Photos by Nikolai Kolupaev
Amanda Carlson (left) and Taylor Gaines co-founded the blog "Beasts, Unburdened," which aims to reduce the stigma of discussing mental health among veterinary students.
Together, we plodded through the trenches, crawled under barbed wire and stepped carefully, trying to avoid land mines in the open field. And then, once we found the calf, we still needed to treat her.
Such a scene could be found only among soldiers or veterinarians, and the comparisons between the two groups are numerous. There is a prolonged and arduous period of training: one group has boot camp, the other has veterinary school. They share a ritual of checking gear and uniforms before heading out to work, and at some point are both called "vets." They both are tight-knit and drawn tighter through common struggles, triumphs and values.
It is a rare privilege to choose a profession where colleagues are more than just colleagues, and only those who are a part of it can understand what that means. You cannot help but feel camaraderie with James Herriot, author of All Creatures Great and Small, as you read about his adventures through the countryside of northern England and his depictions of the people and animals he encounters. Even separated by 70 years and the discovery of antibiotics, there is a filial closeness. Veterinary medicine is a family tree with long roots and many grafted branches.
Why then, with such great interconnectedness, is there an epidemic of poor mental health among veterinarians and veterinary students?
Again like soldiers, members of the veterinary profession tend toward rates of mental disorders and suicide that are higher than in the general population, although the causes, and sometimes the truth of the claim, are debated. This topic has been hashed and rehashed: Do mental disorders arise from the work of being a veterinarian, or are those who enter the profession predisposed to developing a mental disorder? What can be done to effectively lower the higher rates to match those of the general population? Likely, the answer to these questions will not be answered for many years.
We write from the perspective of second-year veterinary students. We see our entire careers before us, and what we lack in experience, we have in equal measures energy and a desire for improvement. It is worth it to us to invest effort trying to solve this problem, and we do not want to wait so long that we become complacent. There is a great and rapid change occurring right now in veterinary medicine, and students at schools across the world are playing a major role.
Taking action
On Sept. 23, 2015, the Ohio State University College of Veterinary Medicine lost second-year student David Hilton to suicide. On Sept. 28, 2014, veterinary behaviorist Dr. Sophia Yin took her own life. On Feb. 16, 2014, veterinarian Dr. Shirley Koshi of New York City was found dead of an apparent suicide.
These tragic events are not isolated; rather, they are symptoms of a problem that has been stalking the field of veterinary medicine for years. These are our colleagues, our classmates, and our friends — bright lives that have been extinguished because, in the midst of helping others, we neglect ourselves.
Growing up, we are taught that health is equivalent to eating right and exercising: vegetables, water and a run around the block. We are always told to try our hardest and to measure success with our wallets. Mental health and wellness rarely enter the discussion.
As adults, it can be difficult to integrate a new facet into our existing definitions. This is exacerbated because discussing emotions or admitting to having difficulties can be seen as shameful, as though universal human experiences need to be kept under wraps in order to save face among peers. As a community, we can work together to create an environment that embraces all aspects of wellness and health.
Veterinarians are inherently compassionate. Why else would we shoulder the burdens of financial debt, long hours and compassion fatigue if not for our utmost regard for the lives of animals? We are determined, driven and work hard to achieve our goals. Often we are perfectionists with Type A personalities who set impossibly high standards for academic and professional achievement. These are attributes that contribute to our success and our pursuit of the profession, but often they end up inhibiting the very goals we originally set out to achieve.
There are stressors and circumstances unique to veterinary professionals that need to be addressed. The environment surrounding veterinary medicine is fairly static (we may never get rid of difficult clients and the intensity of our education), but the way we approach it, and the way we teach others to approach it, will make a difference. For example: Teach coping strategies alongside anatomy. Create an open discourse regarding wellness. Eliminate the idea that struggling is a symptom of weakness or failure.
The establishment of these ideas is not limited to professors or mentors. Each and every student or doctor can contribute toward changing how our field approaches the topic of wellness. Anyone has the ability to teach, encourage and support their classmates and peers. Everyone who makes a decision to be proactive about promoting all aspects of health can make a tremendous impact.
Beasts, Unburdened is a blog we created in October to give veterinary students worldwide a space to share their experiences anonymously and receive support and encouragement from their colleagues. It is intended to encourage camaraderie and to dismantle the isolation that often comes with mental health struggles. The difficulties associated with veterinary school, such as relationship problems, test anxiety, being overwhelmed by the sheer magnitude of information, and alcohol dependency, are not unique to a few individuals. Often, we assume we are the only ones struggling or there is something wrong with us because we are floundering while everyone else seems the picture of competency. The transparency this blog affords through anonymity gives us the opportunity to strip away those insecurities.
The blog initially was created to reach a targeted audience — veterinary students — and give relevant advice. After a few weeks, we began asking for anonymous submissions from readers about the challenges they face. This created a more interactive environment and kept the blog from being just another lecture hall.
To promote levity, we created entries that rely on readers reflecting and commenting on positive things that are happening in their lives. Whether it is simply recognizing good things that have happened or sharing how they make the most of their time and reduce stress, students have the opportunity to focus on what they have achieved. It is a forum for students to share strategies that work for them, and to exchange ideas. These ideas are unique because they come from people in the same situation, rather than well-meaning outsiders.
The blog is also a place where we can create discussions and gather information from students at different schools. Last semester, we informally surveyed veterinary students about their sleeping and studying habits. Seventy-eight students responded, mostly from the University of Wisconsin School of Veterinary Medicine and Virginia-Maryland College of Veterinary Medicine.
The average respondent reported sleeping 6.74 hours per night and studying 4.1 hours per day, not including class time. Participants reported on average working 37 percent more than they think is reasonable, but do only the minimum amount of work needed to get grades they are happy with.
With surveys such as this, we are hoping to learn more about the situations veterinary students face, resulting, we hope, in greater understanding and empathy among peers. This semester, we plan to do a survey on alcohol use, with an aim of determining what is normal. We hope to attract more respondents from other veterinary schools to get a better idea of what is happening and make the data useful to more people.
There are numerous initiatives aimed at strengthening relationships and building support systems among veterinarians and veterinary students. Vets4Vets is a Veterinary Information Network Foundation-sponsored group that connects veterinarians in need with others who can help them. The VetConfessionals project was started by veterinary students at Massey University in New Zealand, applying the popular PostSecret formula to the veterinary profession. Across the world, veterinary students independently are forming organizations to discuss mental wellness and improve the sense of community within their schools.
While a blog or organization is great, it cannot reach everyone. Such approaches are impersonal, and their size makes them slow to respond. What we really need are veterinary professionals who will care for each other on a daily basis. It is imperative to create a network of social support and face-to-face interaction, being genuine with each other and sharing real feelings while removing the stigma of doing so.
People are not meant to live in isolation, even if we sometimes think we want to. It is common for veterinarians to get annoyed with other people. We might believe others are irresponsible, unintelligent or uncaring. The high personal demands of a career in veterinary medicine only make this more likely, causing us to withdraw from colleagues. Even if we do not actively withdraw, we simply may fail to notice or act when another is in need.
The goal of our blog is to encourage conscious action to reach out and connect with others, making sure everyone is cared for. As evidenced by some of the examples above, veterinary medicine as a profession has been moving in a positive direction toward improving its capacity to deal with the problem of poor mental health, but action is lacking at the individual level. Changing this requires that each of us allocates time and effort to make our own health and the health of others a priority.
Why should you consider the opinion of students who would make a manure joke in the first line of an essay? We have little experience, but do know every moment will not be a “James Herriot” moment. As students, we can only guess at the struggles we will face in the future as veterinarians, even as we discuss our current ones. Through it all, we few, we happy few, we band of brothers and sisters, must stick together.
About the authors:
Amanda Carlson and Taylor Gaines are second-year veterinary students at Virginia-Maryland College of Veterinary Medicine. Carlson graduated from the University of Maryland, College Park, with a degree in animal science. She founded the Wellness Committee at VMCVM and plans to continue to expand both the committee and the Beasts, Unburdened blog. Carlson takes care of her well-being by exercising often, socializing with friends and keeping regular appointments with her psychiatrist and psychologist.
Gaines attended college at the University of Maryland, Baltimore County. In addition to a DVM, he is pursuing a Master’s in public health. Gaines hopes to continue trying to help colleagues in the area of mental health and to one day have a job in public veterinary medicine and epidemiology. For his health, Gaines tries to maintain a significant portion of his life outside of veterinary medicine, with such varied activities as lifting weights, bicycling, playing basketball, reading, cross-stitching, being active in church and socializing without talking about anatomy. His favorite person to socialize with is his fiancée, also named Taylor.