The last veterinarians in town
If you've been having trouble getting in with a veterinarian, you're not imagining it. Across the country, pet care is increasingly hard to come by, and more vets are leaving the job.
Alaska’s capital city, Juneau, has lost roughly half of its veterinarians since the pandemic began. Pet owners often have to wait several weeks for an appointment, surgery is scarce, and 24/7 emergency care doesn’t exist.
Now, a local animal shelter is stepping up to try and fill the gap for desperate pet owners, who often have nowhere else to turn.
In an industry rife with burnout, turnover, and high suicide rates, veterinarians and vet technicians are being forced to choose between taking care of animals and taking care of themselves.
Featuring: Tracy Ward, Jocelyn Andrea, Krista Miller, Sam Smith, Sam Blankenship
Juneau Animal Rescue veterinarian Tracy Ward milks a baby kitten on her break.
Sam Smith, one of just a handful of full-time veterinarians in Juneau, Alaska, flattens out the teeth of a miniature horse nicknamed “Skeletor”.
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CREDITS
Host: Nate Hegyi
Reported and produced by Nate Hegyi
Mixed by Nate Hegyi
Editing by Taylor Quimby
Additional editing help from Justine Paradis, Felix Poon, Rebecca Lavoie and Jessica Hunt.
Rebecca Lavoie is our Executive Producer
Music for this episode by Blue Dot Sessions.
Our theme music is by Breakmaster Cylinder.
Outside/In is a production of New Hampshire Public Radio
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The Juneau Animal Rescue
Audio Transcript
Note: Episodes of Outside/In are made as pieces of audio, and some context and nuance may be lost on the page. Transcripts are generated using a combination of speech recognition software and human transcribers, and may contain errors.
Nate Hegyi: Hey everybody. You’re listening to Outside/In, I’m Nate Hegyi.
I’ve been spending a lot of time lately in Alaska’s Capital City, Juneau.
It’s a hip little town full of hip coffee shops and cool breweries. But it’s also surrounded by epic waterfalls, towering green cliffs and tens of thousands of acres of wilderness.
So it can be a dangerous place to run around in the woods.
Kipper learned that the hard way.
Here’s his best friend Barbara Berg:
Barbara Berg: Normally he’s pretty good off leash, so they were out fish creek and he found a porcupine
Barbara Berg: He’s a terrier, he’s a Cairn terrier, so he charged right in there and came back with a face – with a mouth full of quills. And so…. Can I stop you?
Nate Hegyi: I’m recording Barbara in the waiting room of Juneau Animal Rescue. It’s a somewhat drab looking building alongside Glacier Highway. There are a half dozen other folks here with their dogs and cats.
Kipper got his face full of quills the night before. But despite hours on the phone, Barbara couldn’t find an open vet anywhere that had the space to treat him.
So he wound up here.
Barbara Berg: He spent a pretty uncomfortable night out in the garage on this pile of blankets. And then today I started calling around. It's hard when they're not feeling good. There's nothing you can do about it.
Nate Hegyi: To be clear - animal shelters are more like orphanages than they are emergency rooms. They’re not designed to provide serious healthcare. Juneau Animal Rescue can’t do X-rays, or blood work, or most surgeries.
But they CAN dequill dogs. And perform euthanasia.
And, here in Juneau, they’ve become the last stop for desperate pet owners.
That’s because even though there are 32,000 people here… and literally thousands of dogs and cats… right now there are only FIVE full-time veterinarians in Juneau. And that number has been shrinking.
Jocelyn Andrea: we have a seven year old Cairn terrier that got tangled up with a porcupine.
That’s Jocelyn Andrea. She’s got an arm full of tattoos, a dry sense of humor, and works as the veterinarian technician there, which is kind of like a nurse.
She does all the support work for the Rescue’s LONE vet, a part-timer named Tracy Ward.
Jocelyn Andrea: Some of the dogs will try to pick up the porcupines and shake them and everything, and then you're stuck pulling them out of the mouth, under the tongue, in the tongue. Um, usually if they shake them, they get quills all over their chest.
A single porcupine can have up to thirty-thousand quills hiding behind long guard hairs on its back. And each one has these microscopic barbs that face backwards like a fish hook. So they slide in easily enough but they are really painful and tough to pull out.
Jocelyn has spend as much as two and a half hours digging for quills from a dog.
Jocelyn Andrea: As you can see, they’re in pretty deep.
An animal in the wild can die from a face full of porcupine quills. They can’t eat, can’t hunt….
For pets though , quills are rarely lethal - but if a piece is left inside, it can migrate… Pushing DEEPER inside - sometimes into a dog’s organs, or its joints, or even its brain.
So dequilling is a really important and meticulous job. Jocelyn thought she had gotten all of them out, but then she swept her finger over Kipper’s nose… and felt something sharp
Jocelyn Andrea: [whispers] Fuck.
Nate Hegyi: [00:55:04-00:55:06] Is there one deep in there?
Jocelyn Andrea: Yeah, there is. Hey, Ward?
Tracy Ward: One sec. Oh man
Jocelyn Andrea: That might need be a cutdown. No one move.
Tracy Ward: I don’t want to do a cutdown on her nose because they bleed pretty bad, if you can avoid it. I see it.
Jocelyn Andrea: I see it, too. It's right there.
Tracy Ward: [00:57:35-00:57:40] Just go really slow… traction… it's coming.
Jocelyn Andrea: Don’t touch it!
Tracy Ward: [00:58:01-00:58:08] good job! Yes. You are the best tech ever. All right. Awesome.
MUX [ambient subtle music]
Nate Hegyi: Kipper’s situation worked out okay. But there’s no guarantees.
Over the past couple of years, Juneau has lost roughly half of its vets.
This means it can take several weeks to get an appointment, surgery is scarce and there’s no 24/7 emergency care.
So if your dog or cat has a serious medical emergency? There might not be anybody available to save it.
MUX
This isn’t just an Alaska problem. Across the country, there’s a growing shortage of veterinary care. The turnover rates for vets and vet techs are higher than physicians or even nurses.
So Today on Outside/In we’re shadowing the folks at a remote animal rescue to see first hand what happens when a small, isolated town can’t find enough vets - and we’ll try and find out why they’re disappearing in the first place.
MONTAGE
If we burn ourselves out we can’t help anybody // // A veterinarian can only work so many hours a day before they are exhausted and have to turn people away. I can't do it all. There is a limit as to what I can do. I can't be on call 24 seven.
Stay tuned.
#####
ACT 1
Jocelyn Andrea: Can you throw a warmie in?
Tracy Ward: I can.
Dr. Tracy Ward and Jocelyn spend most of their Tuesday mornings in surgery… fixing stray cats and dogs.
On the day I visited they were inserting an IV into an older female cat. It wasn’t going great.
Jocelyn Andrea: All right. Oh, fucking A. It's blowing a little bit. We'll just see how it goes. Okay?
And the pressure is on. Because they both know that these animals don’t have many other places to go.
Jocelyn Andrea: I'm the only pony in town, so if I mess up. No one's coming to save me, you know? Kind of like if Dr. Ward slips and falls and breaks her head on her way into the surgery room….
Nate Hegyi: You’re kind of screwed?
Jocelyn Andrea: We're all kind of screwed, yeah.
MUX
Juneau wasn’t always like this. A few years ago the city had about a dozen working veterinarians and a big clinic that offered extensive, on-call emergency care.
But then the pandemic hit. A couple vets retired. Others moved away. That big clinic with the emergency services closed. And in Juneau, recruiting new vets is really tough.
Tracy Ward: It's remote. It's a difficult place to get to. Housing is expensive.
Not to mention the winters are dark, wet and icy. It can be a hard place to live. But it’s still Alaska’s capital city. And the demand isn’t going anywhere.
And getting care isn’t just about the pets. It’s also about public health. Vets give vaccines that help prevent disease outbreaks of things like rabies, and they perform surgeries that help control populations of stray animals.
The day I shadowed Tracy’s team, they were holding a public vaccine clinic.
They’re by appointment only. On Tuesdays. And their schedule was full.
They had something like forty cats and dogs that needed vaccines and quick health checkups.
Jocelyn Andrea: [01:04:27-01:04:29] we're literally booking the appointments every 8 minutes.
That’s a new patient, every eight minutes, for FIVE HOURS.
One of the first clients is a kitten. Got some quick snuggles.
Tracy Ward: [00:12:13-00:12:14] Oh, you brave.
Then Tracy went right to work.
Tracy Ward: [00:11:29-00:11:44]Eyes, ears, nose, teeth.
A snappy physical exam:
Tracy Ward: Listen to his chest. Palpate his abdomen for any lumps, bumps, abnormal.
Then she gave him his shots, put some goop on his fur:
Tracy Ward: Ok, baby. Poke! Oh brave kitten.
And then kitten was out the door.
Tracy Ward: Oh brave kitten.
Eight minutes.
Next… a Malamute puppy.
Jocelyn Andrea: Hi kiddo!
This dude was a fluffball. But as soon as they picked him up off the floor and onto the examination table… he turned into a Monster.…
Malamute: slight screaming
Malamute: major screaming until he goes quiet.
Staffer: Oh my goodness.
Staffer 2: Talk about a delayed reaction.
He eventually calmed down. Got his shots.
Staffer: Oh my goodness, hello buddy, you’re okay
Staffer 2: You’re okay, come here.
Out the door. Eight minutes.
In a way, these pets are facing many of the same problems human patients do. They’re not getting enough facetime with their providers to do preventative medicine.
Tracy Ward: Like normally, if I was in a private practice, I would be talking to the owner about.
Jocelyn Andrea: Yes for Rabies?
Tracy Ward: Thank you. Is she on puppy food? Is she on a high quality diet? What kind of socialization are you doing? Are you planning on having your spayed?
And these are just the puppies. The healthy ones. For older dogs, there could be a serious issue under the surface. .Like, there was this spaniel that showed up. Tracy could tell immediately something was off.
Tracy Ward: His eyes are a little bit buggy. Which may be normal for him, which, if his owner was here, would be easy to ask. But it also can be a sign of of under underactive thyroid.
She doesn’t have the ability to run blood work here. Or the time. So she gave him his shots.
Staffer: [‘good job buddy!’]
MUX
Eight minutes. 40 cats and dogs. One afternoon. This is triage for a town that can’t find enough vet care.
Tracy Ward: we're not getting to talk to the client. We're not maybe picking up some some little things that might not be immediately obvious. Some of those kind of things. It's a it's a it's definitely a trade off and it's stressful for me. And we have to remind ourselves that we're providing a different service that right now is probably more important.
[mux]
[Meow! Meow! Door shuts ]
While Jocelyn and Tracy were busy doing vaccines, I went on a quick tour of the rescue with Juneau Animal Rescue’s executive director, Sam Blankenship. She took me to this room where they were housing a litter of kittens.
Nate Hegyi: Look at all these guys, 1 2 3 4 5 6 of them? Wow you’re climbing up on me. You want my cords? You want me?
Sam Blankenship: I'm not a climbing tree. Where is he? There you go.
Nate Hegyi: Just love climbing up on me, pooping on me. Whoops. That's okay.
It wasn’t okay. It took a long time to wash off afterwards. Lucky they’re cute.
Nate Hegyi: You’re so tiny! So tiny.
Sam Blankenship: So tiny.
Cute… but there are also way too many of them.
The irony about a vet shortage, is that the fewer vets you have, the more you’ll eventually need.
And that’s because when people aren’t able to easily get their animals fixed - it can lead to a boom in the local population of strays.
Sam Blankenship: Cats breed like rabbits. *laughs* cats breed like cats.
Sam told me they've had double the number of kittens this summer than previous summers.
Sam Blankenship: we're seeing ramifications of the last few years of people not having access to any spaying or neutering or low income spaying and neutering on a regular, steady basis. And we're seeing this explosion of animals, specifically cats in Juneau.
MUX
All of these kittens will eventually get fixed by Tracy and Jocelyn before they are sent out for adoption.
<<sound of shaver>>
Nate Hegyi: And so what are you doing right now?
Jocelyn AndreaUm, shaving his testicles. Shaving and prepping the testicles.
That was Jocelyn. They spent a few hours that day spaying and neutering shelter cats. This one is only a few weeks old. He’s zonked out of his mind on drugs. And… he’s about to get neutered.
Jocelyn Andrea: [00:05:03-00:05:16] So neutering the cat is a pretty quick procedure. It takes us a few minutes, basically, just ligating the vessels that supply blood to the testicle and then removing it completely.
Nate Hegyi: What’s ligating, mean, sorry?
Jocelyn Andrea: Oh, sorry. So tying it off so that it can't bleed. And then we cut off, cut off the testicle and return the stump back into the sack. We leave that open to heal. Male cats can breed numerous times a day and can be responsible for literally dozens of litters of kittens in a breeding season.
Nate Hegyi:Wow. So just neutering one cat. We always say, Oh, we just prevented a bunch of kittens here today.
Because there are fewer and fewer actual vets in town, The rescue is gonna start offering spay and neutering services to the public on a sliding scale. They want to temper this explosion of new strays.
But there’s only so much they can do with limited time and money. It can only pay Tracy to work part-time… Even though she often puts in extra hours for free.
Her boss, Sam, is very aware of how stressful this job can be.
Sam Blankenship: And so we really try and keep each other in check and say, no, it's your day off, go home, we'll take care of this, we'll manage this. So we really try and still still have guidelines, right? // because otherwise, if if we burn ourselves out, we can't help anybody.
MUX
Nate Hegyi: Burnout. A word we’ve heard… a lot
That’s coming up next after the break. But first, have you experienced burnout in your job? How did you handle it? Shoot us an email at outsidein@nhpr.org. We’ll often share your stories in our newsletter and on the podcast.
[BREAK]
This is Outside/In I’m Nate Hegyi.
Burnout.
It’s gotta be one of the most popular buzzwords since the beginning of the pandemic. It’s actually a clinical term according to the World Health Organization. They define it as a syndrome caused by QUOTE “chronic workplace stress that has not been successfully managed.”
This word, burnout, helped fuel the so-called Great Resignation. We’ve seen people quit all sorts of careers from teachers to restaurant workers to vet techs and veterinarians.
Krista Miller is one of the ones that didn’t quit. She’s a vet in Baton Rouge, Louisiana and has definitely struggled with burnout. Says it hit a peak during the pandemic.
Krista Miller: we were slammed because every cough, every sneeze, everybody thought their pet had COVID. And between the number of appointments that were coming in, the protection of your staff, trying to work curbside. It was a lot and it was overwhelming and it definitely led to burnout.
Nate Hegyi: A recent survey found that almost 90 percent of veterinarians have felt burnt out at one time or another.
They can also have a really high debt to income ratios because of expensive student loans.
Then there are some, like Krista, who struggle with being marginalized at work because of their race. Only ten percent of vets are people of color.
Krista Miller: one day I'm facing, you know, normal things like compassion fatigue. And tomorrow I have to deal with walking into the office wondering if people really like me and if my skin tone really matters. So it can definitely be a lot of ups and downs as a veterinarian of color, let alone just being a veterinarian, period.
Nate Hegyi: Now, I don’t know if you caught this, but Krista mentioned a phrase… Compassion fatigue. It’s a close cousin to burnout, but it’s more specific to industries where people deal with pain or death everyday.
Veterinarians have all the stresses of a medical field - AND they routinely put old or sick animals to sleep. After awhile, they might start feeling numb, or helpless, or have doubts about how good they are at the job.
Krista remembers this one dog came in. It just needed a routine heartworm test. But then it suddenly went into cardiac arrest. She gave the dog CPR but she couldn’t save its life and it died.
Krista Miller: And the client thought it was my fault.
[mux]
This dog just came for a heartworm test. I'm not even for sure what happened between the front door and the test and how we got to CPR. So those things sometimes will make you second guess why you took the job. How did you end up in a profession?
You start thinking that you're not good enough and that you're a horrible vet.
Nate Hegyi: These thoughts along with the stress, long hours and a lot of student loan debt can sometimes lead people down really dark alleys. Studies show that veterinarians commit suicide at a much higher rate than the rest of the country.
And around a third of all these suicides were caused by overdosing on pentobarbital, a drug commonly used to put animals to sleep..
Krista Miller: So sometimes it can get overwhelming and you just need a mental health break And I think with that movement becoming forefront that veterinarians are like, Yeah, I do. I need a break sometimes. A real one.
This is why there’s been this big push in the field for a better work-life balance especially after the pandemic.
It’s something Krista has embraced.
Krista Miller: [00:32:59-00:33:13] I can be Mom, I can be Dr. Krista, I can be Auntie Krista, whatever I need to be. I really try to make a conscious effort to be a be a part of other things and disconnect myself from the everyday hustle of being a veterinarian.
But this often means reducing hours or not answering every single worried phone call. Which is why Krista thinks the lack of veterinary care in this country isn’t necessarily because of a worker shortage…
Instead, she thinks veterinarians are just setting healthier boundaries - prioritizing the kind of work-life balance that reduces risk of burnout, compassion fatigue, and ultimately, suicide. .
A recent survey found that more and more veterinarians are willing to switch jobs or even take a pay cut to work less grueling hours.
This works in a big city like Baton Rouge. There are emergency clinics, dozens of doctors to see. As a pet owner, you have choices. As a veterinarian, you have people to cover for you.
But in rural or remote communities, the push for a better work-life balance can have immediate consequences… For both pet owners who can’t find care AND for the vets who stay behind and try to make up for the shortage themselves.
MUX RISE
Sam Smith:[00:16:59-00:18:52] to me it seems like a real high class problem.
This is Sam Smith, one of the handful of veterinarians in Juneau. I met him on a Friday morning, working in a cold damp barn at a farm called Swampy Acres.
Sam Smith: You know, you should be privileged. You are privileged. You should feel grateful to have so much work and have the opportunity to to practice your trade and make money. FADE DOWN
In just about every worker shortage, there always seem to be people who say “nobody want to work anymore.” “What happened to work ethic?” In Juneau, that’s Sam Smith.
Sam Smith:Ain't no free lunch. Never has been. Never will be. You know? Yeah. Have I missed a few parent teacher conferences and soccer practices and whatnot and soccer games for the kids? Sure. That's normal. That's normal. I got to work. You know.
[mux]
It might seem harsh. And maybe it is.
Especially given that sixty percent of veterinarians are women - who don’t all rely on their spouse to take care of the kids, like Sam does.
But you can also see how a guy like Sam could wind up feeling this way. He’s up in Alaska, he can’t get enough help, he can’t even get a vacation without spending thousands of dollars to fly a relief vet up from the lower 48 to cover for him.
When I interviewed Sam, he had just spent the past few hours on his knees pulling teeth from geriatric miniature horses.
Sam Smith: [01:18:06-01:18:10] These little guys. Big challenges. It's hard to get your instruments in their mouth.
[DRILLING SOUNDS]
The one he was working on was so skinny, his nickname was Skeletor.
The sound you’ve been hearing while we talk is the sound of a wet pair of pliers slipping over a molar as Sam tries to rip it out.
Sam Smith: [[00:35:29-00:36:01] I want to get the last molar out of there. I just don't know how to access it.
[mux]
Sam regularly puts in 60 hours of work a week. Misses moments in his kids’ life.
So if he’s frustrated - it might be because he’s overworked and doesn’t often admit it.
Sam Smith:[00:21:11-00:21:24] I can't do it all. There is a limit as to what I can do. I can't be on call 24 seven for every disaster. I need to handle what I can and and I'm at my limit. But it's okay. [00:21:24-00:21:32]
Skeletor started to hit his limit after thirty minutes with those pliers in his mouth.
Sam Smith: [01:37:31-01:37:32] We're close. [01:37:41-01:37:42]
Eventually the tooth popped out of the socket…
Sam Smith: [01:42:10-01:42:24] I've got it out. It's just like stuck back there. His mouth is so tiny. Then I got to try to figure out how to get it. Get the tooth. [01:42:27-01:42:28]
Nate Hegyi: Got it.
Sam Smith: [01:42:29-01:42:45] About time, huh? Yeah. Okay. Good. Well, got it. Took me all day.
[01:46:51-01:46:55] Okay. My knees. My knees have taken a beating. [01:46:56-01:46:57]
Person: Where's your kneepads? [01:46:57-01:46:58]
Sam Smith: In the truck. [01:47:03-01:47:04] So far away. [01:47:05-01:47:09] I might have to take a walk and loosen up and go get them.
MUX
I think what’s happening with vets and really a lot of Americans right now is that we are rethinking how much we want to push ourselves.
What are we willing to sacrifice – what CAN we sacrifice – for work?
It feels like a major pivot from that ‘rise and grind’ trend that I witnessed over the past decade… since at least the Great Recession when good paying jobs were scarce.
Right now, they aren’t. So vets can be choosy about the clinics, the towns and the hours they work.
Beeping sounds, then from Tracy: You want me to feed the baby kitten?
Back at Juneau Animal Rescue, Tracy is supposed to be taking her break.
But instead of eating lunch, she’s feeding milk to a tiny two week old kitten named Smudge.
Tracy Ward: [00:51:44-00:51:58] He was literally found on the side of the road. Barely had his eyes open, no mum that they could find. And no other kittens so far. [00:51:58-00:51:59] It's so small. [00:52:00-00:52:01] He's so tiny.
[00:53:33-00:53:41] Okay, here we go. Yeah. Okay. Wait a minute. Wait a minute.
[00:58:50-00:59:10] been very satisfying. Yeah, really good. The. The response from the community has been. Has been wonderful. So, yeah. So now the thing we have to do after we feed kittens this small don't pee and poop on their own without because normally their mom would lick them after they eat. So we have to take a little baby wipe and stimulate him to go. [00:59:10-00:59:11] To the bathroom. [00:59:11-00:59:16]
Nate Hegyi: So the licking when a mom licks a kitten, it's to help them stimulate to go to the bathroom, correct? [00:59:16-00:59:23]
Tracy Ward: Yeah. So. They just take a little. [00:59:24-00:59:25] Well, Kirkland baby wipes. [00:59:30-00:59:42] Exactly. I'm just kind of give him a little, little stimulation back here. And his foster did tell me he's been very good about me. Pete Yeah, he's been a. [00:59:42-00:59:52] Pretty good boy. Wow. Good kids. [00:59:54-00:59:56] Why y. [01:00:00-01:00:09] Oops. The poop. Come on. Oh, my baby. Mm hmm. Here you go. [01:00:13-01:00:14]
[01:00:14-01:00:18] So one of the less glamorous parts of being a veterinarian. [01:00:20-01:00:29] Good kitten.
There was a clock above the door and was ticking closer to the end of her break. It looked like, probably not for the last time, Tracy was about to miss her lunch.