"How can you say you're not going to do this for nothing? I thought you loved animals."
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That statement is manipulative, it is emotional blackmail, and it is something every veterinarian hears more than once in their career from clients.
Difficult and abusive clients with unrealistic expectations is a major factor that contributes to the extremely high rates of suicide among the veterinary profession.
Studies across the world show vets are four times more likely to commit suicide than the general public, and twice as likely than other medical professionals. Australian studies reflect these statistics.
Almost every vet personally knows at least one colleague who has taken their own life. Wingham and Valley Vets director Alissa Healy and retired veterinarian John Dooley, on the NSW Mid North Coast, are no exceptions.
Both Alissa and John, and many other vets, talk about the realities newly graduated vets come up against quickly after leaving university.
Many vets typically decide to enter the profession from a very young age because of a love of animals. The ATAR needed as entrance to study veterinary science is comparable to medicine, and they endure six to seven years of university study, finishing with a huge debt to pay off.
"You've got young people who go into uni really starry-eyed, they love animals, they want to help animals and that's basically their dream," Alissa says.
You put everything into it and you've got a really committed, loving owner, and you lose them all the same. That's really awful and difficult to deal with.
- Dr Alissa Healy
"They go into the degree knowing the financial rewards weren't going to be anything like going into medicine and dentistry. And they had the brains and ability to do either of those things, but chose vet (medicine) instead because they love animals.
"They come out after many, many years and they come out really keen. And then the reality kicks in that you can't save everything, even with an open cheque book, and it can be really hard losing those patients.
"You put everything into it and you've got a really committed, loving owner, and you lose them all the same. That's really awful and difficult to deal with.
"And then they're faced with difficult clients, angry clients, clients who emotionally blackmail you. And the problem is these young vets, even if they wanted to do it for free, they have a boss that they've got to explain this to," Alissa says.
Medical equipment and machinery for veterinary medicine is every bit as expensive as it is for human medicine. To set up a surgery can cost millions of dollars. Profit margins are slim, and people forget there are no government subsidies as there are for human medicine.
I think it is one of the hardest things as a vet to hear someone say 'I thought you loved animals' or 'vets are just in it for the money'.
- Alissa Healy
"There are all sorts of pressures on vets that are just entirely outside their control and it's really not fair. I think it is one of the hardest things as a vet to hear someone say 'I thought you loved animals' or 'vets are just in it for the money'," Alissa says.
"Not all clients are like this; a lot of them are wonderful and lovely. I must say where I work so many of the clients are incredibly supportive of us and I feel really lucky," Alissa is quick to point out.
Unrealistic expectations aren't always coming from clients. John Dooley says completely unreasonable expectations are sometimes put on recent graduates.
"(They are) being put in positions physically and given responsibilities that they are in no way qualified to undertake," John says.
It's a position he takes due to personal experience as a newly graduated vet.
"At the end of my first three months working in Taree, I was then left solo to run the practice for three weeks. It was completely terrifying. New grads put in that situation have killed themselves."
New grads put in that situation have killed themselves.
- Dr John Dooley
Unrealistic expectations and finances are not the only causes of distress that lead to so many vets committing suicide.
"There are always different reasons for why someone takes their own life. It's not as simple as they're not backed up enough, or clients can be difficult. There are a whole lot of facets that can play into it," Alissa says.
Existing mental health conditions, compassion fatigue, burnout and work/life imbalance (one participant on a recent SBS Insight program focusing on vets and suicide had been on call every day for two years straight) can all come into play.
And, of course, there is the topic of euthanasia.
Complexities of euthanasia
"Other things that impact upon young people particularly is euthanasia of pets," John Dooley says.
"The impact can be the same, often, in a situation where it is clear there is an extremely elderly individual patient with no tunnel or light at the end of it for whom it is the only reasonable thing to do, but still the taking of an action to end a life is not without emotional stress," John says.
"Let alone the other cases whereby, for whatever reason, some perfectly healthy animal is ending up needing to be euthanased and that's an even heavier emotional burden to bear, particularly for many young practitioners."
I think part of it is access and familiarity to the drugs, and also just that conceptual idea about euthanasia being the end of someone's suffering.
- Dr Alissa Healy
Alongside the moral dilemma of euthanising a healthy animal, or one who could be treated but the cost is too high for the client, is the place euthanasia takes in a vet's mindset.
"Overwhelmingly one thing that I think plays a big role is that veterinarians are very familiar with euthanasia as a means of ending suffering," Alissa says.
"Part of the reason the rates (of suicide) are high in veterinarians is that for us, euthanasia is a kind option for animals, and it's not such a jump to think 'I'm not happy in my life, everything's getting on top of me, I'm not getting better, no matter what changes I make it's not improving, so therefore I'll do the kind thing for myself.
"I think part of it is access and familiarity to the drugs, and also just that conceptual idea about euthanasia being the end of someone's suffering," Alissa says.