And you can quote me on that.
This post is going to be a little different. It does involve data, I swear.
Last week veterinarian Shirley Koshi died by suicide. And that sucks.
Suicide sucks, depression sucks, mental illness sucks.
Suicide kills people.
And I'm tired of it killing people, especially people I know- people in the veterinary profession. Depression and mental illness makes people suffer, and I'm tired of that too, especially when it is frequently so needless. I swore an oath to relieve suffering; that ought to include my own and that of my coworkers.
People with mental illness, depression or suicidal thoughts frequently suffer more than they have to because they are afraid to speak up. We are afraid to ask them to. That has to stop. Nobody should have to suffer or die for fear of speaking out. There is nothing shameful about mental illness, depression, or suicide. It's a damn shame, don't get me wrong- but it is not shameful.
I would not be ashamed to ...
....be diagnosed with cancer.
I would not be ashamed to...
....take meds for high blood pressure.
I would not be ashamed to....
....have had a heart attack.
Be ashamed? No. I would celebrate that it was caught, that there was treatment; I would be vigilant about taking my meds and going in for rechecks with my health care team to monitor my condition and adjust my therapy.
OK, those who know me are now cleaning their screens of whatever fluid was in their mouth when they read that and did the spittake. You're right. I would do those things if I were compliant but I'm not. Have you met me? I am the Z pack poster child. If failing to finish the entire course of antibiotics is responsible for resistance, I should be sanitized for your protection.
"Physician, heal thyself" should be tattooed continuously over every inch of my skin. In 40 point font.
And just as some people are noncompliant with minor illnesses or refuse conventional treatment even for major illnesses like Steve Jobs did for cancer, some people refuse treatment for major mental illness. Deal with it. Without blaming them or judging them. It's not your place.
It is your place to be kind, and supportive, and respectful no matter what. No matter if it is a client, a colleague- or yourself. It is your place to get educated and keep looking for times and ways to help. No matter how long it takes, or how many times you are rebuffed or ignored. Now, don't let yourself be abused, and don't be obnoxious. But do be available. Read on for a lesson in how a classmate of mine made herself available.
Last month the North American Veterinary Community (NAVC) held its annual conference in Orlando, Florida. I organized a day long program called Ignite!, presenting ideas to positively engage the profession's most challenging issues. Some of the issues were burnout, suicide, convenience euthanasia, mindfulness and respect.
In the breakout session after Dr. Tracy Witte's presentation, "What We Know About Veterinary Suicide- and What We Can Do About It", a classmate of mine opened up about her experience with having depression and having suicidal thoughts. She was approached by another participant in the breakout, veterinarian Alice Villalobos, to be interviewed for Veterinary Practice News. My classmate agreed to the interview, as she feels that it was putting a face on the issue that let many present in the breakout begin to talk openly and listen with understanding- including some who may have been badly hurting. She is hoping the interview will give others that opportunity to engage this issue as well.
If you want to help put a face on the issue of suicide in the veterinary profession by sharing, in a similar interview, how suicide has affected you, please email us at firstname.lastname@example.org
So with a face on the issue, let's face some facts. In her presentation, Dr. Tracy Witte described three necessary conditions for a fatal suicide attempt:
- thinking you're worth more dead than alive
- feeling like you don't belong
- lacking a fear of death or physical pain
If you have all three of these conditions, get help now 1 800 273 8255 Suicide Prevention Hotline
Talking about it with my classmate over dinner the next night, it took us less than 90 seconds to generate the following list:
- Gender: female practitioners in a masculine structure; to succeed in one role we must fail in the other
- Substance abuse: familiarity, access, perceived need
- The personality type that seeks admission to and is admitted to professional school
- Lack of, or failure to exercise, self care skills
- Physical stress: inadequate sleep, poor nutrition, insufficient exercise
- Workload of school, then practice
- Preexisting conditions: usually not addressed (or stop being addressed) even if diagnosed
- Pain: acute (falls, kicks, bites) and chronic (palpating, drawing blood) injuries; infectious diseases (Lyme, Bartonella)
- Financial stress
- Isolation: physical, social, professional
These ten factors we generated with such ease, predispose to those three conditions that are necessary for a fatal suicide attempt. Ten factors that predispose to the development of three conditions that are required for fatality. 10-3.
They are also factors commonly present, even selected for, in the lives of vet students and veterinarians, and other health professionals. My classmate and I discovered we were both 'perfect tens', and knew many eights and nines. I found that perfectly awful.
A veterinary suicide working group formed after the presentation and breakout. The informal working group has reached out to AVMA for funding and support at the suggestion of incoming AVMA president Ted Cohn. Ted was kind enough to moderate the part of the Ignite! session that included the presentation on suicide. Like many of us, he has been personally affected by the suicide of a colleague, and is thus following the working group's progress and looking for ways to enable the AVMA to support efforts to address this issue.
The group has also been offered the opportunity of putting on a free suicide awareness and prevention webinar in May courtesy of Justine Lee and VetGirlOnTheRun, an online veterinary CE platform. The webinar is tentatively in May- the month in which the most suicides occur. We are narrowing down content and selecting speakers, and have secured funding for the RACE accreditation fee.
Each free, RACE approved webinar attracts hundreds of veterinarians, according to Justine Lee of VetGirlOnTheRun. So in addition to presenting truly life saving information to a large number of vets at a critical time, we could ask how many vets are personally affected by this issue. We can use that info to get more money and support for dealing with suicide and depression in the veterinary profession. We don't really know the attack rate, incidence rate, severity, predisposing factors... basic epidemiology.
And not knowing the basic epidemiology of what's making me, my colleagues and my staff suffer and die... well that pisses me off. We deserve better than that. We deserve better data than that.
So will you help send emails, and contact speakers, and make phone calls, and arrange webinars and poke people for money and research and cooperation? Can you grit your teeth and smile pleasantly at people who rub you the wrong way, because you know they are doing good work or can help? Can you hang in there when nobody comes through and everybody wanders off, back to their daily lives.
I'm sure gonna try. Because lives depend on it.
Will you try with us? Please email email@example.com to volunteer.
Especially if you want to volunteer a digital workspace :)