Compassion Fatigue and Veterinary Suicide Part 2: The James Herriot Effect

What exactly is meant by the James Herriot Effect?  The explanation is a curiosity or infatuation with veterinary medicine for millions of people throughout the world that, through James Herriot’s vivid descriptions of the Yorkshire countryside and his accounts of the animals, their owners, and the people of the community which he served, instilled a picturesque lifestyle with bucolic settings that was rewarding and profitable.  This image stayed with many people who read the Herriot books or watched the television series.  They saw themselves living the lifestyle depicted by Herriot and that meant pursuing a veterinary career. 

The books were written by a Scottish country vet in Yorkshire, England by the name of James Alfred ‘Alf’ Wight under the pen name of James Herriot, a real-life Bristol City soccer goalkeeper.

Wight realized by age 12 that he wanted to turn his passion for animals into a career of treating sick animals. Passion for animals is considered one of the main criteria of pursuing the veterinary profession which has not changed in over 80 years when Wight started in the profession, but veterinary medicine is not just helping cuddly, furry animals.  Even Wight knew it was also about interacting with the owners, being a respected part of the community and helping advance the science of veterinary medicine.  Although the criteria for wanting to enter the field has not changed, times and the profession have evolved.  Veterinarians must always remind themselves why they entered the profession and must always remember that ‘animals do not care what a veterinarian knows, as long as they know the veterinarian cares.’ 

Veterinary medicine has advanced from the days of the Herriot books where veterinarians traveled farm to farm ‘putting out fires’ using simple oral medications, manual palpitations, and late-night parturitions (birthing).  They sustained numerous near misses and strained muscles. They worked in non-sterile environments, and payments were received through food bartering and small monetary exchanges…which did not sustain a practice.  The vets of years ago were part of the community, being praised and respected by the public for helping through tough times 24/7.   By addressing milk fever, prolapsed uteruses, and breached births right in the stalls, it helped the farmers continue their farming duties while their livestock was being treated.  Family pet emergencies were just starting to emerge as a new practice as they were now viewed as part of the family and not considered chattel by all owners.  The clients started to bring their pets to an office as opposed to the veterinarian traveling to the clients’ home. 

Today’s veterinarians seldom travel the countryside as described in the Herriot books. Farmers are more skilled and equipped to handle their emergencies.  Instead, today’s veterinary services are more focused on smaller animals and provide these services inside a small building with several exam rooms where the staff may attend to twenty clients or more in two hours or less with more in the waiting room.  It is a much colder approach than in years past where the animal was treated in their own environment.  It is more stressful for everyone.  Instead of putting out fires, veterinarians now promote preventative measures, vaccinations, more specialized treatments, and there are better diagnostics available.  A wider choice of pharmaceuticals to include injectables is available and the environment is more sterile.  More education is provided to the client on home treatments and first aid.  Payments are made with cash, check and credit card.  There is little to no bartering for services. 

Unless private practice veterinarians have taken courses to understand business ownership and operations to includes accounting, taxes, regulations, human resources, mentoring, and employee relations…the pressure on the owners to not only provide the best care to the patients but keep their business profitable is highly stressful.  Their work-life balance takes its toll mentally, physically, and financially since it requires working extremely long hours to pay off expensive loans, satisfy their business debts, pay their employee salaries, providing employee benefits all while ensuring they keep themselves and their staff current on new diseases, treatments, diagnostics and supporting staff who want to further their own education.  Though practices have front end staff to assist with initial client contact, answering phones, scheduling appointments, and keeping up with the paperwork and payments, they still definitely struggle to keep the practice moving smoothly.

Often, veterinarians struggle to find a balance that works for them.  Their quest to be the best combined with the daily stressor of business ownership cause some to become short with staff.  The result is an unhappy staff who finds their superiors unapproachable, more support staff turnover of vet techs, vet nurses and administration, and more worry for the veterinarian. 

Despite the advancements, many smaller practices have been purchased by corporations and are now run more on a business model than a small private country vet practice which was made famous by the James Herriot books. The result is more practice management oversight, more accountability, far less time with the animal, far less personal touch with the owner, and more paperwork while the veterinarians focus on better preventative measures and less on heroic measures. Heroic measures are often performed by emergency veterinary hospitals and clinics which are fully equipped to provide life saving measures around the clock.

Today’s society is demanding.  They expect veterinarians and staff to have all of the answers, to be open 24/7, to have more access to fancy expensive diagnostics, pharmaceuticals and treatment, they want to know why the services are so costly as well as why their pet may not survive.  Clients balk at paying for the services with some responding with a curt “a bullet would have been faster and cheaper.” It is comments like this and the ungrateful attitudes that prey on a staff that gives it their all within the parameters they are allowed by law.  Veterinarians are the only profession that can legally take a life and that in itself is a huge weight on their shoulders. The hours are still long, the demands keep coming, the gratitude and praise are less each year and to top it off, corporations expect more from the staff regarding community events. 

Veterinarians are highly intelligent, highly educated and often highly driven to succeed.  Some people even say veterinarians are ‘over-achievers.’ As fantastic as these characteristics are for successful individuals, they can also be a curse leading to depression and suicide. 

Even Wight suffered from bouts of depression. He never thought he was good enough in his parent’s eyes. For a period of time, he only had sixty pounds to his name and could never afford to send his children to private school as his parents did for him. The depression at one time led to him receiving electroconvulsive therapy. He turned to writing about the clients, the practice and the community as a way to deal with his depression. But depression was not discussed. It was a stigma then and still exists today, though more resources are offered to anyone feeling they need help.  No one is immune.

When the once perceived bucolic lifestyle of the Yorkshire countryside slips out of reach, when the debts seem unescapable, when a procedure does not go as expected, when clients that once respected them yell, scream and post disrespectful comments on the practice’s website, they will ask themselves over and over what went wrong, and it will eat at their soul.