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How My Need for A’s Almost Cost Me Everything

December 11, 2015 by Dr. Andy Roark Community

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.

Think Twice Before Giving Pets as Gifts

December 9, 2015 by Andy Roark DVM MS

There are few things cuter than a puppy or kitten in a box. But before you consider giving a pet as a gift this holiday season, remember that you’re gifting someone a tremendous responsibility. Pets are a decade-long commitment of time, energy, and money. Talk it out and remember that a pet is a serious commitment.

[tweetthis]Kittens and swim teams – are they good gifts this holiday season? [/tweetthis]

The Veterinarian’s Holiday Survival Checklist

December 7, 2015 by Cherie Buisson, DVM, CHPV

Where did the year go? I need three more Augusts (minus the sweltering heat here in Florida) to catch up! The holidays are always stressful, even for those of us who love them. We have a tendency to do everything possible to make the holidays harder than they have to be. Here are a few tips to surviving all the cheer and chaos.

1 – Postpone – Leading up to the holiday, figure out what must be done and what may be put off until later. Do the windows really need to be cleaned before everyone arrives for dinner? Will anyone care if the front yard isn’t perfect? Can you avoid making that new and complicated side dish this year? Deliberately choosing to relieve yourself of some of the holiday burden ahead of time can make the rest of your to-do list seem more manageable. Remember that clients are also struggling with the holidays – if there is pushback about workups and treatments, consider reassessing at a later date if that is appropriate. You may avoid a complete refusal of care by providing some breathing room.

2 – Cut back – If you are all stressed up with nowhere to go, the point of the holidays is defeated. If you need to spend a bit less on gifts, do it. The only people who will be angry probably don’t deserve a gift at all. How many food items do we need before family dinners become ridiculous? Pick a few favorites, and if anyone wants something else, ask them to bring it with them. If you are dreading holiday parties, decline invitations until you feel less burdened. If you aren’t going to have fun, don’t go. Multiple office holiday parties can get expensive. If the gift exchange game is voluntary, just sit it out this year.

If you are all stressed up with nowhere to go, the point of the holidays is defeated.

3 – Make it fair – If you cook, don’t clean. If you clean, don’t cook. If you are always the host, ask someone else to volunteer. If you are always asked to travel, offer to host and have everyone come to you. Don’t be the person who volunteers to work every holiday unless doing so makes your life better. If your work policy is to see everyone who calls the day after a holiday, encourage extra staffing to compensate. If not, send some cases to the emergency clinic if needed.

4 – Take a break – Go lie down and take a rest if you need to. Escape to a local park or to the movie theater. If work is slow, ask to go home early if you can afford to do so. Take lunch away from the office if possible. One year, my husband and I took a cruise for Thanksgiving. Although we missed spending time with our families, it made the rest of the holidays more enjoyable because we were well-rested.

5 – Keep it simple – Christmas lights always bring a smile to my face – until I have to put them up. Decorating and cleaning for the holidays can be exhausting. A few years ago, I was in a car accident. The thought of not decorating made me feel worse. Instead of going all out I got help with the outside lights and didn’t put a single ornament on my tree. I wrapped it in poinsettia garland and white lights. I’ve gotten more compliments on that tree than any other. It’s been that way ever since. It doesn’t take much to add a festive feeling to your home or office – only do what brings you joy.

6 – Sleep – Being overtired and dealing with guests or clients is a dangerous combination. If you’re not doing something vital to national security, GO TO BED EARLY. If everyone takes a tryptophan-induced nap after dinner, leave the dishes in the sink and go nap yourself. Trust me, they’ll be there when you wake up!

7 – Exercise – One of my favorite holiday traditions is the Ghost Town Bike Ride (this isn’t an actual thing, so don’t Google it). Every Thanksgiving and Christmas morning, my husband and I get up early and ride our bikes. There is NO ONE on the road. The quiet is almost eerie in our busy city. It’s as though the peace and physical exertion provide a Control + Alt + Delete for our stress levels (plus I eat with less guilt). We’ve also done an after-gorging walk in the park that helps our digestion and lets us breathe the fresh air. Even taking a minute to stretch at work or taking a walk around the building can clear your head and make you more efficient.

8 – Eat wisely – Oh, stop rolling your eyes! I know holiday meals are a time when most of us throw our diets to the wind and eat until we can’t breathe. I still eat everything I want, but instead of piling my plate, I take a small spoonful of everything the first time around. I can go back for seconds or thirds if I want, but challenging yourself to eat a giant plate the first round is just asking for trouble. Using a smaller plate can help you not feel deprived. My mom and I tend to split pieces of desserts so we can taste everything without making ourselves sick. I also try to make myself chew everything thoroughly instead of bolting it down. That gives my stomach time to fill up. Remember, you’ll get sick of leftovers before the week is out. Save something for tomorrow! The office break room is a dangerous place to be during the holidays. Put some of the holiday calories out for your clients to enjoy. Wrap a cheer plate for the postal workers, delivery people and reps as they come by.

9 – Let it go – Refuse to take part in work or family arguments or acknowledge slights. It is supremely frustrating to try to fight with someone who won’t respond. If there’s a blowup at work, acknowledge that this is a very stressful time of year and work to defuse rather than discipline. If you are a holiday host, invite guests to step outside for the Airing of the Grievances. If you are a guest, busy yourself with dishes or take a walk if conversation becomes hostile. You are the only person you can control. Release yourself from the responsibility of making everyone happy or keeping the peace.

10 – Remember – Many of us have painful holiday memories. I lost both of my grandmothers within a week of Christmas, so there is always some sadness associated with that holiday. Every year, we toast those who are present and those who aren’t. We tell stories about our loved ones that make us laugh, even if we’ve all heard them a hundred times. If a recent loss is overshadowing the holidays, be kind to yourself and don’t take on so much. Consider honoring lost pets at your office and reaching out to clients you know are suffering. Kindness to others is a win-win.

May your turkey come out juicy and your cheesecake not so much.

I wish you all a peaceful holiday season. May you find more joy than stress. May your turkey come out juicy and your cheesecake not so much. May full mouths prevent ugly words. May the beauty all around you stand out. Above all, I hope you treat yourself with love, kindness and understanding in a world that often lacks all three.

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.

Two Tricks That Keep Bad Pet Advice Alive

December 5, 2015 by Andy Roark DVM MS

I love the Internet. I love discovering new things, meeting people, and getting things done faster than ever before. But there’s one part of the Internet that makes my head hurt, and that’s the way it circulates bad pet advice.

Generally, I’m pretty pleased with how much good pet advice is out there. I feel honored to write for a few online sites and contribute to their libraries of medically sound information, and I love seeing my colleagues dropping knowledge bombs all across the Internet. Still, I can’t help but notice how rarely these pet health articles take off and how often baseless, confusing half-truths go viral. To be honest, it drives me nuts.

Ever heard these myths?

Ice water can kill your dog.

Tobacco can be used as a dewormer.

Garlic is a great flea repellent.

Febreeze is poisonous to dogs.

Swiffer Wet Jets spray poisons pets.

Vets get kickbacks from companies to sell dog food.

You should never vaccinate your pet.

Heartworms aren’t real.

I know I have. And I understand how myths end up online — the Internet has no built-in fact checking mechanisms. But what makes that false information spread like wildfire? If we look at human psychology, we can see two fascinating reasons.

Confidence is king.

I think most of us working in medicine would agree that Voltaire had it right when he said, “Uncertainty is an uncomfortable position, but certainty is an absurd one.” We all wish the answers to our questions were simple. No one likes having to think through a complicated response when faced with what seems like simple question, but complexities are often the reality of modern medicine. On the flip side, people are drawn to sound bites. Even a statement that defies common sense can win over hearts if it is delivered with passion and confidence.

[tweetthis]What makes that false information spread like wildfire?[/tweetthis]

Here’s an example. On the question of whether to vaccinate pets, you’ll generally hear one of three things:

No! Vaccines are bad! Don’t do them!

Yes! Vaccines are good! Give them all and often!

Well, it depends… Really, we need to talk about exposure potential for this specific pet, the health status of this specific pet, vaccine risk factors, and the availability and reliability of titers for measuring current immunity, among other considerations.

So, which of these three positions do you think is medically sound? Which is also the least persuasive when tweeted out in 140 characters or used as the title of a blog post? Exactly. The third choice — the complex one.

The irony is that people spreading incorrect advice often do it with complete confidence, while people working to provide accurate information come across as uncertain. That’s because they are constantly learning, finding new data, and trying to communicate a complete picture. The sad side effect of that diligent approach is that the ones offering up complicated truths will rarely deliver snappy sound bites — putting them at a disadvantage when it comes to propagating information online.

Lesson: Beware one-size-fits-all statements and catchphrases. They’re simple and easy to share, but often incomplete.

[tweetthis]Lesson: Beware one-size-fits-all statements and catchphrases.[/tweetthis]

It’s all about congruence.

You don’t have to be a psychologist to know humans put a lot of stock in the way we think about ourselves. Self image is important to us. We want to believe that we are good, smart, and kind people. Most animal lovers also want to believe they are excellent pet owners. Seeing ourselves that way makes us happy.

When we behave in a way that supports our self-image (say, we take our dog for a nice walk), we feel good, because our actions are in line with our self-image. That’s called congruence. However, if we act in a way that clashes with how we like to see ourselves (maybe we forget to feed the dog before going to work), that’s incongruence, and it bothers us.

So, let’s say we have a friend named Jim who loves his dog and sees himself as an excellent “dog dad.” Jim lives in the heartworm capital of the world, but doesn’t want to use heartworm prevention. He may have had a pet that vomited after taking it, or never used it with dogs when he was growing up, or doesn’t want to spend the money on it — whatever the reason, he just doesn’t believe in using it.

If we tell Jim that being a good dog owner means giving his dog heartworm prevention, he’s likely to get angry. Why?

Jim might feel angry because if heartworm prevention is part of being a good dog owner, then the way he sees himself (great dog owner) and his actions (not using heartworm prevention) are at odds. This incongruence causes Jim psychological stress, even if he doesn’t recognize why.

If Jim wants to feel better — to resolve this conflict — he can do one of two things: he can start using heartworm prevention, or he can justify why he is still a great dog owner without using heartworm prevention.

There is a very good chance that, without even realizing why, Jim will choose the second option because it doesn’t require him to change his behavior. In this case, he will decide heartworm prevention is not required to be a great dog owner. Then he will seek out validation and information that supports this position. He’ll also look for others who share this belief.

This is where a trick of psychology called confirmation bias kicks in. Confirmation bias is the natural tendency we all have to look for information that supports what we already believe, while ignoring or downplaying the importance of information that is counter to what we believe.

In Jim’s case, if he wants to believe that heartworm prevention is unnecessary, he will be drawn to articles or videos or comments that support this theory. He will also naturally skim past or conveniently forget statements that support the opposite. Jim will thus find (and probably share) information that opposes heartworm prevention and restores his self-image as a fantastic dog owner.

(To be clear, my point here is not to stir up an argument about heartworm prevention. This is just one example of conventional wisdom and how it plays into our natural psychological patterns. Please don’t send me letters.)

Lesson: On the Internet, people are drawn to “facts” that make them feel like they’re already doing the right thing and don’t have to change their behavior. It’s just human nature.

Human psychology is a wacky thing, but as we all know, people are the most complex animals of all. The next time you see a temptingly simple headline, pause for a moment and think about whether your mind might be playing one of these two common tricks on you. The real story may be a bit more complicated — but the truth always is, isn’t it?

[tweetthis]Lesson: People are drawn to “facts” that make them feel they’re doing the right thing[/tweetthis]

My Oversight Cost a Dog’s Life- and This is What the Owner Did

December 2, 2015 by Dr. Andy Roark Community

Although I’ve been a veterinarian for over ten years now and feel confident in my abilities, a few years ago I made an obvious mistake that I believe cost a young dog his life, and it left me devastated.

An aggressive Lab mix named Buddy was seen by my associate for not eating his dry dog food. The patient appeared healthy, and was still eating his treats, canned food and table scraps, but the doctor was unable to perform an oral exam due to his aggression, so he scheduled a sedation dental and bloodwork the day of surgery.

I remember that morning being very busy, and I also recall looking at the results of the bloodwork – I thought everything looked good, so we sedated him for his dental procedure. His teeth were perfect, so I checked the jaw for any problems and saw nothing. When the owner came to pick him up, he mentioned Buddy only wanted table scraps now, which led me to believe the dog was just being picky. I discussed feeding options with the owner and sent him home with his dog.

Five days went by and Buddy was back in the office, but this time, he was not eating at all and was unbelievably icteric. We ran bloodwork and found his liver values were extremely elevated; he was in severe liver failure. We started fluids as I tried to figure out what could have happened in the last few days.

As I was rattling my brain, another associate showed me his bloodwork sheet from the dental. The liver values were elevated even then, but I missed it, even though it was right there. How could I have missed this? Did the technician give me the wrong paper? Did I confuse the liver value for another value? I was shocked. What do I tell Buddy’s owner?

I talked to my insurance and was told not to claim guilt, but that didn’t mean I wasn’t going to do everything I could to help this dog pull through. I was out of town over the weekend, so I transferred Buddy to the emergency center and told the vet at the center not to let Buddy die.

I thought about him all weekend, and my associate kept texting me about how I needed to tell the owner, regardless of what the insurance company said. He was right; I had to tell the owner. My conscience could not take it. I made a mistake, an oversight, and now this patient was fighting for his life. If I’d caught this issue at the time of surgery, I could have started treatment on him right away. This owner trusted me, and I was a disappointment to him and his companion.

The weekend passed, and I told him the truth Monday morning. Through my tears, I told him about how the initial bloodwork showed a problem, but I’d missed it and so treatment was delayed. I prepared myself for the worst. I was ready for the yelling, storming out with his dog and/or threatening to get a lawyer involved. But I wasn’t ready for what came next.

I am not sure what his exact words were, but through his own tears, he told me that it was okay. That I was human and we all make mistakes. He consoled me instead of allowing me to console him. I believe there was even a hug involved.

Buddy’s owner forgave me when I couldn’t even forgive myself.

We came up with a treatment plan, and for the next few weeks Buddy was on fluids, antibiotics and liver support. He got a little better, but was not improving like most dogs would, so we performed liver biopsies and cultures. The culture came back resistant to most of the commonly used antibiotics for hepatic infections, and the histopathology revealed cirrhosis as well. His liver was shot. Bile acids confirmed this diagnosis.

We kept him on supportive medications and, for a few months, he did well. Buddy and I actually became great friends – I even watched Buddy one weekend when his owner went out of town.

When I euthanized Buddy, his owner and I cried together. The guilt that I had suppressed for those last few months came flooding back, and because I’d grown to care so much for Buddy over those few months, the sadness was irrepressible. And still, I remember the owner thanking me for all I had done for them and for giving him a little more quality time with his Buddy.

Several months later, Buddy’s owner was in with a new young adult Lab mix … and he requested me. Once again, I was blown away by this man’s forgiveness and trust in me.

I have a framed collage of Buddy pictures that his owner gave me. I keep it in my office, partly as a reminder of the strength of the human-animal bond, but also as a reminder for me to double-check everything on patients.

It’s also a great reminder to forgive others often, as well as forgive myself. None of us are perfect, so I forgive my clients for their shortcomings as owners, as well as myself for my own flaws. Forgiveness is truly a gift, and it’s one that should be shared.

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.

Dr. Jamie Miller is an owner/veterinarian of a small animal and equine clinic in rural/suburban area in western Illinois. She lives with her husband and two small children on a farmette surrounded by numerous species. She enjoys showing her reining horses in her “free” time.

A Musical Tribute to Dr. Google

December 1, 2015 by Kelsey Carpenter

There are many people and websites that claim to have expert opinions on the care and keeping of pets but ultimately, the best source of information is your vet clinic. Everyone’s favorite veterinary songstress, Kelsey Beth Carpenter RVT, takes to her guitar to remind you not to believe everything you read or hear.

[tweetthis]Did Dr. Google go to veterinary school? [/tweetthis]

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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Confidence is king.

It’s all about congruence.

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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