Tune in as we chat with VIN Foundation Vets4Vets® team member, Dr. Susan Cohen. We discuss the difference between compassion fatigue and burnout and explore a new concept Susan has identified as the Red Shoe Syndrome.
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TRANSCRIPT
Intro
Jordan Benshea: Welcome to the Veterinary Pulse podcast. My name is Jordan Benshea. I’m the Executive Director of the VIN Foundation. Veterinary Pulse is the heartbeat of the profession. Join us as we talk with veterinary colleagues about critical topics, from student debt to mental health, and share stories. Stories connect us as humans, as animals, as a veterinary community. This podcast is made possible through individual donors like yourself, and our technology partnership with VIN, the Veterinary Information Network. Thank you for being here.
Meet Susan Cohen, DSW
Jordan Benshea: This episode, we’re having a discussion with VIN Foundation Vets4Vets team member, Dr. Susan Cohen. We share a concept Susan has identified as the red shoes syndrome, different from burnout or compassion fatigue. She has seen this as a regular occurrence amongst veterinary colleagues. We discuss how to be aware of this behavior, along with tangible tools, and suggestions to help. Thank you for listening. Hi, Susan. Thanks so much for taking some time to talk with us today.
Susan Cohen, DSW: Hey, Jordan, it’s great to be with you.
Jordan Benshea: Can you give us sort of like a little introduction? How did you first come to hear about the VIN Foundation or how were you first introduced to the VIN Foundation?
Susan Cohen, DSW: Well, Dr. Paul Pion and I, Paul is a cofounder of VIN, used to work together at a big veterinary teaching hospital in New York. After he left, we kind of kept vague touch with each other. Right after I left that job after 28 years, I ran into him at a conference and he told me about VIN and the VIN Foundation, which was just getting going at that point, and said, “Why don’t you do some seminars for us, we don’t have anybody talking about your issues.” In 2014, the Foundation program Vets4Vets, asked me to start an online support group for stressed out vets. The group started in January of 2015, and we’re still going.
Jordan Benshea: Wonderful! Dr. Paul Pion is the cofounder of VIN and also a VIN Foundation Board member. So wonderful that you happened to meet up at a conference and it led to you and the amazing work that you’re doing with Vets4Vets.
Susan’s Journey to Social Work
Jordan Benshea: So, I’d like to backtrack a little bit and learn more about what was your path to social work? What first intrigued you about the profession and the study?
Susan Cohen, DSW: Okay, well, my path to social work came out of both my work and life experiences. It was personal stuff, the big picture, and then getting annoyed. My first child was born with a lot of orthopedic problems, and in those days, you really didn’t have much help. There were services out there, but nobody knew how to access them. We, just by luck, stumbled on somebody who knew about some financial aid and a great doctor, things like that. That really introduced me to the whole world of disability and social needs. After he was done with all his surgeries, I took the job in unemployment insurance, and it was a very unusual office. It was a place where everybody except New York state residents came to collect unemployment. So, I got a chance to see a national program with certain requirements built into it, that was interpreted differently in each state. I said, well, this is interesting. Each state is creating a program to fit their own needs that are going to be somewhat different from even the neighboring state. The final straw for me was being in the hospital with my second child. There was a woman in the room with me whose child was born with some severe medical problems. By this point, I knew that there were programs out there for practically everything in the book, and I kept waiting for someone to walk in and tell her how she was going to get financial aid, who she could hook up with, other parents whose kids had this problem, and that kind of thing. And nobody did, not one person came in. In fact, it seems to me they were kind of berating her for the fact that her child had these problems, and it really made me mad. So, when I was ready to go back to work or do something, I decided to go back into social work, and I chose a path that was helping people one on one. Looking at the big picture, what patterns did we see? Do we need new programs, or do we need to just plug people into the programs that were there? That’s how I got started in social work and I have to say one of the things that I really like about the Vets4Vets program and the VIN Foundation is that’s how they operate too.
Jordan Benshea: That’s so interesting. A lot of our choices in life come from things that we have passions about or things that we are personally impacted with, and it seems like that was definitely the case with you here as well.
Susan Cohen, DSW: That’s right. I think it’s really important to pay attention to what happens to you in life, but to also try to look beyond just your personal situation, see who else has that problem, or what else could anybody do about it. I find that that’s the way the VIN Foundation works. They listen to their members, they hear what the problems are, if it’s a one-on-one situation, they connect people with someone who can help them. But if the same thing is coming up over and over, lots of people have debt, lots of people are upset about the way things are going in veterinary medicine, whatever it is, they create a program that meets the needs of the people who are out there. To me, that’s the right way to do it.
Jordan Benshea: I happen to agree, but I am a little biased.
Transition to Veterinary Social Work
Jordan Benshea: So, I’m curious, how did your path of social work and your experience from that lead you to the veterinary profession?
Susan Cohen, DSW: You know, Jordan, it is almost the same way that I got into social work. I had some personal experiences, I got to look at the broader picture, and I had a feeling that somebody ought to do something about it. Like me, for example. Before I became a social worker, long before then, I had to take my older cat to the veterinarian. In those days, you didn’t go all the time if you had a cat, but she was getting older, and I thought she’s slowing down a little, someone should check this out. I realized the entire time the veterinarian was examining her that I was getting more and more worried about what was going on. If he spent too long looking at her eyes, I thought, oh, she must be blind, and I didn’t know. At the same time, I’m talking to myself, what’s the matter with you, no one has said anything, then why are you being so upset? When it was all over, I asked her, and she said the cat was fine. She would just need reading glasses if she ever read the New York Times. I thought, you know, you’re being ridiculous. You have a husband, a job, and a child. You have lots of wonderful things in your life. Why are you getting so upset about this cat? I realized that I couldn’t just talk myself out of it and that if I felt that way, there must be a lot of other people who felt that way. So that was my personal experience, and I thought, you know, there really should be somebody in the office to talk to when this is going on. Someone to help you understand what the doctor is saying, help you make a decision, calm you down. But it was just a personal experience at that point. My first job out of social worker school was working with disabled college students. In those days, most of them had been taught at home, didn’t get to go out, there was no accessible public transportation, you couldn’t get into a movie theater in a wheelchair, and things like that. I found many of them had very tight relationships with pets, too. I said, “What’s going on?” I started to think about it, and I realized that in addition to service dogs, if you’re home alone, everybody else is out, mowing the lawn or going to the movies, who’s home with you all the time? Who thinks you’re wonderful, just exactly the way you are no matter what you look like, no matter what you use to get around? Your pet. I seemed to be the one that always realized that one of our students was grieving the loss of a pet. I thought, boy, that’s weird. Why is it that I’m the only one that sees this? I thought, again, about that idea of having a social worker in a veterinary setting. So fast forward a few years, I found somebody who would let me give that a try. This was the Animal Medical Center in New York City. We made it up from scratch. We didn’t know anybody else who was doing it except one person at University of Pennsylvania who seemed to be having a very different experience than I was having. I was very lucky that I had a lot of support there, and that we put this whole field together by ourselves. The thing that was surprising was that I was hired to talk to clients who were anxious, to teach young veterinarians how to talk to upset clients, because they weren’t taught that at all in those days. That was it. What I saw was the third leg of the stool, which was how stressed out all the vets, techs, and everybody else was. I went to the higher ups and I said, “Do you realize how stressed out your staff is?” And they said, “Really?” I said, “Yeah, they’re like really tearing their hair out. They’re coming here from other cities; they don’t have any money. They’re working tremendous hours. They’re really anxious.” And they thought not only was that normal, but that was also good! You know, ordeal by fire makes you a better veterinarian. So, I just started teaching stress management and all of the skills that go with that. And frankly, I think communication skills dealing with clients and your coworkers and stress management are pretty closely related, because if you have the skills to do your job, then it’s much less stressful.
Jordan Benshea: That’s really interesting. I can imagine, I mean, as I’m not a veterinarian, of course, but I am a pet owner. I know that when I go to the vet, I do the exact same thing that you mentioned, where the vet’s taking a really long time, I start going through the list in my head of things that could be wrong, and I’ve created all of those issues before they’ve said anything. Also, I feel like for humans, I find it so vitally important for them to have an advocate when they go into any sort of medical setting, because it’s so hard to remember everything that they need to know. Especially if it’s a tough medical situation, it’s so hard for them to know, to hear everything that they need to hear, especially in something like a cancer diagnosis or a surgery. Having someone else there to be, I don’t want to say a voice of reason, but almost someone there to hear it as well, you’ll get almost twice the information, because you’re going to miss things because you as the person going through it are so overwhelmed with your own personal experience. I almost feel that way with pets. I go in and I have to write myself little notes, because when I go in, I’m like, don’t forget to ask the vet this, don’t forget to ask them this. Similarly, to when I go to the dermatologist, I want to make sure I cover all these different points. Regularly I leave and I’m like, oh, I forgot about this, or what did she say about that? I can imagine that that role that you played was probably extremely helpful, and very innovative. I really applaud you for that. I bet that was really helpful to a lot of pet owners.
Susan Cohen, DSW: Well, thank you. Thanks, Jordan, I’m the same way. After a few years, I realized I was just doing for all the pet lovers what I would want somebody to do for me if I were stressed out. It’s exactly what you said, there’s so much information coming at you, some of it’s in Latin, and they’re using terms you haven’t heard before. Frankly, when you’re stressed out, it doesn’t matter you know that you’re an English major with a PhD, you’re brain just goes to sleep and you forget the meanings of words. I would be in the room. I knew that I knew that I had been in veterinary setting too long when I realized that I thought BID was a word. It’s a concept of how often you give a dose. We throw those terms around all the time, and I just got so used to it, I almost couldn’t hear it anymore. I remember having a very long discussion with one guy about his dog’s GI problems, which to me is a pretty common term, in ordinary life, and we got to the end of our conversation, and he said, “By the way, what is a GI problem?” What I discovered in veterinary medicine is that veterinarians and medical people use terms that sound like regular English, but actually have a different meaning medically. They would say your dog is depressed. I remember again, having a long conversation with a client, who I finally realized, felt she was getting a double message. The veterinarian told her her dog was depressed, but they wouldn’t let her take the dog home. In her mind, depressed meant sad. Well, who wouldn’t be sad locked up in hospital? But now they’re refusing to let her take the dog home when they explain that’s what the problem is? Of course, in veterinary medicine, and I guess in human medicine, it really means slowed down, not standing up much, not having the energy you would normally have. There are lots of terms like that. And, again, once you’re in that situation, you’re already stressed, maybe even before you come in, you’re having problems with your spouse who doesn’t think you should be spending the money on this, your mother-in-law thinks that if you would just get rid of the dog, maybe you’d finally give her grandchildren, I mean that your next-door neighbor thinks you aren’t doing enough. It’s so much emotion to carry. When I started in the 80’s, veterinarians were not taught any of this. In fact, they were pretty much told to not talk to the clients, tell the clients what was going to happen, and the clients should just accept that, and you should never, never, never cry in front of a client. Oh, my goodness. Well, it turns out, that’s okay, too. You know, if you’re crying more than the client, then maybe you’re crying for your issues, but it’s okay to show some emotion, have some compassion, as long as you can also walk away from it a little bit and get some distance so that you can function.
Jordan Benshea: Those are really good pieces of advice, and I think that’s very true. Somebody not knowing a GI issue is gastrointestinal and us thinking it’s something else than what it means in the veterinary profession. Depressed is a really good analogy for that. That’s so interesting. You know, we’re so grateful for the work that you do for Vets4Vets and the weekly support group that you have and that you run. I’m sort of curious, what are you finding, with all of your experience in the veterinary profession, what are you finding are areas where colleagues are struggling currently? I’m sure that you’ve seen it take different paths throughout your career, just as you mentioned in the 80’s the way that veterinarians would respond or be challenged with some things would be probably a little different than what they are now. But I’m kind of curious, what are the areas where you’re seeing veterinary colleagues struggle currently?
Susan Cohen, DSW: I think the biggest change I’m seeing now is the change in the way veterinary medicine is practiced. Whereas it used to be that they had no training with human beings and that was an issue, now they do. They come in often with stress management experience. But veterinary medicine is becoming corporatized. Instead of having small mom and pop kinds of practices, they’re getting either larger, or they’re being bought by big organizations who have their own ways of doing things. We certainly know that veterinarians are coming out with a great deal of debt, and they’re not going to make a great deal of money when they’re in the workplace to pay that debt off. There’s a lot of debate among my colleagues about what the underlying problems are, and there’s no real agreement. Some people think we’re graduating too many veterinarians, and there just aren’t enough good jobs. Some people think we’re attracting some fragile people who need so much support that they just can’t function without it. I don’t know that that is all of the problem by a longshot. I do think the kind of people who go into veterinary medicine are a little different. Now when I started it was, I used to say, Iowa farm boys now plunked down in the big city of New York. Now, male or female, it’s people who grew up with pets, so you don’t have to explain to them why pets are important, but they do seem to take issues of euthanasia and some other things much more to heart than they used to. I’m also hearing a lot more people talk about imposter syndrome, that feeling that if people only knew how imperfect you were, they wouldn’t have anything to do with you. It’s taking every bad outcome or less than optimal outcome so much to heart that you’re paralyzed for days afterwards and sometimes for months. I hear from people who have been in practice for a while, who say, you know, instead of getting more and more confident in my skills, I’m getting less and less confident. I just don’t ever want to do surgery again. Often, it’s not because of one bad case, it’s something that’s building up over time. It’s always been true I think that many veterinarians work kind of alone. Even if you’re in a practice with several other veterinarians, you’re alone in the room with the client, and clients are much more willing to tell you what they really think, to question your ideas. They have other sources of information like the internet, they’ve always talked to their friends, they may talk to their local veterinarian if you’re a specialist and compare notes there. The veterinarian instead of being able to just say, well, I’ve got a white coat on, I’m telling you this is how it is and here’s what we’re going to do, gets a lot of pushback. Now, often this is just a loving, devoted, well informed pet lover who wants to bring up other ideas or wants to know how you got to that decision, but if you’re on the receiving end of it, it can feel as though somebody is questioning everything about you, and they don’t even like you because otherwise why would they even ask you these things? There’s also an issue with social media. We’ve all heard stories of veterinarians and veterinary teams who’ve been bullied on social media. Obviously, nobody’s perfect, we all make mistakes, but now your mistakes can be brought up publicly and often it’s not really a mistake. I read all the time from veterinary practices, techs, and other people saying, we got this very nasty review on such and such a site, we went back to see what could have gone wrong, and we can’t even find a record that this person or this pet was ever in our practice, they probably have the wrong name, but we can’t get this person to take it down. Now all her friends are writing in that we’re terrible, and they haven’t been here either. So clearly feeling that you owe a lot to everybody involved, that you recognize you’re an imperfect person, being afraid that you’re going to get bullied, either by your clients, or maybe by your coworkers, really takes a lot out of people. One of the things that we talk about in this field is what’s called compassion fatigue or burnout. Now, I can describe that, and I will describe that, but I think there are other things going on in the whole veterinary team. Compassion fatigue is a term that was created by a psychologist named Charles Figley. What he was talking about was the trauma that a person can get, not by being in the bad event personally, but by dealing with people who have been in a bad event. It is a secondary, post-traumatic stress disorder. Compassion fatigue, using Charles Figley’s definition, would be a client comes running into your practice with a dog that’s been hit by a car, is bleeding, so there’s this dramatic scene, right? The client is crying, maybe screaming, begging you for help. They don’t have any money, they left their wallet at home, because they were out for a jog. They want you to save their pet at any price. So, you’re dealing with a medical situation, a financial situation, and a very serious emotional situation all at once. That can actually leave you somewhat traumatized. Maybe it brings up things from your past, maybe it’s just the sheer horror of the scene, it could be lots of things. Certainly, if you have a few of those day after day, after day, you can get I’m going to call it twitchy. Right? Post-traumatic stress disorder involves things like being hypervigilant, looking around all the time for danger, jumping at loud noises, feeling that nobody understands what you went through, whether it’s a war experience, or 9/11, or something like that. You can get a kind of secondary trauma if you are a first responder at one of those scenes, or a social worker, or a clergy person. You can get secondary post-traumatic stress disorder from just hearing about horrible accidents that happened in your town. So, you can understand that if you’re a veterinarian and you have to deal with high emotion, terrible scenes, being unable to help somebody who is really in distress or an animal really in distress, you can see how someone might get a kind of secondary trauma from that. Burnout is another term for work stress, but to me, it’s different from compassion fatigue and some other terms, because to me it means caring until you just can’t care anymore and you go numb, kind of like a burnt out match, right? The things that cause it are lots of changes. For example, if you’re working in a small practice with somebody that you know well and that person sells the practice to a corporation, and the corporation wants a lot of changes in how you do things. That can really throw you off. Or it might be that you’re in the same place, but they’re increasing the hours because as we mentioned, student debt and all the competition is leading people to have to work longer, longer hours. So, you either have a situation where there was a lot of change, or a lot of demand on you and not enough chance to really restore yourself. The things that help fix that are stability at work, and very often just taking a vacation. An example would be, and this actually happened where I used to work, a tech would say to me, “You know we’ve had a lot of euthanasias lately and I know that it’s my job to help out, but I can only take so much of this. So, if I’ve already done one that day and I hear an overhead page for a technician that I know is going to be for euthanasia, I go hide in the lady’s room and let somebody else do it.” That’s burnout, right, it’s just getting to the point where you have to shut yourself off, because it’s too painful, or where maybe you didn’t want to shut yourself off, but you just find you’ve gone numb, you just don’t seem to care as much, you’re just going through the motions at work. That’s burnout and it’s different from compassion fatigue to me.
Understanding Red Shoe Syndrome
Susan Cohen, DSW: There’s another situation that I have seen in veterinary communities that feels different to me than either the strict definition of compassion fatigue or burnout. I see veterinarians and their staffs being so deeply committed that they can’t stop caring. Instead of turning off, they are burning full bore all the time. Veterinary teams and their staffs usually have very high intelligence, a deep commitment to animals, and a strong work ethic, but sometimes this goes to the dark side. Intelligence becomes endless study, just one more article, I just have to stay here and figure out one more thing. Commitment to animals and helping them becomes an obsession. I have to save them all. I have to be here at all times. The work ethic becomes a sick kind of perfectionism. We all want to do our best. We all want to save everything and not mess up when lives are at stake, but we’re human beings and we can drive ourselves to the point of feeling like total failures if anything goes wrong. I was giving a talk one day about burnout and compassion fatigue, and I thought, what is this other thing I’m seeing? What’s an image for this? I remembered a movie that I had seen long ago called The Red Shoes. If you don’t mind, let me explain this to you. The Red Shoes comes from a story by Hans Christian Andersen. His story is extremely dark and kind of boring, but the movie is about a ballerina who finds herself caught between love and work. She has a mentor who says he will make her the greatest ballerina of all time if she gives up the entire rest of her life to become his muse and his great ballerina. She falls in love with the composer of this new ballet that he’s created for her, and of course, the young composer says, “Why don’t you dance a little on the side and just be my love and be with me?” Now, what is the ballet? The ballet is based on the Hans Christian Andersen story of The Red Shoes. The basic story here is that a ballerina goes to a fair, and she sees a pair of beautiful red ballet slippers. She must have them, and we, the audience, can tell that the guy who’s selling her these ballet slippers is up to no good. There’s something very fishy about him. He’s some sort of wizard. She puts on the shoes and immediately feels like the best in the world, and she is dancing as she has never danced before. She dances all through the fair, she was fantastic. She then dances into the woods and decides, you know, actually, I think I’m a little tired. I think I’d like to go home. She tries to go home. Her mother is standing in the doorway, but the shoes won’t allow her to stop. So, they dance her out of town and into the next town where she tries to stop at a church and the priest is there with his arms out. She’s trying to get to him, and the shoes force her dance away. In the end, these enchanted shoes force her to dance until she collapses. That felt much more like what I was seeing with veterinarians and their teams. It’s intelligence and work ethic and commitment that won’t stop even when you begin to realize that it’s hurting you. Even when you want to stop. You are driven to keep going. You come home at night you have to read more articles. You don’t want to talk to anybody in your house because they don’t understand what you’re going through and you’re just worried all night long about your cases. You may try some things. Oh, I’ll just wash my hands at the end of the day and let it be. For some people that can work, and it’s something I recommend, but you might find yourself at home still brooding over the case from yesterday, or the client contact you had last week. If anybody says anything to you, you keep it to your heart and say oh, what have I done wrong, it must be me. Or you might get very angry at your clients and think it’s all them, but you can’t stop. That is what I call red shoe syndrome.
Jordan Benshea: So interesting, that’s a really interesting take on issues that we’re seeing in the profession, and that sort of concept that I think we probably all have in our lives and in our own ways, which is that we know that something’s not healthy for us, but we just can’t stop for one reason or another.
Susan Cohen, DSW: Yes, it’s different from an addiction, you know, an addiction is something that at least in the beginning gives you pleasure, and this does to in a way. When you hear about what I call red shoe syndrome, which is a term that I made up to cover this commitment that drives you, an addiction, I think they’re different even though they could sound a little the same. You are doing something that you know is bad for you, the difference is I think, addictions take over your life and most people who have them wish they could get off. If you’re gambling too much, if you’re drinking too much, you may be aware that this is really hurting you, it’s hurting your family, other people can see it, you’re getting negative feedback, because you’re doing this thing and you wish you could stop. With what I call red shoe syndrome, you don’t want to stop. Here’s the thing, if you’re smarter than most other people are, more talented than most other people, it’s very easy to persuade yourself that you need to stay on the job at all times, because nobody else does it as well as you do. If you go home, lives will be lost, the practice will fall into chaos and ruin. Nobody will set the surgery up for tomorrow correctly, whatever it is you’re telling yourself. And you’re probably getting, instead of negative feedback, positive feedback; wow, you work so hard, you’re so great, what a fabulous surgeon. So, you’re getting positive feedback from yourself, but from the people around you, for you to keep doing what you’re doing. So, it’s very hard. Even if you recognize that this has become destructive in your life, it’s very hard to take a step back,
Jordan Benshea: I love that you’ve been able to identify this and that your identification of this red shoe syndrome that you’re calling it came out of you going to give a talk and thinking there’s got to be something else there. It’s always interesting to me, how in life, we’re led down these paths and it just depends on what else is going on in our life that we are sometimes open to receiving that information and exploring more and sometimes not, right?
Strategies for Work-Life Balance
Jordan Benshea: Are there ways that you’re seeing how veterinary colleagues are improving on this or rather, how they are able to help themselves out of the red shoes, per se?
Susan Cohen, DSW: Well, of course, in a perfect world, you wouldn’t put the red shoes on in the first place. Right?
Jordan Benshea: Right, of course.
Susan Cohen, DSW: If you see that you are getting caught up at work and you don’t want to come home, and when you do come home, you only think about work, whether it’s a client that upset you or a case that went wrong, or case that went right, you need to build in some things that will alert you that you’re in that space and force you to have more balance. The thing that I mentioned about washing your hands, veterinarians, medical people wash their hands all the time. If you mentally say to yourself, I am washing away the last encounter I had good, bad, indifferent. I’m starting over fresh with this new situation. Do that mindfully and it can help you. Setting up activities to let yourself go home and be in a different place. If you watched Mr. Rogers when you were growing up, remember he would come in in one outfit, he would change into a sweater for the time he was with you, and then before he went home, he took off the sweater and those shoes and put on a different shirt or jacket and different shoes. You can do that yourself. Get out of your scrubs. Change into a different outfit. Remind yourself that you are going home. One person told me that when she hits the first stoplight on the way home, she tells herself stop, that means I’m going to stop thinking about work. Another person told me that he literally takes the top off the garbage can outside the back door and pretends to throw in all the stuff from work and puts the lid on the garbage can to help him make a break between work and home. Make yourself you know, set timers. If you can’t trust yourself to go home, then appoint a minder for yourself, get somebody who will remind you to just stop reading, stop doing your paperwork, and go home. When you get home, try to be really present for your own pets and your own family. Develop activities that you really care about, so that you feel committed enough to do them. One oncologist I knew was really teetering on the brink of red shoe syndrome and collapse in general. He was going home every night and finding that he didn’t even want to interact with his family because he’d spent all day with people whose pets were dying of cancer. He was staying late to play video games and things like that. So, he took up martial arts and these days, he treats pets with cancer and their people and does that part time and the rest of the time he teaches Judo to at risk youth. He’s a much happier, healthy guy than he was.
Jordan Benshea: That’s really interesting and probably some really helpful tips finding ways to find balance. I like the example of the of the veterinarian who comes home and opens the trash can and then just puts that in there and puts the lid on it. It’s almost the metaphorical I’m putting that outside where it lives, and it doesn’t come inside with me. Right?
Susan Cohen, DSW: Exactly. People who are list makers tell me that that’s very helpful. That if they sit at work and say, oh, just one more, just one more, that there’s no way to make themselves go home. But if they make a list, here’s what I need to get done today and you check it off. When you do things that weren’t even on the list, you put them on the list just so you can check them off. It gives you a feeling of accomplishment for the day and you really have to remind yourself or have other people remind you that you’re a mortal human being. I always think of marathon runners, you know, you’re not going to be a better marathon runner if you try running 24 hours a day. Everybody has to stop at some point and eat and sleep and recover so they can get up and run again tomorrow. And veterinary practice is the same way.
Jordan Benshea: Right. It’s important for people to realize that just because you put these parameters, or these helpful tips in place for your own life, it doesn’t mean that you are less of a caring person. It doesn’t mean that you care less about your patients or that you care less about your clients. It simply means I would say similarly to you’ve got to put your own oxygen mask on first. If your oxygen mask isn’t on, there’s no way that you can continue to help others. Would you say that’s a good analogy?
Susan Cohen, DSW: Yes, I think it’s great analogy.
Jordan Benshea: I really appreciate you sharing this idea with us, because I think that it’s one we’re so accustomed to hearing compassion fatigue, we’re so accustomed to hearing burnout, and I think that one of the scariest things for people is when they’re struggling or they feel so overwhelmed and they have no concept of what it is. It just feels so intangible in the moment, that it’s almost impossible to put their hands around it or their mind around it, because it’s just this very large thing. I love the idea of being able to put this idea of red shoe syndrome onto it, because it helps. We fear what we don’t know and if you know this, then you’re able to say, okay, I know that this is what it is. I’m able to identify it in this way, and therefore I’m able to put these parameters in place and these things in place to help me improve my life and also be a better veterinarian because of it.
Susan Cohen, DSW: Exactly.
Vets4Vets Support Program
Susan Cohen, DSW: One thing that we haven’t talked about that I have found incredibly helpful is our Vets4Vets support group. Vets4Vets programs offer lots of support and the VIN Foundation does. What’s really useful about that group is that we get together once a week and we talk about what’s going on in our veterinary lives, our work live. You can often get the idea that you’re the only one that’s experiencing this. Everybody else is confident. Everybody else is happy. You’re the only one that has second thoughts. Whether you’re a fairly new grad who did really well in school and is now kind of unhappy at her first or second job, or whether you are a practice owner who has been at it for 30 years and is starting not to love it anymore, you think it’s just you. When you get together with other people who care passionately about what they do but are also examining their lives and you get some feedback. Hey, that is really not a healthy work situation you’re in, or that kind of contract doesn’t make any sense, or no, clients really shouldn’t be talking to you that way and bosses shouldn’t be going behind your back, whatever it is that’s stressing you out, to have a group of people who don’t know you and are not going to tell you what you want to hear, but who are going through similar kinds of problems and can look at it a little more objectively, is so helpful. I recommend if your own self-care and trying to set limits, that kind of thing is not enough, certainly don’t be afraid to get therapy, but consider finding a group of likeminded veterinarians that you can talk to and compare notes with.
Jordan Benshea: Yes, our VIN Foundation Vets4Vets program resource is completely free for all veterinarians and veterinary students. Some people think you need to be a VIN member to access the VIN Foundation resources, that’s not the case, all of our resources are completely free and Vets4Vets is one of them. Vets4Vets helps with addiction, stress, feeling overwhelmed, or if you just need someone to talk to. What I really love about Vets4Vets is that it’s extremely tangible. You know, it’s not just a Facebook group that you post something on, it’s really one on one. When somebody first reaches out to Vets4Vets, they immediately have a one-on-one interaction with Dr. Bree Montana. From there, with Dr. Montana they decide what’s the best what’s the best course of action. Do they need immediate support and triage? Do they need an online support group like the one that you’re running, Susan? Or is it one-on-one conversations? It’s amazing! What we find is for a lot of people, sometimes even just, [you can either email or call in and we’ll put that information in the show notes], what’s amazing is for some people, we find that just emailing in or calling in for them is extremely therapeutic, because it’s just that idea that somebody can listen to them. I remember in the times that I’ve gone to therapy, I found the most benefit just to be able to say something out loud, because when you say it inside your own head it sounds very different. Out loud there’s almost like this therapeutic approach to that. Whoa, and sometimes you think, wow, that’s actually a lot easier than it sounded inside my head, justifying it in your own head, right? Then you said it out loud, you’re like, well, that there’s a lot of weight here and I really need to pay attention to this. Or vice versa, right? It might sound very, very scary in your head, and then you say it out loud and, to your point Susan, others in the group might say, “Oh, yeah, I’ve totally been there, done that. This is what I used, or this is how I dealt with it”. Right. I think the most important thing is that everyone knows that they are not alone. The Vets4Vets group is run by yourself and Dr. Bree Montana. All veterinarians and veterinary professionally focused. It’s really, really a great resource out there and I feel offers extremely tangible support.
Susan Cohen, DSW: You know, building on what you just said, I recently cleaned up the email list for the group, because I’d had a computer crash. I wanted to make sure I had all the people who still wanted to be on it. I can’t tell you how many people wrote in they either have never been to a meeting, or they haven’t been to a meeting in two years and said please keep me on this mailing list because I just feel connected to the rest of the veterinary profession this way and I love the articles and I love hearing what everybody’s doing. So, to your point, sometimes just talking to Bree one time because she’s amazing, or anybody else, even one time can make you feel less alone, that it’s not just you, it’s not all in your head, you’re not making this up. You’re not weak. There’s really unpleasant stuff going on and you can then start thinking about what can I change myself? Should I be thinking about getting another job or a different contract or whatever? The resources that the VIN Foundation provides are to me amazing and to get back all the way to the beginning of our conversation, it’s based on people’s real experiences and creating programs to meet people’s needs, rather than saying, “Well, here’s what we do. Fit yourself in.” If there’s a need, we’ll try to address it, whatever it is.
Jordan Benshea: Right, right. I really like what you were saying about the feeling of not alone. Our problems can feel so overwhelming and oh my gosh, I’m kind of embarrassed because there’s no way anyone’s been through this. I can assure you, someone for sure has, and Vets4Vets has probably seen it before. It’s run the gamut and whatever it is, you’re not alone. You’re not the only one that’s gone through this. If it feels horrifically bad, it’s felt horrifically bad to someone else before as well and they’re at the other end of the tunnel. I think that’s some great advice, Susan, in terms of hearing each other speak and being able to leapfrog our mistakes through others’ advice. It doesn’t have to be as painful for everybody, because others have gone through a lot of it before.
Susan Cohen, DSW: I think I would also add that there’s hope. We’ve now had this group and that’s my closest connection to the veterinary field, we’ve had the group since 2015, so more than five years now, and we’ve seen a lot of people come in and say, “You know, I have a reasonably good job, I don’t know, something’s off.” It might take them a couple of years to decide they really don’t want to be at that place anymore. If they leave, where would they go? What should they do? To hear back from them, when they’ve sold their practice finally, or moved to another state, or whatever change they made, and to see how happy they are, or to hear them come back and say, “I’m so grateful for this group, you don’t know what you’ve done for me. I just felt so confused and alone. I just feel like I’m on much more solid footing now.” is such a pleasure. The group and all of the services that the Foundation offers really work. If you feel you’re in kind of a dark place now, have hope we can help you get out of this, whether it takes a week or two years.
Jordan Benshea: Yeah, I think that’s a very good point. It’s all completely confidential, so nobody else knows. Nobody knows from your work environment. No one knows your home environment. It’s all completely confidential and there is so much hope. We do hear so many wonderful stories of people feeling so grateful and that’s wonderful. That is just so much because of the hard work that you do, Susan, and we are so so grateful for your hard work on the ongoing basis. I mean, it’s really incredible. Thank you so much.
Susan Cohen, DSW: Well, thank you. I feel unbelievably lucky to be with this group of people. I can tell you that both the people in the group and the people that I work with at Vets4Vets’ such a gift.
Jordan Benshea: Let’s take a little bit of a lighter note here.
Susan’s Personal Interests
Jordan Benshea: One question that I love to ask people is what is your secret talent? What is something that you enjoy doing or that people might not know that you enjoy doing? Give us a little insight into what makes something that you, that Dr. Susan Cohen, enjoys that other people might not know.
Susan Cohen, DSW: I think probably my most visible hobby is singing in a choir. I’m a tenor even though I’m a woman. I’ve been singing tenor since I was about 14. I just had one of those low voices. I promised myself that since I hadn’t sung since college, that when I retired from full time work, I would find anywhere that would have me. I didn’t care what they were singing, I just wanted to sing again. Luckily for me, half a block away, I found a Conservatory of Music and they’re always short of tenors. Even though it’s a pretty high-power group, I got in and I’ve been doing that for the last nine years now. It’s such a joy for me to be able to sing with other people and it’s been very good for my brain, because when I was 14, or 22, all I had to do was sing through the music a couple of times, and like memorize it. But here we don’t rehearse more than once a week and so you have to force yourself to learn to read music, at least a little bit and practice at home. I think that’s been really good for stretching my brain. It’s a great pleasure testing tenor with a very fine group that sings wonderful, wonderful pieces. We currently having to sing remotely on Zoom, because we’re not able to be together, but actually I just joined a virtual choir for one performance, and I will let you know when that’s happening. There are so many good things about singing. Singing in a group, your brainwaves get in sync, your heart rate gets in sync, your endorphins go way up, your feel-good hormones. So, it’s been a great gift to me too, a great pleasure to be able to sing again.
Jordan Benshea: That’s so wonderful! What a great hobby. I sang in choir in high school, but it’s been quite a while for me, and I applaud you for keeping a hobby that also benefits you in so many ways. I bet that similarly to the ideas that you’re giving to veterinary colleagues, it seems like that’s probably something that offers you a lot of joy in the midst of work and other things.
Susan Cohen, DSW: You know, thank you for saying that. It’s a lot of work and it’s a real commitment and there are some Monday nights, you know, you start your protest, oh, I have so much to do, I have this other thing. You know, all right, I’ll go. Making yourself do those things that you love and are good for you, I’m always feeling excited and stimulated, and glad that I went. That’s for all of us. There are always other things we could be doing, but self-care is something we have to put on the schedule. Joy, pleasure, whatever it is for you, whether it’s physical activity, or painting or, whatever you like to do, you must make time for it, if you want to stay healthy.
Jordan Benshea: That’s very, very true. We have got to take care of ourselves, and self-love is extremely important.
Outro
Jordan Benshea: Susan, thank you so much for taking the time to talk with us, for all of your work with Vets4Vets, and your effort in putting forth and having this conversation with us today. We were very fortunate to have you be part of the Vets4Vets team and veterinary colleagues out there that I know are very appreciative for all your ongoing support and knowledge.
Susan Cohen, DSW: Thank you so much, Jordan. You know, I feel I’m the lucky one here.
Jordan Benshea: I feel the same way. I feel that I’m the lucky one every day and I’m so grateful. Thank you so much, Susan.
Susan Cohen, DSW: Take care.
Jordan Benshea: Thank you for joining us for this episode of the Veterinary Pulse. Please check the Episode Notes for additional information referenced in the podcast. If you enjoyed this podcast, please follow, subscribe, and share a review. We welcome feedback and hope you will tune in again. You can find out more about the VIN Foundation through our website, VINFoundation.org, and our social media channels. Thank you for being here. Be well.
