drferox:

pharmdup:

drferox:

pharmdup:

dxmedstudent:

shinethewaythrough:

drferox:

drferox:

You’re new here and under no obligation to stay.

So it really pissed me off reading this, Anon. I have put far more time and emotional labor than is reasonable into this blog, more than is sane, and strive to be ‘compassionate & empathetic & patient’, but also honest, and that includes honesty about how I’m feeling and mental health.

And that ask, the chocolate one, if it’s the chocolate that we seem to think it is, is the equivalent of “MY CHILD DRANK BLEACH HELP WHAT DO I DO!!!!” And unless that dog was very large or actually ate something smaller and safer than we thought, may well be dead. Unless they actually gave up waiting for me and called their vet. 

That’s beyond frustrating, and it’s not even the worst ask I’ve had this week.

You don’t see what I delete, Anon. Some asks are just so awful from an animal welfare point of view that I feel sick, and don’t want to expose readers to. You have no idea.

I will give my everything to clients and patients, at work. The animals in front of me are always a priority. This blog gets what’s left, and while it strives to be honest and open it is not a professional space. 

And I reserve the right to administer boots per glutes as indicated.

Anon, all due respect, but if you’re actually in a medical field you had better rapidly gain an appreciation for Dr Ferox’s professional ethics and standards, and her approach to being an “out” medical practitioner online. You may have chosen your profession out of an enduring love for your fellow humanity but you’re going to burn out or get sued if you can’t learn that sometimes a hard no is the only message that’s going to sink in, and that hard no is going to ultimately save lives.

I get it, and I agree–of course vets and doctors are empathetic and caring and help their patients. And yet they will still deliberately do things that are going to hurt patients, because the alternative is going to hurt more. Vaccinations? Hurt. CPR? Breaks ribs. Spay procedure? Major surgery. Chemo? Literal poison. But flu shots and CPR and spaying pets and chemo saves lives, and so vets and doctors go ahead and do it.

Dr Ferox is trying to save lives. She can’t do that if people are wasting the few precious minutes their pet might have by sitting at a computer, messaging a stranger on the other side of the world.

And when it’s not just one or two random drive-bys but literally hundreds of people? Hundreds of pets a year, all not being cared for by a vet in the same postcode because people don’t want to believe a FAQ and think that their case is special? Yeah. Fuck being polite.

Storytime: I was petsitting for my brother and SIL a few months ago, and their dog chewed up and swallowed most of a soft aluminum can, the kind that dog food comes in. I was prying sharp jagged little bits of aluminum out of his teeth, and there was over half a can missing down his thoat. For about a half second, I thought “hey, better google!”

Then–I swear, it was like a physical voice in my ear–I imagined Dr Ferox being really pissed off and saying “NO! CALL YOUR VET!”

I called my vet. I took my brother’s dog halfway across Sydney (a city I do not live in and had never driven in before) at midnight to get to the emergency vet. The dog was carsick and threw more of the can up, and they did x-rays and confirmed there was no more danger. He’s now happy and healthy and without any ill effects and it’s because Dr Ferox has never pretended that, polite or rude, her advice is ever going to be anything except CALL. YOUR. VET.

Hold up, anon, let’s have a chat here. I’ve seen anons like this directed towards nurblrs, medblrs in general and vetblrs to varying degrees of politeness, though I feel sorry that Dr Ferox seems to be going through a particularly bad case of them at present. 

I think it’s also interesting that our supposed-medblr anon is… on anon. I’m a little disappointed at that; I really hope this isn’t a well-known member ofthe medblr community, someone who really should be able to put their name (or at least their medblr persona) behind criticism of another peer. Though it was probably well-intentioned, anon one-way criticism isn’t usually constructive, IMHO.

That’s the thing; it’s easy to criticise people when you’re not put in the same position as they are. We don’t know whether anon even has a blog (or is actually a medblr, because anyone can say they are whoever they like on the internet; technically nobody has any proof I’m a doctor, for example), or whether their blog is an out-and-out medblr that actually gets treated as a place to seek medical advice.

Because as someone with probably significantly less traffic than DrFerox, but still a reasonable amount of stuff filling up my inbox (I haven’t been under 80-100 asks in a while), you can get a lot of questions. And some of them are wildly inappropriate, even if they are sent with the best intention. I’ve been sent requests that amount to asking for a diagnosis; by people who perhaps felt like there wasn’t another option. There’s a reason I can’t answer all those asks at once, they are often quite draining. I can imagine that with a bigger volume of asks, it becomes even more draining; I honestly don’t know how Dr F copes, and take my hat off to them for managing to answer what seems like an endless stream of questions as best as they can, whilst having a busy chaotic life outside of tumblr. 

It can feel like a lot of responsibility, particularly when you usually can’t answer straight away; asks about physical or mental health can often be quite urgent. Hey, this isn’t an official help service; tumblrs that open their asks aren’t signing themselves up to provide an actual service, it’s all voluntary chat which might, at best, make people feel a little better. When people ask medical problems, it puts a pressure on you to give an answer that you can’t give. You don’t have the history, the examination, the investigations, the entire health system you work in, in order to provide a actual service. So you almost always can’t (and shouldn’t) provide any medical advice online, but sometimes people struggle to understand or accept that, because they may be at a point of desperation in their lives, and it seemed like a way to get help. 

People go on tumblr after they already pull long shifts during which they are expending all their energy giving compassionate advice and being their best most professional selves. It’s already exhausting to keep up; if you are a doctor, I’m sure you’d agree.Then people come back to tumblr, after long shifts, emotionally wrecking cases at work, personal life drama, and whatever else is going on in their lives, sometimes to be inundated with hundreds of, what is basically, cries for help. Sometimes genuine, sometimes lazy, sometimes just needing reassurance. It can be really, really hard to deal with this. Even though we happen to have blogs about healthcare, those blogs are not a health service. In short, those blogs do represent the professions to a degree (best not to do anything truly horrific as a med/vet/nurblr), but they are not a service and these people are not our patients or clients, but our readers. And what readers can expect is a bit different than what patients can expect; no blog could truly operate at all if it was literally run like a clinic; clinics are all about the patients, but blogs are about the person behind them. Which means that blogs are at least partly, often about people expressing the challenges they deal with, their frustrations with the system, their thoughts, occasionally venting etc. You can’t expect a blog to be run around what you think the person should write, or how they should do it. 

And though I wouldn’t personally form the same persona as different medblrs/nurblrs/vetblrs etc, that’s entirely a personal choice to make; it’s really up to everyone how they choose to do it. This isn’t their workplace, and it’d probably be unfortunate for someone to attach a really outlandish persona to their actual name on the internet, it’s their choice to make, and the consequences for how they treat their internet persona will be theirs alone to take. Whilst I’d probably say something about anything wildly inappropriate, I think it’s important that we don’t decide it’s up to us to police our peers based on our own personal tastes any time we feel they acted slightly different from what we might ahve done, especially if we don’t have the context behind their actions. There’s a difference between ‘unacceptable’ and ‘not how I do things’ that seems to get lost on the internet sometimes. Given our differences in profsession and country, we usually don’t have the background to comment on the standards expected of someone in the country they practice. I’m uncomfortable with how often the ‘medical professionals should act in a way I see fit’ card is pulled by people when it basically amounts to silencing them, or holding them to some kind of inhuman standard of mood and behaviour and I think we need to be careful to ensure that we’re actually focusing on behaviour that is actually damaging to our professions or actually unprofessional. A doc or nurse or vet saying ‘look dudes, i’ve answered this question 50 times this week and I told you I don’t give medical advice so please don’t ask, it’s exhausting; is really… not bringing anyone into disrepute. I think the professions can handle the reality that people can be a bit blunt sometimes.

But I think this goes beyond the several blogs I’ve seen criticised for this, I really think we need to do better at acknowledging that doctors and vets are real human beings with feelings and moods, same as everyone else. yes, we’ve got a professional persona to uphold, but frankly, the outdated image of docs, nurses, vets etc as superhuman perfect individuals who are immune to all human emtion has to go. We’re just… not. And the idea we have to be perfect at all times is damaging and adding pressure to professions that are already plagued by mental health problems; look at the mental health stats and tell me that we are doing well at looking after ourselves. If anything, we are all so used to working within crushing systems and dealing with heartbreaking, difficult things to the point that we normalise suffering and neglect self-care.

If you go to someone’s personal blog, it’s entirely reasonable for someone to say ‘Sorry, I can’t answer that, read my FAQs’.  It’s generally considered good netiquette to read FAQs before submitting questions; this is not new. And given the volume of messages on Dr F’s blog, it’s not surprising if they are tired of fielding the same questions in hundreds of messages. 
I don’t know if anon knows what that feels like, but I can tell you that it’s exhausting; it can  feel like something that is draining you dry but you don’t really know how to stop, and no matter what you say, it keeps pouring in.

There’s a reason we’re not expected to be on-call fielding questions 24/7, and that’s because we too get exhausted and tired and hungry and can’t always be at our 100% best all the time.  It’s certainly acceptable for her replies to become perfunctory at this point. The way people in general (not Dr F specifically) approach this can sometimes be blunt and to the point, but that is part of these blogs being run by humans. And part of docs and vets actually being human.

And lastly, being a vet isn’t exactly the same as being a doc. Though the diagnosing part might be similar to paeds (your patient can’t talk, the parent/owner can help or hinder based on how good they are at being caregivers), the fact remains that we have patients and they have patients and their human clients. Their human clients don’t have the same emotional involvement as a patient does; not that it isn’t significant, but it’s different. Vets face challenges that we don’t (and vice versa), and really, we should be doing what we can to understand and support each other. I certainly don’t think it’s fair for a human doc to tell a vet doc how to do their job, or how to run their blog, which is otherwise an exemplary resource of information and compassion.

In fact, I think we have to be pretty thoughtful before we go lightly telling our peers how to go about things; anonymised ‘I don’t like how you run your blog’ messages don’t foster conversation or examination of how we can do better. And it’s often surprising how little compassion the components of those messages show when writing those messages to begin with.

I think the role we can play in actual healthcare online is really just referring the reader to a provider who can take care of them. That’s it.

It shows how much all of us are devoted to (or swallowed up by) our fields that we identify as our professions online.

We want you to get help. All you can get from us online are the bits left over after our jobs have drained us. Healthcare workers are humans, too, and you deserve someone fresh. We’re often terrified of how providing advice without adequate assessment may cause harm.

I’m so sorry that the vet/med/nurblr asks can be so draining. It’s okay to be humans.

Link to AHRQ’s updated advice on managing the second victim phenomenon that we experience.

I am really hoping this ‘one step removed’ and moderated ask box will work. Already I’ve had less asks than usual and so far none have been particularly rule breaking, so I’m optimistic about this little experiment.

But I have been thinking about the numbers a bit.

There are just over 16,000 people following this blog right now, assuming you are all people and not many bots.

Conventional wisdom estimates that a population of 10,000 with average pet owning density (about 2/3 owning pets) will provide enough work for one full time vet. If I assume most of my readers are pet owners then that’s enough people to keep almost three vets occupied full time. No wonder I was going insane.

(And in hindsight this sickness plaguing me probably did not help anything)

Coming into my blog to ask questions is not the equivalent of asking me something at work. It’s the equivalent of cornering me in the supermarket while I’m in my slippers doing a sneaky ice cream run, or in the pub trying to unwind. I can certainly talk to people, but anything that needs a vet on duty right now needs to be referred to a vet, on duty, right now. And that is not me.

I should get to have some Ferox time. And those reading the blog for many years will have noticed this getting harder and harder as the asks grew and grew. And now it’s at this point where I find a way to strictly enforce boundaries, or I quit.

The ‘second victim’ thing is really interesting, because I do see vet students or new vets sneaking into my ask box for emotional first aid, and I will gladly give time to them, but I end up being overexposed to death stories, which takes its own toll.

I don’t know entirely where I wanted to go with this reply, but I do want to say that I think the situation we find ourselves in with social media is relatively new. My mentors just talked about not living too close to where you worked, so you didn’t run into clients when shopping or walking the dog. Now it’s like if you reveal your profession online, they find you.

The boundaries and right to be human feel like they’re only there if you fight for them.

Close your ask box. Open it when/if you feel interested in engaging.

Honestly, I think you should just keep it closed as a standard procedure and make an announcement for those times when you feel like temporarily opening it.

I’m behind you in your fight for boundaries. I had a mentor years ago who was teaching me about how women often don’t know where to set boundaries. She told me that if something makes me feel at all uncomfortable or unhappy, then that’s a signal for where I could create and enforce a boundary.

Working in healthcare as we do, we’re so often trained to walk over all of our feelings of discomfort about personal care. But you’re not in training anymore.

Your askbox seems to make you uncomfortable right now. I recommend setting a boundary for yourself. Close it. Use your tumblr to explore your thoughts and feelings about your experiences as a vet, or you know, as being a human, rather than another opportunity to solve strangers’ problems.

Use those who love you to help you with the boundary, too, if you trust them and if it sounds appealing to you. Ask a friend to delete all of your current asks in the box before closing the askbox.

Release the burden and breathe.

The ask box is closed. It’s down to 75 now!

I hadn’t ever wanted to close it entirely because I would intermittently get vetlings in acute distress and I didn’t want to close off one of the few anonymous places they could reach out for that sort of first aid.

I am hoping that by setting up the new ask box in this way, with other people moderating, it can function more like a ‘clinic setting’ where other people who are not as bothered as I am can screen the asks and enforce the boundaries without feeling guilty, like having front desk staff who control which problems go through to those working out the back.

It’s actually been closed for ~2 days, and there have been distinctly less rule breakers come through in that time, as well as less asks in general. I’m really hopeful it will work this way.

As for the breathing, that brought a smile to my face because it’s a whole other challenge in and of itself right now.

I wanted to add something former vet tech student… when i was in school… in my first year even my friends and family would go to me any time their pet had problems.  

My response?  Call your vet.

A. I am a student.

B. Techs legally cannot diagnose anything

C. I AM LITERALLY A STUDENT WTF

So yeah.  Dr. Ferox you do what you have to.  Be “rude” or whatever until someone gets the fucking hint.