VETS, doctors and dentists have a suicide rate around four times higher than that of the population in general. So why do so many of us choose to kill ourselves?
There is a point where the pain becomes too much, where the black hole of depression turns into an unclimbable barricade. It feels as if everything hurts, there is no relief.
It’s time for “Stop the world, I want to get off ” but in reality the world will continue to turn with or without me. It is not responding to my needs and is oblivious to my existence. So, in eliminating myself it will stop my bad feelings and stop them forever. I need suffer no more.
But then, at what price? In ceasing to be Marion McCullagh I will be 60kg of clinical waste. I’ll ruin my kids by leaving them a bad example and a burden of grief. My friends will be sad. I won’t see the horse again and who will look after the dog?
For me, so far, reality has kicked in. I’ll phone someone, walk the dog, go for a ride. Throw some excitement at me and I’m happy to rush back into the arena and continue the struggle. The depression gets pushed away again as soon as I am sufficiently involved.
Fun, doing something with good friends, physical or mental stimulus can provide a way out of the bad feelings. Perhaps it is because I am so used to dealing with other people’s problems in the clinical area, so used to timetables, appointments, highlystructured days at work, that I simply cannot switch off and do without them when I have some free time. Like Winston Churchill’s black dog, my depression stays faithfully at heel and moves in whenever it sees an opportunity.
The veterinary profession is well regarded by society. It takes a sparkling school career to gain entry to veterinary undergraduate training. Vets are seen as compassionate, intelligent and effective. Sometimes I think that vets choose their part of medicine because they prefer animals to people.
The pleasure of having a “handson” occupation that deals with problems in the flesh rather than always via e-mail may be undermined by an inherent shyness.
Nick Blayney, the current BVA president, said, “I think vets lead a very lonely life professionally. They don’t get stimulation or new ideas from outside unless they seek them.” The daily routine in practice can be isolating, frustrating or boring and support from management and colleagues may not be enough to balance the stress.
One of the things underemphasised in training is the very high exposure to clients’ grief. Vets are trained to prevent animal suffering and to preserve the function of the animal. Doctors also relieve suffering but are obliged to preserve life to the bitter end.
To a farmer, death can be the end point of production. If it comes too early and is a financial loss, he may express anger, disappointment and a degree of grief but he survives by acceptance and optimism and by moving on to the next task.
Pet owners have a negative view of death and many of them are very bad at accepting that life has a finite time span. We live in an era where sex in all its variety is acceptable but death is taboo.
Compassion is central
Small animal practitioners are expected to kill an animal in the most comfortable way possible. Providing compassion for animals is central to our ethic and we are well trained for it but we find ourselves obliged to extend our skill and compassion to deeply grieving owners on a very regular basis.
We are not trained as counsellors and extending so much sympathy so often can erode the detachment and resilience that is necessary to enjoy life as a practising veterinary surgeon. Counsellors have a strong support system. The grief that they pick up from their clients is dissipated by supervision where they can discuss their case load and gain perspective.
Too much euthanasia wears out a vet, and the more caring the individual the more susceptible he or she will be to the emotional distress which feeds into depression with the potential for suicide.
Performing euthanasia can be regarded as part of anaesthesia, but it is a loss to the veterinary surgeon as well as to the owner. Very often there is an emotional bond between the vet and the animal. I might have vaccinated the dog for 15 years, or seen the horse through the triumphs and disasters of competition.
Euthanasing an animal can leave the practitioner with a personal burden of negative emotions as well as those brought on by mopping up the client’s feelings, which are often complex; the sadness can be embellished with anger, guilt or doubt.
So is this what prompted the equine practitioner to shoot himself in his kitchen and the small animal specialist to set himself up an intravenous drip of Phenobarbital? Is it because we keep animals only as long as they are functional? When they cannot produce a calf or jump big fences or keep us company without soiling the furniture we dispose of them.
“I don’t want him to suffer” is a good wish but do veterinary surgeons apply it to themselves? Does euthanasia get distorted into untimely suicide and what can the profession do to stop this happening?
It seems that there is a niche for setting up an easily accessible support system of debriefing within practices, especially small animal practices where euthanasia is so frequent and sentiment flows so freely. Veterinary surgeons take on every bit as much emotional pressure as human counsellors and do not have the benefit of formal emotional support.
Prevention is better than cure so perhaps it is time for us to take as good care of ourselves as we do of our patients.