Dr. Carrie Jurney is on the board of an online organization that works to prevent suicides. It's called Not One More Vet.
This isn't a mental health support group for veterans — it's for veterinarians.
Veterinarians are killing themselves in alarming numbers. The Centers for Disease Control and Prevention found male vets are 2.1 times as likely and female vets 3.5 times as likely to die by suicide compared with the general population. The much higher rate for women is especially concerning as more than 60% of vets are women.
"I had 86 people in my vet school class," Jurney says. "Graduating class of 2005. Three of them are gone. Died by their own hand."
There's a lot of stress in being a vet. First, there's the financial pressure to pay off a pricey medical school education — recent graduates are often more than $140,000 in debt. And the median pay for a veterinarian in the United States is about $94,000 a year, which is good, but less than half of that for physicians and surgeons.
Then there's the emotional strain. Any given day in a veterinary clinic can swing between scenes of elation and anxiety.
That was evident on a visit to Jurney's clinic in San Jose, Calif., last month.
A couple brought in their huge Rottweiler to see Jurney. Reuben weighs 113 pounds. The previous night, he suddenly couldn't walk.
Jurney and her staff had to put their arms around Reuben to lift him up to be examined. The big brown dog's eyes seemed to grow wide and bewildered.
"I always say one of the great ironies of my career is I got into this because I love animals so much," Jurney says. But "there are not a lot of animals that are ever excited to see me anymore. You know they are often in pain and scared. And then we're doing weird things that they didn't get to consent to. And ... especially in an emergency hospital like ours, there's not a lot of choice. You still have to get it done."
Reuben had MRI. Jurney saw knots on his spine that might block his movement and ordered immediate surgery.
She used a drill to slice through the huge dog's flesh and muscle and see what was pressing on Reuben's spinal cord.
Through a mist of bone and blood, Jurney saw small bits in Reuben's spine that had hardened around nerves.
The surgery took more than an hour: lots of blood, bone and hot bright lights. But Jurney smiled as she slipped down her surgical mask to phone the couple she calls Reuben's dads.
This time, it's good news.
"Hi, it's Dr. Jurney calling. We're all done, your baby's waking up," she told the owners. "They were chronic discs. So those have been there for a while and I think they just scooched out just a little bit more. ... So we made things way, way better than when we started. So I think we did what we needed to do tonight."
Vets deal with disease, disability and death on a daily basis: "our average Monday morning," as Jurney puts it.
"It's a very isolating profession. The hours are long. I can't tell you how many dinners with friends I've been late to or just missed entirely because a case comes in that needs me right now," she says. "I've missed my own birthday dinner."
Many veterinarians practice alone, and sometimes they are the only one practicing for hundreds of miles, making it hard to take time off.
It's a natural profession for introverts, says Dr. Nicole McArthur of Rocklin, Calif., the founder of Not One More Vet.
"We're drawn to animals and then having to do a job where we are working with people," McArthur says. "The animals don't drive themselves here; they don't pay the bills."
Those people are often grieving, often angry.
Both doctors say veterinarians they know have been targets of online trolling and threats from pet owners, and even strangers, who blame them for the death of a much-loved animal. In February 2014, Shirley Koshi, a vet in New York City, took her own life after a cyberbullying campaign against her.
McArthur has quit her profession twice.
"I had a day that I was working emergency and had three euthanasias within a 30-minute time span and they were all very emotional," she says. "One I thought I was going to have to call in a welfare check to have police go make sure this person was OK. And yeah, I walked out. I was like, 'That's it. I'm done.' "
Vets also have access to lethal medicines. It's part of the job.
"It's not a big leap to say, 'I'm a veterinarian who has chronic pain and I have chronic depression and my clinic is underwater and there's no end in sight,' " McArthur says. "And this is a kind of death that we can give ourselves. I get it. I totally get it. I've been there."
Vets who kill themselves are 2.5 times more likely than the general population to have used pharmaceuticals as the method.
The CDC notes that factors including issues Jurney and McArthur talk about — the debt, the long hours, the stress, the access to lethal drugs — put veterinarians at a high risk of suicide compared with the general population.
McArthur and Jurney's group, Not One More Vet, tries to give veterinarians support and a sounding board for the stresses of their work. The Facebook group boasts more than 18,000 members.
It's not professional mental health support but rather "a large group of veterinarians who totally understand where you are coming from," as NOMV says. "We are here to listen, commiserate, and give each other a shoulder, an ear, and a bit of advice when needed."
Testimonials on the group's blog point to the impact of reaching out and of group support in tough times.
Though McArthur quit twice, she came back because she loved it, she says. Many vets say that despite the challenges, "I love what I do."
And the day spent with Jurney showed it's not all doom and gloom. A gifted team of nurses and surgeons had helped a big, beloved dog walk again and brought joy to the couple who loved him. Jurney could go home happy.
A few days after Reuben's surgery, however, Jurney sent NPR a message. It shows how emotionally invested veterinarians can be in their work, both in the good times and bad.
"Hey Scott. I thought I should let you know we lost Reuben today. He had a lung problem — a complication of his genetic problem combined with surgery. I have to be honest — this is gut wrenching. You came to us to see why the job is hard, and there is no better example than this. I am devastated. I've cried through many moments of my mother in law's birthday dinner tonight because my mind is with Reuben and his poor owners. I wonder if there is anything I could have done differently. Even though I know I did everything I could for him, I still wonder if I could have done more."
SCOTT SIMON, HOST:
We're going to bring you another report about the rising rate of suicide in the United States. Caution; parts of this story may be disturbing. Dr. Carrie Jurney is a veterinary neurologist in San Jose, Calif., who's on the board of a group called Not One More Vet.
CARRIE JURNEY: I would tell people, well, I work on mental wellness and suicide in vets. And they're like, oh, veterans, you know, naturally. And I'm like, no, veterinarians.
SIMON: The Centers for Disease Control says veterinarians are more than twice as likely to die by suicide than the general population. Female vets, who now make up more than half the profession, have an even higher risk.
JURNEY: It's really shocking. I had 86 people in my vet school class, graduating class of 2005. Three of them are gone, died by their own hand.
SIMON: We joined Dr. Jurney for a long day at her office.
JURNEY: You know, we fight death for a living. We don't always get to win.
SIMON: There were dogs...
JURNEY: Hi, there, precious.
SIMON: ...Beeps, needles and blood...
JURNEY: I know. We got to go get blood on you. I know, Coco. I know. Don't bite me. That's not nice.
SIMON: ...As well as surprises small...
JURNEY: We just had a c-section in the back, so there are a bunch of brand new baby puppies in the world right now.
SIMON: Are those puppies?
JURNEY: Those are brand new Frenchies. Come on - yeah.
SIMON: ...As four fuzzy, newborn French bulldog puppies napping in towels.
JURNEY: So there are some perks to the job, you know?
SIMON: And as large as Reuben (ph).
JURNEY: So we've got an emergency case here. It's an 8-year-old Rottie who all of a sudden can't walk.
SIMON: One-hundred-and-thirteen-pound pumpernickel brown Rottweiler that a couple wheeled into Dr. Jurney in a cart.
JURNEY: So this came on all of a sudden. Last night, we were fine, and then we weren't fine. OK, no trauma.
UNIDENTIFIED PERSON #2: Yeah, we became not fine about bedtime. It was like midnight.
UNIDENTIFIED PERSON #3: No, he woke me up - right.
UNIDENTIFIED PERSON #2: Usually, you wake him up and - come on, let's go up the stairs. And he's never that (unintelligible) dog. All right, go on. Go up the stairs, go to bed. Couldn't get up.
SIMON: Dr. Jurney and staff have to put their arms around Reuben to lift him up to be examined.
JURNEY: Lift with your knees, kids.
UNIDENTIFIED PERSON #1: Lift with your knees and (unintelligible).
JURNEY: OK. One, two, three. Go. All right.
SIMON: The big, brown dog's eyes seem to grow wide and bewildered.
JURNEY: I always say one of the great ironies of my career is I got into this because I love animals so much. There are not a lot of animals that are ever excited to see me anymore (laughter), you know? They're often in pain and scared. And then we're doing weird things that they didn't get to consent to. And it can be a - you know, especially in an emergency hospital like ours, you know, there's not a lot of choice. We still have to get it done.
SIMON: We're able to speak with Dr. Jurney between patients about the stresses of being a vet. Many have financial pressures to pay off student loans while they try to run a veterinary practice. A typical salary for a veterinarian in the United States is $93,000 a year, which is rewarding but less than half the average salary of physicians and surgeons. And there is the unique emotional strain of their work.
JURNEY: Not everybody deals with disease and disability and death on a daily basis. And, you know, it is our average Monday morning here. And it's a very isolating profession. A lot of veterinarians practice alone. Sometimes you're the only veterinarian for 300 miles, which means it's hard to take time off.
NICOLE MCARTHUR: I think a lot of us are introverted, quite introverted.
SIMON: Dr. Nicole McArthur of Rockland, Calif. is the founder of Not One More Vet.
MCARTHUR: We're drawn to animals. And then having to do a job where we are working with people - you know, the animals don't drive themselves here. They don't pay the bills.
SIMON: It's people who love their pets. They can be upset if a vet has to tell them their dog or cat is sick and needs treatment or get angry if no treatment will help. Both doctors say veterinarians they know have been targets of trolling and threats from pet owners and even strangers.
MCARTHUR: If somebody gets mad, they get online. And then when you have somebody like my fur baby is - this person did something wrong. And, you know, we'll have people from across the world get online and say, well, they need to lose their license.
SIMON: And veterinarians, unlike medical doctors, are often asked to end a patient's suffering. Even as they know it's best for a pet, it's painful for the families who love them and for the vet who cares for them. That emotional stress has caused Nicole McArthur to quit and then return to her profession twice.
MCARTHUR: Yeah, I had a day that I was working emergency, and I had three euthanasias - three within a 30-minute time span. And they were all, like, very emotional and very - one, I thought I was going to have to call on a welfare check to have police go make sure this person was OK. And yeah, I walked out. I was like, that's it. I'm done.
SIMON: And, of course, veterinarians have the means to take life in their own offices.
MCARTHUR: In our line of work, we see a patient who's suffering, and there's no end in sight, there's no hope. And so euthanasia is a very viable option. And so it's not a big leap to say, you know, I'm a veterinarian who has chronic pain, and I have chronic depression. And there - you know, my clinic is underwater. And this is a kind death that we can give ourselves. I get it. I totally get it. I've been there. So...
SIMON: Their group, Not One More Vet, tries to give veterinarians online support for the stresses of their work. Any given day in a veterinary clinic can swing between scenes of elation and anxiety.
MCARTHUR: I'm going to go check on Reuben and see where we're going - how we're doing.
SIMON: Reuben, the huge Rottweiler who suddenly can't walk, has an MRI, which is daunting for a 113-pound dog who flops like a sack of cement when you move him.
MCARTHUR: Reuben is almost too big for the MRI, but they got him in (laughter). It's a big boy.
SIMON: But the images show knots on his spine. Dr. Jurney orders immediate surgery.
JURNEY: Going to take a peek at that last scan, and then we'll move our big boy out and then start the process of his very unattractive surgical haircut and go from there.
SIMON: She has to slice through Reuben's leathery flesh and muscle.
JURNEY: So this is the drill that we will use to take off the bone on Reuben's spine so we can see his spinal cord and what's pressing on it.
(SOUNDBITE OF DRILL DRILLING)
SIMON: Through a mist of bone and blood, Dr. Jurney sees small bits in Reuben's spine that have hardened around his nerves.
JURNEY: That's what we had to get out. So his spinal cord's only about that big. So something that big actually compresses it quite a good deal. So...
SIMON: And that's like desiccated parts of his spine.
JURNEY: Yeah, so it's the middle. And it's supposed to be squishy. And it is not squishy anymore. So we'll see if we can get any more pieces out like that. But that makes me feel better about Reuben.
SIMON: The surgery takes more than an hour - lots of blood, bone and hot, bright lights. But Carrie Jurney smiles as she slips down her surgical mask to phone the couple she calls Reuben's dads.
JURNEY: Hi, it's Dr. Jurney calling. We're all done. Your baby's waking up. They were chronic discs, so those have been there for a while...
SIMON: A long day in which we'd glimpse some of the stressors that can figure into suicides among veterinarians had ended with a triumph.
JURNEY: ...So we made things way, way better than when we started. So I think we did what we needed to do tonight.
SIMON: A gifted team of nurses and surgeons had helped a big, beloved dog walk again and brought joy to the couple who loved him.
Dr. Jurney could go home happy.
JURNEY: All right, my friend, well, I am going to get your baby tucked in. And then I will call you in the morning, OK? Talk to you then. OK, bye-bye. All righty.
SIMON: But a few days after Reuben's surgery, I got this message from Dr. Carrie Jurney. Hey, Scott. I thought I should let you know we lost Reuben today. I have to be honest; this is gut-wrenching. You came to us to see why the job is hard, and there is no better example than this. I am devastated. I've cried because my mind is with Reuben and his poor owners. Even though I know I did everything I could for him, I still wonder if I could have done more.
(SOUNDBITE OF MUSIC)
SIMON: And if you are troubled by thoughts of suicide, there is help. The number for the National Suicide Prevention Lifeline is 1-800-273-8255. You're listening to WEEKEND EDITION from NPR New. Transcript provided by NPR, Copyright NPR.