2020 Ends In Hospital

I am going into hospital later today.

And I am aching to get there, straining towards the moment I close the door to my hospital room on a world I am the wrong shape for right now.

How did I get here this time?

Fourteen days ago I had a regular appointment with my psychiatrist. Just a Bipolar 1 Disorder monthly maintenance appointment. I was completely asymptomatic.

Thirteen days ago I left for our beach holiday and forgot to pack my swim wear. Subtle. I mean that could happen to anyone. Right? But by the following morning I was symptomatic alright. My short term memory and concentration were dissolving like sugar cubes in boiling water.

A buzzing pressure behind my eyes radiated up my forehead. I knew from bitter experience, if I did nothing, soon that buzzing could make me second guess what was real or not.

That was symptomatic enough to page my psychiatrist on a Saturday morning. It’s only the second time I’ve paged him out of hours in 14 years. He called back in under three minutes.

Over the last nearly two weeks, the first of which I stayed at the beach, he telephone consulted with me every second day, adjusting medications, a little more of this, a little more often of that. I slipped from my bed gratefully into the ocean, timing the most sedating medications for times when I’d be in bed not the ocean. I seemed a little better, maybe? But then not.

Back home we continued every second day phone consults, adjustments. This is by far not the sickest I have ever been (although psychosis and catatonic depression requiring ECT to reverse, do set a very low bar)

So why would I want to go into hospital, rather than continue treatment at home?

Here’s why:

The surface of my brain feels as though it is covered in papercuts and being surrounded by people and noise is like having lemon juice dribbled over the cuts.

Trying to hold in the irritability of being around people and noise (including my close family) is like being intensely nauseous with someone threatening to punish you if you vomit.

One of the parameters I use to assess how close I am to needing to go into hospital is ‘the sandwich test’. Think about the amount of concentration and short term memory it takes to make a sandwich – nothing fancy, just two slices of bread, some butter and one topping. For most healthy, able bodied, able brained adults, this is not a challenging task.

Right now – I can still make a sandwich, but it’s a challenge. I am making a decision, based on past experiences, not to wait with hospitalisation until challenge becomes an impossibility.

As for the seasonal timing – Christmas and New Years celebrations? I am veteran enough in the management of this illness to know it has no knowledge of nor respect for holidays and anniversaries. I could list my tenth and fifteenth wedding anniversaries as times spent in hospital, a longed for trip to Paris cancelled because of recent hospitalisation, and that would be the beginning of a list so long I’ve forgotten most of it. These times are just human constructs. If it swallows them I don’t dwell on them.

Instead I celebrate the unscathed special occasions extra hard, to make up for the times there is nothing.

The final reason for going into hospital now, is because I can access this level of care. I am fortunate to have the option of going into a private psychiatric hospital when I am sick. The standard of hospital care I will receive will be excellent. It will far exceed anything the public psychiatric hospital system has to offer.

I loathe getting sick enough to need hospital support. But perhaps even more than this I loathe the hypocrisy of someone with my privilege not utilising that support because of some misguided stigmatising ideas about what it means to be a patient in a psychiatric hospital.

I am profoundly grateful I can afford care in a good private psychiatric hospital. And part of my own recovery, once I’ve stabilised medically, is to remember there are many people living with this illness, and other severe mental illnesses, who are learning to live with them with far less support and privilege than I have. When my recovery feels hard I focus on this:

If I access the supports I am fortunate to have, I am more likely to be around for long enough to help raise awareness of the inequality between our private and public mental health hospital systems, and work towards our public mental health hospital system actually supporting some of our most vulnerable when they need it most.

If you are new to Thought Food and would like to know a little bit about who I am when I am well, you may like to check out:

Who Am I ?

Radio And Podcast Interviews

Rewards For Reports: Entitled or Deserved?

I had an interesting conversation with one of my children this morning.

They opened with this:

‘Why don’t you give me something to celebrate my report card?’

 They paused briefly before elaborating: ‘It’s just that my friends who also got good marks are all talking about the presents their parents gave them for it, and they ask me what I got and I have to tell them I just got a pat on the back and a “well done”.’

Where to begin? Maybe with a little context:

For their entire school careers (so far) I have placed no pressure on my children to achieve academically and almost no importance on the marks they get. Providing they are not falling so far behind that they need additional support, and they are doing their best – I am not invested in the outcome. The only two report parameters I care about are their effort and their behaviour.

So far neither of my children have needed additional learning support. This is something I am grateful for, don’t take for granted, and I definitely don’t take any credit for.

I do my best to make sure they get enough sleep and have a decent breakfast before school. I pay for their uniforms, books, excursions, and other school related expenses. I try to give them an emotionally healthy home to return to after each day at school. And while their academic achievements may be built on this foundation, they are very much their own.

The child who began this conversation with me this morning happens to consistently get very high marks across their report card. None of these marks, or the awards received because of them, have ever been incentivised by my husband or I.

Of course, we are proud of our children when they do well, and we tell them, but we are not about to start rewarding high marks with extravagant material possessions. Here are some of the questions I asked my child to help explain why:

‘Do you feel good about getting a fantastic report card, just for the sake of it?’

‘Do you think the most important thing about you is the marks you get?’

‘For the kids getting the fancy presents for getting good marks – do you think they might feel pressure from their parents to get those marks? ’

‘And what happens if one of those kids has a really ordinary year – for example they get sick, or they have a rough time with their friendships and feel sad, and their marks slip below excellent? How will it make those kids feel if they don’t get the good marks and the presents, because of things that are out of their control?’

‘When those kids grow up and do something really well at work and don’t get presents for it, – because that is not the way the grown up world works – will they feel let down?’

‘And say for example I did give you a fancy big present for getting great marks, would you go to school and tell everyone about it?

I got different answers for each question, but the answer to the last one was (thankfully) a resounding ‘No.’

Whether you choose to reward your kids materially for academic achievement is your decision.

I don’t, because it feels like a slippery slope. It adds pressure. I don’t believe getting top grades at school is a marker for future happiness or success in life. I place more importance on developing my children’s emotional intelligence and mental health than their academic achievements.

I want my children to know that their worth as a person has nothing to do with the marks they get at school.

Living vicariously through your children by either shoving them into the same life path as you followed or wanting them to do better than you did, or (even worse) validating your parenting through your children’s achievements, can all present as pushing them to achieve academically. The problem is these motivations revolve completely around the parents’ needs. They have nothing to do with the child.

But if you want to give your kid a Nintendo switch for their straight A report, please give it with a side of humility and sensitivity. Teach them that doing well at school – while yes it may be the result of their hard work – is not a given for all kids.

Some kids work harder than your kid ever will and will never get top marks. Other kids are not privileged enough to get the basics for good academic achievements (breakfast, a desk to study at). Still others live with a diagnosis whose symptoms make it impossible for them to win any awards.

And none of those kids need to hear yours bragging about their report rewards.

You may also like to check out:

Don’t Try This At Home: Schooling

Mental Health Parenting Truths 101

Talking About Mental Illness With Children

Veterinary Work And Bipolar Disorder: A Podcast Interview

My new little niece

Earlier this year I wrote a blog post Veterinary Work In The Time Of Covid-19: Unspoken Truths which received a lot of attention, especially in the US and resulted in me doing a couple of podcast interviews.

The second one was released recently and dives deeply into my work life before and after the onset of Bipolar 1 Disorder, and the adjustments I had to make for it to be sustainable. It hopefully goes some way towards dissolving the myth that it is impossible to function highly when living with a severe mental illness.

I was interviewed by Dr Kimberley Khodakah and you can find that episode here:

https://anchor.fm/time-to-paws/embed/episodes/Living-a-good-life-despite-everything-el0eqc/a-a3o42u4

The other veterinary podcast episode with Dr Andy Roark https://drandyroark.com/cone-of-shame-episode-30-unspoken-truths-about-covid-19/ came out in May. This one is a bit more veterinary industry oriented than Kimberley’s.

Happy listening!

If you are interested, you can find all of my radio and podcast interviews here:

Radio And Podcast Interviews

Mental Health Parenting Truths 101

Written for Queensland Mental Health Week 2020

At some point you will get it wrong.

It will be well intentioned. It may come from a place of not wanting to replicate your own upbringing or the mistakes you think other parents are making. And it will probably be informed by your experiences and biases.

I’ve always known this…in theory.

But the other day my fourteen-year-old daughter courteously yet clearly served my imperfections in this area up to me. This was no teenage tantrum. It wasn’t even an argument. It was simply a conversation in which I was presented with unpalatable information about myself, and then had to choose what I did with it.

It started simply:

‘Mum, can I please get TikTok? Remember I asked you about it a month ago, and you said you’d think about it.?’

‘Mmhm.’

For context – she gained Snapchat and Instagram over the last few months, to my knowledge has not abused any of her privileges, and right now appears to be in good mental health.

So, we talk about how she’d manage seeing distressing content if it popped up. I probe her with her worst-case scenario.

‘What about animal cruelty?’ I say and follow it with a graphic example.

‘I’d talk to someone about it.’ She answers calmly.

‘Who would you talk to?’

She doesn’t hesitate: ‘Well definitely not you! Probably Dad.’

‘Why not me?’ I ask,

‘You and your mental health stuff – you’d blow it all out of proportion, take me to a psychiatrist, have me medicated and force me into years of therapy.’

I did ask.

And while she is wrong about the imagined consequences of telling me she saw some distressing social media content, she is right about something else.

I am hypersensitised, filled with knowledge of the very worst mental illness has to offer. And not just my own. Every time I go into hospital, I share that space with others who are going through their own worsts.

When I see young inpatients often only four or five years older than my eldest child with bandaged wrists or cutting scars, bolts of fear shoot through me. Fear that one day my children could hurt like that.

Every time after my Bipolar 1 Disorder has put me through hell I am frozen by the threat that I will have given this illness to my children. I know that (beyond not introducing significant trauma to their lives and warning them of the dangers of drugs that can trigger the genetic component of this illness) there is nothing I can do to outparent it. But I still try.

After I got sick I was determined my children would grow up in a family that was open about mental illness. There would be no shame and no stigma. They would know from a young age where I was going when I went into hospital and why.

The knowledge that sometimes mental illness sprouts in childhood and adolescence is heavy and made heavier by the fact that sometimes it is fertilised (even in the absence of major trauma) by parents unwittingly invalidating their children’s’ feelings or experiences.

I never wanted to be that parent. And I am not. But I may have made the opposite mistake.

 By unintentionally force feeding my children my concerns around mental health, could it cause them to turn away from the very tools that could help them should they run into a mental health crisis?

Mental health is stitched into the fabric of our family’s conversations partly due to my lived experience, but also because of what I do. My children have never known a time when I haven’t been a vocal mental health advocate. I write about it. I talk about it frequently – sometimes quite publicly.  

And if I dig deep into my motivation for wanting to change the way mental illness is perceived and treated, my children are at the core of it. That motivation is as simple as it is unrealistic:

I want to fix our mental health system so that it can help rather than harm my children should they ever experience mental illness.

I am loathe to admit it but yes sometimes all my motivation, knowledge and focus, can morph into hypervigilance, ready to pounce on the very whisper of something not being right with my children’s thought patterns.  And in my futile efforts to protect them from my worst nightmares, at times I probably veer dangerously close to pathologizing their emotions, which can be as damaging as not acknowledging them at all.  

I do this reflexively even as I know that parenting out of the fear of what could happen is even worse than living your own life ruled by fear.

And yet, deep down I know that if either of my children get sick it won’t be my fault or TikTok’s. If that happens, hopefully their father’s less informed love will be the perfect counterweight to remind me that while my knowledge might be useful in some situations, at other times applying the full weight of it can be like attempting to kill a fly with a sledgehammer. Ineffective and potentially damaging.

Post scripts:

It was a yes to TikTok.

While I am deeply grateful that right now neither of my children require psychiatric care, my advocacy work will continue, because it is grim out there. I caught up with a friend recently whose child does need a child psychiatrist urgently. The waiting time to get an appointment with a private child psychiatrist is currently twelve months.

Or there’s the public hospital Emergency Room if symptoms become life threatening while you wait…

Published with full permission from the fourteen year old who also helpfully pointed out I’d misspelt TikTok in the previous draft.

You may also like to check out:

Talking About Mental Illness With Children

As Mothers Of Sons

As Mothers Of Daughters

Is YouTube Rotting Our Brains?

On Uncertainty

Written for QLD Mental Health Week 2020

How does uncertainty make you feel?

I ask because uncertainty is having a moment right now. It galloped in with the Covid-19 pandemic, and the further we get into it the more it seems to be digging itself into our awareness.

I used to be deeply uncomfortable with the pebble of uncertainty in the shoe of my life. I liked to know what was ahead. It gave me a (false) sense of control and the misguided belief that just because I couldn’t see uncertainty in my life, it didn’t exist. I deluded myself for decades that when there were no clouds on the horizon, the course of my life was somehow more certain than if I could see trouble ahead.

Then all the certainty in my life was put through a paper shredder within five days of my first baby’s birth.

I got my new baby experience with a side of florid postnatal psychosis severe enough to warrant admission to the locked Special Care Unit of a psychiatric hospital. My sense of certainty and control over my life went down the toilet.

After I’d recovered from this psychotic episode I felt entitled to some certainty. I wanted to know this nightmare was over. And I wanted a guarantee it would never happen again.

So when my psychiatrist mentioned ‘a possible underlying Bipolar Disorder’ and that it would ‘take three to five years to know for sure’, the inside of my head threw a combination of a tantrum and a pity party.

When I got sick again after three years, after seven years, and after nine years and my diagnosis of Bipolar 1 Disorder was confirmed, I still felt entitled. Entitled because: ‘hadn’t I suffered enough yet?’ Entitled to not have to tiptoe through my life with everything clenched, waiting for the next time this thing pounced.

I have only recently acquired some degree of acceptance of the uncertainty this illness introduced into my life. I didn’t enjoy the last two episodes in 2018 and early 2020, but I also didn’t waste energy resisting them. In the same way I no longer spend any of my resources anxiously wondering when it will happen next and how bad it will be, because without wanting to sound nauseatingly Zen, the truth is: It will be what it will be when it will be.

Uncertainty exists in everyone’s life every day. But instead of it floating along in the background, right now it is constantly being rammed down our throats. It’s like having a nasty little gremlin on your shoulder whispering over and over again:

‘You do realise bad things could happen to you at any minute’, when the true risk of something bad happening to you is probably not that different to pre-Covid times.

For our mental health to survive this pandemic we have to learn to live with uncertainty, because the end of it is nowhere in sight. And just like my psychiatrist couldn’t give me any certainty when I first got sick, the smartest scientists in the world aren’t able to accurately answer this question about Covid-19: Will it ever be over, and if so when?

Uncertainty is an uninvited, kicking, snoring bedfellow. So how do we get comfortable with it?

First we tease out what about this situation we can control and what we can’t. For example, we can’t control the flow of information that feeds our uncertainties rushing over us every day, but we can control how much of it we absorb.

And once we’ve done what is in our control to help ourselves, we have to try and unclench from the need to know what is going to happen next. We need to stop trying to know and plan for a future that is like a spiderweb in a storm. Here’s what I mean:

During one of my admissions to hospital I sat staring out of the window of my room feeling as though there was no point in doing the work to rebuild myself because my future was too uncertain, my illness could tear me apart again anytime.

Over a couple of days of intermittent staring I noticed a spider in its web just outside my window. Every night it stormed. Rain, wind, a couple of times hail tore chunks out of the web, at times almost destroying it.

That spider showed me the way out of my tangled thoughts, by not only rebuilding every time after its pristine web was wrecked, but doing so in the face of the risk of the same thing happening again, whether the next day or in a year.

The sword of an uncertain future has hung over every single one of us since the day we were born. Nothing has changed there. It is just up to us whether we choose to battle with uncertainty and lose, or whether we accept that being alive will always mean living with uncertainty, pandemic or no pandemic.

You may also like to check out:

Lessons For A Control Freak

The Other Curve Being Flattened

When Covid-19 And Bipolar Recovery Collide With Unexpected Results

Tokenism In Mental Health Awareness

Tokenism In Mental Health Awareness

Written for QLD Mental Health Week 2020

Saturday 10th October is World Mental Health Day and I feel a little conflicted about highlighting it. There are a lot of positives to having dedicated days or weeks to draw our attention to mental health. But I also believe we need to approach these awareness days with a little caution. It’s too easy to post or repost something related to the topic, tick the box of doing good and move on with our days.

Ironically these tokenistic efforts are becoming more common as awareness around mental ill health grows, especially when we don’t have to move beyond the comfort of our keyboards to feel as though we are achieving change. Of course it is good that there is more awareness, tolerance and marginally less stigma surrounding mental ill health than there was fifty or even twenty years ago. But we have to make sure we don’t replace the old insensitivities with their more modern counterparts.

I have written about my dislike of RUOK day before RUOK Day: Full Disclosure and this year I heard another perspective that reenforced my reasons for disliking this day. When I am well, my psychiatrist appointments usually consist of me requesting scripts for any medications I am running low on, a brief check in with how I’m going and then we chat about the state of the world, my advocacy work, his psychiatry work. This year one of my appointments happened to fall around RUOK day and we talked about the pros and cons of this day. I expressed my opinion and my psychiatrist referenced one of his patients coming in on RUOK day in distress because they were bombarded by people they knew asking them if they were ok. People they didn’t hear from for the rest of the year. People who were probably well intentioned, but using them as the token mentally ill person in their lives, to tick the box of having asked: RUOK?

Awareness around mental ill health should not be confined to one day or one week of the year. Episodes of mental illness flare unpredictably and feel as though they will never end. This feeling is fed by the fact that no one can tell you when it will end. There are good days and worse days. There are days when the risk of it turning into a terminal illness skyrockets. Someone may have a spectacularly good day on RUOK day, a calm and uneventful mental health week, but be suicidal sometime in April or on Christmas day, when it is all too easy to be under the impression that we showed our support for those among us living with mental illness back in mental health week, and Christmas day is busy and by April we are into Caesarean awareness month and IBS awareness month.

 So what can we do to be meaningfully aware of the impact mental ill health has on those of us who live with it, and what can we do to support them for more than a day or a week of the year?

Everyone who lives with mental illness is different and everyone’s experience is different even if they live with the same diagnosis. So, I don’t speak for everyone.

For me – I don’t need to be asked how I am. I have enough insight into my Bipolar 1 Disorder to know when I need to seek help. I am fortunate to have good support systems in place, so I don’t tend to feel lonely or isolated.

For me it is all about the language people use. Hearing or seeing stigmatising language either in the media, on social media, or spoken, punches me in the gut. When I am confronted with words like nuts, crazy, lunatic, psycho, mental institution, – the list is long – it belittles me. It strips away the facts of my life, my healthy functional relationships, my personality, my university degrees, my profession, my interests, my sense of humour and it reduces me to a hellish caricature of who the misinformed masses believe someone mentally ill is.

So, think about how you write and speak around me. If you hear or see someone else perpetuating stigmatising language around mental illness, call it out. Do so politely, but raise awareness of it. I do it as often as I can, but I also get tired of being told to shut up, get over it, or that I am overreacting.

Perhaps the most helpful thing you can do for someone in your life who lives with mental ill health is not to automatically ask them how they are, but to ask them what you can do to make them feel valued and supported all year round. They may answer: ‘Ask me how I am’ in which case you are doing it meaningfully and mindfully, not because it is a certain day of the year.

All that said, Happy World Mental Health Day everyone. In honour of it also being Queensland Mental Health Week from 10th-18th Oct I am aiming to drop a few additional posts in Thought Food this week.

Look after yourselves and each other!

You may also like to check out:

RUOK Day: Full Disclosure

Mind Your Language Katy Perry

Don’t Call Conspiracy Theorists Crazy

Reintegration: Be Careful Out There

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free image from Canva

This past week has not been pretty.

Aside from a call to the poisons information centre, three visits to the dentist, one to a paediatric physiotherapist, one to my psychologist, recalcitrance and poor behaviour from me and my children, it also included a near fatal accident.

I nearly killed a young man at the beginning of this week.

And I did not want to write about it. The shame and incomprehension of this close call burn me in waves. But this incident bore a loud message, which I did want to write about.

On the first day back of school after months of lock down, I hadn’t planned to drive my children to their schools. We are walking distance from both. But time does strange things on school mornings. It slithers away at warped speed and suddenly, the window to comfortably walk to school on time slams shut. So, I drove them, on the proviso that this was going to be an exception.

Driving conditions during isolation have been muted. The amount of traffic diminished to that of a tiny country town in the middle of the night. School traffic ceased. Work commuter numbers slashed.

On that first day back at school, cars converged on the local streets and clustered around the schools like flies on a carcass. Drivers were filled with more emotion than a regular school drop off warrants. Joy. Fear. Dread.

My feelings? Happiness over the end to at home learning mixed with mild irritation at not having managed to get both kids out the door on foot on time. And once I’d dropped them, an urgent need to get back home and away from the chaotic traffic.

Impatience bloomed. I decided to make a right turn from a side street onto the main road across two lanes of traffic, to get me home more quickly than a series of left turns would have. The car in front of me went during a break in traffic in the first lane and was let in by a driver in the second lane.

I could see the same driver in the second lane holding a space for me to cross. So, I went.

I don’t remember if I glanced to my right to check the first lane was still clear. But the moment I slammed on my brakes and a young man on a red motorcycle had to swerve to avoid me, is burnt into the pit of my stomach.

I am a careful driver. In over 25 years on the road I have never had a serious accident. I have never driven drunk or while under the influence of prescription medication or non prescription drugs. I don’t text and drive. I was not sleep deprived or sick that morning.

So why this serious error in judgement?

Distraction, yes.

But there was more to it. While we have been in isolation, our worlds shrunk to our homes and occasional short car trips on empty roads, it has almost been like a lengthy period of hospitalisation.

I know from all the times I have discharged from hospital after weeks inside that just because I am out of hospital, my life doesn’t just snap back into place. I have to put the pieces of it carefully back together.

Re-entry into the world after isolation is the same. Our reflexes are slower. We are more vulnerable to chaos.

I am not nostalgic for isolation time. I don’t want to regress into the woolliness of those early iso days, drifting down deserted streets, staring perplexed at empty toilet paper shelves surrounded by people with harried expressions behaving as though the world was ending.

I will be very happy to never again step into the uncomfortable ill-fitting role of someone attempting to assist with my children’s at home learning.

But the jolt of re-entry has been a wake up call. A wake up call that I need to take the time to consciously reintegrate after this most bizarre episode of ‘home hospitalisation’.  My brain and body need some adjustment time. My children’s brains and bodies need some adjustment time.

Perhaps the most poignant aspect of my near miss accident happened immediately afterwards. The young man on the motorbike pulled over and came up to my car. I wound down the window ready for, and feeling deserving of, his abuse and anger.

He didn’t abuse me or even swear.

He asked: ‘Did you not see me, because that was really close?’

All I could say was: ‘No, and I am so, so sorry. I am so sorry.’

I will never forget the young man’s face, his emotional intelligence and compassion in an adrenalin soaked moment. And I will never forget his parting words:

‘Be careful out there.’

We need to collectively ‘be careful out there’ as we re-integrate after isolation or we will misjudge situations and possibly make fatal errors.

Postscript:

The other lesson learnt the hard way by another member of the family this week (and one I doubt has anything to do with reintegration) was not to open a tube of superglue with your teeth.

 

You may also like:

Don’t Try This At Home: Schooling

The Other Curve Being Flattened

My Mental Illness Makes Me A Better Parent

 

World Maternal Mental Health Day: It’s Not All Postnatal Depression

Alex pregnancy and Elsa
End of 2009

My mental illness was born with my first baby.

I never considered my mental health as part of the decision to have a baby, because when I first fell pregnant within a month of trying, I had never experienced mental illness.

The pregnancy was uneventful.

Then I went into a thirty-three hour labour on two hours sleep. This severe sleep deprivation and the swirling hormone levels woke a slumbering monster, a genetic predisposition, which ensured that by the time my baby was one week old, psychosis had wrenched me away from reality. I found myself in the Special Care Unit of a private psychiatric hospital trying to explain my way out of my delusions, while my husband and mother cared for my daughter at home.

Welcome to motherhood.

Continue reading “World Maternal Mental Health Day: It’s Not All Postnatal Depression”

Don’t Try This At Home: Schooling

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I am not home schooling my children at the moment.

That implies a level of competence that far exceeds my attempts to provide a bit of supervision while they do what could pass for some form of schoolwork.

In fact, what I am doing could no more be called ‘home schooling’ than calling what my children’s teacher does when they are at school, ‘veterinary surgery’.

The new educational arrangements have made me ask myself this over the last week:

Are there any professions (apart from teachers) who are being asked to convey how to do their whole job to the general public in a very short time, using only online resources? I can’t think of any.

Yet suddenly teachers are expected to translate their university degree and years of practical experience into a format that parents with no training or experience in education can apply to their unwitting children at home.

And there will be some parents who will anticipate the same results as when their kids are being taught at school by the teacher.

I accepted a long time ago that I have no interest in the intricacies of how my children’s education is delivered. And I am not expecting to suddenly become enthusiastic about it, just because external circumstances have changed.

I do care about my children’s education. But my role and the teacher’s role in providing that education are clearly defined and there is little overlap.

I view these as my roles:

To love my children unconditionally and make sure they know it. To set clear boundaries for them. I am privileged to be able to afford to feed them, clothe them, and buy their educational resources. To do my best to allow them a good night’s sleep in a room free of devices, during the school term. To offer them a decent breakfast and a packed lunch, or at least the ingredients to make them. To offer them support in completing homework or schoolwork set by their teacher.

And to make myself available for communication with their teachers at any time.

I regard teachers with awe for the job they do. I know from friends who are teachers the high levels of empathy, patience, resilience, and emotional intelligence, among many other skills, they draw on to do their work well.

I also respect my children’s teachers enough not to encroach on the territory of their expertise.

When I attend parent teacher interviews, I only tend to ask four questions:

‘Does my child seem mostly happy and engaged? Is their behaviour appropriate? Are there any areas they are falling behind in? And, Is there anything else you would like me to know?’

Do you know what I never ask about?

The curriculum. Because I trust the teacher to know it inside out.

I feel for the parents who ask in depth questions related to the curriculum during parent/teacher information sessions, because right now they may struggle with the concept that they can’t single handedly provide their child’s school education at home, no matter how much they research the curriculum.

From an epidemiology point of view, at the time of writing, I believe the best place for my children is at home. But at the same time, my care factor for the quality of my children’s academic education ranks way below how much I care for not only my mental health, but the collective mental health of my family.

I acknowledge that while the two cares might not be mutually exclusive for many households, in mine – they don’t always sit well together. I may be biased by my own life experience, but that experience tells me this:

If my children fall behind in the curriculum, I am confident they will eventually catch back up to where they each normally sit. And they won’t be alone in that experience.

Yet if I tried to deliver the full curriculum to my children at home, I would transfuse the stress of my unsuccessful attempts into them. Over time, their mental health would suffer. Mine might suffer to the point of me having to be hospitalised again.

It would make as much sense as my children’s teachers attempting to perform surgery on their dog with only my online instructions to guide them through.

So, the alternative of my children having to work harder to catch up when this is over feels fairly benign. And this doesn’t mean they are doing nothing now. It just means I don’t hold myself to the unattainable standard of replicating my children’s in school educational experience at home.

And I could be way off here, but I imagine whenever I eventually return my children to their formal school based education – their teachers may prefer those children with their mental health relatively intact and their academic knowledge lagging, rather than the other way around.

(Additional note: The veterinary surgery analogies were drawn from my experience of working as a small animal vet.)

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Veterinary Work In The Time Of Covid-19: Unspoken Truths

man wearing face mask using his phone in the dark
Photo by Engin Akyurt on Pexels.com

Long before Covid-19 arrived, vets and vet nurses were quiet, hard workers who didn’t complain about less than ideal working conditions. And, possibly unbeknownst to most of the pet owning public, for many veterinary staff, challenging working conditions were the norm.

Since this crisis hit, these essential workers are not getting much opportunity or airtime to communicate the difficulties they currently face at work.

The advent of the Covid-19 pandemic has put the challenges of veterinary work on steroids.

I know a bit about what it takes to work in this industry.

I fell in love with veterinary work at fifteen, when I started volunteering at a local vet clinic. I wiped down tables, cleaned cages, and held animals. Then I started work as a casual junior vet nurse on Saturday mornings.

I committed the second half of my teenage years to the tunnel visioned hard work it took to get into veterinary science at university.

I worked as a small animal vet for twenty years, in many different practices in Australia and the UK. Working conditions ranged from excellent to atrocious.

Thanks to my experiences, I know this:

Vets don’t talk about their work stresses outside their own tightly knit vet circles. Some of us don’t even confide our struggles to our colleagues. We talk about our cases in detail for hours, but many of us still cringe at opening up about the state of our mental health.

Our clients get our kindness, our compassion our sympathy our skills our knowledge, our communication skills. But they never see our vulnerability. They don’t understand how high our risk of burn out (borne of caring too much and being overworked and undervalued) is.

They don’t see that when we walk through the door of the clinic our rostered working hours become irrelevant because we give ourselves over completely to everyone else who walks through that door after us.

Our clients don’t feel our pain when we lose yet another amazing member of our profession to its sky-high suicide rates.

I am currently taking a break from veterinary work while I concentrate on writing and mental health advocacy work. But I have many vet friends who are out there working and hurting.

I have spent the last couple of weeks collecting descriptions of work life from some of my (currently working) veterinary friends and contacts, because I believe that for the veterinary profession to survive this pandemic with its collective mental health relatively intact, the pet owning public needs to know about the difficulties its workers face at this time.

Here are some of the (summarised, paraphrased, and quoted) insights these vets generously shared with me:

On Covid-19 Regulations:

Some aspects of veterinary work make social distancing between staff impossible. For example, it is not feasible for a nurse giving a wriggly, excited puppy a cuddle and a vet looking in its ears with an otoscope, to be 1.5 metres apart.

Some of the protocols necessary to minimise the risk of Covid-19 transmission, such as contactless consultations (where the owner waits outside the clinic in their car, the pet is transported inside by a nurse in PPE, the vet examines the pet and then phones the owner to discuss further diagnostics or treatment), severely hamper efficiency and slow everything down.

Vets are used to working as efficiently as possible:

‘Normally I would type the history while the owner is in the consult and do an exam in between taking notes. Now I can only do one of these things at a time.’

Contactless consultations also limit a vet’s ability to read their client’s body language during the consultation, which can interfere with effective communication between vet and client.

Pets can be more anxious when separated from their owners. This may mean it takes longer to perform a physical exam, or it may be impossible to do as thoroughly as the vet would like.

Covid-19 level cleaning recommended between consults is more labour intensive and takes longer than usual.

On Finances

Downsizing or closure of a practice due to further restrictions or a Covid-19 infection will have negative effects on the practice’s financial stability very quickly.

‘The nature of small to medium sized veterinary practices even in normal times is to run with incredible efficiency, but still on very low margins. They cannot sustain even mild to moderate downturns. They will not survive and jobs will be lost long before the drop of 30% revenue occurs required to be eligible for the Job Keeper Payment.’

Locum vets are particularly vulnerable to job loss now. As practices work to minimise the risk of a Covid-19 infection in their permanent staff, many locum vets are having their shifts cancelled, and are facing the financial difficulties and mental health challenges that come with job loss.

Vets are also more aware than ever of the financial constraints facing many of their clients.

‘It is super sad when you see a client who wants to do everything for their pet, but they have lost their job and can’t afford it. It breaks my heart. I am doing a surgery at a 25% discount tomorrow. The client didn’t ask for it, but I feel so sad for them.’

‘I feel even more conscious of the usual dilemma we have in vet practice of having to mix financial discussions with emotive ones as most people are understandably a lot more stretched financially right now. But veterinary practices are also under a lot more financial stress and if our invoices are not paid, there won’t be a vet for clients to take their animal to.’

And now more than ever vets are at risk of being on the receiving end of their clients’ financial frustrations.

‘I’ve already been abused in the car park once this week and I am preparing myself for a lot more of that to come as the stress is almost palpable in the air.’

On Mental Health

Vets often hold themselves to a very high standard. Under sub optimal working conditions that pressure will increase stress levels further.

‘Veterinary practice is already an emotionally draining vocation with highs and lows every day. Our staff feel responsible for their patients and care for our clients. And it goes against the grain to just drop our standards of care because of what’s going on. So, we are not going to start cutting corners.’

Many clinics have split their staff into two or more teams to reduce the chance of the whole clinic having to close if one staff member contracts Covid-19. This means vets and nurses may be working under short staffed conditions and even longer hours than usual:

‘The phones are ringing constantly. We hang up and pick up the next one. I am answering dozens of phone calls daily as a vet, as well as being my own anaesthetist, recovery nurse, and doing the usual vet things. And right now none of us have regular access to our stress relieving hobbies.’

Splitting staff into teams at work usually also means no contact between teams outside of work.

‘There were genuinely tears after the last ‘normal’ shift as people realised they may not see some of their friends for weeks, months even.

Before Covid-19 brought added work stressors with it, vets were already at a high risk for mental ill health. This knowledge weighs heavily on many of us:

‘I’m concerned that abuse of controlled substances will increase and don’t even want to think about the suicide issue the veterinary industry already faces.’

To Clients

Vets appreciate the many clients who are doing the things that make their work less stressful, such as practicing social distancing, being patient when things take longer than normal, and assessing what might constitute an essential phone call.

For example, now is not the time to phone your vet clinic for a lengthy discussion about which breed of cat you should get.

‘If the public can show extra understanding towards vets and vet nurses that will only be a good thing. We are not the only profession under strain but the pressures we are under are very real. Everything is taking longer so people need to be patient.’

‘We place a lot of blind faith in the honesty of strangers at the moment…I feel angry when I hear of my colleagues having got to the end of a consult only to have a client mention that they just came back from a cruise a week ago.’

‘Thankfully 99% of our clients are understanding and adhering to protocols without complaint, but I don’t think they quite understand how hard everything is for us right now.’

Shortages

‘The shortage of equipment is tricky – no hand sanitiser, limited paper towels and gloves. It makes it hard to follow the guidelines to use hand sanitiser between every patient. Some human medications we use are in short supply, which will be hard to explain to clients when their pet’s medication needs to be stopped suddenly.’

‘We have also been asked to supply a list of things we can donate if needed – such as ventilators, propofol, midazolam, and surgical gowns and gloves.’

What is getting us through?

Now more than ever, humour, teamwork and appreciative clients balance out the challenges of veterinary work.

‘On the positive side of things, I work with a group of amazing humans and the way we all have each other’s backs has definitely shone even more so in recent times.’

‘On the upside we have always been good at the ‘make do and mend’ mentality. Also, we were born for this – we just need to pretend every person is a parvo puppy!’

(Parvovirus is a highly infectious, potentially fatal viral infection, most common in puppies, and requires full isolation nursing.)

Our team are amazing and have chosen to pull together with a plan to fight and minimise risks to client and staff safety, mitigate risk to the business and work toward sustainability.’

‘We have had wonderful support from our clients and community who have commended us for our initiatives during this pandemic to ensure both human and animal welfare,’

To conclude I will reach for words one of my close vet friends passed on to me. Even though upper management of veterinary practices, can be notoriously out of touch with the needs of its veterinary workers, this directive from the upper management of my friend’s practice encapsulates perfectly what I would want all vets working through this pandemic to hold close to each day, and what I would want all veterinary clients to be aware of and respect:

‘Throughout our career, veterinarians have always put our patients first, then our clients, then ourselves. In this pandemic, we must put our safety and the safety of our nurses and support staff first.’

 

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