Falling in love with veterinary medicine again through loss

March 5, 2018
Maureen Horner Noftsinger, DVM

Maureen Horner Noftsinger, DVM, is the CEO at Emergency Veterinary Services of Roanoke in Roanoke, Virginia.

I was devastated after the passing of two of my classmates and best friends, but I found a way to pull myself together and love this profession again.


I went to vet school at Virginia-Maryland College of Veterinary Medicine. In my class, we chose seats and sat in those spots for an entire year. I got to know Chris the summer before second year when I learned he was going to be my lab partner. I met Matt because he and Chris worked together that summer. Second year, we came in on the first day of class and some of us chose new seats. I sat behind Chris and Matt so I could talk to both of them. Those were our seats for the next two years.

Chris and Matt had a very strong bond by then and I became their sidekick. The three of us were always joking. I was the voice of reason with those two. They were the class clowns who kept everyone laughing, and they also helped me learn to laugh at myself and not take myself so seriously. We studied together, skipped classes together and passed notes. We partied. We also did Hokie football together-that was the glue. We lived for Hokie football. Matt lived within walking distance of the stadium and hosted tailgates for every game. We met each other's families, traveled together and graduated side by side. Those were some of the happiest times of my life, and when I'm asked if I would make the choice to go to vet school again, I always say, “Absolutely.” I loved vet school. As difficult as it was, I met incredible people who are my best friends today.

Jumping into the ‘real world'

I started at Emergency Veterinary Services of Roanoke (EVS) right out of school. I ended up, by default, managing the clinic. After a few years, Matt came to work with me at the emergency clinic. Chris finished his internship and wanted to work in emergency medicine, so naturally he came to EVS too. The three of us worked together for a few years. It was like a dream come true to work with my two best friends. Don't get me wrong-it wasn't all good times. We had disagreements. It was much harder to spend time together outside of work because one of us was always working. But we were connected and there was a love and mutual respect among the three of us that bound us together. Plus, laughter and stories were woven through our lives and could bring us to hysterics in an instant.

Chris eventually went to work at another emergency practice, then opened his own practice. Matt and I continued to work together for over 10 years. We faced many challenges in our personal lives and survived with laughter and love. He was a brother to me and to many others we worked with. We would openly tell each other we loved each other, and I referred to him as my brother constantly. Our clients adored him because of his good looks and charm.

But Matt had suffered from depression for years. A few years ago, we both felt it best for him to leave full-time emergency medicine because of the unique challenges faced by ER doctors. I told him his mental health had to be his priority and that I would support him and love him no matter where he worked. He stopped working full-time but still was working a few days a month with us. He seemed to be doing well-laughing again-and he even started dating. He seemed happy and took a trip to South Africa.

When we learned he had died by suicide, we were devastated. He had seemed better. He had seemed happier and content in his life. Everyone was in shock because he was always so easygoing. He was loved by everyone he met.

Chris, Matt and I had grown apart over the years. Hokie football always drew us together though, and even if we weren't together, we always texted during the games. So as soon as I found out Matt had died, I contacted Chris because I wanted him to hear it from me. We cried together. I told him I loved him-that he was my brother and I wanted to reconnect.

Chris wasn't happy running his practice anymore. He told me he wanted to come back and work with me at EVS. He said I had been through hell and back with my personal medical problems, the issues at the clinic and Matt's death, and I had survived. He said he wanted to help me grow the clinic. I hired him back full-time.

Things were good for a while. Chris seemed to be more mellow but still kept everyone laughing. He enjoyed emergency medicine. He loved the challenge of the cases, genuinely wanted to help the animals and was open to feedback that would improve his clinical skills. There was a soft side to him that he would occasionally let other people see. But he wasn't the same Chris. He had always had insomnia but now it was worse. He was rarely sleeping. His behavior was erratic at times. Things got worse. One morning, Chris stopped by the clinic, joking as always, then he checked into a hotel and was found dead shortly after. We don't truly know what happened. It doesn't matter-Chris was dead too.

Chris' wife called to tell me and I fell to the ground. I couldn't do this again. I couldn't carry my staff through this again. It had only been 14 months since Matt's death, and now Chris was dead too. How could this be possible? My staff immediately called my husband to come and they surrounded me with their arms as I lost it, kneeling on the floor rocking back and forth. My EVS family felt slapped by the pain and we gathered at the clinic in disbelief.

My husband arranged for me to see my therapist immediately and then drove me there and sat with me. Everyone was worried about me. I was worried about me. And for the first time in my life, I could only focus on me and my immediate family-on making sure that my mental health was my priority. The EVS staff is also my family, and during those first few days, we gathered at the clinic just to be together to talk about Chris and process this grief. It was compounded because we hadn't yet fully recovered from Matt's death. I'm not sure you ever fully recover from something like that.

We had an EVS family memorial for Chris. We needed closure to try to get back to functioning. The clinic had to close for a few days and I couldn't set foot in it to work for weeks. One Saturday night I was lying in bed and I was supposed to work the next morning but I just couldn't do it. I felt physically ill and like I was suffocating just thinking of it. I called one of our shareholders and choked through tears and a rising feeling of panic to ask him to work for me. Thankfully, he agreed. I will always be grateful for that.

At the same time, one of our doctors was out because of complications with her pregnancy, another doctor was out to have surgery on an abscess in her hamstring, and another doctor was on a trip to Israel to visit her father. For the first time in the more than 16 years I had been at the clinic, I cried “uncle.” I couldn't do it. My mental health was at the breaking point. I wondered what God was trying to tell me. How could all of this happen at one clinic? Emotionally, I wasn't doing well. I continued to see my therapist because I knew I had to take care of myself.

Finding peace

Right before Chris died, my husband and I had bought a small farm and it became my sanctuary. It's peaceful and beautiful there. I watched the dogs play in the pond and chase dragonflies. I did a lot of thinking, reading, praying and yoga. I walked and hiked just to be outside. I reveled in my children's happiness and focused my efforts on being present with them. My husband was very observant and protective of me, and I am grateful for that. He was afraid to leave me alone for the first few days after Chris' death and I welcomed the company. I focused on gratitude and all of the wonderful things in my life. As each day passed, I was able to breathe and to realize the gift that I had been given in knowing my two friends.

When I went back to work, I realized being at the clinic felt different. Things had changed for me. Seeing clients didn't fulfill me as much anymore. The overnight shifts were draining me to the point that I wasn't recovering physically anymore. I wanted to be with my EVS family but didn't want to be there working. Something in my soul had shifted and I knew I needed to focus my efforts somewhere else.

Over the last six months I've instituted a lot of changes. I'm not working overnights anymore and I've delegated a lot of the day-to-day responsibilities to the staff and focused on growing the clinic and moving forward. I like to describe myself as the clinic visionary. I want to create a workplace where people are truly happy to be there. I want to work with people who are passionate about what we're doing, who believe in my mission and help me elevate our standard of care. By focusing on the animals and the care they need, we can be challenged and fulfilled, creating job satisfaction.

I also want to help shift the staff's perspectives to make veterinary medicine more enjoyable. I want to help us find satisfaction and fulfillment in what we're doing. I want the staff to be challenged, support their career goals and find ways to achieve them. This takes a lot of open dialogue and communication. I want to prioritize mental health not only in me, but in my clinic and veterinary medicine as a whole.

Many of us have an idealized view of veterinary medicine before and during veterinary school. We want to work with animals, and every veterinarian I've met has been passionate about this in some way. Then reality hits after we get out of school. The student loans become a hard reality when you realize what your payments will be. Most of us strived for perfection our whole lives to get into veterinary school. And then we realized that there is no way we can be perfect. And yet our mindset is that we should be.

Historically, as veterinarians, we've contributed to this dilemma by being on call 24/7, forgoing our personal lives and health to be there for the animals. Traditionally, our jobs were to care for animals in a very practical way, often for trade. As the profession has changed and developed, unfortunately the service model hasn't been adapted. Clients expect us to be there because we always have been. It's our collective job to set the boundaries that we haven't been good at enforcing.

I love veterinary medicine and veterinarians. We are an incredible group of people who are hard-working, dedicated, passionate, loving and caring. The suicide epidemic in our profession is devastating. I'm saddened every time I hear of another veterinarian who has taken their life. Many organizations are doing things to promote wellness, but we have a long way to go.

I know that my mission is to help in some way. Obviously, I'm not a psychiatrist or therapist but I know that you can shift your thoughts in ways that can help you fall in love with your life again. The negative thought loops in your head can be interrupted. It seems very hard, but it's easy once you have the tools.

Steps you can take

My advice for you is simple really:

1. Meditate. Meditation can change your life. Take five minutes in the morning and evening to settle your mind. It takes practice, but make it a non-negotiable part of your day.

2. Focus on gratitude. You'll be amazed by the shifts you will feel in your life. I do it every day. On the really bad days, my gratitude is for the things we can take for granted like my heart beating without my thinking about it, or my breath or running water.

3. Stop complaining. This alone can shift so many thoughts you will be amazed. I participated in a challenge where I just noticed my complaints on a daily basis. I was shocked at how much better I felt just by not putting those complaints out there for me to hear over and over again. When you complain you're attracting people who will also complain, and it becomes a vicious cycle. When you focus on gratitude, the complaining stops.

4. Don't go it alone. Most important, find someone who can help you refocus your thoughts. For me, therapy became a swirl. I felt like I was going around and around in circles. But it wasn't until I started focusing on my thoughts and beliefs and realizing that I could change those that I started to feel a shift. My therapist noticed this shift and commented on it.

5. Identify helpful resources. Life isn't supposed to be hard, but it can be if you don't have the tools to function with. There are many places to find these tools and how you use them depends on your journey. There are courses you can take, books you can read or listen to, videos to watch. Some of the information is free and some you'll have to invest in. Think of it as investing in your mental health and ask yourself if it's worth it to have a strong heart and mind.

My own mental health became the most important thing because without it I can't function. Being there for my kids is very important to me. It isn't selfish to invest in yourself. It seems silly, but you have to be willing to make you a priority. If you're ready to change and are willing to accept that you are responsible for your life, you can truly fall in love with your life, job, marriage and relationships again. It takes work and it helps to have friends that can hold you accountable, but it can be done.

Dr. Maureen Horner Noftsinger is the CEO at Emergency Veterinary Services of Roanoke in Roanoke, Virginia.