If I could write a letter to my younger self

Photo: Shutterstock.comWhen I was accepted into veterinary school, I was 20 years old, a naive idealist straight out of college. While I learned how to pull teeth, kill fleas and be an excellent veterinarian while at the same time learning to not get kicked, bitten or scratched- that wasn't all I needed to be good at my job. Some things I know could have only come with life experience and age, but if I had the chance to go back and talk to fresh-faced, 20-year-old me, there would be five things I would tell myself that I would need to learn in order to succeed at this adventure of a profession. 

1. Self-confidence, AKA the foundation of EVERYTHING 

Graduating from veterinary school was arguably the most difficult-to-come-by accomplishment of my life. (Child-rearing ties in difficulty, but I'm not done with that yet so it doesn't count).

As you know, gaining acceptance into veterinary school is a dream come true. But then the reality of what it means to be a part of the veterinary world slowly sinks in over your four years. From my own experience, between sheer exhaustion of, and constant competition with, other students, my confidence and passion began to slowly erode away.

Little by little, anxiety and self-doubt began to replace naive confidence. I earned my first "C" my second year and my first "D" my third year-before that, I was a 4.0 student. The voices (more of a committee than anything) inside my head were constantly chanting, “Not good enough! Not good enough!”

Professors seemed to delight in piling on the exams and the work, and some of the fourth-year attending clinicians in practices were, shall I say, less than kind during rounds. Oh, who am I kidding, some bordered on mental and emotional abuse. I suffered my first-ever panic attack the second year of veterinary school, which primed my nervous system for 15 years of anxiety-murder on the adrenals, I tell ya. 

Suffice to say, veterinary school was brutal. And after four years of eating, breathing and living UC Davis vet med, I was changed-and not for the better.

My lack of confidence hurt my ability to help my patients and, for a long time, live a life fulfilled.

My lack of self-confidence affected me in clinical practice: I second-guessed my ability to diagnose and treat patients and I grew afraid of surgery, fearing that I would do something to hurt a patient. My lack of confidence hurt my ability to help my patients and, for a long time, live a life fulfilled. Fortunately, I'm happy to report that all of my patients always survived surgery.

What I wish I could go back and tell myself in veterinary school, and what I want to tell all veterinary students now, is that you are badass! And you deserve your spot in veterinary school. You've earned it, and you are going to be an amazing doctor.

Unfortunately, a healthy self-esteem, as touchy-feely as this statement seems, is not optional. But you are smart, and no matter how worn down or torn-down you feel in the throes of veterinary school, you will learn and grow as well as bless so many pet owners in your career.

Do what you can to protect and nurture a healthy self-esteem: read books, attend lectures, hang out with people who make you feel great about yourself. A well-adjusted sense of self is critical for career success and satisfaction. And remember: Nobody is expected to know everything-that's why it's called “practice.” Learn from your mistakes, grow in confidence and know that your clients, your family and your peers believe in you.

2. Work-life balance is a survival skill

As any veterinary student will tell you, work-life balance in vet school is … a joke. 

Instead, it's more like work-work balance, but still you grit your teeth and hang tough for the promise of a diploma. I was a young wife in veterinary school, and I don't remember seeing very much of my husband those four years. I felt even worse for other students who already had children.

I remember one Saturday afternoon in particular. The other students and I had all been in clinic from 6:30 a.m. to 8 p.m. for five days prior, then up later studying for board exams. That afternoon, one of the other students, a mom, was asked to stay on for the day to do the treatments for her patient, even though there was staff at the hospital already to do weekend treatments. And, kudos to her, she said no- she had made a commitment to her family to go home and be with them and she honored that commitment. The stand she took still leaves a lasting impression on me to this day.

For me, it was very difficult to get out of the mind-set of work, work, work all the time, and because of that my family and my emotional well-being suffered for years. I work a lot from home these days, and I am constantly fighting against the tendency to work every day.

The thing I wish somebody would have told me is that I am more than just my diploma and that family and emotional health is more important than my career. While I believe being a healer in veterinary medicine is a calling, if the healers are exhausted and sick and burned out- then where will we be? As veterinarians we need to take care of ourselves, now more than ever.

3. Veterinary medicine is about caring for people, too

Confession time: I have a tendency to be a neurotic introvert. I suffered from debilitating shyness as a child, and it has taken an incredible amount of internal work to tame the neurotic monster that lives inside my head. (Pro tip: Sometimes I give it cookies).

Second confession: I didn't realize being a veterinarian meant you had to talk to, and care about, people. I may have changed my mind about veterinary school if the old-me had known that, as I'm sure many others would have as well.

Exam rooms, as you know, are uncomfortably small-you have to squish yourself in there with the client, maybe the client's spouse, children, grandma, support animal and a large dog that is panting so much he's single-handedly turning the exam room into a sauna. 

That first time in an exam room, I was so absorbed with myself, I had not mental room for my client.

I remember the first time I saw a client in an exam room by myself. There was sweat rolling down the inside of my lab coat, my heart was beating in my throat, and my hands were shaking. I was so absorbed with myself-making sure that I sounded smart, didn't forget anything and did my exam right-that I had no mental room for the perspective of the client. This tendency created barriers between me and my clients for years. It wasn't that I didn't care; I just had no idea how to care about anything beyond my own nerves.

What I didn't realize was that to be a good veterinarian means more than razor-sharp medicine and surgical skills, it means caring about the people that bring their animals to you. If you don't care to connect with these people then you will never be truly able to help them, because you don't understand them or their needs.

In early practice, I found myself being judgmental about “uneducated” pet owners and looking down on people who wouldn't follow my instructions. I'm ashamed of that version of myself. What I realize now is that I should have been compassionate and understanding. I should have worked to find a common goal with pet owners, which is the health and well-being of the pet that they love. 

I am a healer, an educator and an advocate for not only animal health, but human health as well. I wish somebody would have told me that in order to be successful as a veterinarian, you need to first focus on the client, their needs and concerns, and then use that information to frame your recommendations for the pets. A good way to think about it is to imagine you are a person that helps other people with pet problems. People matter.

4. Authenticity-preferable to people pleasing

I hate two things: conflict and disappointing people. Unfortunately, there's a lot of both in the world of veterinary medicine. Early on, I would tell people things they wanted to hear that weren't necessarily true about their pets, because I couldn't stand to have people upset at me. I gave people false hope, withheld information, wouldn't connect with clients in their grief over a euthanasia and bent the truth when it came to my own mistakes, all in an attempt to please my clients. Don't make the same mistakes as me.

What I wish somebody would have told me is that authentic communication is preferable to people pleasing, even when you say something that you think may upset the other person. I have learned to make it my goal to be authentic with my clients when I communicate with them, and by and large they have appreciated it deeply.

On the off day when people are upset at the news I have to deliver, I remember that my goal in the conversation is to be authentic and kind, not to people please. That way, if the other person is upset, I'm still OK. Sometimes I'm still a coward and hide from conflict, but every day I am a little bit braver than the day before.

5. Just because you can extend life doesn't mean you should

In veterinary school, I remember my ICU rotation vividly. The intensive care unit at Davis was crazy-pants busy. We were always full of animals that were at death's door, and the cutting-edge technology and skills of the clinicians brought many of these animals back to life. Many of these animals went on to live long, happy lives. Other animals, however, were ready to go.

But their owners were not ready to let them go.

While the ICU saved many lives in a positive way, I can't help but think that some of the lives should not have been extended. I remember one patient in particular that belonged to a famous celebrity who was far away. The animal was on a ventilator with no hope of recovery and, yet, day after day we kept the animal's heart beating and the lungs breathing until, finally, the owner decided to let the animal go.

To extend life just because I can sometimes goes against my oath to do no harm.

That animal, in my opinion, suffered longer than it should have.

There were countless others. Another case that stands out to me was a boxer that had malignant brain cancer. The owner was bereft and incapable of making logical decisions, he wanted to pursue surgery, even though there was no hope of eliminating cancer from this dog's body. Nobody counseled this owner on the quality of life that the dog would have, and I felt if the dog could have spoken for himself that he wouldn't have wanted his remaining days to be in a hospital. So the dog went to surgery, suffered a great deal and then died a couple of weeks later. It felt wrong. 

While my patients in private practice are rarely that dramatic, I do have very old and frail patients that have many diseases that leave them in chronic discomfort. With modern science, I can easily keep these patients going, and in the past I did whatever the client wanted to keep the animal going long after it had lost all muscle mass and become a walking skeletal zombie; a shadow of its former self.

What I wished somebody would have told me in vet school was just because you have the technology to extend life doesn't mean you should. Nowadays, we have more options than in the past, including palliative care that allows animals to pass without pain, and quality of life assessment scales (this one is from Lap of Love) that help owners make the decisions about end of life care in an objective manner.

What I have learned in my 15 years of practice is that sometimes, to extend life just because I can, goes against my oath to do no harm. Now I find fulfillment and peace in helping an owner decide to euthanize a debilitated furry family member, and some of my greatest moments in clinical practice come from holding the hand of a grieving client.

A life as a veterinarian is not for the faint of heart, and we are people with just as many failings as the pet owners who trust us with their pets' lives. I am so grateful for the people along my journey who have allowed me to fail, learn and keep going. If you're just starting out, much like my 20-year-old self, give yourself lots of grace, love yourself with a kung-fu grip and hold on-this ride is a good one.

Sarah Wooten, DVM, divides her professional time between private practice at Sheep Draw Veterinary Hospital in Greeley, Colorado, and writing articles and filming video content for various media outlets. She is a frequent speaker at the CVC conferences.