Same forest, different trail.

With not much time left to live here I need to finish exploring all the woodland trails I have not yet taken. The "local" mentality says they're not going anywhere, I can do it some other time, - until my time as a local comes to an end and I feel more like a visitor on holiday, and familiar places acquire an allure that is not mundane. Almost an anticipation of the nostalgia I know I will feel after I leave. The trail I took was new to me but eventually rejoined a well-known one that led through a deep forest to Alice Lake. It was unbelievably warm and smelled like April on this last day of February. I got back just in time to grab some groceries and a bottle of wine before heading home to watch the Olympics closing ceremony. At the store I ran into one of our clients and my first, uncharitable, thought was "Oh great... " seeing as he is a very chatty man and I never discovered the secret of putting a polite end to a conversation. But what he wanted to tell me was that their cat had lost a third of her bulk and was bounding around as they finally got her to eat wet food on my repeated advice. Oh, and her poops were no longer little hard pellets, they were nice and juicy. The things that fill a veterinarian's heart with gladness... . Elated, I proceeded to the meat counter to find something appetizing.

Not a single thought I put out here is a new insight, all has been said before by people wiser and better than myself. So with all the wealth of wisdom out there, why are my fellow veterinarians still burning out and even committing suicide? I had no desire to think about this on a day like today but was reminded of the fact as I did a search for blogs by and for vets. Yes, there are lots of reasons for frustration: people who haggle or weasel out of paying, people with a sense of entitlement and no sense of responsibility, people who are determined to see us as greedy, new clients who start the appointment by declaring as a general reproach that they have already spent X amount of dollars on their pet's problem, people who hoard animals and neglect them, etc., etc. But nobody ends their life out of annoyance with other people. I can't see it being about the failings of other people or the entire rest of the world, it has to be more personal, a case of "it's not you, it's me" if a cliche is at all appropriate. I suspect it is the most conscientious, the most self-demanding among us who come to accuse themselves of something they deem unforgivable. Like not being able to give people an answer after batteries of tests, and their animal still ill or even dead before an answer is found. I can see how enough of these would shape into a self-accusation. I don't know if this is what drives some of us to end our lives. There is also depression which casts a horrible gloom and hopelessness over anything else a person is going through. My own depression years are behind me, I dealt with it and grew out of it before I started vet school. So I cannot fully empathize with a veterinarian afflicted with this blight, although I can empathize quite well with a depressed civilian. Here is what I mean by this.

The language we use to refer to our work - "from the trenches" - is a reminder of the military origin of medicine as we know it. Field surgeons, expected to work for days without sleep: this image is at the heart of medical and veterinary training to this day. Few people question whether this is still necessary; this is after all how previous generations of medics were trained and forged, and the power of inertia is great. So we are an army of footsoldiers in the midst of a society encouraged to get in touch with its feelings and coddle them. (Oh, the cult of feeling! Don't let me get going :-) But a war has to be against something, so what is ours against? Disease seems like a good and obvious answer. Or how about a war on consumerism toward animals? As in no more perpetuating of really cute breeds that can't give birth on their own or that suffocate to death on a hot day. Something nice and manageable like that. Maybe there should be no war at all; maybe we should all go home and become civilians, conscientious objectors. Eh?

Two howling cats say they have not eaten in years. Time to step down from that soapbox in the clouds.

You think too much!

Maybe the early arrival of spring in February had something to do with it, but I felt a relief and lightness after I announced to my boss that I will not be renewing my contract once it is up in three months. The longer I waited to summon my courage, the less time he would have to find a replacement. Not fair to anyone. He said he was very sad about my decision. So was I - but only a little, and for a little while. And ever so slightly guilty for waiting almost two years to admit that this line of work is not for me.

This is not a Hallmark story of the evil uncaring boss and the overworked employee with a strong sense of justice. The terms of my employment are very fair, and I have been fortunate to work among people who had more faith in me than I had in myself (this, however, is not difficult :-). As the recession rolled by and I gave away more and more recheck exams for free, I was never chided for this but rather reminded to value my own time and efforts. The staff knows that I like to recommend EVO and Wellness canned foods for enormous cats on the brink of diabetes, and no one has suggested that I recommend m/d instead. My opinion, albeit based on meticulous research rather than non-existent experience, was respected and solicited from the first day I started here. My boss and I share a very similar sense of humour and do not hesitate to use it to diffuse the inevitable tension that comes with our work. And yet here I am - backing out, giving up, quitting, (insert chiché of choice here). This post started as a rough draft of an explanation I feel owe to my boss but probably more to myself.

My work appeared in a different light once I knew I would no longer be here in three short months. Quite abruptly I stopped having the little panic attacks I had been having for months every time the phone rang after hours to tell me of an animal that needed help. I was no longer afraid of not knowing what to do or how to do it. My knowledge and skills had not changed, only my propensity to worry about their absence. I drew some strength from the fact that I had already been through the worst, - my personal idea of the worst, - so nothing could happen now to trump that. That worst consisted of a little Boston terrier whose owner dearly wanted pups, who was made to conceive them despite her steadfast indifference to any male sent her way, and who like most Boston terriers could not give birth naturally and needed to be cut open to be delivered of her pups. Something was wrong before she ever conceived them. Her uterus tore like rice paper with the gentlest pressure, but I needed to get the three pups out before they were starved of oxygen and had to suppress worry about anything else (which for a worrywort takes a huge effort). Two of the three pups were not breathing after five minutes, after ten minutes, then a shrill little voice, then silence again. As my nurse and assistant worked to make them breathe I turned my attention to the mother and closing the rents in her uterus. I was sick to my stomach with a despondency and anxiety for which there is no English word, the two puppies were still silent and trying not to think about them was futile, and the task of repairing the torn and disorderly flesh seemed endless. Only one puppy lived, she is now a strong and pushy youngster. The mother dog recovered without a care in the world and needed to be reminded of her motherly duties for days before she caught on. Two days later my boss delivered two pups from the breeder's other Boston terrier, and neither of them survived beyond a day. The breeder was devastated by the outcome and her pocketbook by the bill. This was the beginning of my decision to leave, to never put myself in the way of such unhappy turmoil again.

My problem is that I think too much, and as a habit carried over from my previous life I take the inherent uncertainty and imperfection of my work as a personal failure. (And our work is inherently imperfect because our best guesses - called diagnoses - cannot keep up with the changes in the living body we call the patient.) I launched into veterinary medicine at the tender age of forty after a career of teaching at university - subjects that had nothing to do with the sciences. Nice leisurely subjects that invited long leisurely discussions that were, as it seemed all too often, of no consequence. Something in me chafed at this suspected insignificance, and at the dust that settled in the library on articles published by my colleagues and read by no one. I wanted to do something of consequence, at least to see if I was capable of this, and I wanted it to involve my high-school love of science. This is how this story began.