Perspective

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.

There is an epidemic in veterinary medicine that no one is talking about. It’s cyber-bullying, and it must stop. Disagreement and constructive debate are healthy and productive. Abuse is not.

I’ve had a rough couple of weeks, honestly. The fact is, I am being targeted and attacked by an animal activist group. They call the clinics where I work, lay down direct and passive-aggressive threats on social media, and send nasty and harassing emails.

[tweetthis]I am being targeted and attacked by an animal activist group.[/tweetthis]

You may be surprised to know these people do not have a problem with how I practice medicine. The topic they’re talking about? We have some similar thoughts on it. They actually know I’m sympathetic to their beliefs about their cause. The reason they’re threatening me like this — within just inches of what would be ruled unlawful harassment — is that they want me to agree to speak out for them and publicly shame and condemn veterinarians they disagree with. I believe methods matter as much as cause, and I will not sign on to that kind of unethical behavior. So now they’re taking abusive steps against me.

I wish I were making this up, but it’s entirely, confoundingly, dishearteningly true. I couldn’t believe it was happening to me. Upon further research, I saw that it was happening to others as well. I felt like it was time to say something.

I have learned a lot from this experience, and I’d like to share a few things.

1 – Nothing will ever happen because someone tries to bully me into it. I will not do anything because I am harassed or threatened, or because someone tries to shame me. Listen, I’ve got enough insecurity and shame in my life; I’m a working parent who can’t be everywhere at once and a doctor who can’t always save the lives placed in my care. I don’t need extra insecurity or shame from bullies, so I’m not taking it. No, thanks.

[tweetthis]I will not do anything because I am harassed or threatened.[/tweetthis]

2 – I’ll support the causes I believe in on my own terms. There are so many causes I believe in passionately. (One of them happens to be protecting members of a profession with one of the world’s highest suicide rates from emotional abuse. So here we are.) The values I hold dear and the animal-related causes I believe in are why I work tirelessly in the clinic and on this website. And you know what? I pursue them passionately without hurting or bullying anyone. If I can work this way, so can anyone else. Threats and bullying simply aren’t necessary to champion a cause, no matter how worthy it is.

3 – This problem is an epidemic. People who have decided threats and abuse are an acceptable way to make their voices heard are attacking veterinary clinics across the country. As I began to look for resources on how to deal with personal attacks, I was bowled over by how rampant this is. So many people told me they’re dealing with a similar problem. Almost no one knew who to reach out to, and most of the people I talked to thought they had been singled out. If it’s happening to you, please know: You’re definitely not alone.

[tweetthis]If cyber-bullying is happening to you, please know: You’re definitely not alone.[/tweetthis]

4 – The vast majority of people who want changes in medicine are good. It warms my heart to see how many people and organizations use ethical persuasive tactics to effect change. Real bullies are very few and far between, but they are skilled at gathering good people behind a good cause, then manipulating those people to become complicit in their abusive tactics. Bullies steal the words of people with good intentions and use them as weaponry in extremely unethical attacks. Actions you’d probably never agree to are attributed to your name without your knowledge.

5 – You can end this. Before you support ANY activist group (by acting on their behalf, endorsing them, clicking to indicate support, or sharing any media they create), please remember: Methods are as important as the cause. Of course, you care about animals and their welfare. Of course, you want to support a good cause. But if you do not support bullying, then you should not support groups who bully, regardless of the cause they are trying to advance.

Spending a few minutes on a group’s Facebook or web page may give you an idea of the tactics leaders in the group use. Unfortunately, these groups often hide their aggressive activities in fear that their supporters will withdraw or that legal action could be taken against them. So:

Google the name of the organization and “cyberbullying.” If there are even a few results, you should take pause. Most of these groups will continually deny accusations to escape legal trouble. How many accusations need to be made before your suspicions are high enough to walk away? Please do not support or empower abusers or bullies.

Finally:

• IF YOU are threatening, punishing, harassing, bullying, or abusing someone to try to make them do what you want, STOP. That’s not OK in any context. It’s that simple.

• IF YOU are someone who cares about a cause and you think a group you support might be bullying, please don’t let this break your spirit. Quit the group but keep working to educate and make your voice heard! Be creative, be tireless, be passionate — and find people who share not only your cause but also your methods for achieving it.

• IF YOU are being bullied, do not suffer in silence. The American Veterinary Medical Association (AVMA), American Animal Hospital Association (AAHA), and the American Association of Feline Practitioners (AAFP) are all working together to support veterinarians being abused. If your practice is being targeted in an abusive way by groups or individuals, reach out immediately. Email AAHA at publicrelations@aaha.org or AVMA at reportcyberbullying@avma.org. You do NOT need to be an AAHA or AVMA member to contact them. They want to help everyone.

Also, check out these resources:

AVMA Cyberbully Resource (Members)

AAHA Publicity Resource (Members – Log in for resources)

AVMA Reputation Management

AVMA Cyberbullying Petition on change.org

For me, this is not about causes. Remember, I’m being harassed by someone who knows we both want to move in the same direction. This is about bullies manipulating others and using fear and abuse to force people’s consent — and it needs to stop now. The AVMA, AAHA and AAFP monitor serial abusers, and I hope they may potentially be able to take legal action against them in the future. No one has the right to threaten or abuse you.

[tweetthis]This is about bullies manipulating others & using fear & abuse to force people’s consent[/tweetthis]

My senior year of veterinary school, an oncology resident I respected a great deal sat us all down and told us his number one piece of advice: “No matter what you tell a client,” he said, “Make sure you say it with utter conviction- even if you’re not sure you’re right.” We all nodded, wide-eyed and desperate for anything to make us seem more knowledgable than we were.

It worked for certain people. You know the type. They already had authoritative personalities and could easily tell a client, “YES. This is 100% what you should do.” Clients, besotted with their certainty, complied. And when it failed utterly and completely to do as it should, they shrugged it off and went to the next thing.

That never worked for me.

[tweetthis]If I suggested something I had the merest hint of doubt about, they could read it in my face [/tweetthis]

If I suggested something I had the merest hint of doubt about, they could read it in my face, that moment of hesitation, the way my eyes darted to the side. And if it fell apart, even if that’s the way medicine works and sometimes doody happens, I would go home and rend my scrubs and beat myself up for being human. It felt wrong, and we all knew it. It didn’t make me stronger, it made me feel like even more of an imposter.

Owning Your Doubt

A few months after graduation, I found myself flying solo at a new corporate practice. I was terrified. Who would I ask about that pedicle that wouldn’t stop oozing, or that strange shadow in the vomiting dog’s duodenum? Staring in uncertainty, I felt the paternal ghost-hand of that resident resting on my shoulder as he whispered, “Just go with it. Own it.”

I ignored him, kind of.

I looked my clients in the eye, took a deep breath, and said with utter conviction, “I don’t know what that is. Could be this, or this. I’m going to call a director and get another opinion.”

Or, “I have never done one of these procedures before. I can take it on, or you can go to the referral center.”

I owned it. It wasn’t an embarrassing admission but a fact. I didn’t apologize for it, I wasn’t embarrassed by it, because we all knew I was new and my lack of experience was a temporary condition that righted itself very quickly. I was confident in who I was at that moment, and that conveyed itself in everything I did.

Sure, I lost out on some opportunities to ‘practice’, but my clients always knew where we stood, and I never had to beat myself up for subterfuge. In short, I traded the short term pretending to know more than I did for the long term trust.

[tweetthis]I traded the short term confidence for the long term trust.[/tweetthis]

A year later, a funny thing happened. We got a letter in the mail- out of all the 400 members of the corporate practice, my dinky little Newbie Clinic in the sticks had the highest score in the nation for customer loyalty.

My supervisors were confounded. No one could believe it. “But you’re not even a year out,” they said. “Are you some sort of surgical wizard? Are you a vet savant?”

Far from it. I was new, inexperienced, and still had oodles to learn. I got things wrong and made plenty of newbie mistakes. And I never apologized for my newness, just as I still never apologize for who I am today. It just is.

Never fake who you are. And never apologize for it, either. The confidence you must own is not in what you know, but who you are. And it works.

[tweetthis]Never fake who you are. And never apologize for it, either.[/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.

My wife and I are having a really stressful week.

You see, she has taken up curling (you know, the Olympic sport that looks like shuffleboard on a hockey rink), and she’s practicing like mad for a big tournament. Meanwhile, over at the improv comedy club, I’m coaching nine amateur comedians for their upcoming performance at a local coffee house. Between chasing stones on ice and doing terrible celebrity impressions, whew — things are tense.

I kid. In all seriousness, our lives are full of legitimate stress. We are raising two children together; I regularly face the nail-biting anxieties of veterinary practice; and my wife puts in long hours toward tenure as a college professor. We work our faces off trying to be good parents and professionals and spouses. We have very little free time, and — just like you — we have plenty of grownup responsibilities weighing on us.

Still, we make time regularly to do these two ridiculous things: curling and comedy. Crazy, right?

Well, no. It’s not so crazy. And here’s why:

One of the greatest traps I see people in the veterinary field fall into is allowing their lives to become a tightrope pulled between home and clinic. They go from one of these places to the other and back again, in an endless cycle, until they feel pulled thin and run down.

When this happens, it becomes difficult to recharge and refresh. People start to feel as if they’ve lost the nuances of their identities and can’t quite get perspective on anything. If they’re not in one place, they’re in the other, and the back-and-forth tension is never relieved. That’s why two places isn’t enough. They need a third place.

Let me explain: The term “a third place” is commonly used in city planning and community building to indicate places and locations outside the home (“the first place”) and the workplace (“the second place”) where people gather to socialize.

In 1989, a man named Ray Oldenburg published The Great Good Place, which would become a classic text in the field of community building. In this book, Oldenburg argues that third places (like barber shops, cafes, clubs, parks, etc.) are vital for creating a sense of community. That is, third places allow people to engage in ways unrelated to their home or workplace, and those interactions make people feel like they have meaningful, fun ties to others and belong to something greater than themselves. Lots of books and articles have been written about the importance of third places to our social fabric.

[tweetthis]Practice and family are not enough. Here’s why.[/tweetthis]

In our line of work, a third-place is anywhere we can engage with people who are not in our families or our veterinary practices, to talk about or do something unrelated to veterinary medicine. For me, it’s a public library, where I go to practice comedy. For my wife, it’s the local ice rink, where she cultivates her skill in a quirky sport. A practice manager I just met, who’s very busy between her work and her children, makes time to hit the rock climbing gym regularly. One of our technicians goes to comic conventions whenever she can. A front desk staffer plays in a band. It’s amazing how having a “third place” to go can actually reduce stress and improve happiness.

In fact, I think making a third place into a third priority (after home and work, of course) just might save our sanity. I’m not advocating for skipping out on patients or missing important family moments to practice kung fu, but I do think it’s worthwhile to find something that can be prioritized after family and work and before pretty much everything else. (You know, putting the oxygen mask on yourself before helping others.)

It is so easy to decide we’re too busy to make time for ourselves — to say “no” to hobbies, outlets, and activities that could enrich our lives and alleviate some of the home/work tension. I’d like to see more people say yes to a third thing, a third priority, a third-place of fun, learning, mutual interest, or community. Maybe even something as crazy as curling or comedy.

[tweetthis]It is easy to decide we’re too busy to make time for ourselves — to say “no” to hobbies[/tweetthis]

Do you have a third place? If not, I hope you’ll consider finding one.

 

For many former inmates, it’s difficult to find work since they left prison. The Thoroughbred Retirement Foundation seeks to rehabilitate the inmates while introducing them to another opportunity: the care and keeping of retired racehorses.

 

 

[tweetthis]Rehabilitating inmates through #horse grooming education – new hope, second chances[/tweetthis]

Human beings are very intelligent, but we can also be stubborn as mules. One of the hardest things we face is not jumping to conclusions in the face of certain events, and even trained scientists find they have to struggle against their own biases to rely on logic when examining cause and effect. With the dawn of social media, however, jumping to conclusions has gone from something that is annoying to an activity that really should be an Olympic event. Even worse, some people are so invested in the conclusions they have jumped to that they will believe an inflammatory and untrue post on social media before they will believe experts in the field.

Even though I know this, I am the first to want to jump to conclusions. When I give a medication, administer a vaccine or perform a procedure and something goes wrong, I always look first to see if what happened was my fault. It takes a supreme effort of will for me to think through the situation logically and to include all the possible causes in my rule-out list. Sometimes, my clients aren’t having it. Nope, they know in their hearts that the problem was caused by (insert “food with grains”, “vaccines”, “heartworm prevention”, etc.). Sometimes they are right. Many times, however, they are dead wrong. This article isn’t for any of those clients. This article is for the veterinarians who flog themselves for mistakes that may not have been mistakes at all. Let me give you three scenarios—all of which happened to me—that prove that cause and effect aren’t as simple as they seem.

Sometimes pet owners aren’t interested in logic. Sometimes vets aren’t either.

Scenario # 1

I had a cat come in for an anesthetic procedure. The cat and owner were new to our practice and, when I examined the cat, I found that she was dehydrated and underweight. I canceled the procedure.

Instead, I drew blood and gave her some subcutaneous fluids. She spent the night in my clinic. The next morning, she had a seizure—the first of her life. She rapidly spiraled downward from there and ended up on manual ventilation. Her poor owner was devastated and had to euthanize her.

Now, if I had gone ahead and done the procedure, I (and the owner) would have assumed that the surgery and anesthesia was the problem. I would have torn apart my protocols and ruthlessly investigated how I could have done it better. If I hadn’t been able to find anything, I would have lamented that the cat had an underlying brain/heart/lung, etc. problem that I didn’t or couldn’t pick up on during the physical examination. I’m sure it would have scarred the owner for life, and she would have been reluctant to ever put a pet under anesthesia again.

Luckily, I listened to my gut. That instinct didn’t save my patient, but in the aftermath I knew that there was no way I did something to cause a seizure based on only providing fluid therapy. It was still agonizing to explain to the owner, and I felt I had failed even though I did nothing wrong, but thankfully I had reached the right conclusion.

Scenario #2

Another cat came to me for a rabies vaccination. He was 3 years old and appeared handsome and healthy. Two days after vaccination, however, he came back with congestive heart failure.

The owner was convinced the vaccine was the cause. I ordered an echocardiogram that showed the cat had severe heart disease that likely had been going on since birth. It’s possible that the vaccine triggered the heart failure, but there’s a big difference between a trigger and a cause. For example, being startled, running from the dog or the car ride to the vet could have upset his delicate balance and triggered the exact same series of events.

Scenario #3

I was working a shift at a spay-neuter clinic when a client brought in three adorable kittens. As they were being checked in, the owner mentioned that they had been vomiting.

Upon further questioning, the owner revealed that the kittens had eaten lilies. We declined to perform surgery and told the owner to take them to the ER immediately. She refused (and was very upset that we wouldn’t do surgery), and all three kittens died the next day.  The owner had declined presurgical blood work (typical in a charity clinic). If their physical examinations had been normal and I had proceeded with surgery, who would have been blamed? Likely not the poisonous plants, but the veterinarian who tried to help a client in need.

Cause and effect.

You’ll never get all of your clients to believe the information you provide, or avoid jumping to the wrong conclusions. The best you can do is take a thorough history, perform a thorough physical exam, provide recommendations, document them and never let anyone pressure you into doing something that makes you uncomfortable.

You’ll never get all of your clients to believe everything you say. Do your best.

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.