The Cost of Hiding Our Humanity

Every day, veterinary teams move from a euthanasia appointment straight into a new puppy visit — and are expected to just switch gears. But what does that emotional whiplash actually cost us, and do we have permission to feel it?

In this episode, Natalie Marks, DVM, CVJ, CCFP, Elite FFCP-VA and Founder/CEO of VANE, joins us to discuss ideas from her article "3 Ways Veterinarians Can Stay Present Without Burning Out" (Today's Veterinary Business). We dig into why teams need to align on whether it's okay to grieve, cry, or show emotion in front of clients — and why the answer should be yes.

We also explore the real relationship between efficiency and humanity and we also dive into the question: when does healthy resilience curdle into emotional armor that disconnects us from our patients, clients, and each other? Natalie introduces the idea of "clinical empathy" and a gut-check for spotting numbness before it takes hold, plus a concrete next step that leadership teams can implement to build a culture where being human is welcome, not hidden.

Thank you to Joan Marshall of PIMidlantic for sponsoring this episode! Want to take the Predictive Index Assessment? Click here!

Thanks for listening!

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Transcript

SPEAKER_01 0:10

Flight Plan Quick Consult is sponsored by PI Midlantic and Joan Marshall. Predictive Index helps veterinary leaders better understand what drives their people so they can hire more thoughtfully, improve communication, build stronger teams, and lead each employee more effectively. Joan is a former human resources executive who used PI within several companies before becoming a PI Midlantic consultant nearly 25 years ago. To learn how Joan can support your practice, contact her directly at jmarshall at Pimidlantic.com. Welcome aboard. You're listening to Flight Plan Quick Consults, your go-to podcast for veterinary insights that are fast, focused, and designed to elevate your practice. I'm your host, Brenda Tasma Medina from Encore Veterinary Consulting. Whether you're between appointments or heading into a strategy session, we've got takeoff ready tips, tools, and takeaways to keep your team soaring. So buckle up as we discuss the cost of hiding our humanity with Dr. Natalie Marks. Welcome, Natalie. Please let our listeners know a little bit more about yourself.

SPEAKER_00 1:23

Thank you, Brenda, so much for having me here. It's great to be with all of you. I'm a small animal veterinarian by training, practiced for over 20 years, owned a large practice in Chicago for a majority of that, and spent some time in Atlanta prior to my Chicago stint. Since exiting clinical practice, I do quite a bit of teaching and consulting. I'm also chief veterinary officer for two companies, a diagnostics company out of the UK focusing on microRNA, so early detection of disease. And then also OpenVet, which is a clinical AI partner for practicing veterinarians in uh in the US and now global. And I also uh co-own and run VAIN, which is the veterinary angel network for entrepreneurs. So we focus on direction connection and funding for startup companies in animal health, propelling innovation forward.

SPEAKER_01 2:16

You are a busy lady.

SPEAKER_00 2:19

I am. I like to be busy, but yes, I totally am.

SPEAKER_01 2:23

Well, I um ran across your article, and um I just really it hit home with me, and I thought, oh, we need to be talking about this more. Um and it was in um today's veteriness, if I'm not mistaken. Um and I ran across it a couple of weeks ago. I'm just really excited to have you on the podcast today so that we can dive a little bit deeper into this topic. So in your article, you talk about the cost of hiding our humanity. And when you say hiding, what does that actually look like in today's veterinary practices? What are the subtle ways that we ask ourselves or our teams to leave part of who they are at the door?

SPEAKER_00 3:07

Yeah, and thank you for acknowledging this. It was a hard article actually for me to write because it um the impetus came from my experiences with my mom in her last months of life dealing with brain cancer and our experiences with the human healthcare team and those that did hide their humanity from us and what it felt like on the other side of that exam table, and those that didn't. And I started thinking about how that related to veterinary practice, both myself as an associate, sort of working my way up to practice owner, and then from the other side of that, how our our customers, how our pet parents and clients and extended family and team members feel when they are asked to hide. And I I thought about even what I did to hide that. And one of the most common ways I see that, and I think everyone listening to this could relate to it, is you have a euthanasia at four o'clock, it goes till 4 55, and you have a new puppy or kitten exam at five o'clock, and we hide so beautifully. I have that in quotes because I think it's a sad, beautiful the pain that we experience and empathize going through that euthanasia experience, and often they're extremely painful for everyone in that room, and then are expected to have this bright, shiny, sunny face five minutes later with a brand new client who expects that and deserves that, right? Right. Um, but that is that's not how we feel. And uh we often also, and I and I see this quite a bit in younger associates who are confused and perhaps need guidance and mentorship of am I allowed to grieve with that family? Am I allowed to cry when something happens? Am I allowed to show that this really hurt when I lost this hemoabdomen on the table or I lost this respiratory distress cat in the tree in the treatment area on emergency? Um are we allowed to show emotion? And if so, what level? To what depth? How long? To who? So I saw that quite a bit in human health care. And personally, I related so much more to the clinicians that we met with with my mom, who did show they were human. Um, it felt more authentic. I felt more connected to them. I felt like then I could show that, um, showing pet parents that we feel it. We're not we are human, we're not robotic. Um, and and I think that's something that as teams we need to align on in our hospitals is what are the answers to all those questions? But most importantly is to allow people to be human, to have, and we'll get to some of the tactics around that, but um, that is so critical for every team member in our hospital to be allowed the time and space to show their humanity.

SPEAKER_01 6:10

Yeah, I I I well, as you were talking, I was reflecting on when I was a CSR, and I can remember distinctly, I cry very easily. Um, very soon.

SPEAKER_00 6:20

I do too.

SPEAKER_01 6:22

And and I don't think, you know, it it made me embarrassed, you know, and I would try and get out of the room as quickly as possible because I'm like, what am I doing? You know, I'm losing my emotions in this room because no one told me that was okay, right? Yes, and I think a lot of a lot of our team members feel that way.

SPEAKER_00 6:41

Yes.

SPEAKER_01 6:42

So as a consultant myself, you know, I work with a lot of practice owners and managers, and I really see that they're under a tremendous amount of pressure to improve efficiency, profitability, access to care. These are things that are super hot topics right now. How in your from your point of view, how can leaders pursue those very real business goals without unintentionally creating an environment where people feel they have to suppress their emotions, their humanity?

SPEAKER_00 7:12

Yeah. I love this question because I've thought about this a lot and as well. And what I want people to understand is that creating efficiency does not equal erasing humanity. You create efficiency in your practice to allow humanity to happen so that you have the extra cushion, so that you have the extra time, so that you can schedule not back-to-back euthanasia, euthanasia, euthanasia, or euthanasia puppy because it youth, right? So that you have the ability to show humanity to clients. Because again, owning a very successful hospital in Chicago where I had, you know, decades and decades of families and legacy clients who kept coming back. I never heard from them in reviews. I'm only a client at this hospital because they have the speediest checkout process. No demand. It was because Dr. Marx stayed with me after hours grieving with me with my pet because we took care of this golden for 12 years of life, right? That it's that's not why people stay. It's important operationally to be efficient for lots of different reasons. We I think Brenda, as a consultant, right, you would agree there's so much opportunity for us to continue to strive for more efficiency. But the connection is what retains clients, right? It's it's not the wow, you have an app and a QR code and you've figured out your payroll, and so you're strategizing. That's all important because it creates the space for us to have humanity. So that's what I want is that we're not we're not choosing profit over people. We're we're creating efficiencies so that your hospital has wiggle room for people to be who they are. And that's the best of both worlds. And so I hope that's clear is that when your hospital is working with consultants like Brenda or working with different apps and technology that comes in to create efficiency, your goal should not be we're becoming more technical and robotic. Your goal should be, wow, this is allowing my people, who is the most valuable part of a hospital, right? Allowing my people to be the people that they are, to be authentic, to show clients that we are humans underneath our our, you know, scrubs and and whatever faces we wear. Um, and I think that's the most important thing. And that is a top-down mentality that can't be the leaders in the practice saying, yes, all of my team members can do that, but I'm gonna show stone face, right? Uh we have to lead by example and lead with warmth, compassion, empathy, and kindness and let that always trickle down.

SPEAKER_01 10:04

Yeah, including that why, I think, is so, so critical because, you know, when the team just hears, oh, she's coming in to work on efficiency, they think of me as that business consultant and I'm just there to help make a better profit. But, you know, I'm so enamored with, you know, medical record keeping with the utilization of AI because the first time I saw it in practice, I was with the team member, I was shadowing. And my takeaway was yes, it saved them time, but the beauty of the depth of connection between the team member and the doctor with that client was just so, so different than it was looking at a computer screen and reading off these questions. There was, you know, we could talk to them like a normal person and have a conversation, and you saw that relationship start to build and flourish. So, yes, talk about the why.

SPEAKER_00 11:03

Yes.

SPEAKER_01 11:04

Um, so as a veterinary professional, we often develop emotional armor. I struggle with this, but I try and put that armor on. It's a way to survive those difficult days. At what point does healthy resilience become emotional self-protection that actually disconnects us from our patients, our clients, or even our own purpose?

SPEAKER_00 11:29

Yeah. I struggle with this too. Um, and I've all sometimes gone too far. And I think that's that's one of the points that I want to stress in this in this this moment here with you. We have to remember, and I think this is an important point. Resilience flexes, right? So you might have a challenging interaction, a difficult conversation with a team member or a challenging client. But remember that resilience flexes into those difficult, uncomfortable spaces, but it comes back. Armor gets put on and it doesn't flex at all. So it takes some self-awareness and reflection as a veterinary professional in any role in a hospital to step back and say, Have I put on my sort of coat of resilience today? Or am I shielded in full armor? Because the people shielded in full armor are the ones that are saying, when someone says to you, How are you doing today? I'm fine. I'm fine, just move it on. Or you are in a euthanasia and you find yourself numb. I have no feeling about this. Either way, I have no feeling. Whether it's could even be frustration, I'm two clients behind and this should have been something else. And you're going through all these, but if you aren't feeling anything, if you've gotten to a point where nothing seems to touch you inside, it's because you've left your armor on too long and you're not choosing healthy resilience. I like to teach a concept of clinical empathy. We all are empathetic people, or we wouldn't be in this profession. But remember, empathy involves putting yourself in the other person's shoes and trying to imagine what that might feel like to be losing their family member or to having to choose between what's in their heart or what's in their budget, right? In making decisions. There's a lot of those moments that happen throughout a day in a hospital. Clinical empathy, though, protects you a bit in that you're putting yourself into that person's shoes in the clinical moment. Not, wow, now I all not just I'm dealing with having to decide, you know, I've got a bleeding, you know, bleeding abdomen in front of me, and this client's trying to make change, make decisions about whether to pursue treatment or choose end of life discussions. But then what happens is we often go beyond clinical and we go to, and I know this family's dealing, their son is ill at home, and the husband just lost the job, and now I've got to, and then we take on this whole other empathetic picture, which weighs on us. And that is one of the factors that leads to compassion, fatigue, and burnout. Instead of us practicing to deal in the clinical moment, we can deal with clinical empathy. That allows us to be resilient and come back. It's when I took on family's entire other life, right? Uh, all of the other things that are part of their human story and had to weigh that down on me too. It's not to say we can't lead, again, be compassionate and kind and patient. But if we focus on the clinical empathy part, yes, it must be really hard to have to decide between end of life and choosing a referral that doesn't have a good prognosis, right? I can empathize with that. I understand clinically what that means, and I can stay in that world so that I can be resilient and come back for my next client. But most importantly, I can come back to the family I have waiting at home for me that needs me to be a mom or a parent or a, you know, a spouse or a partner or a friend or whatever I have roles at home, right? That's priority two. So I think that's key is to take a moment when that'll take a walk outside at lunch or quiet time at night or over coffee and think to yourself, have I honestly had moments where I haven't felt anything? In those euthanasia, in those hard discussions, when a team member comes to me crying about another case, are you numb? And if you are, the first step is acknowledging it. And there's no judgment here. I've been there. I've been there myself. But it's a sign that we need to recognize you might be armored versus resilient. And we can help. There are resources and lots of ways for us to take that armor slowly off and allow you to practice clinical empathy. So um, maybe that's something we can talk about at a later time, Brent. I don't want to go over the whole podcast. But I think that's that's the line that I see that people need to acknowledge and be self-aware of. And then we can try to get back to the resilience part.

SPEAKER_01 16:20

Shed that armor. Yeah. Yeah. So if if a hospital leadership team were listening to today's podcast, this conversation together, and they wanted to start creating a culture where people feel safer being authentically human, what's one practical change that they could make tomorrow?

SPEAKER_00 16:43

I would say it's permission to pause. So even if it's 60 seconds, even if you have a space in your hospital, it could be a remodeled closet. It doesn't have to be big, but a space of silence and safety that a team member can go when they need a pause and not be penalized for it. Right? You've got an appointment waiting. There's gotta be a way to message that this person needs that time to pause. They need time to regroup, they need time to shed the tears, they need time to freshen their face, they need time to take some deep physiologic breaths, calm down their nervous system, acknowledge that it's okay what they did, not be rushed into another moment of critical thinking and emotional kind of instability because it compounds and it becomes traumatic. And just like we've been talking about now for a long time around the emotional health of pets and how those traumatic moments are triggered and permanently stored in their amygdalas, the same thing happens in people. It's traumatic, it's stored, it builds. It's gonna take longer the next time that person has a similar experience to recover to baseline. So I would encourage leadership teams to also role model and demonstrate this, but the permission to pause, even if it's just 60 seconds, to regroup on your own turf in a safe, secure space where no one is bothering you, and the ability to then with a clearer mind and also that permission that you are allowed to show those emotions with no judgment on performance or no judgment on you as a team member, and then return to work. I think there is soft and passive language in hospitals around this, but I would love a formalized policy around that. So there is weight to it. Because I don't think every hospital holds people accountable to this as much as they say, because it's easy to see, especially clients, you know, I've been waiting, blah, blah, blah, or phone calls waiting, or an email's waiting, or and pretty soon I know this happened to me as an owner. I've got four people standing outside my office waiting because I'm, you know, I've got to answer all these different questions. We're human too. So you get permission to pause after a challenging conversation, after a sad case, after an outcome that's not expected, a complication, anesthesia. Everyone gets permission to pause. And I think if we could formalize that across the board and hold people accountable in the best way, right? That they do get that permission without judgment or penalization on performance, it would change the game.

SPEAKER_01 19:35

You said something I think very important, which was the leadership team has to model this for them. I remember working with a client who he was taking me a tour through his practice, and he'd built the most beautiful staff break area with couch and all he'd taken everything into consideration and he said, Yeah, but nobody uses it. And I stopped and I said to him, I'm like, Where do you take your lunch? Oh, well, I don't have time for lunch. And I'm like, you've got to model what you want the team to actually do. Otherwise, they feel like the expectation is keep going. That's why they're not using this room. And so I think that is a very important point here because I could see some of our listeners running out and saying, Oh, let's just create a little meditation room, and then they just keep running. And it's like, no, it's like you've got to take that pause, you've got to give it a embrace it yourself as a leader. Yes.

SPEAKER_00 20:29

Yes.

SPEAKER_01 20:30

So when people leave this episode and they head into work tomorrow morning, what's one thing you hope that they'll do differently? Not because it's better for the business, but because it's better for the people doing the work.

SPEAKER_00 20:44

I hope that everyone listening that's in one of these moments where it's not a routine wellness vaccine, but there's emotion of some kind, whether it's heightened or lowered or anywhere in between, that they allow it to land. That they allow themselves to actually be present in the moment, not judge themselves if they get emotional, not judge themselves if it takes that permission to pause to recover, but to allow their a small part of your humanity to show to a client. And I for a long time struggled with does that make me look weak? Does that make me look less confident? Does that make me look um less stable, right? And not in control, especially as a hospital owner or leader. And what I found was the exact opposite. It showed vulnerability, it showed humanity, it was much more approachable to my team, to my clients. They related, they didn't see it as so distant. It actually brought us together. So I would encourage everyone, even if it's a small micro moment, to allow the pause, allow it to land, allow yourself to feel, not be numb, but then give yourself that permission to pause. Don't feel you have to rush right into the new puppy appointment. Don't feel you have to rush through a moment because you're afraid you might show emotion. Um, I'm not saying, yes, sit with a client for six hours and divulge your entire life story. Um, it's micro moments. It's practice. It doesn't come naturally to all of us, and that's totally okay. But give yourself a moment to just be in the moment and see the reaction from the other side because it's very rare that it's not positive. And the one thing I think, Brenda, you and I, we align a lot of things, but I think one thing we would both firmly align on is that this is a relationship-centered industry. We're not transactional. We are about human-animal bond at the very core. So develop the relationship. Relationships mean trust two ways, right? So when you show trust in the room that you can show emotion, your client will in turn see that. And that strengthens your bond. And they will show and potentially even divulge information that helps you take better care of that patient, right? Things that they were potentially a little too nervous or scared or anxious to divulge. Um, it only lends itself to better bonds and much more rewarding practice.

SPEAKER_01 23:40

Well, thank you so much, Dr. Marks, for being with us today. And thank you to our listeners for flying with us on Flight Plan Quick Consults. Thanks you to our generous sponsor, PI Mid Atlantic. If today's insights helped you climb to new heights, be sure to subscribe, leave a review, and share this episode with your crew.