiously waited.

“Are you sure?” Tanner’s mom replied when she found out.  Tears rolled down her face. Her mom agreed to bring Tanner in to start her chemotherapy that morning. We all cried again, but tears of happiness. We are all in awe over the kindness and generosity of this anonymous donor. I was told the donor said, no one should be without their pet for holidays. Truly priceless.

The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.

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ABOUT THE AUTHOR

Dr. Sue Ettinger is a practicing veterinary cancer specialist, international speaker, book author, and is currently the head of the Oncology Department at the Animal Specialty & Emergency Center in the Hudson Valley, NY. She is one of approximately 400 board-certified specialists in medical oncology in North America. She received her veterinary training at Cornell University College of Veterinary Medicine. She completed her residency in medical oncology at the Animal Medical Center in NYC in 2003. She has recently won the Woof Pack Award for Exceptional Doctor Performance in the Northeast specialty region.

Also known as Dr Sue Cancer Vet^®, Dr. Sue is the co-author of the Second Edition of The Dog Cancer Survival Guide, which is a best-selling book in small animal health for the last several years. She co-hosts the podcast The Pet Cancer Vet on radiopetlady.com. Dr. Sue is most passionate about raising cancer awareness, and she has developed “See Something, Do Something, Why Wait? Aspirate.^®” to promote early cancer detection and diagnosis.

Dr Sue’s popular Facebook page has over 31,000 fans. She can be found on social media at www.facebook.com/DrSueCancerVet and @DrSueCancerVet on Twitter.

2015 was the worst year of my life. (Well, until 2016, but hold that thought.) It started innocently enough, with a series of talks about hospice and OneHealth and how working with death in veterinary medicine made us better equipped to handle other deaths in life, then it ended with the old adage of God laughing at your plans.

“I see you are speaking about the important of hospice,” He boomed, stroking His long grey beard (I was brought up Catholic, I can’t imagine it any other way). “It’s great that you’re talking about families and the importance of dying at home and all that stuff.” Then God called my bluff by, quite unexpectedly, sending my young and vibrant mom brain cancer and forcing me to figure out just how far I was willing to commit to this whole “death is a family affair” thing.

So like I said, bad year.

Anyway, at the end of 2015, my sister and I sat by a fire and threw a lot of things in it, literally and symbolically torching what had indeed been a dumpster fire of a year. Up until last year, Christmas was absolutely my favorite holiday ever. I played it at Buddy the Elf level, to give you an idea how much I loved it. It was the only time of year that I could unfailingly rediscover that warm fuzzy feeling of a fleece blanket and a perma-hug, joy and anticipation and goodwill that not even the annual Christmas Vet Clinic Death March could overcome. It was magic, electric, life-affirming. In short, this was me through 2014:

via GIPHY

And then in 2015 we wound up somewhere around here:

via GIPHY

I left every decoration in the box and went away for Christmas, for the first time in my life. The joy was gone, evaporated, pouf. I looked around for it, hoping some imprint of the magic would remain in my brain like the sparkling trails left in the sky as a firework fades into black, but….nothing. It was just one of many significant things cancer stole, but it has the added insult of circling back every 12 months to kick you a few more times, for good measure.

I survived 2015, through a combination of relentless gratitude, meds, family and friends. I say this not because I want to show you all how well I’m doing but to let you know that sometimes, surviving is pretty much the best you can do, and that’s ok. I embraced the “count your blessings” routine for a bit because I had to in order to get up every morning, but I am also the first to admit that this lasted only through the first six months. In 2016 that act got old and I spent a good amount of time wallowing.

2015 was bad for me, but 2016, as far as I can tell, sucked for almost everyone. I don’t know why. Maybe it’s some weird black hole vortex of suckitude that happens once a century? An evil wizard placed a curse on 2016? Across the board, so many friends lost loved ones, and jobs, and houses, relationships, and a sense of security. Take, for example, last week’s Friendsgiving dinner at my dear friend’s house. This is who I was sitting with:

• The host, whose car was totalled the week before and was just now able to get out of bed and walk across the room;
• A friend who lost her mother and best friend within weeks of each other;
• A man whose young daughter was hospitalized for seizures of unknown origin earlier in the week;
• A doctor who is losing her job and entire life’s work at 35 because she has severe degenerative illnesses and can no longer work;
• A friend dealing with the pain of unexplained infertility;
• And me, refilling the quickly emptying wine glasses with rapid abandon.

At the end of the night we all sat looking at each other with a sense of empathy and flat-out exhaustion. Like, I get that it’s good to count your blessings and all, but SERIOUSLY, isn’t there a point where we get to just puff out our cheeks and say, “Wow, this really sucks”?

A few days ago, I posted a link to the infamous dumpster fire ornament tutorial on my Facebook page with an open invitation for anyone who wanted to, to come to my home and make one. When life sends you a dumpster fire, turn it into a festive ornament, that’s what I say. Crafting for the Cranky. A good number of people responded with a “heck yes!” and one person, a very nice and kind person who is the one woman I know who had a great year, responded with a sad face and a suggestion to focus on the positive.

She was not invited to my ornament party.

I am a big fan of resilience and doing what you can to survive and recover from bad circumstances. That being said, I also think a good part of that resilience means giving yourself permission to just stew and be sad and mourn for a bit too without feeling like you need to minimize just how bad you’re doing on any given day.

So I guess what I’m saying is, as a veteran wallower, if you’re having a sucky 2016, I get it and I give you permission to skip the Ugly Sweater parties, cookie exchanges, and cocktail hours. There’s a time and place for everything, even a good long pity party. Getting irrationally upset by a rerun of Love, Actually happens to the best of us. Sometimes you just have to watch the dumpster fire burn, you know what I mean? It’s ok. You’re only human.

If you’re having a terrible 2016, I’m sorry. I will sit by the fire with you and let you rage a little bit, because you should let it all out. Don’t be afraid to ask for what you need, especially if what you need is space. And if you’re having a great 2016, a grand old time of things, just be content to sit quietly on the edge of the shadows with a fire extinguisher. Sometimes just listening is the best thing you can do. Save your pep talk for the times it is explicitly requested, and it will be- just not right this minute.

Happy holidays to you all, and “Tolerable/Survivable December Dumpster Days” to those downtrodden elves who knows exactly who you are. Cheers.

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The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.

The following is an excerpt from the new book Unlikely Companions: Adventures of an Exotic Animal Doctor (or, What Friends Feathered, Furred, and Scaled Have Taught Me About Life and Love by Laurie Hess, DVM with Samantha Rose.

“DID I TELL you I found my python?” my intern, Lauren, had asked me.

Lauren’s missing ball python, Cecil, had been the topic of much conversation in the surgery room. Ball pythons are a very popular pet snake, especially in apartments because they rarely grow longer than five or six feet and do not get very wide in girth—except they commonly go missing, often for months or even years at a time. I’d gone over to Lauren’s twenty- two-story high-rise in Midtown Manhattan, where many of the interns lived, to try to help find the brown-and gold-speckled snake, but after a thorough search we conceded that he seemed to have disappeared without a trace. After several months, Lauren had given up on ever seeing him again.

“Where’d you find him?”

“Oh, I didn’t—another tenant did. My neighbor Jill got into the elevator, and there he was. Curled up in a tight little ball in the middle of the elevator floor. Pretty fantastic, right?”

Lauren was beaming, but I couldn’t help wondering if “fantastic” in this situation was a relative term. I doubted that Jill shared Lauren’s enthusiasm when she stepped into the elevator and found a four-foot python at her feet.

As if she’d heard my thoughts, Lauren chortled, “Well, I guess it did freak her out a little bit. She said she felt something touch her foot and ignored it until Cecil uncurled and started crawling up her leg. She screamed, kicked him off, and ran out of the elevator so fast, she said, that she left her strappy sandal behind.” Lauren giggled to herself. “Oh, Cecil, he doesn’t mean any harm.”

I imagined that Cecil must have survived for all those months on the building’s rodent population, but I didn’t share that conclusion with Lauren, since she still lived there. Stumbling upon a food source is the best-case scenario for a lost snake like Cecil, although snakes can survive for long periods without any food at all. They will curl up and go into a sort of shutdown mode, in which they slow their heartbeat, lower their temperature, and stop moving. Their already slow metabolism comes to a near standstill, and they can survive without food much longer than most any other animal I know of. I remembered my client Gus, the owner of a red, brown, and yellow milk snake that was about three inches in girth and went missing for nearly a year. Like Lauren, Gus had thought he’d never see his pet again, but the snake must have been living in the pipes behind his fridge. One morning, he slithered out of his hiding place, and Gus stumbled on him in the middle of the floor. Looking rather emaciated and weak, like a deflated bicycle tire, the snake was in desperate need of emergency care, so Gus gently coiled him up and transported him to our hospital in the bottom of a laundry basket. There I treated him for extreme dehydration with a dose of an electrolyte solution under his skin and some liquid food through a tube passed down to his stomach.

Excerpted from Unlikely Companions: Adventures of an Exotic Animal Doctor (or, What Friends Feathered, Furred, and Scaled Have Taught Me About Life and Love by Laurie Hess, DVM with Samantha Rose. Copyright © 2016. Available from Da Capo Press, an imprint of Perseus Books, LLC, a subsidiary of Hachette Book Group, Inc. Available at Amazon.