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Perspective

The 4 Gifts of Veterinary Medicine – Rotate Your Dogs

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In this episode, Dr. Andy Roark and Jamie Holms revisit an old article on balancing happiness, stability, and giving in vet medicine. They reflect on changes in perspectives over the years, discussing the evolution of these core principles while exploring the intricate facets of happiness, intentional giving, and the dynamics of optimism and realism in the veterinary field.

You can also listen to this episode on Apple Podcasts, Google Podcasts, Amazon Music, Soundcloud, YouTube or wherever you get your podcasts!

LINKS

https://drandyroark.com/the-4-gifts-of-veterinary-medicine/

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ABOUT OUR GUEST

Jamie Holms is a chicken mom and the Administrative Manager for Dr. Andy Roark, and the Uncharted Veterinary Conferences. Jamie is passionate about helping the people who are helping pets and is a firm believer that the future of the veterinary profession is bright. Jamie is obsessed with baby goats, axolotls, hedgehogs, tea, plants (especially hoyas), kindle books, food, and sleep – not necessarily in that order.

EPISODE TRANSCRIPT

Dr. Andy Roark:
Welcome everybody to the Cone of Shame veterinary podcast. I am your host, Dr. Andy Roark. Guys, I am here with a one and only Jamie Holms. We’ve been digging through some old articles of mine. Boy, she was digging real deep at the bottom of the bag to pull out an article that I wrote back in 2017 called The Four Gifts of Vet Medicine. This is an episode that came up or an article that came up talking to my good friend Dr. Sarah Boston recently. And then Jamie also was around and kind of pulled it out for looking at, and anyway, it is a really, I hope is a good discussion. I thought it was a good discussion. It is all about balancing, giving happiness and stability in our careers and what does that balance really look like. And then Jamie was asking if my thoughts on are those really the three drivers? Have I changed my mind in the last six years? And so we talk about that a lot. So anyway, it’s a really fun conversation. I hope you guys will enjoy it. Let’s get into this episode.

Kelsey Beth Carpenter:
(singing) This is your show. We’re glad you’re here. We want to help you in your veterinary career. Welcome to The Cone of Shame with Dr. Andy Roark.

Dr. Andy Roark:
Welcome back to the podcast, Jamie Holms. How are you?

Jamie Holms:
I’m good. How are you Andy?

Dr. Andy Roark:
I am really good. I always loved doing episodes of the podcast with you. I heard really nice things the last time you got together. We did the choosing the rulers that we measure with, and I got a lot of nice notes about that and they were like, you should do more episodes with Jamie. And so I thought, you know what? I think that’s probably true.

Jamie Holms:
Oh, that’s kind. I think that that I like to dig in and get a little deeper into your articles than you have the opportunity to do. Because an article, it’s not a book.

Dr. Andy Roark:
No. Yeah, correct. It’s, it’s funny, I have heard that people struggle to fill like a thousand or 1200 words and I not, I struggle not to write 5,000 words.

Jamie Holms:
Yes. Yeah.

Dr. Andy Roark:
They’re like, what is this? And I’m like, it’s the article. And they’re like, you’re supposed to have the back page, Andy. Not the whole article, the issue.

Jamie Holms:
Not the whole magazine. Yeah, exactly. Well, I was looking back at the way back machine. Are you ready?

Dr. Andy Roark:
The way back machine? Yes!

Jamie Holms:
Yes, the way back machine. We’re going to go all the way back. I think it’s 2015 if I’m not mistaken.

Dr. Andy Roark:
Oh wow. That’s way back!

Jamie Holms:
It’s way back. But this is an article that I know both Sarah Boston and I really love that you did about sled dogs. Do you happen to remember this article?

Dr. Andy Roark:
I only remember it because Sarah Boston, she is a onco surgeon, a veterinary onco surgeon and brilliant. She has a podcast called Co Medicine, which is supposed to be comedy and medicine squ together. And so she had me on and she specifically asked me about it and I was embarrassed. I was like, Sarah, I have very, very limited recollec. I remember an article, I said minute, then I had to go look at it. So I have actually recently looked at it. Oh, fantastic. Only because she caught me. Only she caught me flatfooted.

Jamie Holms:
Yeah. Well, I mean it was, what is that, seven years ago? So I think there’s a little grace to be given there. It reminded me of the story of the Indian elder who was telling a child that who was having some trouble with emotional regulation and they were like, how do I deal with this? And the wise man says, you have two wolves inside of you and you have the anger and you have the goodness, and the one that you feed is the one that survives. And I have always thought with that, and you know me, I have that duality of mind where it’s like it’s right or it’s wrong. Only one dog survives only. We’ve only got one sled dog that’s going to make it to the end of the Iditarod. And you have to choose which one it is.

Dr. Andy Roark:
How many dogs do you have right now, Jamie? I

Jamie Holms:
Have two. And only one’s going to make it.

Dr. Andy Roark:
Only one’s going to make it okay. No. Okay. Alright. Just checking. Yeah. Poor Biscuit. Yeah,

Jamie Holms:
Poor Biscuit. Poor Biscuit. She’s being, I just got a puppy and he’s about 15 weeks old and he very much wants to bite her on her ears and she does not like her ears touched. And so the biting on the ears is not working out real great for her. She does not like it. And he’s like, maybe if I try again in five minutes it’ll be okay. We’re like, no, she doesn’t like it.

Dr. Andy Roark:
Yeah, got to keep checking in persistent. So anyway. Okay, so there’s two wolves. I do like it. It’s the one that you feed.

Jamie Holms:
Yeah. Right. Well yours is about the sled, which is life and the three dogs are giving happiness and stability. And I wanted to go back and first of all ask, do you still think that there are three sled dogs or have you found any others? Because it’s been seven years and we’ve grown and changed in vet Met. So do you think there’s more sled dogs now?

Dr. Andy Roark:
Oh wow, that’s such a good question. It was funny. A lot of times I look back at articles to see where I was in my life and what was going on. And so this was clearly a time and when I was seeing a lot and I was probably feeling a lot of just giving and giving and not you write the article or the book you need to read, which, but I was seeing a lot of burnout. I think the idea is that there, so when I wrote this, there’s three dogs. There’s happiness, which is you taking care of yourself, and then there’s stability, which is kind of financial security. It is you making a living, getting your needs met and then there’s giving, which is you doing for other people? Clearly. I think I was feeling it this time and I was seeing a lot around me of people who they just give and give and give and give.
I said in the article, the most common dog to get starved is personal happiness. A lot of people who they’re like, I have to take care of my family and I have to take care of my team and I have to give to the world and that’s all I have to do. And the big thing is, where are you in this? This has got to work for you. And they’re like, oh no, I’m sacrificing myself, my happiness. And so I think I saw a lot of that. I think I was thinking about the dogs. I think it’s a lot of it is how much I think if I could walk it back, if I wanted to parse this part now in my new for where I’m now, I think I would probably parse happiness into other things. So I do think that there’s giving, and I do think giving is important and intentional giving matters.
And I think I understand a lot of times when we see commentary on social media or out in the world, it’s reactionary commentary is people are like, they’re responding to anger or pain. And so when they say pet owners stop asking us to do these things or stop, I don’t know, stop treating us like jerks, you think, is that really the relationship you have? And it’s like, no, they’re responding to something. It’s not. If you really met them on a calm moment, ask them, they would have a much more robust response. But we’re seeing this emotional reaction. So anyway, I think for a lot of these things when we start talking about giving or start talking about happiness or we’re talking about stability, I think that we’re leaning into this really kind of narrow view of what that is or it’s coming from a place of reaction.
I think if I was going to parse ’em apart, I think happiness is kind of a loaded word and I think that it’s still that balance is key. You know what I mean? Yeah. I think I would probably lean if I was going to do new dogs now, I think interpersonal relationships would be, I think I’d probably parse the happiness into interpersonal relationships and come out how to say it, but basically what I need to recharge and or feel satisfied by. And so I think that those are different things. And so I would say you should still be driven by giving and you should make sure that your needs are being met. And at the same time, I really have become a big believer since 2015 or 2017 or whatever, I’ve definitely become a much bigger believer that our interpersonal relationships really matter. And I think that you kind of put family in there and I think you put colleagues and friends in there and do you know people? Are you taking care of those relationships or are you head down just doing work, paying the bills, things like that. And a lot of us I think are very lonely because we forget about those relationships. And the last part is are you getting what you need out of this? Are your needs being met? So I think if I was going to do it differently, I’d probably split it into four. I don’t know. What do you think? Am I missing something here? It’s hard to rethink it, but I’m glad you asked.

Jamie Holms:
I really like what you said when you said intentional giving because I think that that’s something that we lose or we feel like we’ve lost. And you and I have talked a lot about agency in the past, but I feel like we vet med feel like we don’t really have control over what we give or how we give it because when someone says, Hey, there’s a c-section, can you stay? You often don’t have an actual choice, especially when morality gets involved in and we get stuck in that trap. And so we feel like we don’t have an option. And that’s one thing that I have some friends who work for an organization and one of the things that they say repeatedly is I get to do this. And I love that because it reframes it and it’s an option of I get to do this. And I think back to I was a phlebotomist and I worked at an organization, it was a tiny group called the Lab and they were really small and I got to do things like do blood draws on people in their car when it was inconvenient for them to come in.
And I got to do things to help people be less afraid. And I worked with a lot of elderly and a lot of individuals who had a lot of needle phobia and I basically had free reign to do whatever I needed to do to make those people comfortable. And some of it was white coat syndrome, like don’t come into the building because into the building just is too scary. And the company was bought out by a large organization with a lot of rules and we weren’t allowed to do those things anymore. And it really put me in a mindset of these things that other people were like, what do you mean we do blood draws in the car? And then all of a sudden they were like, we got to do that and now we don’t get to do that. And so I think that that’s an interesting way to look at it. And I think that you can use that intentionality with both stability and happiness. And I agree with you, I am not a big fan of the word happiness.
If I had the choice of being happy for the rest of my life, I would not choose it. I want joy, I want wonder. I want these things that feel deeper and bigger. And I think that we have the capacity through vet med. We see some of the worst things, but we also get to see some of those amazing miracles where an animal pulls through that you never thought was going to pull through or a family. You get to see generations of a family come through with their pets. And I think we’re definitely blessed in that way.

Dr. Andy Roark:
If you dream of doing team training with your team, getting your people together, getting ’em on the same page, talking about how you guys work together in your practice, I’d love to help you. You can check out drandyroark.com and check out the store. I have two different team training courses. These are courses for teams to do together to get on the same page and to talk about how you do things. I do things, I have my angry clients course and I have my exam room toolkit course and they are both available and there to come out. Alright guys, let’s get back into this episode.
Well, there’s a lot here to unpack. So I like your point about happiness. That word has, I still use it, but I don’t like it very much. I think that we’ve kind of been sold a false bill of goods about happiness and what happiness is supposed to be. I was talking to this veterinarian who’s really deep thinker and very smart and she talked about going to counseling with her partner. And one of the things that she really struggled with is her partner’s position that happiness is not important. And she’s like, what do you mean happiness is not important? And he said, it’s just not important for me. And she says, how can that be? And she said, what makes you feel good? And he says, meeting my obligations makes me feel satisfied and that’s enough for me. If I am meeting my obligations, then I am satisfied.
And she was like, this was a real sort of sticking point for a long time and trying to understand this person who was her partner and she had to really work on it. And I got to tell you, I’ve thought a lot about this and I do. I of get where a partner’s coming from? I do. And then also I can a hundred percent struggle and be like, what do you mean meeting your obligations is enough? But I think that we all know someone who’s like that and they’re like, yep, this is what I do. I meet my obligations and that’s enough. I don’t think I’ve told you this before. I don’t think we’re made to be happy. I really think that we are creatures molded by natural selection and species that are content go extinct. I think we’re made to be a little bit unhappy.
I think our default state is unhappy because that’s what makes us grow and explore and try new things and spread out and take action and hunt for food so we can have a nice little chubby layer when the winter comes. I think if we ate a little berry and we were good for the day, I think we’d starve the death in the wintertime. So we’re made to be unhappy. And so if happiness is the goal, then I think that we are always feeling like we’re failing. I don’t think we’re supposed to be happy. And so I thought a lot about that. I want to jump back to your, I get to do this and say, oh, I frame this up and I get to do this. And it’s funny when you were talking about you did this thing and you went out to the car and you did these things to sort of accommodate these people and then that was taken away.
I can’t help but think about the open hospital concept where the pet owners can go wherever they want. And I know you’ve got experience with that, but I think for a lot of people they’re like, that’s terrifying. But I can also see that if you did it and you got comfortable with it, you would recognize or you probably take pride in the fact that you say, yeah, we have people come back here, they can see everything. I think I could see myself very quickly as part of become my identity of going, yeah, we do everything in front of the pet owners. I think the only thing that scares me is what if I mess up? But I would be fine. I would be fine and it would take some time and I would practice and get comfortable and after a while you get comfortable doing things on display.
And I know that that’s true. Having not done it, I think it’s still scary for me, but I think that I would come to love it and then if I had to stop do it, I would feel it was taken away. I wrote this piece recently. I’m just curious, I’ve not talked with you about this, but I’m curious what you think about it. I’ve been thinking a lot about optimism and happiness and kind of what this really looks like given where I’m in my life. And so I’m in my late forties at this point. I can see 50 from where I am. Same. My wife had breast cancer a year ago and she’s fine. Everything’s gone well. But that was a significant thing in my life and I know you’ve seen and had things like that as well. And the whole just choose happy. I still think that every day you get up, you can decide if you’re going to be happy as a default or if you’re going to be upset or angry or cynical or afraid as a default.
I think you can decide what I’m starting out at happy and I’m to try to hold on to happy and that’s the choice that I’m going to make. I don’t think that’s toxic. I don’t think that’s discounting of anything other than I’m going to try to do this. And so I do think that there is value in optimism. I like looking at the world with an optimistic view that things are going to get better, I suspect. I think wonderful things are going to happen. You said you wonder and joy. I think looking at the world and going, there’s things out there that are amazing and wonderful and I’m going to find them and I can’t wait to see where this day goes. I think that that’s good. And at the same time, the world is a hard place. And when you live through disease or pain for family members or people that you care about, you can’t lie to yourself and be like, I’m just going to choose to be happy about everything.
And I think that that’s a paper shield and I don’t think it really works, and I don’t think it’s honest. So I went looking for insight on happiness a long time ago, and I really do like some of the Buddhist ideas. And a religion is 5,000 years old. They got some things figured out. And the Buddhist say, and it’s funny because I’ll see people and they’re kind of shocked because I have this reputation as Mr. Positive and the guy who loves fat medicine. And then I will stand in front of people and say things like, what life is suffering? Life is suffering and you should own that. Or I’ll, I’ll say, medicine is really just picking your poison over and over and over again. And they’re like, this is the positive guy. This is the funny guy that we came to laugh with. And oh, there was another one that I really like.
There’s a psychologist named Stutz is his name. He’s got a documentary with Jonah Hill, but he said this thing that I have loved and picked up, but he’s like, no one. And I mean, no one can escape uncertainty, pain and constant hard work. And I’m like, that’s awesome because it’s true. And it’s just like, yep. And the number of times I’ve been like, Andy, you’re never going to be comfortable. You are never going to escape discomfort for any significant period of time. You’re always going to be uncertain and you’re always going to have to work your tail off. If you just accept that, then you can go on. And so I think that that clear-eyed, pragmatic look at the world and what it is and what it means to be human, I think that’s also important. And so bringing this all the way back around, I have been thinking a lot about the balance in those two mindsets is can you hold onto clear ride pragmatism? Nothing in this world is guaranteed except hard work, uncertainty and discomfort. And I think tomorrow’s going to be a good day. And I think that there were wonderful things that are happening and there are people that I want to know better and there’s time to be joyful and opportunities for me to explore and do things that I’m excited about in the time that I have. And those things, I think to some people, they feel contradictory. You can’t choose happy and believed life is suffering. And I would say yes you can.
It takes some balance and perspective, but there’s nothing wrong with that. I don’t think they contradict as much as a lot of other things I have to hold in my head to be a veterinarian.

Jamie Holms:
True. Absolutely. I completely agree. I have often been pegged as being pessimistic, which I have wholeheartedly disagreed with most of my life. I’m like, I’m a realist. That’s how I see myself, because I don’t think everything’s going to turn out badly. I couldn’t keep going if I thought that. I believe that things are going when things are hard, I believe that this too shall pass. It’s going to get better. And it’s a season and you don’t have any idea how long your seasons or your droughts or your rains or your amazing harvests, you don’t have any idea how long they are going to be. And so you enjoy the things. And I was looking at, oh, you shared with me some pictures not very long ago. And in there

Dr. Andy Roark:
The nature photographs?

Jamie Holms:
And in there were ones that were pictures of natural disasters. And so one of them was a picture of this field that was just covered in snow and it was so beautiful. And the person who took that photograph was there in the middle of this terrible snowstorm and was like, you know what? That’s gorgeous. That’s gorgeous. And it’s just like, it’s beautiful.

Dr. Andy Roark:
That’s awesome. Yeah, I love that. What comes to my mind is I went with my family and we went to Phoenix as a Christmas trip a couple of years ago before the pandemic, so it’s probably been five, six years now. And so we went there and we were going to go up and go up to Monument Valley and look at all the places and go to the Grand Canyon and everything. And we did, and it snowed on us. It just dumped snow. And I remember at one point being in this lava field and it looked like Mars. You know what I mean? There was nothing really growing in this area. It was just this weird rock and also this beautiful snow on top of it. And I took tons of pictures and they do not do justice to what was there. But I think that’s amazing about incredible nature photography is the ability to actually come close to doing justice to something that’s out in nature.
I cannot do that with my iPhone, you know what I mean? I’m always very excited taking pictures and then later on I’m like, this does not convey what was there. But anyway, but it is that mixture of beauty. I’ll also say that about you too, is you and I have known each other a long time. You are my first employee. You are one of my best friends. You are a realist. I would fight with anybody who says that you’re a pessimist because you are a realist in that. Well, you do. The number of times that I have frantically pitched you an idea, and Jamie, just walk with me, look at what could be possible and we could do this. And you have been like, let’s, you know what? Let’s go for it. There’s so many times that no one can say you’re a pessimist because I have walked you into way too many adventures that you didn’t have to go on.

Jamie Holms:
That is very true.

Dr. Andy Roark:
But you are a realist as well, because Which is good because a lot of times I’ll be like, we get too thiss. And you’re like, I have questions, Andy.

Jamie Holms:
So many questions.

Dr. Andy Roark:
I have so many questions about how this actually goes down. I think we’re good for each other, but I would say you are not a pessimist. You are a realist who wants to be an optimist. That’s what I get from you. Yeah. I think I’m an optimist who wants to be a realist. That’s what I want.

Jamie Holms:
Yeah. That’s where I think that makes sense. Well, I mean that’s the balance, right? So that’s how we find it. Okay, so I have one more question about this article.

Dr. Andy Roark:
Okay, I forgot about the article. Yeah, let’s talk about that.

Jamie Holms:
Have you ever been on a sled sled? Never. Never. Oh my God. I want to do it so bad. So bad.

Dr. Andy Roark:
I have buddies. I have one friend in particular who somehow got involved with the Iditarod when we were in vet school, and he’s just been doing it forever. And I’m like, I might as well go to Mars as to the Iditarod. I’m like, this is just, it’s something like I can kind of get my head around it, but I have no idea what it would actually be. And I see the pictures and I watch videos, and I’m like, I am so out of my depth here. Well, I want

Jamie Holms:
To be real clear. I do not want to do the Iditarod. I want to go for maybe a mile and then have a Starbucks, but I want to do it. I want to do it. I have heard it’s amazing, and I love the feeling of flying, and I imagine that that’s what it’s like. And I love the excitement of the dogs.

Dr. Andy Roark:
I could get into that. I want to create a new sport called Hover Sled, and it’s a sled, it’s like a hoverboard, and then dogs can pull it in Florida in January, or I don’t know, California. We could find an area that’s 70 degrees Fahrenheit, 20 degrees Celsius, beautiful. And then they could pull the sleigh without the blistering cold. That seems to be required right now, like roller sled. We could just have basically, I want to tie dogs to a shopping cart and ride around that. That’s what I’ve decided.

Jamie Holms:
I’m pretty sure that’s already a sport, but I’m not sure if it involves dogs.

Dr. Andy Roark:
I think I’m going to investigate that. That’s what I’m going to

Jamie Holms:
Go do. You go do that and I’ll just hang out with Allison and

Dr. Andy Roark:
We’ll, well, I mean, I’m coming for your two dogs because only have bad dog, skipper Roark, who I do not trust to pull my shopping cart alone. Sure. So I’ll be over soon.

Jamie Holms:
Okay, sounds good. I’ll see you then, Andy. Bye.

Dr. Andy Roark:
See you soon. Thanks. And that’s it. That’s what I got for you. I hope you enjoyed it. I hope you took something out of it. Thanks to Jamie for being here. Thanks to you guys for being here. Take care of yourselves, everybody. I’ll talk to you soon.

Does it ever feel like the world is getting too big?

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One of my favorite ideas from the Hitchhiker’s Guide to the Galaxy is that of the Total Perspective Vortex (TPV). In the book, the TPV was a machine built to show beings a glimpse of the infinity of creation… and it’s used as the ultimate torture device. Human’s brains, it seems, are not meant to process the expanse of the universe. I find the idea that knowing how tiny we are in the universe would be the ultimate torture is darkly funny.

Recently, however, I’ve been feeling a bit like we are all plugged into the TPV and someone is slowly turning up the wattage. We are living in a world where information seems to flow into our eyes and ears faster and faster. More things pop up with breaking news alerts, attention-grabbing chimes or text messages than ever before. More and more screens and streams vie for our limited attention. Short, looping videos that we can swipe through increase the breadth of information we take in by reducing the depth. 

You know what makes this expanded view of the world troubling? For me, it’s the feeling that we are seeing more and more of our world… while the number of things we can control doesn’t budge. We’re not just seeing, hearing and knowing an ever-increasing amount… we’re seeing, hearing and knowing an ever-increasing amount of things that we have absolutely no control over. 

A bigger world with no more control can make us feel less important and empowered. It can make us feel like we are a drop of water tossed around in an increasingly vast ocean, and you know what? That’s a lonely, frustrating way to feel.

I think these feelings of powerlessness may be why people seem to be acting meaner than ever before. Rude behaviors in public, mistreatment of people doing customer service work, aggressive driving… couldn’t it all be a product of people feeling that the world has gotten so big that they desperately need to find a way to show they still have some control? 

Could people be more likely to break rules or hurt others when they feel a need to prove to themselves (and the world) that they are not inconsequential or that they still have some power? Could the epidemic of loneliness be related to feeling smaller and smaller in an expanding world?

To be clear, I think there has never been a more exciting time to be alive. Our ability to learn and connect is incredible and growing by the day. I also think that the potential to feel like we’re in the Total Perspective Vortex, that we are so small in a world that is so large and beyond our control, is more real today than ever.

Going forward, let’s remember that it’s not wrong to be selective about what information we take in. Surviving in a world of limitless noise and knowledge will almost certainly involve making choices about what we spend our emotional energy on, and how much time we spend just gazing at the outlets that would like to have our attention. We have the power to step out of the TPV, or to turn its wattage back down for ourselves.

Sometimes, it’s worth the effort to turn off all the noise and focus exclusively on the things we can control: The work we do with our hands, the relationships we have without screens, and the impact we make on those around us. If you’re feeling overwhelmed, maybe it’s not you. Maybe the world is just too big and it’s time to take back our focus and put it where it matters most. Right in front of us.

The Right Number of Disasters

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I was recently listening to an interview where an economist was criticizing the way modern media reports the news. He said that the mainstream media tends to grab onto a disaster, thrust it into the national spotlight and then ask the question “how do we prevent this from happening again?!”

The economist said this behavior is misguided because some disasters need to happen and trying to eliminate them shouldn’t be an aspiration. The example he gave is this:

Let’s say that you have a house that collapses in an earthquake and some people get hurt or even killed. Some might ask the question, “how do we make it so that no houses ever collapse in earthquakes?” The problem with this question is that we don’t want to have a society where no house ever falls down in an earthquake. The number of building restrictions, the amount of building materials and the enormous cost of making every building earthquake proof would be astronomical. Housing costs would skyrocket.

Obviously, we also don’t want a society where lots of houses fall down whenever there is an earthquake. That would mean that we are under-regulating and monitoring residential building, and that we aren’t valuing the safety of our citizens. 

We should be aspiring, according to the economist, to not have too many or too few houses falling down in earthquakes. A healthy society will have the “right number of disasters.”

Similarly, if we had a society where no crime happened, we would have to be living in the most controlling, invasive police state the world has ever seen. Think about it, to have zero crime, there would have to be complete surveillance, the harshest of punishments, and dogmatic commitment to law and order by at least the vast majority of citizens. It sounds like a nightmare.

Saying that a society with no crime doesn’t make sense does not, of course, mean that we want crime. It also doesn’t mean we think crime is something we should ignore. It’s simply an acceptance of the idea that the tradeoff for letting people have freedom is dealing with the fallouts of personal freedom that we don’t necessarily like.

The basic premise here is that acting like disasters should never happen is a mistake. So is pretending disasters don’t matter. The balance, it seems, should come from asking ourselves: “do we have the right number of disasters?”

We want some houses to fall down in earthquakes because that means we haven’t gotten completely out of control with building costs and regulations, and we want some amount of crime to happen because that means people still have freedom. 

Likewise, in our clinics, if no one ever gets angry about the price of services we probably aren’t charging enough to run a healthy practice. If no one ever fails to follow a set protocol, then I question whether people are actually thinking about the specific case in front of them. If no patient ever dies in surgery, then are we pushing ourselves to save as many lives as possible?

Things SHOULD go wrong in practice. They shouldn’t go wrong in great numbers, and the same thing certainly shouldn’t go wrong over and over. However, there absolutely must be disasters in a healthy practice. Here, just like in the media, asking what we can do to eliminate problems is generally the wrong approach. The right one is about asking ourselves “are we having the right number of disasters?”

An Honest Look at What We’re Thankful For

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I’ve seen more than a few shocked faces as I, the guy known for holding the torch of positivity in veterinary medicine, tell people that “life is suffering.” If you’ve listened to my podcasts or read my articles, you’ve heard me tell people that medicine (and management) is simply picking your poison over and over again. One of my favorite quotes centers on the idea that no one, and I mean no one, can escape pain, uncertainty, and hard work. Not exactly the mantra that people expect from the smiling, laughing guy who loves his job.

I think that there is a perception that being positive (or grateful) is about fooling yourself. It’s about refusing to see challenges and hardships, or at least to discount the impact these difficulties have on us. I do think there is power in “choosing happy” and I reject the idea that looking on the bright side always constitutes “toxic positivity.” That idea is simply a cudgel the cynical like to wield against the optimistic.

The healthiest view of the world I have found is a balance between optimism and a pragmatic, honest look at the challenges we are destined to face in this life.

Pretending that hardship isn’t all around us or that the world is fair doesn’t make much sense. Neither does wallowing in the knowledge that we have very limited control over much of our lives and death comes for us all. A balance between these mindsets, however, can be a thing of beauty.

As I reflect on what I’m thankful for this holiday season, my list looks different than it has in the past. Yes, I’m thankful for my family and interpersonal relationships, and I’m optimistic about my chances of deepening and strengthening those bonds in the coming year. I’m thankful for our profession and to have work that I find meaningful and rewarding. I think veterinary medicine has a bright future, and I’m genuinely excited to see where it is going.

At the same time, my list is balanced by a more clear-eyed perspective on how fragile life can be, and a knowledge that hardships inevitably await us all on the road ahead. I’m grateful that my family is healthy. That gratitude is deepened, not diminished, by the fact that one year ago my wife was beginning radiation therapy for breast cancer. I am proud of what my business has done and is doing, and that pride is stronger because we have faced setbacks, suffered failures, and navigated uncertainty. I cherish the laughter around me, because I have seen a lot of tears.

Today, I am more grateful for what I have than ever before. It’s a deep, rich gratitude that I think comes not from blocking out everything but the positive, but by truly seeing the difficulties, learning to accept them, and then looking towards the future with an intentional and dedicated optimism.

My wife is healthy. My children are safe. My job is rewarding. My business is a success in the ways that truly matter. I feel thankfulness for these truths in my bones because I know they are not guaranteed.

What are you thankful for?

Those You Know, But Don’t Know

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When I used to drop my kids off at daycare, my primary focus was ejecting the children from my car so I could get on to my mile long to-do list. Screeching tires, flying gravel and… was that a little girl wearing a halloween costume in March? I passed through the parking lot as quickly as possible.

From an efficiency standpoint, this was great. I was knocking things off the list and making stuff happen! From a relationship-with-daycare-workers-and-other-parents, it was pretty bad.

Relationships are funny and fickle things. You can’t put them on a checklist and mark them off. You can’t show up, say a compliment and walk away. No matter how charming you are or how much corporate communication training you’ve had, building relationships takes time. It requires doing the work to know another person. Putting in the time of simply being together. There are no shortcuts.

I spent years as a veterinarian ducking into and out of exam rooms like a game show contestant navigating an obstacle course. I took great care of pet owners and pushed appointments quickly and efficiently. But at the end of the day, when my technicians would go home, I had no idea where they went. I didn’t know what they did, or who met them when they got home.

I knew the people I worked with, but I didn’t really KNOW them. I knew their competencies and behaviors. I knew their quirks and what made them laugh. I didn’t know, however, what they cared about, how they thought, or what they aspired to become in the future. I didn’t know what they wanted to accomplish before they died, what their most meaningful life experience had been, or what made them proud at the end of the day.

I regret not knowing those things. 

I think a lot of us believe we don’t have better relationships with the people around us because we don’t have time to build those relationships. I’m not so sure that’s true. Recently I’ve been pondering the idea that maybe it’s not time that holds us back. Maybe it’s a lack of curiosity. Maybe we forget to wonder about people we see everyday. Or maybe we’re just too shy to ask people about themselves.

In my experience, most people are thrilled to have someone want to know more about them. They smile and open up. They feel special and seen. Asking deeper questions so we can better know others isn’t a weird thing in practice. Instead it’s usually a path to deeper, more trusting relationships. 

Who do you know, but don’t really know? What could you ask them today to start to make that journey?

Perception: It’s All How You Look At It

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Today I am thrilled with my dog. I am so, so happy. Do you want to know why? Because he only destroyed a very nice pair of socks belonging to my oldest daughter. 

For those of you who have been reading my letters for a while, you might remember that Skipper Roark is a devout anarchist. He lives life to the fullest and has no interest in joining the brainwashed “good dog tribe” that he hears me talking about every day I visit the clinic. He lives by his own rules… and Skipper hates rules.

Anyway, the socks he ruined were brand new and quite nice. He tore them to shreds while I was running errands with the kids. You might think this would make me angry or upset, but I’m not at all.

The reason I’m thrilled is because my daughter (whose dirty laundry was raided) was absolutely certain that Skipper had eaten at least one pair of underwear while on his rampage. We searched the area and… there was no underwear to be found. She was certain her underwear had been in the hamper… but “there’s none there now.”

I suddenly became absolutely certain that we were headed to surgery. It might involve the emergency clinic that night or our clinic in the morning, but surgery felt imminent. I started questioning whether it was worth trying to find someone who could scope him at 9pm. Guilt (I’m pretty sure I was the last one to close the laundry room door), logistics and medical expenses flooded my mind.

And then… My daughter found the underwear. It was rolled up in other laundry and well-hidden until her final, last ditch effort to set her father’s mind at ease.

Immediately I began praising bad dog Skipper. I hugged him and texted my wife (who is traveling and had no idea any of this was happening): “SKIPPER DIDN’T EAT ANY UNDERWEAR! HE’S A GOOD BOY!”

My wife’s response was nowhere close to as positive as mine. She responded “Well, did he eat something else?!” and was not happy about the socks. To be honest, I think she was even more irritated that I didn’t seem to remotely care about expensive hosiery being trashed.

And that’s the thing about perception. If someone tells you your dog destroyed socks, that would bother you. But if someone tells you your dog is headed to surgery and then says “Oh wait! We’re okay! He just destroyed socks!” you’re probably over the moon.

Hardship in life is often this way. When bad stuff happens, it’s not toxic positivity to try to look at things a different way. It’s just adjusting your perspective to make life a little easier.