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InFocus

Overcoming cultural insensitivity

ANDREW KNIGHT continues his series on CPD with a difference with a tour of Jack the Ripper territory

PERHAPS it was the neurologically-damaging effects of unhealthy levels of exercise sustained during my expedition to the mountains of Mallorca (Veterinary Practice, February 2009).

Possibly my electrolyte levels had been unduly and dangerously warped by the lightning strikes that narrowly missed as I fled the peaks like a drowned rat, exacerbated by the electrical conductivity of copious quantities of sweat mixed with rain water.

Perhaps, on the other hand, it was my proudly Australian heritage. Or it might simply have been the mind-numbingly desensitising effects of long years of veterinary school and, thereafter, practice.

Whatever the cause, I detected within myself a disturbing lack of cultural sensitivity. Where was my appreciation for classical music, art and poetry? Surely a well-rounded veterinarian should be fully conversant with the finer things in life, and able to carry on engaging discussions with clients and animals (I prefer the latter) from a wide range of cultural backgrounds.

Take Marmaduke the poodle and his elderly guardian Mr Bates, for example, who apparently spent countless happy hours together watching historical documentaries. What did I know of history?

A solution

It was clearly time to embark on another continuing education trip to rectify such deficiencies. After careful perusal of the available options, I found the perfect cultural education solution: London’s Jack the Ripper tour!

Jack, was after all, one of the seminal historical figures of the city in which I was practising, and it would behove the culturally astute practitioner to learn something of his history, I thought.

I dutifully reported to a location in Whitechapel one sultry evening, just as the light was fading. The ancient churches and cultural highlights described by our guide contrasted chillingly with gruesome descriptions of dastardly deeds inflicted by the world’s most famous serial killer. The English were clearly best at something, I thought, sporting failures notwithstanding.

I was taken aback, however, by the widely-held suspicion that Jack had been a surgeon, because of his demonstrable ability to engage in rapid dissection, identification and retrieval of mammalian organs. In fact, my professional integrity was somewhat affronted!

As the tour wore on, however, I began to discern important evidence that Jack was not, in fact, some kind of deviant ancestral colleague.

Good communication

The first strong clue arrived in the form of an infamous letter addressed to the chairman of the local vigilante committee, purportedly “From hell”.

It stated: “I send you half the Kidne I took from one women prasarved it for you tother piece I fried and ate it was very nise I may send you the bloody knif that took it out if you only wate a whil longer.”

The veracity of this particular letter, amongst copious hoax mail received at the time, was established by the presence of an accompanying portion of human kidney, probably excised from victim Catherine Eddowes, who was missing her left kidney.

Now, if my veterinary school experiences are anything to go by, one can appreciate that medical schools and their students might not always meet the standards to which they aspire.

Nevertheless, one might reasonably expect that medically-trained graduates would correctly spell “kidney” so automatically that significant conscious effort – not to mention a level of imagination rarely evident – would be required to misspell it so badly.

Culinary standards

Similarly, student cooking – at least in my veterinary student household – also fell short of standards that might have been expected, from time to time. One such occasion was our 1999 Disgusting Cooking Award, presented with due pomp and ceremony to a housemate for eating three-day-old pizza out of the bin.

Nevertheless, regardless of our dubious hypoglycaemic and mental states, after long nights in the anatomy museum prior to exams, we never stooped to frying organs misappropriated from the neighbouring pathology lab.

Jack, however, operated in a destitute and extremely overcrowded part of London, in which three major abattoirs were located.

It is hardly inconceivable that an illiterate, hungry and poorly-educated abattoir worker might have smuggled out body parts for later consumption, and that such crimes might have provided the inspiration for even dastardlier, subsequent deeds.

Surgical knowledge

Additionally, a black-and-white photo of one of Jack’s victims revealed incisions not described in any surgical text I have ever perused, but which might well have resembled certain butchering cuts.

Little did I realise my surgical knowledge would find such an application although, admittedly, my lecturers did try to impress on me the diversity of potential veterinary occupations.

Finally, the psychopathology of abattoir workers is known to exceed that of virtually any other profession. Immersed in a world of animal fear, extreme violence and death, whilst wielding knives that confer unparalleled injury rates, these underpaid, poorly-educated workers manifest severe rates of mental health problems, domestic violence and marital breakdowns.

Veterinary psychopathology

Whilst the psychological states of veterinary colleagues sometimes appear to leave room for improvement, thankfully I have yet to see one on the verge of hitting the alleyways after a late night at the clinic, scalpel blade in hand, with murderous intent on his mind.

Certain disturbing parallels between abattoir workers and veterinarians do exist, however, which we ignore at our peril. Veterinarians also have high levels of exposure to death, by euthanasing those with severe and untreatable illness or injuries. This is, perhaps, the only profoundly humane and important service we offer to animals that we deny to people.

The danger incurred by such familiarity with death, is, however, that we may too readily look to it as a solution, both for our patients and ourselves.

This may be one reason why our suicide rates are twice as high as for physicians and dentists – despite similar access to lethal drugs – and four times those of the general population1 .

Seeking help

Bizarre exercise regimes, cultural insensitivity and particularly poor singing voices may all be normal among veterinarians, at least in the experience of this author.

If, however, a colleague appears overly stressed, unusually moody or depressed, remember www.vetlife.org.uk – one of several programmes offered by the Veterinary Benevolent Fund to help veterinarians access emotional and professional support.

Although rarely recognised as such, practising veterinarians – particularly, those who euthanase only when truly in the best interests of their patients – are truly valuable and special people. For the sake of the animals, their guardians and overworked colleagues, we must help one other remain healthy – and alive.

1. Mellanby, R. J. (2005) Incidence of suicide in the veterinary profession in England and Wales. Vet Rec 157 (14): 415-417.

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