When Darkness Overwhelms

(Updated from the original August 2016 post.)

This essay is going to be a departure from my usual lame attempt at a lighthearted tone. This essay is going to be about suicide in the veterinary profession. Statistics are not available for Canada, but in Britain two separate studies found the suicide rate among veterinarians to be four to six times that of the general population and double that of dentists and physicians. The American Centers for Disease Control did a survey of 10,000 veterinarians and found that a shocking one in six had considered suicide. I personally knew two colleagues here in Manitoba who took their own lives, and in 2014, a prominent and very well-liked behaviour specialist killed herself, drawing some media attention to this little-known aspect of the profession.

To the casual outside observer this will be unexpected and possibly even slightly bizarre news. Aren’t veterinarians generally well respected? Isn’t it a secure, interesting and rewarding career? Isn’t it a dream job for so many people? Isn’t it wonderful to heal innocent animals and get paid to play with fluffy kittens? All of that is true. Except the part about the fluffy kittens. Why, then, does darkness overwhelm so many of my colleagues? There are three significant reasons.

The first reason is that veterinary medicine attracts a disproportionate number of idealistic, introspective and sensitive people. Sensitive to the point of neurosis. This is true of all of the health professions, but it is even more so in veterinary medicine. Some of these introspective people are more comfortable around animals than around other people. They do not fully understand that it is actually a people job that happens to involve animals rather than the other way around. Grappling with this reality can be very problematic for some. Add to this the fact that competition to get into veterinary college is extremely high, and success favours perfectionists who can produce high marks. Perfectionism and idealism are fated to be brutally ground down by the chaos of reality in practice. And then their innate sensitivity lays them wide open to the second reason: the inherent and often surprising multi-factorial stress of the job.

Of immediate relevance to sensitive people is the fact that a veterinarian is at times marinated in death and grief. There are weeks — many weeks in fact — where I perform one or more euthanasias each day. Sobbing, crying, wailing, grief-stricken people, some of whom we’ve known for many years, are a routine part of our day. And for those of you who think this is simply a question of overwrought crazy cat ladies or frou-frou poodle people who too much resemble their dogs, I have two things to say to you. The first is that if you have not experienced a deep bond with an animal, then you are missing out on a key human experience, one shared by people from all walks of life, all backgrounds, all levels of intellect. It is one of the richest threads we weave. The second is that you have no more right to judge the grief of someone closely bonded to their pet than a blind man has to judge a photography exhibit. Simply trust me that these are normal people with legitimate and intensely felt grief. Additionally, a veterinarian is expected to be competent across a range of species and a range of disciplines, from dentistry to radiology to dermatology to . . . you name it, wedging the door wide open to so many opportunities to fail. And remember: “sensitive.” Mix sensitivity and failure and see what happens. And I haven’t even mentioned the financial stress of trying to be affordable to clients yet still able to service sometimes enormous debt burdens and meet payroll, etc. Or the stress of being a manager when you went to school to be a vet, not a manager. Or the angry clients. Or the angry spouse, upset because you’re stuck late again.

The third reason is that we know how easy it is. How easy it is to die. Those daily euthanasias are consistently peaceful, painless, quick and reliable. One hundred percent reliable. We know the dose. We know the delivery methods. We have the drug right there. Can you see now why it happens too much?

And to make things worse, this is clearly an iceberg situation, where the suicides are only the visible tip of a massive mental health problem in the profession. According to an exhaustive American Veterinary Medical Association survey, just under a third of all veterinarians have experienced depression at least once since graduation. A smaller Canadian study found that 1 in 10 veterinarians were currently classified as having depression, and another 15% were borderline. Also, a third of veterinarians in that study were suffering from anxiety, and a shocking 47% scored high on measures of emotional exhaustion. Clearly the problems run deep and run wide.

Fortunately, our professional associations are beginning to take notice, and mental health support is increasingly being incorporated into the services they provide. And what can you, the reader, do? You can’t do much about the first and third reasons listed above, but you can definitely do something about the second. If your friend or family member is a veterinarian, do not trivialize their stress. Understand that the real job is far more complex and serious than you imagine. Offer to listen with an open heart. And if you are a client and your veterinarian has done something to make you angry, please recognize their human fallibility and frailty, and try to find a calm and respectful way to address your concerns.

And what about me? Well, fortunately I had a “happy optimist” chip deeply implanted at birth. The zombie apocalypse could roll into town and I would say, “Cool, this will make for some excellent photos!” And, “Maybe brains are better with a bit of smoked paprika?” I have painted a bleak picture when in fact most veterinarians are fine — even better than fine — but burnout is very real, and depression is very real, and, for a small, tragic minority, suicide is very real too. Not only in veterinary medicine, but in society at large, we must work to demolish the stigma that still surrounds mental health. If your leg is broken, everyone wants to talk about it, but if your brain is broken, hardly anyone does. This is wrong, and it is doing so much harm.

This is for Terry and Craig and Sophia.