This article was originally printed in the Nov/Dec 2022 issue of the California Veterinarian magazine.

Most of us in veterinary medicine are pretty good at rolling with the punches. I have worked in this field for 20 years, and I struggle to think of a day where everything was “ideal.” There is always a piece of equipment broken, a staff member absent, a computer system that was down. Truth be told, I love problem solving and the “get it done” attitude in veterinary medicine. It has always provided me with ample opportunity to flex my adaptability and that skill has served me well.

For several years, I was one of the only locum neurologists in the country. I would fly around state to state, and fill in for other neurologists. Always a new staff, always a new computer system, a slightly different set of surgery equipment. Many days I wasn’t even really sure where the bathroom was in the clinic I was working in and I was pretty comfortable with that. My brain enjoyed the fresh challenges.

However, even as a highly adaptable person, the last year has exceeded my comfort level. I have not adapted as rapidly, or as completely, as I usually would. Resources taxed to the max, and uncertainty in every decision put me in a space where I felt like I was just holding my breath. The lack of even a clear endpoint to this emergency left me gritting my teeth and just putting one foot in front of the other. I was surviving the challenges, rather than adapting to them.

Dr. Han Selye, a renowned researcher in stress, described that our reaction to prolonged stress has three stages: alarm, resistance, and exhaustion.

Alarm is that first huge adrenaline and cortisol surge we get. Remember the first day of lockdown? I remember talking to my friend Dr. Bruce Francke shortly thereafter. Bruce is a practice owner and during this stage, he described their conference room as “the war room” where he and his practice manager would have daily meetings to talk about how to implement safety policies.

This phase can be exciting. As an adrenaline junkie, I will admit I sort of love it. However, the shock eventually wears off, the adrenaline bleeds away leaving only cortisol, and that is when resistance begins.

In resistance, your body is trying to adapt to a sustained level of cortisol. But much like that balding, pot-bellied Cushingoid patient you saw last week, you don’t deal well with a constant high level of stress hormones. I was in this phase for about four months. Curbside was no longer logistically difficult. The uptick in emotional outbursts from my clients was no longer new. I have a pile of masks that color coordinate with my scrubs by the front door. I was surviving, but I would not call it thriving.

As the stress continues without adaptation, we enter into exhaustion. Exhaustion is where we burn out and can’t deal with things we normally could handle. We are simply not designed to sustain a high level of alarm and stress.

2020 has been a signature year in its constant barrage of stressors, so it is really no wonder that so many veterinary professionals I talk to are simply exhausted.

Exhaustion crept up on me in September. I am vigilant about burnout, so when I noted some of its signature signs (exhaustion, cynicism, and inefficiency), it shook me out of the routine of getting through the day. I recognized that my current mode was not sustainable and I needed a reset.

I had been skipping taking time off, a vital part of my self-care, because honestly where would I go? Plane trips, hotels—all of the things I would normally do on a vacation—aren’t really practical right now. But the truth remained, I needed a reset.

After a bit of creative planning, I found a pandemic-friendly vacation: an Airbnb within driving distance of my house. After a few blissful days away, I finally stopped holding that breath. With fresh eyes and a rested brain, the creative thinking and planning parts of my brain have sprung back to life. And rather than just putting one foot in front of the other, I finally feel like I am taking productive steps towards not just surviving, but thriving in this new environment. I am starting to truly adapt. I feel like myself again, or at least I am starting to.

If you are feeling that exhaustion, I encourage you to take a step back in whatever way you can and let yourself recover. How to accomplish that reset is different for everyone, but the need for it is universal. To truly adapt, we must respect that our body and our brain need a break from the stress. You cannot hold your breath forever.

This wellness series is proudly brought to you by a sponsorship from Boehringer Ingelheim Animal Health.