Navigating Mental Health in Emergency Veterinary Medicine

In any profession, when you’re super busy taking care of others, humans or pets, it’s easy to overlook the need to care for your own mental health. At VEG, we prioritize the well-being of our customers and ourselves. We offer counseling options for our veterinarian staff that fit their needs and schedule. It’s crucial that our people aka “VEGgies” have the proper resources to care for their mind, body, and emotional health. After all, the stronger we feel, the better we can bring others to a place of healing.

In this interview, we talk with VEG Medical Director, Dr. Sarah Hoggan. Dr. Hoggan has over 20 years experience as an emergency veterinarian, gaining a unique and insightful perspective on mental health in the veterinary community. With two TEDx Talks added to her already-impressive resume, she is an inspirational thought leader in the vet med space.

What’s your role at VEG?

I am the Medical Director at the Oceanside, CA hospital that opened in June of 2024.

You’ve been an emergency doctor for over 20 years. What has been the hardest thing about working in this field?

Absolutely the hardest thing about working in this field is the basic reality of what we see. We don’t get puppy wellness visits. Good news does not show up to an emergency room most of the time.

When you think about it, what we see on a daily basis are the nightmares that wake people up in the middle of the night. The dog getting attacked by a coyote, a cat that gets locked into a garage or a shed somewhere, is missing for days, and comes home so sick and dehydrated, it is barely alive. We literally see the stuff of nightmares.

The other facet of that is you are watching families say their goodbyes to a loved one. You are watching young men, who are saying goodbye to the dog they grew up with; this is the dog that taught them what nurturing feels like, this is the best buddy they grew up with from the age of 4 to 18. It is really hard to watch that process. It’s really hard to watch grown men drop to their knees, and sob when they’ve been taught to bottle their emotions and that they shouldn’t have any. But this is a moment where they just can’t help themselves.

Our job is to be more than stoic, it is to be heroic and be a rock for these families. Over time this can get harder and harder, and you run out of empathy; or you can learn some tools and mechanisms to deal with the difficulty.

When did you notice that mental health is a major issue within veterinary medicine?

Going through vet school, we always had a counselor that was available to talk to the students. So it was always very immersive since starting, even in vet school. It’s become even more apparent over time.

The “Not One More Vet” organization has become even more prevalent and known. I lost one of my classmates to suicide. Recently, I’ve lost a technician that I worked with some years ago to suicide. Seeing the fallout of our profession has made the importance of suicide prevention very, very real. I myself have even noticed that some days are more stressful than others. Some days, I reward myself with a bit of chocolate. Other days, I’d say yeah; I’d eat a whole pan of brownies to self medicate my emotions.

I agree, and think many would say that this profession isn’t an easy one, for many reasons. As we talk about suicide prevention in the veterinarian industry, I know that you’ve done talks about pet loss grief and the effects it has on owners, but how do you manage those emotions as an emergency doctor?

Basically a lot of veterinarians have an intense level of empathy. The benefit is that you feel a lot so you understand what clients are going through at a very basic level; but you also become a sponge and absorb some of those things.

Eventually you feel like it leaves a stain on you; that you feel like you can’t get out no matter how hard you scrub; and you just can’t bounce back. Those are one of the signs of burnout. It’s a cumulative process. If you feel like you can’t wash those hard days off, you can’t go home and shower or hug your dog and make it better anymore.

That’s where you have to recognize that it’s starting to impact you. Then that’s where our support system really matters. And not just one support—layers are necessary. Layers of support, layers of communication, so you aren’t alone and you aren’t exhausting one support source.

When you think about safety nets that firefighters or acrobats use, they are multi-layered because it’s the thickness of the net, the weave, that augments its strength and ability to catch you. It’s the same for us, but those layers aren’t made of string or twine; they are family, friends, colleagues, your partner. Don’t be afraid to test those layers and reach out.

For example; I didn’t know Robin Williams, the actor/comedian. But when I heard the news of him taking his life I thought to myself I wish he would’ve called me or that I could’ve helped. I imagine a lot of people feel that way. If I felt that way about someone I didn’t even know, imagine how I’d feel when it’s someone I do know.

The day my stepson took his life, he called three people. I wasn’t one of them; I was at work. Three people who didn’t take him seriously, three people who chose not to do anything about it. And we lost Jeff (my stepson).

So don’t be afraid to reach out if you’re having trouble. Whether it’s suicide, you’re having a rough day at work, or you just can’t get from under the terrible things you’re seeing as an emergency doctor. I know, I promise, there are people that will do everything they can to help you.

You are a 2x Ted Talk speaker and have been very vocal about grief and its impact. What motivates you to speak about mental health?

What motivates me is multifactorial. First is how I was raised. My dad is a psychologist, my mother is a Special Education teacher, my sister also went on to be a PhD psychologist, and my stepmom is a PhD psychologist.

Talking about things is very much natural to me. People have family game night, my family actually hates games so instead, we would sit down and talk. My dad would talk to us about the complexities of bi-polor disorder or schizophrenia. I worked at his office in high school and I saw a lot of things first hand; how people tried to fix things/deal with things on their own and then finally, reached out for professional help.

When you see things like depression, or regret, or grief causing pain, it seems very natural to me to talk about it; to try to help somehow. Sitting there and not talking about it, pretending it doesn’t hurt or scar us, is not okay; it will just get worse.

If we just talk about it and translate it so people understand, we are better able to help. They know that they’re hurting, they don’t know why they’re hurting. Talking about it makes the hurt less scary and less overwhelming. You can then use that tool of understanding to process it. It disempowers the pain and hopelessness you have.

You mentioned that talking about these things is natural for you. What is your advice for someone struggling with their mental health?

I advocate so strongly for having layers of communication available. Reach out to someone you trust and reach out to someone who shares your knowledge. If someone comes to me and says I’m really having a tough time at my computer company. I would listen and do my best but I don’t know computers, I don’t know software. I wouldn’t be useful.

But if someone comes to me that works in veterinary medicine, I understand what they’re saying and I can be a safe place. I know what they’re going through and that allows me to empathize, not just sympathize with them. I am not going to judge them or tell them to put on their big boy/girl pants.

If a trusted friend or colleague isn’t enough, or if you feel like you can’t trust someone with what you need to say, you might need someone who is professionally trained to help you. I mean someone that is a therapist, a social worker, someone with a PhD in mental health.

Please understand though, just because someone has a degree, they may not be who you feel safe speaking with. It has to be someone who fits your needs; who you connect to. Just like some vets who are soft and cuddly and others are more calculating and analytical, therapists are the same. You have to find one that fits you. One that meets your needs.

Speaking from my own experience, in 2019, my first husband died, my son left for college and my stepson died by suicide. That happened in about a 3 month span. That was at the end of 2019 and I thought things had to get better! Boy, 2020 was going to be my year. Well, we all know how 2020 went. Making things worse, I also got a new job as a Medical Director of my existing hospital; but I was receiving no support or training. I was alone in every way: I went home to an empty house and as management; I felt I couldn’t lean on my colleagues for support. So I absolutely reached out, I have a whole lot of family members who are therapists but they know me so they weren’t objective. They still saw me as the insecure 12 year old I once was. I’d talk to them and they’d say “You know you are kind of sensitive.” That was the opposite of helpful.

So, I decided to reach out to a therapist. I found someone through my insurance. I didn’t know her at all, and it was a terrible personality clash. I went once and she made me actually feel worse! So I asked my friends for a referral and I found a therapist who was great for me. She listened without judgment and helped me recognize I had several different life events that were authentically hard to handle. I had to swallow my pride and realize that this was bigger than I could hold onto alone; and I needed some help navigating all I had been through. Realizing that I needed to go and get professional help was the best thing I could have ever done for myself.

One of the reasons I waited to see a therapist was the cost. I felt like the $50 copay for a 60-minute talk was too much. The funny thing is, if I could purchase a magic wand for $50 that you used every two weeks, for just one hour, to make myself feel better, then I guarantee I would buy that magic wand. I finally realized, spending money on therapy was making an investment in myself that would yield exponential rewards. And, it has!

I think the magic wand would be great but if you could implement one thing in veterinary medicine that you think would improve the well-being of veterinary professionals, what would it be?

Maybe context—then we would treat ourselves with more grace. By context I mean, think of all the horror movies that are out there. They show terrible things happening to people in terrible ways. Yes it’s fiction, but it’s still really graphic to see.

Do you know how rare it is to see animals being harmed in horror movies? If so, it’s never too graphic. Do you know why? That’s because it’s incredibly hard to see. People would be outraged to see a dog or cat harmed in a fictional horror film, but that’s what we see every day as emergency veterinary professionals; that is our reality.

Our job is incredibly difficult both physically and emotionally! We aren’t in this profession by accident. This wasn’t a summer job we never left. Veterinary medicine is a calling and a career. You don’t go hundreds of thousands of dollars into debt, for something that you kind of care about.

We all have embraced this lifestyle, the good parts and the bad parts, because we love what we do. And yeah, we’re incredibly strong for doing this job; but every single thing in the world has a breaking point. And the goal is that you don’t let your job stress get you to the breaking point.

Everyone needs help sometimes; that is the reality of being human. Also, everyone in the hospital helps carry the load. It is up to the strongest to carry the most- however, the title of “strongest” changes every day. If you need help one day; you will be the strongest in the future.

The other thing I would like to adjust in vet med is I’d really like us to stop emotional discrimination. Which is a term I invented (I think) but what I mean is our job is intrinsically hard. If you are talking to a client and your voice cracks, if you do a really hard euthanasia and a tear rolls down your cheek, it does not make you unprofessional, weak, or unstable; it means you care. This “I don’t feel things” persona is so outdated, and judging yourself or a colleague harshly because their composure slipped for a minute is not okay.

Now, do I think you need to lay down on the floor and ugly cry until a nurse needs to go get someone, no, not at work anyway. But it is okay to recognize that if you get choked up, or your eyes well up, or if you in some other way manifest your emotions in front of a client, it doesn’t make you weak or unprofessional. It’s quite the opposite; it means you care. And that’s the whole reason people come to VEG.