“It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does strive to do the deeds; who knows great enthusiasm, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly…” —Theodore Roosevelt, 1910
Vulnerability: The quality or state of being exposed to the possibility of being attacked or harmed, either physically or emotionally (Dictionary.com).
Well, here is an uncomfortable subject for my fellow veterinary professionals… vulnerability.
Why is vulnerability so difficult for veterinarians?
Many personal and organizational factors within veterinary medicine make vulnerability a challenging skill for veterinarians to master. Doctors make hundreds of cognitively taxing decisions every day. Many of the decisions have difficult tradeoffs and consequential outcomes—death- or life-altering effects being the most devastating. These decisions are described as having a high opportunity cost (immediate consequences) and can lead to cognitive scarcity or decision fatigue.
In the veterinary profession, like the human medical profession, mistakes and failure are not tolerated or as readily accepted as with many other professional industries—hence the need for malpractice insurance. The responsibility for medical care and patient outcome lies solely on the shoulders of the veterinarian. All support staff are practicing under the license of the veterinarian, meaning when mistakes happen, it is the veterinarian who is liable in the eyes of the law and the board. It’s also the veterinarian who needs to make the dreaded call to the owner to explain the circumstances and take the full brunt of the owner’s wrath, disappointment, or sadness.
With such high stakes, bring on the veterinary defense mechanisms. Being vulnerable can be both difficult and terrifying. Why? Because being vulnerable opens us up to getting hurt or experiencing shame.
Here are a few scenarios that illustrate why the shame comes easily and vulnerability is especially difficult for veterinarians:
- You make a mistake during a surgical procedure or medical diagnosis, and the patient is harmed. “I’m a bad doctor.” Shame.
- You admit a medical error to a client, and you’re taken to the board or sued. “I’m a bad doctor.” Shame.
- You do not take the extra appointment during your block-off time because you’re swamped and you desperately want to leave work on time to make it home for a personal commitment. Your client, your boss, and your colleagues are angry. “I’m selfish. I’m a bad doctor.” Shame.
- As an associate, you voice your concern about the unfairness of the current doctor compensation structure during a doctor’s meeting. Your boss gets frustrated and doesn’t get it, while your colleagues, whom you know share your same concern, remain silent. “I’m not a team player. I’m greedy or unreasonable.” Shame.
- You admit to a colleague that you were secretly relieved when that last sick “ain’t doin’ right” (ADR) appointment at the end of the day decides to euthanize rather than work the pet up and hospitalize him because it meant you could go home only one hour (rather than three hours) after the end of your shift. Your colleague is horrified you could even think such a thing. “I’m a horrible person and a bad doctor.” Shame.
How veterinarians can embrace vulnerability
Let’s take a deeper look at some of the most common ways veterinarians attempt to protect themselves from vulnerability and some practical solutions to combat these behaviors.
The armor: Not embracing happiness
How to take off the armor:
- Practice gratitude
- Notice the every day “little things”
- Celebrate milestones and acknowledge success
- Give more than you get
The armor: Perfectionism
How to take off the armor:
- Own your stories
- Embrace your feelings of inadequacy and imperfections as the shared human experience
- Dare to be yourself
- Be the best version of yourself despite your flaws
- Strive for healthy achievement—what went well?
- Always grow—how can you improve?
The armor: Engaging in numbing behaviors
How to take off the armor:
- Set boundaries and find real comfort
- Acknowledge and identify the emotion
- Allow yourself to feel happy and difficult emotions when appropriate
- Stay mindful of your numbing behaviors and their triggers
- Define what is OK and what isn’t OK
The armor: Indirect behaviors, like pretending, avoiding, blaming, and lying
How to take off the armor:
- Be direct and transparent
- Be present
- Pay attention
- Move forward—don’t dwell
- Speak up
The armor: Cynicism, criticism, arrogance, and cruelty
How to take off the armor:
- Harness shame resilience: Move from a place of shame to a place of empathy without sacrificing your personal values
- Own what you say to others
- Reality check the comment (yours and others)
- Be open to feedback from those who matter…all the rest is just noise
How veterinary professionals can ask for help
If you’re struggling, how do you find the courage to ask for help?
- Practice self-compassion. We are human, and we all need help occasionally.
- Realize that people are social creatures. We are wired to help each other, but you must ask.
- Be clear, concise, and specific about what type of help you need and when you need it.
- Depending on the type of help needed, timing the ask may be important.
During this holiday season, I hope all my fellow veterinary colleagues can take a moment to stop, reflect, and appreciate the small things. Embrace your flaws—they are part of what makes you YOU. Ask for help when you need it—you are worth it.
(In case you’re wondering: Yes, I’m a huge fan of Brené Brown. Much of this blog post was inspired by her work.)
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