A preliminary task: count the amount of people around you who have committed suicide in recent years.

Vets are conscientious, detail-oriented, and great at science. Calculations are a normal part of their work. 

Magda Jaszczak takes a moment to consider. One, two, three… Thirteen people, she counts. 

The first was a doctor who employed her in a clinic in northern England sixteen years ago. He was kind enough to give Magda two months to move out of a neighbouring town and organise her life in the new environment. When she moved there for good, he was already dead. Next, there were three female vets. In 2019, they passed away one by one, all within a span of three months. One of them used to be Magda’s mentor. She had just founded a thriving clinic. The second one was an internationally renowned academic teacher. She trained veterinary nurses. A few months ago, another acquaintance of Magda, a 50-year-old vet, passed away, also having committed suicide. In the Swedish town where she currently runs a clinic, a vet killed himself four years ago. Quite recently, at a hospital in a large city next door, it was a young female graduate, an intern. And so on.

Magda: “In this industry, everyone has a colleague who has died in this way, regardless of whether you work in Poland, England or Sweden.”

Natalia Strokowska, a vet working in Warsaw, says that for her, it’s three people. “Last year, it was a friend from university. She suffered from bipolar disorder. Earlier, a colleague who I helped find a job abroad. He was addicted to drugs. Oh, and a veterinary technician. He treated my guinea pig once. He had been stealing drugs, he was addicted to them. Nobody knew.”

Szymon Najdora, the owner of a veterinary clinic in Katowice, knows two people: “Four years ago, it was one of my employees. A great vet who was adored by her clients. A few hours before she had called me to ask about her vacation; she had wanted to extend it to meet a friend. At that time, we were taking care of a dog at the clinic who had had a strange accident. He was left at home with a group of children, and when the parents returned, his hind legs were paralysed. The owners left him with us. They did not want to contribute to the treatment. It was a tough experience for the entire team, but this girl was hit the hardest. She fought hard for that dog. We even got him a trolley so that he could move around. The dog is doing well now, the partner of our late colleague adopted him. 

I went to another funeral last November. She was a young, talented woman who had achieved a lot. Also around 30 years old. That’s why it hurts so much. Among my other colleagues, there have been five suicide attempts in the past few years.”

Paula Dziubińska-Bartylak is the owner of a clinic in Bydgoszcz and specializes in exotic animals, dogs and cats: “In 2020, my close friend committed suicide. A few years earlier, in the first year that I worked in Poznań, it was a female colleague who was on duty on New Year’s Eve. At another clinic, years ago, another female colleague. She tried to do it at the clinic. Our chief, who went out to consult on a horse, came back because she’d forgotten to take her equipment and medication with her. She arrived just in time. The girl was lying on the office floor, and they managed to resuscitate her. If I were to count the suicide attempts among my colleagues and close friends in the industry, I would run out of fingers.”

A few years ago in the UK, vets were asked, “If you couldn’t treat animals, what kind of profession would be an alternative for you?” Many of them filled in accounting. Magda: “Yes, it makes sense. Most of us are perfectionists, proficient in sciences. Maybe if we were dealing with figures and not animals, we wouldn’t lose so many people.”

The murderous training begins at university: veterinary medicine is one of the most difficult and demanding programs. Before the first major exam, students need to learn the anatomical systems of several species: from pigs and cows to horses, sheep, dogs and cats. You need to remember every bone name in both Polish and in Latin. And this is just the beginning. There is also mental conditioning, an aspect where students, especially female ones, learn that they are nobody.  

Natalia Strokowska is originally from Kraków. Seven years ago, she completed her course in veterinary medicine at Warsaw University of Life Sciences (SGGW). For the first three years of the program, she alternately studied, worked, and slept. She hardly had time for private life. She spent half of her time breathing formalin fumes in the dissecting room and the other half looking through a microscope. From the very beginning, lecturers told her she wouldn’t make it. Students took to sedatives. Every now and then, someone ‘disappeared.’ They dropped out of university, took a medical leave of absence, or ended up in a psychiatric hospital. It was whispered about in the university corridors. 

Natalia also ended up consulting a psychiatrist during the third year of her studies. She received a referral for publicly-financed therapy in her hometown Kraków. She could not afford a course of private therapy in Warsaw, so every Friday she would buy a cheap ticket for a TLK train to Kraków, attend a therapy session, gather strength among her relatives and friends, and then on Monday she would return to the capital for classes. Natalia is an attractive, tall blonde woman and over time she started to earn extra money by modeling. She also took part in the Miss SGGW competition. One professor asked her, “My dear, would you prefer to become a vet or walk down the runway?” Another lecturer, infamous for his ‘weakness’ for pretty girls, handed her a note after a class inviting her to his office. A few years later, he got dismissed on a disciplinary basis. There was also another professor who liked to lean against female students under the pretext of peering into the microscope from behind their backs. He flunked Natalia by a quarter-point, forcing her to resit exams in the September session. At the end, he commented, “I hope this time you can demonstrate your abilities.” He currently teaches at another university.

Today, Natalia is completing her PhD thesis and is a lecturer herself. She notes that some of her students are no longer capable of even hiding signs of self-harm. Natalia sees the suffering in their pale, tired, grey faces. She is able to guess their condition by looking at the pulled-down sleeves of their jerseys. And although the current authorities at her university are aware of the importance of the mental health of future vets, the measures taken are just a drop in the ocean of their needs.

Natalia: “The profile of a veterinary surgeon has changed during the last thirty years. Until the 1990s, the profession was dominated by men who treated farm animals. Today, there is a demand for the treatment of pets, and it’s mostly women who want to study veterinary medicine. They often have a strong sense of purpose, they love animals and want to save them. Then, once they’re at university, they bump into old-school lecturers who sometimes openly show their disrespect. There is an unwritten rule of ‘survival of the strongest.’ In my class, after the first two semesters, the drop-out rate was 40%. In the following years, we were joined by the so-called “parachutists,” those who ended up a class down to repeat a year. The record-holder in my class repeated his year three times, he was several years older than us.” 

Magda graduated from Warsaw University of Life Sciences 16 years ago. “After the third year, I had a mental breakdown and took a leave of absence. Mobbing was ubiquitous at the Faculty. Any pretext was good enough for the lecturers to flunk a student at the exam. One of the lecturers derided me for having red hair. I got a diploma with a mere Pass. When I did my specialisation course in England, I graduated with honours.”

In England, Magda became involved in the activities of Vetlife Charity, which runs a helpline for vets and veterinary students. “In England, they see changes similar to those occurring in Poland. There, the 50-year-old vets in checked shirts and dirty gloves are being replaced by the so-called “pony girls,” the daughters of wealthy parents who loved their ponies so much that they decided to study veterinary medicine. Then, when such a “ponygirl” is confronted with reality, she experiences shock. They are often perfectionists, slim, flawless women wearing well-fitting clothes who, unlike their older colleagues, do not take to drink but suffer from anorexia or torture their bodies in gyms. While I was working at the charity, we received about 20 emails a day from male and female vets. They wrote about self-harm, anorexia, depression, suicidal thoughts, and problems with their clients and bosses. Our task was to offer them support, which included referring them to an appropriate therapist.”

Paula: “The word ‘leisure’ was removed from my vocabulary when I was first started studying veterinary medicine. The amount of work you have to put in is shocking: the treadmill never stops, you have to give it 120% all the time. There were times when I would go to sleep in my day clothes which I came home from uni and then I would wear them the entire following day. I didn’t want to waste time changing my clothes, I would rather study. Studying veterinary medicine, I learned to reduce my own needs to zero.’

Szymon: “I don’t have bad memories from my studies in Katowice. But I did see the pressure that the female students faced. Derision from the lecturers and claims that there is no place for women in the profession was a daily occurrence. The women had to work a lot harder than the men to achieve the same results.”

If there existed a survival manual for vets, the first chapter would be about the university and might end with something like this: “So you have survived university and believe that it will get only better from now on, huh? You don’t even realize how wrong you are.” Szymon: “Maybe if someone told us right away in the first year that this job is not really about animals only, then we wouldn’t have to attend so many of our colleagues’ funerals.”  

Survival Manual, Chapter Two: “You will barely make ends meet and you’ll be considered a rip-off merchant.”

It’s 2014 and Natalia’s just started her first job at a clinic near Warsaw. The boss mentally abuses doctors and 17 employees pass through the clinic in three years. Natalia’s earnings: PLN 980 handed over in an envelope, no social security. Natalia models on the side so she can get by. When she receives her doctoral scholarship, she reaches 2,000 zlotys a month. For several months she passes through various veterinary clinics in Warsaw where she is employed illegally or part-time. In 2015, she registers as a freelancer and starts teaching Medical English. The doctoral scholarship is spent paying the social security contributions, a bookkeeping service provider and a room at a dormitory. She also gets her first contract for doing on-duty jobs at British clinics. After a few years, she finds jobs in Sweden. This is the first time she sees any savings in her account. 

Sedlak & Sedlak’s report shows that the average net salary of a veterinary surgeon in Poland is PLN 2,900. The research conducted by the company Natalia works for (Vetnolimits) in 2018 shows that more than a half of Polish veterinary surgeons have financial problems.

Natalia: “People often consider a vet to be a rip-off merchant basking in luxury. The reality couldn’t be more different. The wealthy ones are the clinic owners who have worked for their position over the years or the vets that take care of large-scale industrial herds. Single-vet surgeries or small clinics often barely get by. Clients require services at the level of human medicine, so vets go into debt buying very expensive equipment like ultrasound scanners, X-ray scanners and tomographs. Products that amount to hundreds of thousands or even millions of zlotys of credit. On top of that, there are the costs of specialisation courses and life-long training, which we pay for ourselves. And our clients are not always willing to pay for the service delivered. What if the animal does not wake up from anaesthesia after surgery or dies despite our attempts to save it? Has the service been delivered or not? Some think it hasn’t been and are prepared to fight to prove they’re right. I hear from other vets that uncollected bills for veterinary treatment may even exceed 50,000 zlotys.”

Szymon: “People buy a pet at a pet store for 50 zlotys and expect its medical treatment to cost more or less that amount. They are shocked when they learn that a surgical procedure will cost them several hundred zlotys. They raise hell, they insult us. Sometimes clients who cannot afford treatment leave their pet, for instance, a rabbit, with us and then we pass the animal on to charities. This is not a good thing because it teaches people that what is broken can be left behind. Several times a year, we also find animals in serious condition abandoned at the door of our clinic. That’s why I believe that having an animal should be a privilege. A luxury.”

Survival Manual, Chapter Three: “You have no idea what extreme despair or extreme rage truly mean.”

Natalia remembers a woman nine months pregnant who came in to have her old dog examined. An ultrasound examination showed that the animal had a giant, bleeding tumour on its spleen. The owner howled in shock and despair and fell to the floor. She lay with the dog for a dozen or so minutes and wept, holding her pregnant belly. Her mother was sitting next to her, also crying. Natalia sat down next to them and held their hands until they calmed down.

Paula: “When an animal dies during surgery, people can roll on the ground and shout, “It can’t be true! It is not possible!” On such occasions, I don’t know what to do. Go out? Lie down next to them and comfort them? I definitely cannot say, “Please pull yourself together and take a seat.” During our studies, no one prepared us for what it would be like to work with people. We never had psychology classes. At the beginning of my career, I didn’t feel equipped to inform clients about the death of their pets. I would dial the number and hang up because I was crying. Finally, there is also the question of the bill. I might forgo my own remuneration, but what about the cost of the procedure? The fee of the anaesthetist who will send me an invoice?” 

The despair of clients is sometimes paired with aggression. 

Five years ago, Szymon consulted a client about his dog. The animal weighed 10 kilos, half of its intended weight. The dog was vomiting violently, it had a tumour that covered almost half of its leg and a few airgun pellets in its body. The owner reluctantly agreed to euthanasia. Later on, he gave Szymon a single-star internet rating with a comment: “If I hadn’t chosen that particular vet, the dog would probably be alive today.” Szymon: “Not a week goes by without me being called a quack and a murderer. Over time, you’re supposed to become immune to such things, but when someone leaves crying out, “We’ll burn this shack of yours to the ground!”, your skin crawls. The worst part is that these aggressive owners often cause their pets’ fatal conditions themselves. We recently had a rabbit with an enormous tumour on its testicle, decayed teeth, a stone in the urethra, a broken leg, and a tangle of fur and dried faeces. The owner looked straight into my eyes and said, “He was fine yesterday.” He tried to pass on the responsibility for the pet’s condition to me.”

Paula feels like she has already heard everything out there. She was called a “heartless murderess,” and one client threatened to kill her child. There were also those who announced that they would destroy her or “fight her until she broke.” 

She also had cases like this one. A dog already has heavy dyspnoea but the client doesn’t agree to euthanasia because she wants the pet to die at home. It will be in agony for two days because “the owner loves it so much.” Paula questions this love. Because if the owner did love the dog, why didn’t she seek medical treatment for the dog six months earlier instead of waiting for the tumour to drag over the ground, decay and eventually rot? Paula sees multiple cases of such neglect every week: “Most of these animals could have been cured. As it is, instead of curing them, I have to euthanise them or watch their human take them home, thus condemning them to more torment. How am I supposed to recover from something like this?”

At the other extreme, there are clients who are not going to let go. Even now, Paula can remember an old cat with kidney failure whose owners kept dragging it from one specialist to another for a year. They spent thousands on its prolonged death: more pumps, more nasoesophageal probes, more nasopharyngeal tubes and drips. The cat was as good as dead. Paula recalls it spread on the examination table like a wet cloth, surrounded by cables and IV drops and tormented by suffering. Paula couldn’t do a thing. The owner can do what they like in this situation. If they want the animal to suffer at home unattended, no one can stop them. But if they are willing to spend tens of thousands on persistent therapy, the vet is equally helpless. The common denominator of both situations is suffering. The kind of death that Paula would not wish on any human being.

Paula: “Desperate people are capable of anything. Why did no one teach us at the university how to talk to them?”

Natalia: “We shepherd our clients through powerful crises even though we don’t have any psychological training to help us to do so. We do it intuitively, at the price of our own sanity. Over time, some cut themselves off from their own emotions in order to survive. It even has a name: “compassion fatigue.” Emotional exhaustion is caused by your own compassion. But if you’ve stopped feeling anything, it means it’s high time to consider changing your profession. 

In January 2019, the US CDC (Centre for Disease Control and Prevention) published the first large-scale study on mortality rates among American vets. The results were alarming: in male vets, the probability of suicide turned out to be more than twice as high as in the general population; for female vets, this factor is as much as 3.5 times. Research has also shown that vets specialising in the treatment of pets are at the highest risk of death by suicide.

Researchers try to explain these statistics by referring to the specific working conditions of vets: working overtime, poor work-life balance, the growing demands of clients, and the necessity of performing euthanasia – not only in old and sick animals but also in those neglected by their owners. 

But that’s not all. Research done in both the USA and the UK shows that veterinary medicine attracts people of a specific personality type: conscientious, empathetic perfectionists. These traits in themselves can contribute to the development of mental disorders resulting from high levels of stress, and when we add in extreme working conditions, this creates a perfect storm – a combination of circumstances in which tragedy comes easy. The issue of money is also important. Most veterinary medicine graduates leave university with massive debt that they have to pay back over the following years.

In Poland, no statistics similar to the American ones have been collected, but there are many signs that the problem is universal and exists in most European countries. The research of Natalia Strokowska shows that one in every five Polish vets has considered suicide, and 4% of vets have frequent suicidal thoughts. In addition, they suffer from addiction, mostly alcohol and drugs, from financial problems, working overtime, low levels of job satisfaction and disturbed family relationships.

Survival Manual, Chapter Four: “You will see more suffering than you can bear.”

Szymon: “There are happy moments, but in general this is a so-called disaster industry.”

Natalia: “I was devastated by a recent shift during which I put down a dog.”

And it was not so much this single death, but the endless loop: life, death, life, death. The euthanised dog’s owners wanted the presence of a tumour confirmed by post-mortem examination. Natalia carried the dog over to the examination table and opened its stomach. While her hands were inside its still-warm body, the receptionist burst into the room, “You need to hurry up, there’s a client coming with a kitten to be vaccinated.” Natalia put away the liver containing the tumour, took off her gloves, disinfected her hands, and stretched her mouth with a professional smile. It’s a joy to meet a new family member. You need to admire it, stroke it tenderly, and enjoy its arrival together with your client. But your thoughts are elsewhere. They’re next door, with the body of the dog that an hour ago was still very much alive. For which someone is mourning. The client with the kitten left, and Natalia came back to the other room to close the dog’s body. She could not swallow her lunch. Within minutes, she would be performing another planned euthanasia.

Magda: “In England, where I worked for 13 years, I once had to put down a pregnant bitch together with her entire, as-of-yet unborn litter. The client could not afford a caesarean. The bitch was in bad shape and she probably wouldn’t have survived the surgery; despite that, this euthanasia was one of the worst ones for me. In my own clinic, I could have let the client pay for the caesarean in instalments, but it was a veterinary corporation, so I didn’t have that option. The clinic owners only took care of the bottom line. The killing was on me.”

Paula describes her last working day. First, patient number one dies – a rabbit brought in by the owner two days too late. On Saturday, the man sent an email to the clinic, in which he said that the animal refused to eat. He was told to bring the rabbit in immediately. He wrote back that maybe he would find time on Sunday afternoon. He didn’t. He brought in the extremely dehydrated rabbit on Monday. The fight for its life began immediately because the animal no longer had the swallowing reflex. By Tuesday morning, the rabbit was dead. During the post-mortem examination, it turned out that the ulcers had perforated its stomach wall and all the undigested content had spilt into its belly. Patient number two: a guinea pig that suffered from pneumonia. Paula had been fighting for it for months, but on that day, despite resuscitation, the guinea pig died. Patient number three: a rabbit with gastric dilatation. It might survive. 

Paula: “Don’t forget to mention that this was, in theory,  my day off. I just drove over to the clinic to help the girls who just couldn’t handle so many emergency patients.”

Magda: “I broke down on the day on which I had to perform nine euthanasia procedures. It was on the 23rd of December, a date known to vets all over the world as the ‘holiday cleaning’ day.

Paula: “In Poland, we call it the “warehouse clearance.’”

Magda: “In England, we would put down the biggest amount of animals before Christmas Eve. They were mostly old dogs, often in poor condition. However, with a little push, they could live a little longer. But the thing is that an old, deaf dog with a smelly muzzle is hardly attractive to Christmas guests. Especially when a breeder is already waiting for a new puppy to be collected. Pre-Christmas euthanasia procedures are interspersed with vaccinations of puppies. It hits your psyche. The more so because neither in England nor in Sweden am I entitled to refuse to perform euthanasia. There, everything can qualify as persistent therapy and for that, I can be sued.’

Paula mentions that before Christmas Eve, the owners try everything to persuade her to perform euthanasia. “He’s definitely going to get worse during Christmas,” is one claim clients often make. In such situations, she says that her decision depends on the outcome of the clinical examination. If she finds the dog to be in very bad shape, she agrees. After all, this is a final act of mercy towards the dog. Since the owner had done nothing for the dog for ten years, they could just as well have taken it out to the forest and abandoned it there before Christmas. Instead, they brought the animal to her. If the dog is not in a desperate condition, Paula informs the client that it needs medical treatment. Some clients take offence and leave. Others change their mind. 

Paula: “I once had a client whom I told that her dog needed a blood test. She looked at me in shocked disbelief, “How’s that? A dog has blood?” I try not to get upset with such things. When I bought my first car, I had no idea that the engine oil needed to be changed at times. The mechanic looked at me with pity. Some people have a similar approach to buying a dog. Then I try and educate them and sometimes I see a change: suddenly they start taking good care of the animal, buy specialist food, and order the most expensive tests. Such miracles also happen.”

Magda took a medical leave after the ‘holiday cleaning.’ The family doctor she saw couldn’t understand what her problem was: Do you have debts? Family problems? Are you in danger of losing your job? Magda shook her head. No, the point was that within a single day she took nine lives. The doctor shrugged and gave her a referral to a psychologist. The therapist was young, a recent graduate. She couldn’t bear to listen to Magda’s story.

Magda: “That’s why we screened the psychologists we employed at the Vetlife Charity. Vets had repeatedly complained that the therapists in England didn’t view them as patients but rather saw them as professionals. Some of them went as far as taking out their phones mid-way of a therapeutic session to present pictures of their own dogs. Or they would ask, “Okay, so which anthelmintic is the most effective in your opinion?”’ 

Chapter Five: “There will always be someone to say you haven’t done enough.”

Natalia: “We often face painful dilemmas. For instance: the animal could be cured, but the owner cannot afford to pay for the treatment. I feel like crying when I read the criticism on the Internet that says that we should save such animals at our own expense because being a vet is a mission in and of itself. My reply would be: Do doctors adopt babies found in baby hatches? Do dentists take pity on the homeless who hang out in front of their offices and put tooth crowns in or give them root canal treatment for free? Because we, vets, constantly pick up injured birds, cat litters, tormented dogs or puppies stuck in boxes at our clinic doors. And we treat them, often for free, and find them new homes. But to many people, especially those who comment anonymously on the internet, this is still isn’t enough.”

Paula: “Not long ago, I had a client whose rabbit did not wake up from anaesthesia after surgery. It wasn’t anyone’s fault, I warned the owner beforehand about how this sometimes happens. Despite this, the woman could not believe it had happened. She sat down in my office and, in tears, demanded an explanation. Meanwhile, clinic employees were calling other owners to say that their pets’ surgeries would be delayed. “So what the hell are you doing there all day?” a client waiting for his rabbit to get castrated shouted. That day, we called it a day at one in the morning. It’s impossible to please everybody.”

Chapter Six: “Save yourself.”

Paula: “I’m not tired of my own compassion, I’m tired of death.”

For Paula, the need to keep jumping from mourning to joy and back is similar to bipolar disorder. In 2020, she felt that none of the versions of herself was real. Not one who comforts distraught clients, nor the one who expresses happiness about having cured a dog’s lymphoma. Arriving home from work, she would stare at the wall and feel nothing. She had the impression that she was made of cardboard: clean, without any feelings, perfectly indifferent. And this is where it gets dangerous. It doesn’t matter to a ‘cardboard person’ whether they live or die. When her close friend committed suicide, the thought crossed her mind that ‘just one step and we can be together again.’

Paula: ‘Our entire industry is steeped in dying. To us, death seems a simple and perfect solution. After all, we know everything about it. We are getting accustomed to it every day. This way of thinking is extremely dangerous.’

This year, Paula decided: “Enough is enough. I need help.” She started therapy and also attends classes with a coach to better cope with the management of the clinic. She does it both for herself and for her little daughter. The ‘new Paula’ tries to turn the phone off and reminds herself that she cannot help everyone. The ‘old Paula’ goes to the clinic even on vacation and sometimes doesn’t come back home for three days in a row, sleeping at the office. That’s how she is: someone else’s suffering torments her. As long as it’s possible for her to reduce it to a manageable level, she keeps working. She feels pity for both animals and people, even when the latter’s ignorance or neglect infuriates when. 

Magda has set up her own clinic in Sweden. She’s also become involved in creating the country’s first charity to support vets with mental health problems. For Swedes, who don’t like to speak out about uncomfortable problems or emotions, this is a novelty.

Szymon says that he has therapeutic support available at home because his partner is a psychologist. And when he notices that a client is unable to cope with a pet’s death, he discreetly hands over her business card.

Natalia Strokowska has founded her Vetnolimits company where she offers mentoring and professional support to vets. Not long ago, together with Halszka Witkowska, a suicidologist, she talked about the risk of suicide in her profession at a virtual Congress of Polish Psychiatrists. Several hundred psychiatrists listened to her speak. 

She talks a lot about mental health with her students. Natalia: “This is a generation that is different from mine. They are not ashamed to talk about what hurts them. For them, consulting a psychiatrist or a psychologist is not a reason to feel ashamed but a logical solution when the realities in their life become too difficult. They thank me every time I tell them about my own experiences because it makes them feel less alone. This does not mean, however, that the call for systemic changes should be stopped. First of all, the ways in which vets are trained has to be changed. In order to prevent tragedies, students should learn something about psychology, ethics, and mechanisms of coping with difficult situations during their university years. One thing will not change for sure: this profession will always attract people who are exceptionally sensitive and empathetic beyond compare. We must not let them be destroyed.”