The Vet Cookbook is BACK!

Does assembling a salad in a jar count as cooking? Absolutely!

You might have heard about the Vet Cookbook?

If not, it was essentially a compilation of recipes and stories to promote wellbeing among veterinary team members. People from every area of the veterinary sector – from veterinary nurses, technicians, practice managers, animal attendants, academics, specialists and GPs and even those who had left practice – sharedrecipes.  

Like our patients, veterinary team members need fuel. It’s even better if that fuel is pleasurable to eat! Sharing food is a wonderful way to come together, support and nourish each other.

It is hard to believe but the Vet Cookbook was published by the Centre for Veterinary Education back in 2017.

We had some fabulous submissions. It was a tough job pulling it together (I was part of a team of dedicated co-editors, including Deepa Gopinath, Lis Churchward, Asti May and Jenna Moss Davis) but we did it.

Chocolate hazelnut "Dogs-in-the-mud cake".

The not-for-profit cookbook sold two print runs and is now a collector’s edition. With the funds raised, we held several events including a wellbeing day (talks can be viewed on the CVE’s Mental Wellbeing Hub) and two sold-out writing courses taught by outstanding Australian authors Tracy Sorensen (The Lucky Galah, The Vitals) and Brendan James Murray (The Drowned Man, Venom, The School). This year, the Vet Cookbook is back. 

That’s right, we’re working on the Vet Cookbook II. The theme is “celebrating the wins” – we want to hear from all veterinary team members, near and far, about what you enjoy about working in the sector. Our editorial team includes Lis Chuchward, Kimberley Blackett, and Sharmila Kumaran (you might recall her as the author of the decadent strawberry cheesecake in VCB I!) 

And we’d love to hear your favourite recipe!

For those who are creatively inclined, we’re also keen for submissions of images of artwork (e.g. could be a painting or drawing, poem, creative writing, sculpture or composition).

We’ve already had some brilliant and creative submissions, ranging from simple recipes to the more complex, to wood block prints, drawings, paintings and photos, and we’ve got room for a few more. You can upload your submission here:

https://form.jotform.com/241008103636849

Please don’t be shy! We’d love you to be part of this – or give a gentle, encouraging nudge to that person in your workplace who loves making food. Please follow the VCB FB page for updates: https://www.facebook.com/vetcookbook/ 

Wellbeing and veterinarians - thoughts from the New Zealand Veterinary Association's wellbeing symposium

The New Zealand Veterinary Association hosted its first symposium on veterinary wellbeing

I’ve just returned from the New Zealand Veterinary Association’s first ever wellbeing symposium, held in Christchurch. I was invited there to speak about ethics rounds, an intervention designed to help veterinary team members with ethically challenging situations that can lead to moral stress, moral distress, or even moral injury. More on that in a later post.

The reason for today’s post is to share a couple of the themes discussed at the symposium.

The MC, Dr Charlotte (Lotte) Cantley, opened the symposium with an incredible account of her recovery following a catastrophic and near fatal horse-riding accident (the horse was okay), and a grueling schedule of treatment and rehabilitation. According to Lotte, “resilience is not bouncing back to how we were but being flexible, adapting to and embracing the uncomfortable changes life throws at us”.

Given her account, uncomfortable is an understatement.

So here is my take on the major themes of the first day.

Collegiality and compassion

One thing that came through loud and clear was that one of the biggest impediments to the wellbeing of veterinary team members is, well, other veterinary team members. The way we treat one another, whether we are aware of it or not, impacts us. As speaker after speaker raised this issue, heads around the room nodded. Tears were quietly shed.

Sonja Olson, author of Creating Wellbeing and Building Resilience in the Veterinary Profession, argued that we need to stop referring to communication and people skills as “soft skills” and name them what they are – power skills, tools that improve collegiality, understanding, shared decision making, adherence to negotiated recommendations and ultimately, good clinical and policy outcomes. https://www.routledge.com/Creating-Wellbeing-and-Building-Resilience-in-the-Veterinary-Profession/Olson/p/book/9780367418793

Dana Carver, from GoodYarn (an evidence-based, peer-delivered mental health literacy program https://www.goodyarn.org/)  , talked about situations that negatively impact our mental health. As she said, when we suffer an obvious “sudden negative change or event” (like the death of a family member), people tend to be demonstrative in their care. They swoop in with offers of assistance. They make casseroles. But what happens when we experience other things that negatively impact our mental health? According to Dana, these include things like a lack of justice, a lack of life balance, relationship problems, poor physical health or chronic pain? In these situations, we aren’t good at asking for help…and people may not offer it. What we can do is make time, or make an effort to connect in some way. Its better to do something, ask the question, say something, than worry about looking like an idiot. I could recall plenty of missed opportunities to extend support to someone, to make that casserole.

We heard a lot about implementing wellbeing plans into practice, and ensuring that this was more than just promoting a token day. Stephen Hopkinson, the founder of a large dairy practice surveyed his own staff to ensure that the wellbeing plan subsequently developed would actually meet their needs. To his surprise, they found that gossip, negative comments, exclusion and not helping others were the number 1 things negatively impacting staff.

Sometimes this is coming from a place of anxiety or hurt. Those behaving this way may not even be aware that they are having this impact.

He argued that we need to ensure that the discussion about mental wellbeing isn’t just about vets. All team members need recognition. Hence his team celebrate:

• -        National Administrative Professionals day (April 26)
• -        World Veterinary Day (April 30)
• -        National Receptionist day (10 May)
• -        Veterinary Nurse and Technician Appreciation day (14 October)

Because winters are cold in New Zealand, they also run “soup days” in winter – providing staff with a small budget to buy ingredients on the practice account, so they can make soups and share with the team. According to them, this marries well with the “5 Ways to Wellbeing”:

1. Keep learning – learn a new soup recipe
2. Be active – dance and sing when you make the soup
3. Give – share the end product
4. Take-notice – mindfully sip your soup
5. Connect – rate each other’s soups, swap recipes, and cook together

The 5 Ways to Wellbeing bookmark, produced by the Mental Health Foundation https://mentalhealth.org.nz/five-ways-to-wellbeing 

Denise Quinlan, who acknowledged that everyone gets crispy, shared her strategies:

• -        Prioritise ruthlessly (so if someone asks you to do something new, which thing on your to do list do you need to bump?)
• -        Promote autonomy in the workplace
• -        Support one another
• -        Value each other
• -        Act fairly (avoid those perceived injustices)
• -        Provide clarity (lack of clarity about job roles was a big reason for people to be disgruntled at work)

Her colleague, Paula Davis (author of Beating Burnout at Work https://stressandresilience.com/burnout-book/ ), provided a list of “Tiny Noticeable Things” that we can do at work to help demonstrate that we value each other.

Source: Paula Davis, Beating Burnout at Work.

Imposter syndrome

Every speaker admitted that they have imposter syndrome. In fact, Sonja has given hers a name (I won’t share it here, you’ll have to ask her).

Imposter syndrome is well-documented among the general population, as well as veterinary team members https://pubmed.ncbi.nlm.nih.gov/32571984/ . It tends to flare when we try something new, or perform in front of our peers, or start a new job. In a profession where life and death and animal welfare and human wellbeing so often hang in the balance, imposter syndrome can serve us well, driving us to improve, not to rest on our laurels. No one could pin down a guaranteed way to manage imposter syndrome without throwing the baby out with the bathwater…but it helps to know that imposter syndrome is something that everyone struggles with – and probably gets worse the higher we achieve.

Massey University Dean of Veterinary Education Jenny Weston did remind everyone that we can ultimately be our own worst colleagues – engaging in critical, judgmental, and negative self-talk that we would never extend to anyone else. Not only did she have everyone up on the dancefloor – she commandeered a team of well-practiced back-up dancers.

Rather than worrying about our own imposter syndrome (she/he/they are, realistically, probably not going to leave us – as per above, they do serve us well on occasion), maybe it’s more productive to recognise that others are experiencing this too, and be aware of the way we might impact those around us by inadvertently reenforcing that, and perhaps not doing enough to show our appreciation.

Update - supporting veterinary team members supporting animals and people in Ukraine

I’ve been trying to stay informed about the humanitarian disaster unfolding in Ukraine, and the human and animal refugee crisis in neighbouring countries as Ukranians are forced to leave.

This is a crisis for the people of the Ukraine, its animals (companion animals, farm animals, working animals and wildlife) and its life-sustaining environment.

Regarding animals, the main challenges are appear to be processing animals with limited or no paperwork, so there is a big need for microchipping and identification of animals, vaccination (particularly for rabies as this is a requirement to move animals across most borders), worming, treatment for animals that are injured or ill ,and provision of food and fodder for animals.

Those veterinary team members who are working on the ground face massive logistical challenges and resource shortages, but all have stressed that they need support for some time.

In Australia, Veterinarians Beyond Borders have set up a donation portal, which can be accessed here:

https://portal.vetsbeyondborders.org/campaign/urgent-appeal-for-ukraine-animals

The European College of Animal Welfare and Behaviour Medicine (ECAWBM) has been involved with the establishment of Vets for Ukraine:

https://vetsforukraine.com/

From the US, Greater Good is one organisation working on the ground, and their website is found here. They are publishing webinars containing regular updates, see here: https://greatergood.org/

Please note that the above links are limited to organisations I’ve personally interacted with, and this selection is by no means complete.

International Women's Day, Flood crisis and supporting veterinarians in Ukraine

 

Today is International Women’s Day. I acknowledge the incredible work of female veterinarians, veterinary nurses, animal health technicians, practice managers, and those working hard in our professional associations to support us.

I would like today to acknowledge my late colleague, Dr Helen Fairnie Jones, who co authored “She’s No Lady – She’s the Vet: Stories from 100 Years of Female Vets in Australia”. The book documents the incredible career trajectories of pioneering and trailblazing women, and can be purchased via this site. 

At the moment, colleagues on the East Coast of Australia, particularly South East Queensland and Northern New South Wales, are experiencing the impacts of climate change, with record-breaking floods. I know of three veterinary practices that have been physically destroyed. They will rebuild, but they need support. The Australian Veterinary Association’s Veterinary Benevolent Fund is providing assistance, and accepts donations. 

Colleagues have established a Northern Rivers Livestock and Horse Flood Disaster fund to help purchase and distribute fodder, field equipment, animal yarding and transport, veterinary pharmaceuticals and helicopter fuel so that stranded animals can be located and fed.

To donate visit here:

https://www.gofundme.com/f/northern-rivers-livestock-horse-flood-disaster

For those seeking to act on climate change, please consider volunteering for and/or donating to Veterinarians for Climate Action. More info here. 

Meanwhile in Europe, The Federation of Veterinarians of Europe (FVE), together with the European Federation of Companion Animal Veterinary Associations (FECAVA) and the World Veterinary Association (WVA) have established a web portal designed to act as an information hub with links to different efforts to assist Ukranian veterinarians their families, and animals.

Please note that this page will be updated as information about new initiatives becomes available. www.VetsForUkraine.com

Veterinary bibliotherapy: The Chloroformist, by Christine Ball

 

The Chloroformist by Christine Ball, pictured here with a stinger anaesthetic machine.

Have you ever wondered what the experience of undergoing surgery would be like without anaesthesia? In The Chloroformist, written by anaesthetist and Woodford Library Museum history of anaesthesiology laureate Christine Ball, provides some vivid descriptions as she tells the compelling story of anaesthetic pioneer Joseph Clover.

As part of my PhD research, I’ve been researching advances in veterinary care and associated ethical challenges (you can read more about that here). 

One of the most important advances in healthcare – of humans and animals – is anaesthesia. It is difficult for most people to comprehend surgery without anaesthesia, particularly major surgery. Aside from causing patients fear, anxiety and distress, it increases the risk of infection (it is very challenging to maintain a sterile field if the patient is trying to escape) and injury (to the patient and/or operators). Lack of anaesthesia means that surgeons must operate much faster, with less time to attend to finer details, and increased risk of error.

Clover, a surgeon, developed an interest in anaesthesia, and become one of the most highly skilled and renowned experts in its delivery – particularly chloroform - during his lifetime.

According to historical records, the first major surgery in a human patient involving an anaesthetic occurred in 1846. Prior to the routine use of anaesthesia, surgery was brutal. For example, Ball documents the surgical treatment of men with bladder stones. 

Bladder stones I removed from a dog via cystotomy, performed under a full general anaesthetic.

Having removed these from animal patients – all under full general anaesthetic, and all treated with post-operative analgesics – it is hard to contemplate doing so on a conscious being. As I read this book, I could not help but reflect on the history of veterinary medicine, and be grateful that I work at a time when anaesthesia and analgesia are utilised routinely (and are of course still being refined).

Clover, a breathtakingly conscientious doctor and scientist, described by an equally breathtakingly conscientious Ball, kept detailed records of his anaesthetics. He was known for his gentle manner, reassuring patients (fear may have increased the risk of anaesthetic complications), as well as his commitment to careful patient monitoring. As someone who had trained as a surgeon, Clover was able to cultivate close working relationships with surgeons, improving outcomes for patients. When anaesthetic complications occurred, he would trouble-shoot these, and he invented and refined various devices for administering anaesthetics safely to patients.

The book will appeal to anyone interested in the history of medicine, anaesthesia, analgesia and surgery, and animal experimentation – an unregulated practice at the time.

The Chloroformist is meticulously researched and beautifully constructed.

The brief, final chapter is a surprising masterstroke. I found myself crying on the bus as I turned the last page. Someone please turn this into a television series!

Reading this book has left me with a desire to take a tour of the Geoffrey Kaye Museum of Anaesthetic History when it reopens. What an extraordinary resource.

The Chloroformist, by Christine Ball, is available from Melbourne University Press, RRP $34.99.  

Mental wellbeing tips from Dr Natasha Wilks

 

Dr Natasha Wilks, a veterinarian and career coach, in surgery.

It seems everywhere you turn, everyone is burned out. The world wasn’t prepared for a global pandemic, nor its acute, chronic and acute-on-chronic impacts.

We know that the veterinary sector, like many others, has been hit with an increased case load in the face of a major workforce shortage. In some ways, it is a blessing. Tourism, hospitality, the arts and many other sectors have been decimated. Teachers, healthcare providers and those caring for others have had to deal with unprecedented and frequent change. We know, because many people in these sectors are our clients. Many of us are living in lockdown (I don’t think I’ve written a post without using the L word for some time now).

“While hugely rewarding, the veterinary profession also entails numerous challenges to mental health that necessitate the need for proactive management. Currently, the increase in workload is exceeding capacity all day, every day.  Vets are exhausted and overwhelmed.  It is like running an ultra-marathon.  There is currently a huge demand for vets and nursing staff, and with everyone in the practice being so busy, there can be breakdowns in team dynamics,” said Dr Wilks.

Dr Wilks is supporting the partnership between leading Animal Health company Zoetis and Beyond Blue, which is in its sixth year, with an on-demand webinar, Wellbeing for Vet Practices, with practical strategies for maintaining mental wellbeing in practice for vets and clinic staff. 

Zoetis is supporting mental health challenges in our sector by donating to Beyond Blue. Over the past five years, Zoetis has helped raise $500,000 by donating $5 from products sold during the campaign period (July to October 2021). They aim to raise another $100.000 by the end of 2021.

According to Lance Williams, Zoetis Senior Vice President and Cluster Lead, Australia and New Zealand, all funds raised will go towards the Beyond Blue Support Service.

 

“To date, Zoetis’ donations across veterinary and rural farming initiatives have allowed over 8,000 people, including vets, to get the help they need through the Beyond Blue Support Service and we are hoping to help more people this year,” he said.

 

This support is vital. You may be aware of reports of support services receiving record calls. According to Beyond Blue CEO Georgie Harman, the Beyond Blue Support Service continues to experience increased demand since the beginning of the COVID-19 pandemic.

 

What can we do about mental health? Dr Wilks offers five tips.

 

·       Start with you - Everyone is different, so it’s important to understand what is challenging you and why. Where possible, try to identify issues or instances that you find stressful and question what core values of yours they are at odds with.

·       Understand what works for you - There are definitely some basics that everyone should work on to help with their mental health, the key five - physical activity, healthy nutrition, sleep, taking breaks and holidays.

·       Change your perspective - As vets, we go through academia seeing mistakes as failures that affect our grades. In the real world, we need to live with the unexpected, so we have to be realistic and kind with ourselves to grow from adversity.

·       Find empowerment - Clinical Leaders and Practice Managers should provide a clear process for dealing with customers and guidance on when to escalate problems. Letting team members know that they have your support and what they can say in tough situations will give them the confidence to engage and disengage as needed. Part of dealing with difficult conversations is also understanding that customers are going through some of the same challenges we are.

·       Speak out and get help – Reach out to organisations that specialise in supporting mental health. Beyond Blue has developed a free six-week program, NewAccess for Small Business, that offers support by trained mental health coaches who have a background in small business. For more information, visit www.beyondblue.org.au/newaccess-SBO

In addition to the NewAccess program, the Beyond Blue Support Service offers free and immediate counselling, advice and referrals via phone, webchat or email. Beyond Blue’s online resources can help people take steps towards recovery and feel less alone. Beyond Blue’s online forums tap into a peer network that gives people connection and support from others who have been through similar experiences. The forums are safe and welcoming, monitored by a specially trained team.

For more information about depression and anxiety, visit www.beyondblue.org.au. To talk to a mental health professional for free, contact the 24/7 Beyond Blue Support Service on 1300 22 46 36.

Free web chat is also available from 3pm until midnight at beyondblue.org.au/getsupport and you can join the forums for free and download the safety planning BeyondNow app from the website.

For more information for veterinary professionals on how to support Zoetis to raise funds to encourage mental health through its partnership with Beyond Blue, visit zoetis.com.au

Veterinary bibliotherapy: All My Patients Are Under the Bed

 

"All My Patients Are Under the Bed" by Dr Louis J. Camuti, Marilyn Frankel and Haskel Frankel.

I’ve been delving into veterinary history for a couple of projects, and stumbled upon the veterinary biography of one Dr Louis J Camuti, written with support from his clients and friends Marilyn and Haskel Frankel. The book, AllMy Patients Are Under the Bed: Memoirs of a Cat Doctor provides a fascinating insight into veterinary practice in the 20^th century.

Dr Camuti was born in 1893, and worked until his death – likely due to a fatal arrythmia when driving – in 1981. He was aged 87 and had been in practice for over 60 years.

The book is intended for a non-veterinary audience, focused mostly on anecdotes about quirky cat owners and their cats. But it contains some fascinating insights into veterinary practice in a different era.

Dr Camuti graduated from New York University in 1920. He lived through the great influenza pandemic in 1918, contracting the virus in 1919 when he was a second lieutenant in the New York Cavalry. When the flu struck his camp, over 100 men died. He made it home – with a fever – and married, but as a precaution didn’t kiss his new wife.

When the horses were struck by shipping fever, Dr Camuti was given the job of destroying all of the sick horses - one that caused significant distress.

"I told myself over and over again that the animal was sick and could not be saved. Wasn't I really sparing it pain? yes, but it was something I had to remind myself of everyday. I knew that bringing the peace of death to an animal was as much a part of being a veterinarian as helping a dog to give birth to its puppies, but still I suffered. I guess I was still a kid, and like all kids who think of becoming
doctors, the first thought is of life. It is only later on that you have to face death as part of the job" (p51).

We now know that killing animals can be a source of moral stress for veterinarians. And moral stress can indicate there are systemic animal welfare issues that need to be addressed. In Carmuti's case there was no alternative to killing the horses, he was a subordinate given the order. But he did endeavour to change the method of killing to ensure it was as humane as possible in the circumstances. Perhaps these traumatic early experiences drove him to focus on companion animals.

He later discussed a request for euthanasia of a seemingly healthy St Bernard. This didn't occur because Dr Camuti, who purchased a bottle of chloroform from the pharmacy on the way to the housecall, accidentally anaesthetised himself when he opened it in a poorly ventilated bathroom. Both the vet and the dog survived.

Early in his career, Dr Camuti established a few practices, but his penchant for feline patients became known and he performed house calls in New York City. In the latter two decades of his life he set up an exclusively house call practice. He would begin his evening rounds from about 4pm, sometimes until well after midnight, often getting to bed at 4am. His wife Alex would book appointments – before people had mobile phones or email. She also rode alongside him and waited in the car, ready to move it if the parking inspectors or police turnedup. He would attend up to 30 housecalls a week.

Many of Dr Camuti’s clients did not have cars or cat carriers. Getting to the vet was impossible. And Dr Camuti felt that his patients were more relaxed in their homes – though he did spend a lot of time trying to find his patients in their homes (that aspect of house calls remains unchanged).

He would ask clients to have his favourite hand-soap ready (Cashmere Bouquet), and boil syringes (they were glass then) on the stove tops of his clients. He practiced when there were no analgesics registered for use in companion animals, when Nembutal (pentobarbital) was used as a sedative, and when blood tests weren’t routinely performed. If a patient needed surgery, a spey for example, he would often perform this in the owner’s home, on the kitchen table or similar. Veterinary practice is very different now.

After he survived a cardiac arrest, Dr Camuti couldn’t climb the stairs to reach patients in apartments above the first floor. So he took to examining many cats in the hallways of huge apartment buildings in which they lived (I would have been terrified of a patient escaping). On the day he died, he was still seeing patients.

The book makes much of the “quirky” relationships people had with pets. It was written before anthrozoology was established as a field of scholarship, well before James Serpell’s book In the Company of Animals put the human-animal bond on the academic map.

When I read about practice, at a time when there was no pain relief for veterinary patients, when there was little awareness about animal welfare, when humane euthanasia could not be guaranteed, it reminds me how far our profession has come.

That is not a criticism of Dr Camuti. He was the first feline-only veterinarian in the USA. Despite limitations in practice, Dr Camuti was deeply concerned about animal welfare, expressing his views about declawing: 

"People who have cats declawed usually do so for one of two reasons: to prevent being scratched by an aggressive cat or to preserve their furniture. Such people are obviously thinking only of themselves, not of the pets they are supposed to love. For their own selfish reasons they put their cats through a surgical procedure which is severe, both physically and emotionally. Very often a cat is declawed without any attempt on the part of the owner to train the animal first to use a scratching post. The cat never had a chance. In fact, I've known of cases where a prospective owner demands a cat to be declawed before he'll adopt it. I certainly would never give a cat to such a person because the request itself is an indication that the household is not suitable to a cat". p91. 

And he goes on. This passage reminds me of important positionstatements on declawing in cats, published more recently by the American Association of Feline Practitioners and the International Society for Feline Medicine.

He was also against ear cropping and tail docking in dogs, and raised concerns about the neglect of long-haired cats, the impact of inbreeding, failure of many people to recognise (and control) their cat's reproductive potential, and the hoarding of animals. He treated a range of exotic pets, back at a time when people could acquire a primate on a whim without any sort of license, permit or clue as to how to meet the animal's welfare needs.

Veterinary biographies like these are such important historic records, often for the minor, seemingly routine details they capture about past veterinarian’s daily routines and habits. This biography is worth a read. Especially if you do appreciate cats. 

On another note, if you are tempted to write your own veterinary (or non-veterinary) biography, the Vet Cookbook is hosting a writing workshop on narrative non-fiction with award winning author Brendan James Murray. Check it out here.