Burnout and Stress, Parenting, Personal Wisdom, Travel

Silence

Silence

 

After 3 to 5 hours of hiking, baskets full of silence fill to space between us. Silence filles the sweeping landscape, as well.  I love this time in the hike.   We walk, breathe, appreciate, are together – in silence.  The silences that come before are of different quality. Sometimes they are angry at the hills going up and down.  Sometimes they are filled with daydreams.  Admittedly, sometimes they are filled with panting. However, this time of silence comes with contentment and togetherness.  No just together with each other, but together with everything, the wind, the hills, the grass… All of it.

 

I am fortunate to have a child that I weaned on grassy silences and miles under her feet.  She will hike 6 hours for the price of a couple of shared scones and a package of blueberries.  Even better, whenever I ask if she wants to go to the road, she asks if that is how the trail goes, and if it doesn’t go to the road, neither does she want to.  I am lucky that way, as sometimes I would definitely go to the road myself, missing some of the beautiful sites!  She amazes me, tolerating hours of rain, hours away from Percy Jackson books. I don’t know why, sometimes. However, I am always grateful.

 

As we hopped down the rocks of Hadrian’s Wall Trail, I realized that I have an opportunity. Like my daughter, I have the opportunity to create who I am in my next tomorrow.  I was thinking about my foot, the plantar fasciitis I acquired the last year. Stress related. Standing long hours on a hard floor. The running, I believe, was just ancillary.  Today, it is bothering me a bit, but yoga, physical therapy, and destressing have changed it substantially.  Today, I am hopping down rocks, flying towards my next future, just as she is flying towards her first future.  I can choose something thoughtfully, something that allows me health, that is lower in stress.  What a wonderful gift!

 

Before we set out on this trip, I told my fiance that I was happier, that I could finally feel the lessening of stress.  That is wonderful.  As it this.  This is different.  It’s like the idea is really viscerally dawning on me. I have a new start!

 

We both have the opportunity to choose a future. I am hopeful for both of us.

 

Today’s Favorite Food: Sticky Toffee Pudding

 

 

 

Burnout and Stress

Check in number Three – Increased anxiety

Check in number Three – Increased anxiety

 

In addition to quitting my profession, and beginning the set-up of a new business with my fiancé, I also have to parent a teenager. I have a rental house that has to be remediated after tenants did thousands of dollars of damage.  This property, which I am fortunate to have, is five hours away.  Plus, I’m going on a trip to England, which I can scare afford at this time, now that I have quit my jo and profession. Also, I’m getting married. All before summer ends.

 

I’m feeling a little stressed.

 

I’m sleeping better, certainly. My self-esteem is improving.

 

My busy-ness factor however has not reduced. I’m completely stressed out over how I measure my self-worth if I’m not bringing in income. About not bringing in income.  For 21 years there’s been one way I earn income which I’ve equated with self-worth. Now I have to find a new system to find my own self-worth. That’s quite a challenge!

 

In addition, the list of things to do with starting a new business, or even managing a life, is overwhelming and never ending.

 

I’m learning new skills, every day. I’m learning how to use WordPress,  Siteground,  Webbly, and how to build a website.  I’m learning how to promote a new business. I’m involved in several courses for new certifications. These are very exciting to me: I am a skills junkie. It is a central aspect of my Busy-ness Factor.

 

In addition to these ‘hard skills,’ there are dozens of  ‘soft skills’ to learn in these transitions. Learning how to work with a business partner, when to flex, went to capitulate completely, when and how to divide tasks, how to change the task division, division of labor when things are going well, how to rescue or be rescued when things aren’t going as expected. How to have a regular work schedule and be productive.

 

Then there are new relationship skills: How to be supported, How to have a shared income and spending system. How to negotiate purchases. How to save for retirement, or even for a new dryer we desperately need.

 

There’s a sense of urgency in, however, with the new business to do list.

 

Sometimes – it makes me want to throw up.

 

Really I just want to stay at home. And cook. And make herbal preparations. And work out. And parent. And be a lover.  And meditate. And take yoga teacher training. And mindfulness-based stress reduction certification.  And go to school. And start a couple women’s groups, continue to develop my Threshold Choir, and my abilities to be a director, which also it means taking piano lessons, and possibly voice lessons.  Oh, and travel. Maybe I want to much to really want to ‘just’ stay at home.

 

I think I need another teen hood/early 20-year-old. In my life.

 

I need the space and time to re-create my life and who I am in it. Carving that space out is actually only half the battle. Utilizing the space – that’s the harder half. Doing so in a time and place where I still need to bring in income – well that of course is trickier.

 

It’s a privilege I experience in this moment to be able to face these questions and battles. I know that. And in my soul, I’m deeply grateful. At the same time I’m completely freaked out.

Burnout and Stress, food, Food Medicine, herbal medicine

Braised Cabbage, Apple, Carrot, and Sausage with Kumquats and Mustard Seed Rice

Braised Cabbage, Apple, Carrot, and Sausage with Kumquats and  Mustard Seed Rice

 

I came home tired from work. Yes – the one I vehemently quit a minute ago…

I do have to eat, after all.  Different place same profession. It’s temporary. That made it was better, but I felt pretty down at the end of the day.  Okay, pretty, really depressed, grey, down, stormy, etc.  The last thing I wanted to do was cook! But I also knew I would come home feeling the same way after work each day this week. Plus I rely on left-over’s for my lunches. Pickings were slim – I was going to have to bite the bullet and cook.

I looked in my fridge. It was an odd list: some Apple Sausage, Cabbage, Carrots, Apples, and some left-over kumquats. My daughter loves them – for about 3/4ths of a pack, then these exotic little citrus fruits languish in the fridge. I like them when I eat them, but I always think I don’t. So they languish.

My fiancé would have added some bacon or at least ham, crème of something soup, and cheese. But he is off on vacation. Leaving me left-over-less. So sad!

I came up with this recipe and was delighted by the results! It’s savory, light, a little spicy, a little sweet, with little surprises of tang with the kumquats.

We’re going to talk about cruciferous vegetables, myrosinase, sulforaphane, mustard seeds and all sorts of fun things here in the next few blogs. But for now- some recipes!

 

Braised Cabbage, Apple, Carrot, and Sausage with Kumquats and  Mustard Seed Rice

 

Ingredients (4 to 6 servings)

  • 1 Tablespoon butter, ghee or Extra-virgin olive oil.
  • 1 pound of Apple Sausage or Sweet Italian Sausage chopped
  • ¼ cup sliced Kumquats.
  • 1 teaspoon cracked black pepper
  • ½- 1 Teaspoon whole mustard seeds
  • 2 tablespoons of Extra-virgin olive oil divided into 2 portions
  • 1 cups carrots sliced
  • 5 – 2 cups mixed cabbage, chopped (red and Napa shown)
  • 1 large apple chopped
  • 2 tablespoons of white balsamic vinegar
  • 1 Tablespoon Umami
  • (savory flavoring, make something up if you don’t have this)
  • 1 Dash Worcestershire Sauce
  • 1/4 teaspoon of dried thyme
  • salt, pepper and honey/sugar to taste

 

1) Put 1 tablespoon of Butter/Ghee/Olive Oil in a large skillet on medium high heat. Sauté sausage until brown. Add the Kumquats, cracked pepper and whole mustard seed. Cook 1-3 minutes; the less you cook the mustard seed, the spicier the dish will be. Remove from skillet and set aside in a bowl.

2) Add 1 tablespoon of Olive Oil and sauté the carrots for 3-5 minutes until colorful.

3) Add the cabbage, carrots, and apples. Sauté stirring well, until cabbage wilts, about 3 minutes.

4) Return the sausage/kumquat mixture to the pan, mix well.

5) Add a Dash of Worcestershire Sauce, then the other spices, mixing well. Lastly, add the balsamic vinegar. Cover 1 minute.

Serve hot with Mustard Seed Rice generously flavored with sushi rice seasoning.

Mustard Seed Rice #1

1 cup rice of your choice

1 teaspoon to 1 Tablespoons Whole Mustard Seed

½-1 teaspoon salt

Cook as directed.

Serve hot.

Once cooked, mustard seeds are not terribly spicy. They do add interest visually, and a nice crunch to the rice. I prefer this to plain rice. But I am just like that, you know!

 

Mustard seed rice #2

1 teaspoon ghee

½ – 1 tablespoon mustard seed

Rice, cooked as directed

Before serving rice, add ghee in a pan, add yellow, white or brown mustard seeds, or a mixture. Remove from heat when the sputter and start to pop. Add these to the rice and serve immediately.

 

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Burnout and Stress

Quitting

Quitting

 

I quit my job. That’s not true – it’s more than.

I am quitting my profession.

That too is not true. I am giving up my belief in my profession. There will still be hours and days and month of work, maybe even extending into years.

 

 

Sometimes we open our eyes and the truth is seen.  Not uncommonly, this is very unpleasant.  We may have spent years not seeing certain things.  In addition, it is difficult to unsee what you have seen, to not know what you know. Some would say it’s impossible.

I opened my eyes during a CE course on stress reduction in my profession. I am a veterinarian.  I know – puppies and kittens all day.  Well…it’s not really like that.  It is a highly stressed, highly leveraged industry.  Recently, we lost several prominent veterinarians to suicide. I personally deeply felt the loss of Dr. Sophia Yin, the veterinarian who really brought Low Stress Animal Handling, and Fear Free vet care to the fore front. “They” started taking a look and studying our profession.  Recently the information has started to come out.   More and more, information is being accessible and presented – for those who want to hear.  At my last continuing education conference there was one course on stress burn out and meditation.   I went for the meditation.  What I found out: My profession is now rated as the number one job for suicide, suicide ideation, burnout and compassion fatigue. I guess that warrants being studied.

I went in to the lecture fairly dubious.  I seated myself next to the door, so I could leave if I got bored. A social worker, speaking at the conference, laid it all out for me. Each item she ticked off, I said “Oh! Yes – that’s true! And that. Plus there’s a lot more stressors than that, which she obviously isn’t even aware of. But Oh Dear! They only see a fraction of the tolls this work takes .”

I guess I was ready to be educated. I wasn’t ready to have the veils torn off my eyes. I pondered this new information, this new vision for several months. I have to admit, I think this seeing was my undoing.

After, I could never hold it together, blithely sail through the daily stresses, unaware. I couldn’t not see the stressors, and that was a problem. I kept noting them. I watched as they followed me and my fellow workers around.

That fuzzy one, that is Overwork – if feels so good, as you ‘Do Good’ – but like a giant leech, it sucks the life out of you!

That one over there is Referred Trauma. I know – It’s so tiny! It’s just a little bit of someone else’s story. But those bits stick to you. When you get hundreds or so of them on you…

That one beside it, yes, the bigger one, the one that looks like that aggressive dog, who can’t be restrained, muzzled, touched or even tranquilized, and who’s owner is saying he would never bite us, but also won’t hold onto the leash? That one is just plain old Trauma, much scarier than it’s cute little cousin. Still, you can just herd one of those big guys out the door. And usually you can.

The problems is they still hang out in the parking lot, attach their trunks and suckers to your cars – and follow you home. You don’t think they’ve moved in, until you can see them again, in herds roaming around your kitchen. Suddenly, you’re angry with your daughter for not finishing her homework, but don’t bounce back from it like you should, you can’t sleep at night, and forget romance!

 

“Veterinarians suffer from feelings of hopelessness, depression, and other psychiatric disorders two to three times more often than the general population,” quotes a Boston Globe article. One third (1/3rd) have anxiety, and another third are borderline for anxiety. (That equals 2/3rds of the veterinarians!!) 47% scored high on emotional exhaustion. 67% of female veterinarians showed clear signs of burnout and another study showed that 53% of male veterinarians were also in this category. Another report – 75% of vets studied fell below the average for resiliency. (Can Vet J. 2015 Jan; 56(1): 89–92.)

I can attest to that. My resiliency was in the crapper. That is why I started this blog and my herbal/food medicine. I got the flu and couldn’t recover. Of course behind that was, surgery, steroids, travel, moving, remodeling, poor social connection, divorces, custody suits, and a host of other stressors. But I got to the point that I could not physically recover. I certainly also had the burnout, stress and suffering. In the List of Signs and Triggers of Compassion Fatigue below, I tagged at least 11 of the 14 signs in Feb 2017.

Two studies published in the British Veterinarian Association’s journal, The Veterinary Record, found suicide rates are double or more those of dentists and doctors, and four to six times higher than the general population. 16% veterinarians have considered suicide, 9% have attempted suicide, and 49% felt they were still at risk to repeat such attempts, according to a 2014 CDC study.

Again, I totally understand this. My wishes for a tree to accidentally fall across the road and kill me, have never, thankfully, been realized. When I really noticed the places to where I have gone, AND I got a pretty simple flu and could not recover, I decide to make changes in my life. I prefer to have a life, versus a tree falling on me. In addition, I prefer to have a life, over having an existence.

 

My personal belief is that veterinarian medicine is a whole lot more stressful for a whole lot more reasons than even the outsiders see. I also believe that those in the industry, i.e. veterinarians, are blind to most of these stresses, most of the times. When we do see them, we blow them off. They still exist, they are part of the package. Unless you rip our blinders off, we won’t even see the boogiemen in the corner. and there is a reason for that – We don’t want to!!!

We like being veterinarian’s and we really want to do our best for everyone. That doesn’t make it a stress free career, it just makes it a blind career.

I love my profession. I am proud of the work I did to get here, the fact I Do Good in the world, that I make a difference, and can feeding my family through my work as a veterinarian. However, it is not longer a good place to be. It is no longer safe. I suspect it never was. So for now, I am taking a break. It may only be a few weeks or a few months. I may come back to my profession with a new outlook, or a new role. But for now – I am checking out.

I am trying to learn how to slow down. I am learning how to breathe, how to take the time to do a hour of yoga a couple of times a week. I am learning how to drive the speed limit, come to a full and complete stop at stop signs. I am blogging about my experiences as I change.

 

Resources and Notes:

Here is a list of Signs and Triggers of Compassion Fatigue from the Book Professional Burnout….

  • Exhaustion
  • Reduced ability to feel sympathy and empathy
  • Anger and irritability
  • Increased use of alcohol and drugs
  • Dread of working with certain clients/patients / staff
  • Diminished sense of joy of career
  • Disruption to worldview, heightened anxiety or irrational fears
  • Intrusive imagery or dissociation
  • Hypersensitivity or insensitivity to emotional material
  • Difficulty separating work life from personal life
  • Absenteeism – missing work, taking many sick days
  • Impaired ability to make decisions and care for clients/patients
  • Problems with intimacy and in personal relationships
  • Poor client care and low competition rates of clinical and administrative duties

 

Why do so many veterinarians commit suicide? – The Boston Globe

By Sy Montgomery SEPTEMBER 19, 2016https://www.bostonglobe.com/lifestyle/2016/09/18/why-many-veterinarians-commit-suicide/iCCgr46bIJpgEeesPHTe2L/story.html

Can Vet J. 2015 Jan; 56(1): 89–92. Suicide in veterinary medicine: Let’s talk about it. by Debbie L. Stoewen

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4266064/
JAVMA – Studies confirm poor well-being in veterinary professionals, students

https://www.avma.org/News/JAVMANews/Pages/160501c.aspx

 

Veterinarians are four times more likely than the average person to commit suicide and twice as likely as other healthcare professionals.

http://veterinarynews.dvm360.com/farewell-dr-sophia-yin

 

More than one in six veterinarians might have contemplated suicide since graduation. The survey results, based on answers from more than 10,000 practicing veterinarians

https://www.avma.org/news/javmanews/pages/150401d.aspx

Notes from he Field: Prevalence of Risk Factors for Suicide among Veterinarians – United Stated, 2014. CDC – February 13, 2015 / 64(05);131-132, Randall J. Nett, MD, et. al.

https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6405a6.htm

 

Workplace stress, mental health, and burnout of veterinarians in Australia (PDF Download Available). Available from: https://www.researchgate.net/publication/51728726_Workplace_stress_mental_health_and_burnout_of_veterinarians_in_Australia [accessed Jun 12, 2017].

Professional Burnout, Vicarious Trauma, Secondary Traumatic Stress, and Compassion Fatigue…. Jason M. Newell and Gordon A. MacNeil (pg. 59), p.45 in Rank, Zaparanick, Gentry reading