Never Forget to Pray

I was at a tie stall barn today, working on a down cow (hypocalcemia aka milk fever aka really hard time standing up) for a 93 year old man, whose family has had this farm for his entire life. Hunched over from obvious years of hard labor, a torn plaid shirt that was probably purchased in the 1920s. The lines of passion and tears were clearly marked on his face. He sat over me in silence, waiting for the bottle of calcium to work its magic in his beloved holstein.

After I finished treating her, the vet went out to the truck to clean up the supplies and check on some other emergency calls we had to accomplish for the day. While absent, I took the time to look around a barn that was over 4x my own age. The broken floor boards on the ceiling, the smell of silage everywhere. But despite the antique look of the place, I could feel the old mans pride and passion brimming off the walls. This is where his grandparents first brought their dairy to back in the late 1800s. There was an untold history here, and I wished I had more than 45 minutes to explore.

As I was saying goodbye to the farmer, his granddaughter ran in from the house, followed by whom I assumed to be his daughter. The little girl asked me if I was a veterinarian. I gently pointed to the vet I have been shadowing for over a week as the one to ask. She looked up, surprised to learn I still had a long way to go to being a vet. And stated "Well I'm going to grow up and save all of the animals, especially the cows for my grandfather, so he can keep milking the cows in heaven." This statement took me by surprise, because usually, I try and avoid conversations that have anything to do with leaving this world.

The grandfather, still leaning on the barn door with a silent but soft demeanor, smiled at me and then his granddaughter. He thanked me for helping him with his cow, without ever explaining what his young granddaughter's comment meant.

He called for her, and they went and sat down in the hay together, while she played in what was obviously a cow pie. As I walked out of the barn with my vet, I heard him tell her "You don't have to save the world. I believe that's already been done." I smiled as I left through the milking parlor. Above the door leaving the barn, I got a quick glimpse of words that this man has lived by for 93 years.

"Never forget to pray."

I am the 4.1%

It has taking me a long time to be able to admit when I need help. Not only am I quite stubborn, but in general, a very leadership focused person.  I cannot count the times I have doubted my abilities, talked about leaving my professional degree program, as well as fallen into a psychological trap of inadequacy. I have ADHD, and I chose to do something about it. 

According to the National Institute of Mental Health, 4.1% of the U.S. adult population has Attention Deficit Hyperactivity Disorder. I’m one of that 4.1%; in August, I was diagnosed with ADHD, primarily inattentive. Like most adults diagnosed with ADHD, I had ADHD as a child, but my symptoms did not become problematic until I was under so much stress that my coping mechanisms were no longer sufficient. In my case, that stress was graduate school, and I spent much of my first two years severely impaired. The worst part of it was that to an outside observer, my difficulties looked for all the world like laziness and being too involved, while from the inside, everything felt overwhelming.

The DSM-IV states that for an adult ADHD diagnosis, “There must be clear evidence of significant impairment in social, school, or work functioning.” Before graduate school, I wouldn’t have qualified for a diagnosis, because I didn’t feel impaired. I rejoiced in the strange ways my brain works, the tangential intuitive leaps, the great creativity, and the ability to keep many tasks going at once. Since the symptoms of my iteration of ADHD include issues with self-motivation, lack of focus, and difficulty working in advance, graduate school made it feel less like an adventure and more like a serious disability. 

I often lose my train of thought with my research and school work entirely, taking a full week to complete tasks that I know should have taken a few hours at most. The feeling of inadequacy when compared to student who could do productive work 12-15 hours a day was punishing, as was my negative self-talk about my lack of productivity. I intellectually knew I was intelligent, but when I couldn’t focus, when I was doing poorly in my classes, when I was falling behind ... I always felt like I wasn’t smart enough, and that I never could be smart enough. 

In retrospect, it was not only my ADHD that was causing the chaos in my life over the past two years. My version of ADHD has performance-related anxiety along with it, and when my ADHD caused me to perform poorly in school, my anxiety would act up, which would make it even harder for me to focus, which would make the anxiety worse, and eventually I’d lose the ability to do anything but curl up on the couch, not drink the cup of tea next to me, and stare at the internet. Veterinary school made this cycle escalate to a whole new level. Since this was keeping me from pursuing the science career I’d dreamed about since I was 10, I developed depressive symptoms. I didn’t notice until later, but I stopped enjoying things. I’d stopped running half marathons, and I didn’t listen to music muchtalk with my family. I didn’t find volunteering enjoyable. I didn’t feel like socializing, or making new friends, or really much of anything.

Having my official diagnosis helped a lot. Once I realized that this disorder was no longer a hindrence but a blessing in disguise, I fully began to grasp the benefits of having a wide open train of though. After starting treatment during my first year in a veterinary curriculum, the first improvement I noticed was that I could filter out background noise. The pervasive brain fog that had plagued me for months lifted almost immediately. I could focus on things when I wanted or needed to, and I could just as easily stop focusing on them. 

Although I have experienced a great improvement during treatment, I have some nervousness related to talking about our ADHD to specific people. From classmates to friends, I generally do not advertise that I needed help. And for the most part, have never felt the need to draw attention to myself. I will now gladly speak openley about this hardship in my life, and try and get people to understand my point of view. It is not laziness to the infamous "college student trying to get ahead." Unlike most professional DVM students, I merely want to survive and advance, and maybe make a difference to someone along the way. 

ADHD is a real disorder that can cause significant amounts of distress and impairment in everyday life. It is not an excuse for laziness; it’s a difference in the brain. Adult ADHD is often not obvious because the public concept of the disorder is that ADHD is for small, hyper children, not intelligent adult graduate students who suddenly can’t cope with their workload. Furthermore, ADHD isn’t a state of being “abnormal.” I vastly prefer to say that I’m not neurotypical. Being typical is fine for some things, but when you’re working on difficult creative problems, like finding new and innovative research ideas, having typical thought processes can be a detriment. The way my brain works might not be common, average, or pedestrian, but when it works with me instead of against me, it’s a powerful advantage.

A Different Point of View

With all of the media articles surrounding the negative parts of being a veterinarian, I wanted to write a bit of a different point of view.

When you are upset at work because you have more files to process or emails to respond to, think about a veterinarian, who spent all night in surgery to remove a ruptured spleen.

When you complain that you have no time to exercise, think of a veterinary resident - who spends 18 hour days on their feet, with patients whose lives depend on their every decision.

When you wake up from a sleepless night, think of a veterinary intern - who spent all night with a blocked goat, and is still expected to have her cases ready for rounds by 7 am, herd checks all day and students asking 1000 questions, and she comes in with a smile still on her face.

When you think there is no hope left in humanity, think of veterinary students. Who despite every setback, rejection and obstacle, are convinced that they will make a difference to someone, whether that be an animal or human.

We come into this profession for one reason: Make a difference. Heal. Save. Prevent. Treat. Improve Life. There are many reasons this career can bring you down. Exams will make you feel like you know nothing, patients that don't respond to all your best efforts, clients who think you are only here to pay off your loans.

But from my point of view: I could not see another way of life worth living. A profession, career and passion worth all of the time and effort that goes into being a medical professional. Its not about money. Its not even about saving lives. It's about making an impact for the better, one patient at a time.

...And that makes this profession worth fighting for.