When I entered veterinary school, I thought I’d graduate into a position of decisive clarity. After all, knowledge was clearly a ladder and as each class stacked on top of the last, I felt I must be getting closer and closer to having all the information necessary to be a doctor who knew what to do. Surely the accumulation of almost 20 years of (mostly) correct answers would grant me a sense of both control and certainty as I looked into the sad eyes of the ill patients set before me. At some point, all of this was going to come together and give me a sense of confidence about how to practice medicine… right?
Well… that didn’t happen.
Friends, I’d like to share with you (and especially those of you who are just graduating from veterinary school and entering the workforce) one of the great secrets of practice. Here it is:
Neither graduation from veterinary school, internships, residencies, nor decades of practice will grant us the control or certainty most of us thought we’d have when we became doctors. Instead, and quite conversely, our training has granted us the opportunity and responsibility of being the person who gets to make decisions when there is little or no certainty.
That’s it.
Veterinary school does not lead us to the job of continually selecting what is good for our patients and what is bad for them. It instead transforms us into people who are educated and respected enough to carry the burden of frequently choosing between two or more objectively bad options. Our DVM degrees don’t give us clarity. They qualify us to lead others into and through the humbling fog of uncertainty that surrounds emotion, resource management, illness, and death.
I don’t tell you this to deflate anyone’s spirits. I’m also not saying it to take anything away from our wonderful profession. I simply think that we do young doctors a disservice when we don’t tell them clearly what the job they are training for entails. We set them up to believe that decisions should be much easier than they actually are, and that can make them feel like they are failing when they are, in fact, just searching like the rest of us.
The reality of what we do, the navigation of uncertainty, shouldn’t be surprising to us. This challenge is what waits for all who climb to the top of their chosen vocations. To be truly great at something is to have risen past the easy answers so that people come to you with problems others are unable to solve. As Dean Acheson, secretary of state for Harry Truman, once said: “At the top, there are no easy choices. All are between evils, the consequences of which are hard to judge.”
The same is true for facing down illness. Our training often does not light the correct path for us, our clients, and our patients. It simply makes us the best people available to hold the torch and lead the search in the darkness.
If you find yourself searching and wonder why you never seem to get the easy cases, please know that you are not doing anything wrong. You are simply living the life of a healer in the real world. You are shouldering the responsibility that our patients, clients, and society need someone to carry. Yes, the burden feels heavy sometimes, but it is a responsibility we should be proud of. Anyone can google a “right answer.” It takes a special kind of person to make decisions when there IS no right answer. That is the work of the veterinarian.