The Vet Cookbook is BACK!

Does assembling a salad in a jar count as cooking? Absolutely!

You might have heard about the Vet Cookbook?

If not, it was essentially a compilation of recipes and stories to promote wellbeing among veterinary team members. People from every area of the veterinary sector – from veterinary nurses, technicians, practice managers, animal attendants, academics, specialists and GPs and even those who had left practice – sharedrecipes.  

Like our patients, veterinary team members need fuel. It’s even better if that fuel is pleasurable to eat! Sharing food is a wonderful way to come together, support and nourish each other.

It is hard to believe but the Vet Cookbook was published by the Centre for Veterinary Education back in 2017.

We had some fabulous submissions. It was a tough job pulling it together (I was part of a team of dedicated co-editors, including Deepa Gopinath, Lis Churchward, Asti May and Jenna Moss Davis) but we did it.

Chocolate hazelnut "Dogs-in-the-mud cake".

The not-for-profit cookbook sold two print runs and is now a collector’s edition. With the funds raised, we held several events including a wellbeing day (talks can be viewed on the CVE’s Mental Wellbeing Hub) and two sold-out writing courses taught by outstanding Australian authors Tracy Sorensen (The Lucky Galah, The Vitals) and Brendan James Murray (The Drowned Man, Venom, The School). This year, the Vet Cookbook is back. 

That’s right, we’re working on the Vet Cookbook II. The theme is “celebrating the wins” – we want to hear from all veterinary team members, near and far, about what you enjoy about working in the sector. Our editorial team includes Lis Chuchward, Kimberley Blackett, and Sharmila Kumaran (you might recall her as the author of the decadent strawberry cheesecake in VCB I!) 

And we’d love to hear your favourite recipe!

For those who are creatively inclined, we’re also keen for submissions of images of artwork (e.g. could be a painting or drawing, poem, creative writing, sculpture or composition).

We’ve already had some brilliant and creative submissions, ranging from simple recipes to the more complex, to wood block prints, drawings, paintings and photos, and we’ve got room for a few more. You can upload your submission here:

https://form.jotform.com/241008103636849

Please don’t be shy! We’d love you to be part of this – or give a gentle, encouraging nudge to that person in your workplace who loves making food. Please follow the VCB FB page for updates: https://www.facebook.com/vetcookbook/ 

Wellbeing and veterinarians - thoughts from the New Zealand Veterinary Association's wellbeing symposium

The New Zealand Veterinary Association hosted its first symposium on veterinary wellbeing

I’ve just returned from the New Zealand Veterinary Association’s first ever wellbeing symposium, held in Christchurch. I was invited there to speak about ethics rounds, an intervention designed to help veterinary team members with ethically challenging situations that can lead to moral stress, moral distress, or even moral injury. More on that in a later post.

The reason for today’s post is to share a couple of the themes discussed at the symposium.

The MC, Dr Charlotte (Lotte) Cantley, opened the symposium with an incredible account of her recovery following a catastrophic and near fatal horse-riding accident (the horse was okay), and a grueling schedule of treatment and rehabilitation. According to Lotte, “resilience is not bouncing back to how we were but being flexible, adapting to and embracing the uncomfortable changes life throws at us”.

Given her account, uncomfortable is an understatement.

So here is my take on the major themes of the first day.

Collegiality and compassion

One thing that came through loud and clear was that one of the biggest impediments to the wellbeing of veterinary team members is, well, other veterinary team members. The way we treat one another, whether we are aware of it or not, impacts us. As speaker after speaker raised this issue, heads around the room nodded. Tears were quietly shed.

Sonja Olson, author of Creating Wellbeing and Building Resilience in the Veterinary Profession, argued that we need to stop referring to communication and people skills as “soft skills” and name them what they are – power skills, tools that improve collegiality, understanding, shared decision making, adherence to negotiated recommendations and ultimately, good clinical and policy outcomes. https://www.routledge.com/Creating-Wellbeing-and-Building-Resilience-in-the-Veterinary-Profession/Olson/p/book/9780367418793

Dana Carver, from GoodYarn (an evidence-based, peer-delivered mental health literacy program https://www.goodyarn.org/)  , talked about situations that negatively impact our mental health. As she said, when we suffer an obvious “sudden negative change or event” (like the death of a family member), people tend to be demonstrative in their care. They swoop in with offers of assistance. They make casseroles. But what happens when we experience other things that negatively impact our mental health? According to Dana, these include things like a lack of justice, a lack of life balance, relationship problems, poor physical health or chronic pain? In these situations, we aren’t good at asking for help…and people may not offer it. What we can do is make time, or make an effort to connect in some way. Its better to do something, ask the question, say something, than worry about looking like an idiot. I could recall plenty of missed opportunities to extend support to someone, to make that casserole.

We heard a lot about implementing wellbeing plans into practice, and ensuring that this was more than just promoting a token day. Stephen Hopkinson, the founder of a large dairy practice surveyed his own staff to ensure that the wellbeing plan subsequently developed would actually meet their needs. To his surprise, they found that gossip, negative comments, exclusion and not helping others were the number 1 things negatively impacting staff.

Sometimes this is coming from a place of anxiety or hurt. Those behaving this way may not even be aware that they are having this impact.

He argued that we need to ensure that the discussion about mental wellbeing isn’t just about vets. All team members need recognition. Hence his team celebrate:

• -        National Administrative Professionals day (April 26)
• -        World Veterinary Day (April 30)
• -        National Receptionist day (10 May)
• -        Veterinary Nurse and Technician Appreciation day (14 October)

Because winters are cold in New Zealand, they also run “soup days” in winter – providing staff with a small budget to buy ingredients on the practice account, so they can make soups and share with the team. According to them, this marries well with the “5 Ways to Wellbeing”:

1. Keep learning – learn a new soup recipe
2. Be active – dance and sing when you make the soup
3. Give – share the end product
4. Take-notice – mindfully sip your soup
5. Connect – rate each other’s soups, swap recipes, and cook together

The 5 Ways to Wellbeing bookmark, produced by the Mental Health Foundation https://mentalhealth.org.nz/five-ways-to-wellbeing 

Denise Quinlan, who acknowledged that everyone gets crispy, shared her strategies:

• -        Prioritise ruthlessly (so if someone asks you to do something new, which thing on your to do list do you need to bump?)
• -        Promote autonomy in the workplace
• -        Support one another
• -        Value each other
• -        Act fairly (avoid those perceived injustices)
• -        Provide clarity (lack of clarity about job roles was a big reason for people to be disgruntled at work)

Her colleague, Paula Davis (author of Beating Burnout at Work https://stressandresilience.com/burnout-book/ ), provided a list of “Tiny Noticeable Things” that we can do at work to help demonstrate that we value each other.

Source: Paula Davis, Beating Burnout at Work.

Imposter syndrome

Every speaker admitted that they have imposter syndrome. In fact, Sonja has given hers a name (I won’t share it here, you’ll have to ask her).

Imposter syndrome is well-documented among the general population, as well as veterinary team members https://pubmed.ncbi.nlm.nih.gov/32571984/ . It tends to flare when we try something new, or perform in front of our peers, or start a new job. In a profession where life and death and animal welfare and human wellbeing so often hang in the balance, imposter syndrome can serve us well, driving us to improve, not to rest on our laurels. No one could pin down a guaranteed way to manage imposter syndrome without throwing the baby out with the bathwater…but it helps to know that imposter syndrome is something that everyone struggles with – and probably gets worse the higher we achieve.

Massey University Dean of Veterinary Education Jenny Weston did remind everyone that we can ultimately be our own worst colleagues – engaging in critical, judgmental, and negative self-talk that we would never extend to anyone else. Not only did she have everyone up on the dancefloor – she commandeered a team of well-practiced back-up dancers.

Rather than worrying about our own imposter syndrome (she/he/they are, realistically, probably not going to leave us – as per above, they do serve us well on occasion), maybe it’s more productive to recognise that others are experiencing this too, and be aware of the way we might impact those around us by inadvertently reenforcing that, and perhaps not doing enough to show our appreciation.

Veterinary bibliotherapy: awe

 

An awesome creature resting next to a book about awe.

“Something happens when you dive into a world where clocks don’t tick and inboxes don’t ping. As your arms circle, swing and pull along the edge of a vast ocean, your mind wanders, and you open yourself to awe, to the experience of seeing something astonishing, unfathomable or greater than yourself.” Julia Baird, Phosphorescence, p23

It wasn’t until I read Julia Baird’s bestselling biography/meditation on photoluminescence, that I really reflected on awe. What is awesome? What generates awe within us?

According to Jonah Paquette, author of Awestruck: How embracing wonder can make you happier, healthier and more connected, awe is a feeling of perceptual or conceptual vastness, combined with experience that transcends our understanding, and forces us to accommodate new information from a different, perhaps bigger, perspective.

Emerging research on awe shows that it makes us feel less alone, diminishing the ego and giving us a sense of the greater forces that surround us.

Awe can be negative – its origins relate to fright or terror, particularly in relation to a divine being – or positive. That negative type of awe can be a powerful driver for change, and even ethical conduct. Awestruck focuses more on positive awe.

Research has shown that awe makes us kinder, more generous, and more curious about the world. Studies have shown that awe has a number of psychological benefits, including increasing satisfaction, making us less materialistic, reducing stress, helping us grow and change and making us more humble.

At a biological level in humans, awe may be associated with reduced levels of inflammatory interleukins – could it have an anti-inflammatory effect?

Could awe be anti-inflammatory?

If all this is true, that seems a good reason to cultivate awe, which is what the second half of Awestruck is devoted to.

First, it is helpful to understand the many forces that can blunt or crush awe: anxiety, multi-tasking, addictive technology, habits, routine, desensitisation…the same forces that nibble away at our wellbeing.

Paquette discusses strategies to minimise the awe-crushers, for example limiting exposure to addictive technology.

But he and Baird also talk about strategies to deliberately seek out awe: for example, disrupting our habitual existence, doing small things differently, and being mindful of the world around us.

According to Baird, “One of the more surprising findings of recent research is how commonly awe can be found: in museums, theatres, parks, ponds, while listening to a busker, or even, surprisingly, in microdoses, while watching a commercial or reading a story.”p31

There are so many potential sources of awe, but a strong theme emerges from both Awestruck and Phosphorescence: one of the most common and powerful sources of awe is the natural world.

The natural world is a consistent source of awe.

And that is probably what resonates with me the most. When I think about awesome experiences, the common factor is animal life. Whether its hearing the exquisite soft snoring of a cat in a deep sleep, or observing a horse grazing in a paddock, animals are a constant source of awe. Neither of these books are written with a veterinary audience in mind, but when I talk to friends and colleagues about what drove us into the profession, and what sustains it, there is often a sense of awe.

These books provide compelling arguments for seeking and cultivating awe, and provide some -practical suggestions about how to do so. Awe-chasing seems like a very valuable use of one’s time.

They also provide compelling reasons for protecting these sources of awe, most of which are threatened by our unsustainable lifestyles.

Veterinary bibliotherapy: "Emotional Female" by Yumiko Kadota

 

Hero also loved Emotional Female, but for slightly different reasons. Image (c) Anne Quain 2021.

In February 2019, the Sydney Morning Herald ran an article by Kate Aubusson entitled “Exhausted Surgeon Dismissed as an Emotional Female”.

I recall reading the heartbreaking story of plastic and reconstructive surgery unaccredited registrar Yumiko Kadota – the punishing hours she worked, the extreme demands she faced in her workplace, including sleep deprivation, and her account of the dismissal of her own illness by medical colleagues.

What struck me was how ironic it was that any kind of healthcare system was designed in such a way that it could have a detrimental impact on the health of its workers. We see healthcare professions as healthy, right? They know the stuff about health and wellbeing that we don't. But knowing and doing are different things.

Dr Kadota’s story resonated in the light of the current discussion about the wellbeing of veterinary professionals. We devote energy to promoting and restoring the welfare of our patients – right down to reflecting on their fear, anxiety and distress in veterinary settings, and doing everything in our power to minimise these. Synthetic pheromones. Places for shy patients to hide. Allowing buddies to be hospitalised together. Offering treats when we give injections.

We talk about the five freedoms of animal welfare – freedom from hunger, thirst, discomfort, pain, and freedom to express normal behaviours. We know all about welfare and the things that compromise it. 

But we seem challenged when it comes to protecting our own freedoms, promoting our own welfare. In some cases, I think it is safe to say that we wouldn’t work dogs or cats like we work ourselves.

And when I say ourselves, I am not suggesting that the blame lies with individuals. Sickness in healthcare settings is a complex interaction between individuals, management and environments – the systems in which we operate.

I contacted Dr Kadota and she gave a brilliant talk at the Mental Wellbeing for Veterinary Teams Symposium in 2019 about the need to put your health first. 

                                Dr Alicia Kennedy, of Cherished Pets, with Dr Kadota.

Earlier this year, Yumiko – describing herself as a “recovering doctor” – released a frank book about her experiences.

Appropriately, the book is entitled “Emotional Female”.

It is a thought-provoking, highly readable autobiography documenting a gruelling career trajectory. Despite clear differences between veterinary and human healthcare, I think many veterinary professionals will be able to relate.

Yumiko talks about beginning her career with konjo – Japanese for approaching everything with guts, “drawing inspiration from the samurai spirit”. She describes the challenges of her medical degree and training, early encounters with trauma and suffering, reflecting on what it means to be “a good doctor”, and the constant drive to be better.

As she climbs the training ladder, she admits that “I did sometimes wonder if I’d ever be satisfied. When there’s always more, you feel like you’re never good enough.”

At the same time, her social life becomes “bargaining with friends and loved ones all the time – a continuous cycle of cancelling and making up for cancelling.”

She shines a spotlight on sexism, misogyny and the treatment of women who “speak out”.

Her work becomes all-consuming, but it isn’t sustainable. Yumiko, a doctor, eventually becomes a patient, aware that the roles can be seen as mutually exclusive.

“We accept when patients have mental illnesses, but if it’s a colleague there can be a lot of stigma attached. It’s seen as a sign of weakness or a personality flaw. I was realising I had the same prejudices and needed to fight them.”

Emotional Female is a brilliant, sometimes difficult, always compelling read. It will make you think about what it means to be a good health care professional, how health care systems impact the health of healthcare professionals themselves, and what it really means to be a good doctor.

Sickness presenteeism: we need to rethink going to work when we're sick

Covid-19 is changing the way we think about sick days, personal wellbeing, public health and PPE.

One of the things that Covid-19 has already changed is our attitude to sick-days. For a long time, many of us have assumed that its better to soldier on when we’re not feeling well. We do so to avoid letting colleagues down, to ensure continuity of care, and sometimes out of financial necessity. It may also be because there’s just no hard and fast rule about what constitutes “too sick to work”.

Veterinary team members aren’t the only people who struggle on. A medical colleague co-authored this global study comparing work related behaviour and the phenomenon of “sickness presenteeism” (essentially, turning up to work when you are sick) in health care workers vs non health care workers. Influenza like illness in health care workers is a particular concern given their contact with vulnerable persons. But Covid-19 has highlighted just how much non-medics have contact with vulnerable persons.

Anyway, in this study the researchers surveyed 533 people across 49 countries (getting a large number of responses on a global survey is a tough gig!). Of those, the majority (58.5%) would continue to go to work with signs of an influenza-like illness. How does that play out? Well, 26.9% of healthcare workers would go to work with a fever (versus 16.2% of the non-health care worker population), while 89.2-99.2% of health care workers would go to work with one or more of the following: sore throat, sinus cold, fatigue, sneezing, runny nose, mild cough and/or reduced appetite. That compares with 80-96.5% of the non-healthcare worker population.

The authors recommend better sick-leave policy management and greater uptake of the influenza vaccine. This is especially pertinent given that signs of Covid-19 are very similar to ILI.

You can read the full paper here. 

It will be very interesting to see whether sickness presenteeism is reduced since the advent of the Covid-19 pandemic.

On the topic of self-care, a colleague shared this monthly action calendar from Action for Happiness. You can view and download a copy here. 

Veterinarian Joe Herbert has started a facebook group to promote well-being in the vet profession. The group is for veterinarians.

What happens when a vet gets sick? Interview with Dr Ian Nielsen

What happens when a veterinarian gets sick? Not 24-hour-bug sick, but full-blown sepsis, disseminated intravascular coagulation, comatose for weeks sick?

Equine veterinarian Ian Nielsen had had a bad run. The veterinarian/grazier’s practice was hit hard by drought and the equine influenza (E.I.) outbreak. Then a seemingly simple stomach ache mismanaged turned into a perforated ulcer, and a sudden, critical illness.

Ian survived, documenting his experience in Still Here: A Wild Ride to Survival. The book describes the ensuing farm and veterinary dramas, legal action, some very grim prognoses and a self-devised rehabilitation which even Nielsen admits was “insane”. All of this with a damaged brain, a failing heart and a “drunken” nervous system.

Almost ten years later, at the age of 74, Ian continues to run an equine practice, follows a strict gym program and races a single scull in master’s rowing regattas. He is incredibly philosophical about the experience, and was happy to answer our questions.

No one plans illness, but what was the impact on your practice?

It was seriously badly timed. I had had insurance throughout my life – both life and income protection insurance. But it was going to end when I was sixty-four and a half (just six months before my illness). When I pulled out of my Canberra horse practice, I had let the insurance lapse. I’d been on the farm with five years of drought already and thought if I lost my health I’d battle on, but it was an earth shattering financial situation, as you go from a pretty healthy income to zero.

We’d been through that before with equine influenza - going from a big income to stop. Suddenly, you don’t have a big turnover but an awful lot of expenses just to keep the practice going.

With E.I., I had to decide whether to take a part-time Government job with the Department of Agriculture to help solve the problem, or should I stay on and look after my clientele? I didn’t chase the money, but decided to service my clients.  We went backwards financially then. We were in the so-called green zone and all the green zone vets fell on their swords a bit. Mostly work stopped.

After I was ill I couldn’t work at all. At that stage we were lucky, my wife Trish was the receptionist and book keeper and I’d wound back to a grazier-come-veterinarian. We had no wages to pay. My workload was already less than frantic, but that wasn’t entirely by choice. We’d moved to the country away from Canberra, I wanted to scale back a little bit anyway.

I was at that stage of life where I’d upskilled enough to work at the smart end of vet practice and do lameness and reproduction and not as much ambulance stuff. I was reasonably healthy at the time this happened, just had arthritic issues. Then suddenly, crash! Bang!: I stopped and vacated the earth for six weeks. When I tried to work again people were pretty scared of actually seeing me.  I looked a little moribund. A lot of my clientele started to vacate the practice. I did a few newsletters as you do and said rumours of my death have been greatly exaggerated. But if you look physically 50 per cent, they imagine you’re mentally 50 percent…

Without giving too much away, reading your descriptions in the book, your physical condition sounds terribly painful.

We all have a slim memory for pain, otherwise we wouldn’t reproduce ourselves. When I look back at the things that were painful, I now have no real concept of that pain. It seems to have vanished. In hindsight I think I was lucky to have had the experience. It was an out of body one, I was just observing what happened and because I am innately a scientist, having enough knowledge to follow my own biological mechanisms and watch healing and the body’s response to forces was just fascinating. It was a great trip.

Despite surviving the ordeal you had some long-term complications including peripheral and central neuropathy, yet you continued to practice. How did you manage this?

The neuropathy was crook, and in fact I am still out of balance and easily knocked off my legs. The hardest part was that I did have – and still have – some difficulty retrieving vocabulary and sentence construction. I do this constant search in my head for the right word. There has been an amazing improvement with recovery, but you can imagine it was very frustrating not to be able to say what you could think. I was not able to say it because I’d lost large areas in my prefrontal cortex and amygdala - also affecting my short-term memory.

While doing my vet work I had to make very careful clinical notes. That was really good, it made me much more observant and careful about my clinical appraisal. My memory was jerked by re-reading notes, but if I ran into a client or they caught me unawares on the phone and said “Myrtle is better today”, I’d say “Give me a second, I’ll look in my book” and it turned out that I’d seen them yesterday!

What about the physical side of working with horses?

When I studied, equine practice was considered a men’s profession, because you had to throw horses around instead of sedating them. Even when good sedatives became available, there was a common belief that it was almost an admission of defeat and poor horsemanship that you had to resort to sedation. That belief still exists in the marketplace where people say “You don’t have to sedate my horse, the other vet didn’t”.

In the old days females were considered second class citizens because they weren’t strong enough. That is nonsense. I can be blown over by a solid wind now. The truth is that horses are innately sensitive to a threat. If you are not offering a threat to them, they are calm. I wonder as I look wobbly on my feet, perhaps they see me as less of a threat. I’ve not been injured by a horse since then.

As a practitioner yourself, although an expert with equine patients, how did you cope as a patient?

Because I was involved with the College (the ANZCVS) and its development, and because I am intrigued by how things work, pathophysiology is what it’s all about. Epidemiology and pathophysiology are the gateway to finding out new diseases and not being surprised by things or the way they appear because it’s logical.

It’s often said that in being a vet, you are your own worst doctor, but you’re probably not. Despite the fact that medicos think I am a second class medico, it has helped. I don’t just give my doctors my history or symptoms, I give them advice as well. I really feel that for my wife and I, I’ve been an asset in our medical care.

She has a nasty lupus condition which manifested itself with sudden onset, strange clinical signs. I kept saying you can’t get five diseases at the same time. I said it will be one disease, because of the sudden onset. So we had 2-3 years of traipsing around to different specialists…and I was chest-thumping because of the multiple diagnoses she received.  That was plain bad medicine.

From the perspective of rehabilitation and recovery, an awful lot was determination (bloody mindedness) and some was knowing what I was doing. Rehabilitation is a poorly studied discipline. For example, surgeons will cut your knee open then tell you to go home – no post op advice given. Mind you we’re not much better in veterinary medicine.

In horses, we have no controlled studies on recovery from bowed tendons, for example. We have studies trialling a set plan, but not against a control or against another plan. Vets write up the clinic’s advice sheet but it isn’t based on solid evidence.

I did learn a lot. To have taken legal action meant my solicitors pulled out all the stops and got furious about getting proper diagnostics, so I spent many hours at hands of medical specialists one way or another. I had tests with neurophysiologists and psychiatrists and psychologists, who could clearly define the areas of brain that were destroyed, and could see it on an MRI. I’d love to have a repeat MRI now and see the extent of recovery.

The plan you devised for your recovery was gruelling to say the least. To what extent do you think it is important for patients to research their condition, collect data and develop their own plans?

When I turned a corner, I went from recovery to starting a program of rehabilitation with a team that I selected – a physiotherapist, a podiatrist, my consultant physician (who didn’t know he was on the team but was in charge of my heart), and my personal trainer.

So three of out of four them knew they were part of the team. I also had my psychiatrist, although he also wasn’t aware he was part of the team. They were there as backstops, and I would lay down the benchmarks that I was trying to achieve…and my wife in the background was prepared to sue everybody if I dropped dead doing it while I was writing waivers saying I’d rather die than fail.

I had decided on hypoxia as the cure to all nervous ills. I seemed to recover and I believe it was a genuine recovery based on my plan, not a placebo. My working title for my book was N=1, but nobody but scientists knew this is the ‘anecdotal equation’. When my consultant physician said I should write it, I said, “Come on, it’s an N=1 story.  It’s not truly a scientific story”. So I don’t use references in it for that reason. But I wrote it anyway.

Do you have any advice for veterinarians or future veterinarians?

Enjoy it.  It really is a fun job.

You really do need income protection of some form or other. In my case I kept income protection insurance going all through the kid’s childhoods, and when they were at uni, so we had them covered. But after that I went along on the basis that I had cash as I needed it. As it happened we blew all that.

So Trish and I are church mice now. We don’t have big expensive living habits. I row my boat, and if I can I will go back to painting watercolours.  Trish sews very well.  It is not terribly expensive. And I continue working as an equine vet while I can, because I enjoy it.

Thank you Dr Nielsen for your time. You can read in detail about his experiences in his book Still Here, available on Amazon or directly from Dr Nielsen’s website http://www.stillhereiannielsen.com/

Dr Belinda Parsons shares her resilience pie

Dr Belinda Parsons with Charlie

Do you tend to blame yourself or flagellate for outcomes beyond your control? It’s a common response to negative outcomes. Dr Belinda Parsons shared her strategy with The Vet Cook Book (and yes, we are still working behind the scenes to bring this colourful, delicious tome to life). Over to Dr Parsons…

My time at university taught me about the importance of resilience. The ability to keep on plugging away at life when sometimes it all seems too overwhelming. As a vet student I faced the death of my dad to melanoma, being enveloped in grief and was accosted by the realisation of human mortality. Resilience didn’t stop me from breaking down but is what helped me to get back up. It is not an intrinsic value that you either have or don’t have. Resilience can be learnt, built 

upon and with practice gets stronger.

Throughout my career I have been confronted with depression, burn out and anxiety. My resilience allows me to talk openly about it and use my position to help destigmatise mental health disorders. One concept that I believe many vets struggle with is the misbelief that we are the ONLY factor that affects whether our patient lives or dies, is cured or remains sick.

After a particularly horrid week in the veterinary hospital and the death of three of my patients I broke down emotionally. Feeling a surge of self-loathing and the familiar creep of depression I made an appointment with my psychologist. It was there she directly shattered my sense of self-importance for the better. She asked, “what makes you so special that you are the only factor that affects whether your patient lives or dies”.

So much of my psychologist appointments are about learning skills that aid in dealing with my circumstances, changing abnormal thought patterns and protecting myself against my depression recurring. On this day, she introduced me to what I am referring to as resilience pie.

Resilience pie is a superfood for your brain. It provides a visual representation of the factors affecting patient outcomes. For someone who is blaming themselves and experiencing a high degree of guilt, self-loathing and self-hate it can help to break this down. This first step in making this pie is to create a list of the factors at play. They can be as follows (taken from the original resilience pie).

• ·         Thorough exam
• ·         Animal response  
• ·         Treatment
• ·         Owner compliance
• ·         Disease
• ·         Hospital environment
• ·         Stress in hospital
• ·         Stress levels of owner

Once you have the list of factors then it is time to allocate a percentage value to each piece of the pie. Delve into each factor and ponder what it will be responsible for and how much pie it is going to take up. It won’t be long before you notice that even with the right diagnosis, right treatment and dedicated owners there are always some factors that you cannot control like the ability of the animal to respond to the treatment, the disease and the varying ways it can progress.  

This gives me the mental space I need to process the situation, move away from playing the self-blame game and becomes a constructive way to learn from my mistakes without taking excessive responsibility for the outcome. So next time you start to feel the all-consuming responsibility of a patient’s death, instead of eating humble pie, break out resilience pie instead.

Thanks Belinda for sharing. If we can use tools like this to get beyond the emotion and focus on learning from negative outcomes (even those of which no one can wield any form of control), its a positive. Belinda is a tireless advocate for the mental wellbeing not only of veterinarians, but everyone around her. 

Belinda is currently in the Top 50 for Bondi Vet. You can vote for her at https://bondivet.com/vet-search/top-50

Or you can read more about Belinda at www.drbelindathevet.com

Mentoring in the veterinary profession

Veterinary problems are always less confronting when discussed with a mentor over morning tea...

When I was a new graduate, I was struggling to intubate a dog with airway problems. Flustered, concerned about the patient, terrified I was making things worse, I called a neighbouring practice and the vet there – her name was Sue – dropped everything, drove over, showed me what to do and gave me a hug.

“You couldn’t pay me a million dollars to relive my first six months out”.

she said.

Her words – although alluding to the stress of being a new-grad – were an instant balm. Knowing this incredible, generous woman had been through what I was going through and survived – but acknowledged it had been stressful to her – made me suddenly feel not alone. She didn’t make me feel bad for interrupting her day. She didn’t make me feel like I was out of my depth in this job because I couldn’t do something simple. She acknowledged it was tough and offered her support.

Sue drove away again and I’ve not seen her since. She was not a formal mentor, but that is a moment of kindness, that informal mentoring moment, is one I will never forget and certainly one which gave me confidence to reach out to colleagues. It also taught me the importance of being there for others.

I’ve learned there are dozens, even hundreds of people like Sue in our profession. Vets, nurses, technicians, specialists – so many are so willing to help if asked. Which brings me to mentoring.

Have you ever considered participating in a formal mentoring program? Mentoring is an incredibly rewarding opportunity to provide support to other colleagues. It’s not about being a counsellor or psychologist, rather it’s about acting as a sounding board, sharing experiences and it’s really a two-way development process.

Most of us mentor colleagues, and are mentored, informally. But participating in a formal program is fantastic as you receive training and support. Both the University of Sydney Faculty of Veterinary Science and the Australian Veterinary Association are seeking volunteer mentors to match with students and new graduates. The University of Sydney program was established by veterinarian and counsellor David Foote (read more about his work here).

I am Director of the Bachelor of Veterinary Science mentoring program at the University of Sydney, so I think it’s safe to say I am sold on the benefits of mentoring. But I thought I’d ask some other mentors about their experiences. Drs Cathy Warbuton, Bill Howey and Kim Lim were happy to share their thoughts and some lessons learned along the way.

Dr Cathy Warburton

Why did you become a mentor?

I did not have a great time in my first job and my determination to succeed made me stay longer than was healthy. A wise mentor may have helped me to choose a different practice to start in, brain-stormed coping strategies with me so that I could better survive the experience and/or helped me to see that the problem was not all mine and I might be better to cut my losses and leave. I find it very rewarding to be that objective person easing somebody elses’ transition to practice. The happiness that comes from helping others is my other main motivation. The veterinary industry can be amazing – and it can be tough. I want people to see more of the amazing and avoid the unnecessary tough stuff.

Did you have informal mentors?

I have never been part of a formal mentoring program. During my 25 year career I have had some excellent and supportive bosses who have been informal mentors. The downside of mentor bosses is that they have a vested interest in the outcome of your work, introducing potential bias in to the interaction. The best informal mentors for me were those that acted like a sounding board and then left you to make your decision.

What was the best advice or support you ever had from an informal mentor?

The two best pieces of advice were; 1. Do the right thing by the pets and clients and the money will come. 2. You have to be healthy to look after others. Do what you need to do to stay healthy.

When in your professional life would you have liked a mentor?

All through my career - although I may not have thought that I needed one in the early days. I am your typical high achieving, competitive vet (I like to think I only compete against myself – but maybe I am delusional). I have been through burnout and back more than once (you would think I would have learnt the first time!). It has taken me a long time to realise that just because I could, doesn’t mean I should. A mentor may have helped provide an alternative perspective on the life I was leading and decisions I was making.

What can mentees offer in the relationship?

Enthusiasm, fresh eyes on old problems, youth, different life experiences sometimes in other industries. A mentor-mentee relationships is definitely a two way exchange of information and ideas – just as any effective communication should be.

Dr Bill Howey

Why did you become a mentor?

Naively I thought I could help. Now I know my limitations!

Did you have informal mentors?

My ‘informal mentors’ were actually my first two employers. They were both tough; but kind. Lucky me!

What was the best advice or support you ever had from an informal mentor?

‘Common things commonly occur’. ‘When you eliminate the common diseases there’s nothing very much left’. ‘Be positive even if you don’t feel confident’. ‘If you can’t be sterile at least be scrupulously clean’.

When in your professional life would you have liked a mentor?

Almost always; even after all these years!

What can mentees offer in the relationship?

I am greatly stimulated and encouraged by the attitude and application of my mentee; this is enough. I wish I could do more!

Dr Kim Lim

Why did you become a mentor?

Having known a couple of vets that have taken their own lives, my immediate reaction was, “Why didn't they talk to someone? I felt guilty that I didn't notice”.

While having Asian vet students on work experience, I also noticed that I had useful skills in understanding cultural etiquette that I could pass onto them.

Did you have informal mentors?

I was lucky that my first boss was a good role model on how to deal with clients. He also supported me during adverse situations. The rest of it I learnt over the years talking to colleagues, clients and other complementary practitioners.

What was the best advice or support you ever had from an informal mentor?

It doesn't matter if you come on a bike or in a flash car, just don't be ordinary.

I put a dog down for an elderly client in my early career and asked her if she would be alright. She replied that she had buried her husband and her son so she would be alright with this death. I was in my early twenties and had never buried anyone. It made me really humble and value life lessons, not just veterinary knowledge.

When in your professional life would you have liked a mentor?

From when I was a student. I think if you are lucky, you get some of it when doing work experience.

What can mentees offer in the relationship?

My mentee is a little older than my kids and may become a bit of a mentor to them because what would mum know! The satisfaction of seeing my mentee stand on more solid ground and deal with challenges while having someone to check in with is enough for me. I am by nature a fixer so enjoy seeing pieces of the puzzle come together.

The only 'downside' is that you feel responsible for another young person, like having another child, you feel anxious when they are applying for their first job, elated when they get it , anxious when they look for accommodation etc, it is probably partly an Asian thing or maybe just my fixing tendencies.

Thank you Cathy, Bill and Kim.

If you’ve thought about being a mentor but not sure how to go about it, or want to sign up please see below. Your profession needs more mentors.

If you’d like to sign up to mentor a new veterinary graduate, please contact Monika Cole at the Australian Veterinary Association at monika.cole [AT] ava.com.au NB you need to retype this address with the "@" symbol.

If you’d like to sign up to mentor a veterinary student in final year or in the DVM program at Sydney University, please contact frances.roqueza[AT]sydney.edu.au NB you need to retype this address with the "@" symbol.